Nearly two-thirds of people with bipolar disorder have been misdiagnosed at least once in their lives, and on average, they would consult nearly four clinicians before getting a proper bipolar diagnosis. The amount of time it takes for a person to obtain a bipolar diagnosis and adequate care is perhaps the most concerning aspect. It takes an average of ten years from the time a person has their first bipolar mood episode before receiving treatment specifically for bipolar disorder. This treatment gap is the product of a widespread misconception of bipolar disorder, how it manifests itself in episodes, and a general aversion to discussing a chronic mental illness, particularly when symptoms are present in a young person.
What is bipolar disorder?
According to APA, bipolar disorder is any of group of mood disorders in which symptoms of mania and depression alternate. In DSM–IV-TR and DSM–5, the group includes primarily the following subtypes: bipolar I disorder, in which the individual fluctuates between episodes of mania or hypomania and major depressive episodes or experiences a mix of these: bipolar II disorder, in which the individual fluctuates between major depressive and hypomanic episodes; and cyclothymic disorder. The former official name for bipolar disorders, manic-depressive illness, is still in infrequent use.
Disclaimer: This article is meant for educational purposes only. Do not use information in this or any other article to self-diagnose or diagnose other people. If you feel that you or someone close to you may possess some of the characteristics mentioned in this or any other article on our blog and need help then please, consult a licensed mental health professional. This article is not a substitute for professional advice, but for general guidance.
Symptoms of bipolar disorder–
People with bipolar disorder can experience extreme mood shifts. In many cases, people will alternate between highs (manias) and lows (depressions) with intervals of stable mood.
Some of the most common symptoms of mania include:
- extremely elevated mood
- reduced need for sleep
- an exaggerated sense of confidence and optimism
- racing speech, thoughts, or both
- reckless or impulsive behavior
- grandiose ideas
- inflated sense of self-importance
- irritability or aggression
- poor judgment
- hallucinations and delusions, in severe cases
Symptoms of bipolar depression include:
- constant fatigue
- feelings of worthlessness and guilt
- inability to concentrate or make simple decisions
- unexplained aches and pains
- prolonged periods of sadness
- unexplained crying spells
- significant changes in sleep patterns and appetite
- irritability, anger, and agitation
- indifference and pessimism
- excessive anxiety or worry
- inability to find pleasure in former interests
- social withdrawal
- thoughts of suicide and death
What is borderline personality disorder (BPD)?
According to APA, borderline personality disorder in DSM–IV-TR and DSM–5, is defined as a personality disorder characterized by a long-standing pattern of instability in mood, interpersonal relationships, and self-image that is severe enough to cause extreme distress or interfere with social and occupational functioning. Among the manifestations of this disorder are (a) self-damaging behavior (e.g., gambling, overeating, substance use); (b) intense but unstable relationships; (c) uncontrollable temper outbursts; (d) uncertainty about self-image, gender, goals, and loyalties; (e) shifting moods; (f) self-defeating behavior, such as fights, suicidal gestures, or self-mutilation; and (g) chronic feelings of emptiness and boredom. See also mentalization.
Symptoms of BPD include:
- uncertainty about one’s role in the world
- frequently changing interests and values
- a tendency to view things as either all good or all bad
- changing opinions about others quickly, e.g., perceiving someone as a friend one day and an enemy the next
- a pattern of unstable, intense relationships with family and friends, for whom feelings alternate between closeness and love to hate and anger
- unstable, distorted self-image or sense of self
- attempts to avoid imagined or real sources of abandonment, e.g., stopping communications with someone in anticipation of them cutting off ties
- self-harming behaviors, such as cutting, burning or overdosing
- difficulty trusting people, sometimes because of an irrational fear of their intentions
- feelings of dissociation, such as feeling unreal, having a sense of being cut off from one’s body, and seeing oneself from outside the body
- recurring thoughts of suicide
- impulsive or reckless behavior, such as unsafe sex, drug misuse, reckless driving, and spending sprees
- intense episodes of depression, anger, and anxiety
- chronic feelings of emptiness
- fear of being alone
Today, I will be listing down some of the ways to differentiate between bipolar disorder and BPD;
1. Quality and Degree
The first big difference between these disorders is that bipolar is a primary mood disorder, while borderline is a primary personality disorder characterized by long-term interpersonal dysfunction. As a result, bipolar disorder expresses itself in mood episodes that can shift quickly or over long periods, with periods of ostensible balance in between, referred to as the baseline mood zone. As a result, bipolar disorder symptoms are classified as episodic. Borderline personality disorder, on the other hand, is considered pervasive where the disorder’s symptoms and functional effects persist through mood states. People with borderline appear to be happy, mellow, or just having a “good day,” as a bipolar-type baseline mood zone. While immediate behavioral signs can indicate a stable mood state, borderline personality is often characterized by an ongoing entangled and dysfunctional mess of interpersonal relationships and self-image, regardless of mood state.
2. The origins of symptoms and their behavioral consequences
Michael G. Pipich, a psychotherapist with over 30 years of experience diagnosing and treating bipolar disorder, says, “One way to approach this is to ask the question, “What primary aspect of the particular disorder is driving the secondary product?” Bipolar disorder is a disorder of mood, which originates genetically and affects the brain’s ability to regulate emotion. In effect, the bipolar mood swings drive consequences in the person with the disorder, including increased impulsivity and interpersonal disruptions.”
3. Treatment approach
According to Psychology Today, “As someone with bipolar disorder progresses through stabilization towards post-stabilization, therapy can focus increasingly on the prior functional consequences of the disorder (e.g., financial distress, extramarital affairs, drug abuse, etc). This progression can make therapy more broadly effective concerning related life issues and allow for other treatment modalities, such as couples therapy, to be more adaptable to particular life conflicts.
In therapy for borderline personality, the increased sense of reliance on the therapist as a trusted figure often reignites profound fears of abandonment, which promote ego defenses, paranoid projections, and the unconscious reenactment of psychological trauma, all of which can reoccur throughout treatment. A therapist treating a patient with borderline personality should anticipate and prepare for these features as they become manifest in the transference phenomenon.”
4. Duration of symptoms:
In BPD, mood changes are often more short-lived. They may last for only a few hours at a time.
Bipolar disorder, on the other hand, causes changes in mood that can last for days or even weeks.
5. Causes of the symptoms:
Mood shifts in BPD are typically triggered by an environmental stressor, such as a disagreement with a loved one.
Mood shifts in bipolar disorder may occur out-of-the-blue without any triggers.
6. Sleep Cycles:
During periods of mania and depression, people with bipolar disorder have severely disrupted sleep cycles.
People with BPD can have a regular sleep cycle.
According to some estimates, 75 percent of people with BPD have self-harmed. They can see self-harm as a way to regulate their emotions or control volatile or strong emotions. Even though self-harm is less common in people with bipolar disorder than in people with BPD, suicidal attempts are more common.
8. Unstable relationships:
Many people with BPD have very intense, conflict-riddled relationships. People with bipolar disorder may have difficulty maintaining relationships because of the severity of their symptoms.
Michael G. Pipich MS, LMFT (May 28, 2020).Bipolar and Borderline: A Differential Roadmap. Retrieved May 12, 2021, from
Kristalyn Salters-Pedneault, PhD (February 18, 2020). Differences Between Bipolar Disorder and BPD. Retrieved May 12, 2021, from
Jennifer Huizen ( February 6, 2019). What’s the difference between borderline personality disorder and bipolar disorder? Retrieved May 12, 2021, from