Bipolar Disorder or Borderline Personality Disorder?


By David Joel Miller.

Bipolar Disorder or Borderline?

There are several differences between these two disorders. But it is important to remember that it is possible for someone to have both problems which greatly confuses the issue.

The largest differences between the two are sleep and time. Ego strength and character structure also play roles in this choice of diagnoses. I have exaggerated the differences to make the distinction clearer.

Sleep matters.

To be Bipolar you must have had a Manic or Hypomanic episode. The key characteristic of those episodes is long periods (time) of above average energy and decreased need for sleep.

In hypomania, the person may be able to get by on a few hours of sleep, 3 or 4, and they feel fine. In full-out mania, they may even go all night without sleeping and still be just fine. At least they think they are fine. Others around them may notice they are irritable from lack of sleep but they think they are just fine.

Also in Bipolar when they are up they feel great, expansive. The same person may have episodes of depression and during those times they may sleep too much or too little but the telling point is that in the up times they will tell you they are on top of the world, full of energy and can just do so much without needing to sleep like lesser people.

With those Bipolar manic episodes comes tons of energy. They like to go up in the attic and swing from the rafters. They might work all day then go to the casino and gamble all night only to go back to work the next day like nothing has happened.

Time.

People with Borderline have many moods within a day. The can be “touchy” easily set off and others may hurt their feeling without meaning too or even knowing why. People with Borderline Personality disorder are full of pain and rarely have a good day. They can be so bruised that a look or word can hurt them.

People with Bipolar have longer periods of up or manic feelings. When times are good for them they are really good. They may go weeks, months or even years when they are on top of the world. But eventually the crash comes and there will be long periods of time when they are depressed, possibly unable to get out of bed. Recurring episodes of depression is a common feature of Bipolar Disorder.

Ego strength.

Borderline Personality Disorder is pain based. Many borderlines were abused, neglected or deserted. They are needy in relationships but always distrustful that the person they are with will leave them.  Borderline may threaten to kill themselves if you leave them.

Bipolar people mostly don’t care what you think of them, at least not when they are manic. They know they are smarter than Einstein and better looking. They believe they can work miracles. This overvaluation of themselves and their abilities gets them in trouble a lot. The take excessive risks not because they want to hurt themselves like the borderline but because they really believe they will win.

Borderlines are anxious, Bipolar people could care less. Let this one leave and they will find another.

Sex.

People with Bipolar Disorder are often hypersexual. They can’t seem to get enough. This will lead to sexual indiscretions which ruin their established relationships. When manic they just can’t seem to stop themselves. When you’re manic the whole world looks good.

Borderlines are rarely secure in a relationship, fearful that if this partner leaves them, that confirms their fear, they don’t deserve a partner. They will stick with a partner, often an unworthy one, because they fear that if they were to break up they just could not take it.

Who loves their disease?

Someone with Bipolar disorder resembles a Vegas Gambler when they are on a winning streak they want to ride it forever. When the crash they hate themselves and can’t face the wreckage they have created. Bipolar people like being manic. They frequently quit taking their meds just so they can feel manic again. Mania is seductive like a new lover, but one who keeps treating you wrong. Still, you want to recapture that allure.

Borderlines are more like characters from a soap opera, bad stuff keeps happening to them and they wish the pain would end. They live in a world of pain and hurt. They wish they could find a way to get things to change. They are often angry and feel others don’t treat them right. Frequently they are correct. They have been mistreated by someone somewhere and they keep trying to find a way to make it right, to make the pain go away.

Do they ever not have symptoms? – Character structure.

Someone who has Bipolar disorder has a “Mood disorder.” They have specific times (Periods) when they have mania or Depression but other times they have no mood symptoms. These times of apparent “normal” behavior may last for months or years and then something kicks off another episode of mania or depression.

Someone with Borderline Personality Disorder has a “Personality Disorder.” The presumption here is that they learned to be this way and are like this most of the time. They learned to protect themselves, store their anger and release it in bursts and other survival techniques. The trouble is that the way they handle emotion makes them and those around them miserable.

The younger you were when you learned basic ways of being with others the harder it is to change. Most people with Borderline Personality Disorder continue to have some symptoms even after treatment, though with good care they can and do get much better.

Please check out my other posts on Bipolar disorder and Borderline personality disorder the list of categories is to the right.

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

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2 thoughts on “Bipolar Disorder or Borderline Personality Disorder?

  1. Hi David.I have both these disorders (Bipolar 2) and felt like you were writing about me!! Lol
    Even the sex thing! My good days are incredible and can go for weeks…sometimes the down days blind side me…I don’t even see them coming!!
    I’m very impulsive to and that doesn’t help. Enjoy reading your posts. Just wish I couldn’t relate to it.*smiles* xx

    Like

  2. Pingback: Why are so many children being diagnosed Bipolar? | counselorssoapbox

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