Bipolar Disorder Vs. Borderline Personality Disorder (BPD)
Updated: 11/4/2025
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TLDR: Bipolar Disorder Vs BPD
Bipolar disorder and borderline personality disorder (BPD) are often confused, but they are two different mental health conditions. They both can cause intense mood shifts, but these mood changes differ in important ways.
Bipolar disorder involves distinct episodes of hypomania or mania that last days to weeks. These episodes are often followed by depressive episodes that may be quite severe.
BPD, on the other hand, is a personality disorder. It involves mood swings that are much more rapid than those seen in bipolar. Other symptoms include intense emotions, unstable self-image, and fears of abandonment. These issues may cause serious problems in relationships.
Both conditions have elevated rates of suicide, but they are treatable with medications and/or therapy.
Although there is a lot of stigma with both conditions, many people live full, meaningful lives with proper support.
Borderline personality disorder (BPD) and bipolar disorder are both profoundly misunderstood conditions that are often confused. BPD and bipolar disorder are not the same disorder. In reality, these two conditions are entirely different. Both involve mood shifts and emotional dysregulation. However, they are entirely different in causes, symptoms, and treatment approaches.
Here, we’ll break down the differences between bipolar disorder vs borderline personality disorder to help you better understand these two conditions.
Similarities: Bipolar Disorder Vs. BPD
Let’s talk about the Bipolar Disorder Vs. Borderline Personality Disorder similarities.
Mood Shifts
Both borderline personality disorder and bipolar disorder both cause extreme mood shifts.
Stigma
There is a significant stigma attached to both of these disorders, even among healthcare providers. People may hold harmful and false beliefs about BPD and bipolar disorder. The perception in the media of both disorders is damaging.
Which is worse: borderline vs bipolar stigma? Recent studies have found that the stigma for BPD tends to be worse. That’s because the public perception of people with BPD is that they are toxic and manipulative. In the medical world, people with BPD may be seen as “unfixable” or “untreatable.” This perception can be very disheartening and harmful for people diagnosed with borderline personality disorder.
Suicide Risk
People with BPD and bipolar disorder are both at a higher risk of self-harm and suicide.
Up to 60 percent of people diagnosed with bipolar disorder attempt suicide.
Nearly 70 percent of people diagnosed with borderline personality disorder attempt suicide at least once in their lifetime.
The rates of completed suicide are about the same for both disorders (10%).
Depressive symptoms are the main driver of suicide in people with bipolar disorder, while impulsivity and intense emotions tend to drive suicide in people with BPD. People with borderline personality disorder may turn to self-harm because of extremely heightened emotions.
If You Are In Crisis, Reach Out
If you are having thoughts of harming yourself or someone else, call or text the 988 Lifeline to talk to a trained counselor 24/7. If you have a plan to harm yourself, contact 911 (in the USA) for immediate assistance.
Outlook
Both of these disorders are highly treatable. There’s help out there for both. With hard work and consistent treatment, a person can live a normal life with either disorder.
Differences: Bipolar Disorder Vs. BPD
These two disorders can look alike, but there are some important differences.
Diagnostic criteria
The first thing that separates these disorders is how they are diagnosed. These two disorders are listed in different categories in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Bipolar Disorder Diagnostic Criteria
Bipolar disorder is listed in the Bipolar and Related Disorders category of the DSM-5. Warning signs of bipolar include extreme shifts in mood. Bipolar disorder symptoms include periods of mania or hypomania that alternate with depressive episodes. Depressive episodes are not required for a bipolar I diagnosis, but they are typically present. During these mood episodes, a person will have extreme shifts in mood, activity levels, and behavior that affect their functioning.
BPD Diagnostic Criteria
BPD is a personality disorder. Personality disorders are lasting, fixed patterns of feelings and behaviors that deviate from the norm. To receive a diagnosis of borderline personality disorder, a person must have at least five of the following:
Unstable sense of self
Issues controlling anger or rage
Significant mood shifts that last several hours or more
Significant efforts to avoid abandonment
Self-harm or suicidal ideation or behavior
Persistent feelings of emptiness
Pattern of intense or unstable relationships
Impulsive, dangerous behaviors like unsafe sexual encounters or drug use
Depersonalization or feeling cut off from reality
At its core, borderline personality disorder significantly affects how a person feels and thinks about themselves, as well as others. It causes uncertainty in how a person views themselves and others. People diagnosed with BPD have an intense fear of close relationships ending. This unstable sense of self and fear of abandonment is typically not present in bipolar disorder. Also, people with BPD not only have mood shifts, but they also have intense feelings that accompany the mood shifts.
Mania and hypomania (abnormal elevations in mood), which are core features of bipolar disorder, are typically not present in BPD. Also, people with borderline personality disorder do not have a decreased need for sleep, which typically occurs with bipolar disorder.
✅ Key differences:
People with borderline personality disorder usually have intense emotional reactions that are related to relationship stress. In bipolar disorder, the symptoms are not necessarily triggered by relationship stress.
Also, mania or hypomania is a core feature of bipolar disorder. This is not present in BPD.
Prevalence
Borderline personality disorder is less common than bipolar disorder. It is estimated that approximately 1 percent of the population experiences borderline personality disorder. About 4.4 percent of people in the United States have bipolar disorder.
Treatments
The treatment plan for both bipolar disorder and borderline personality disorder typically involves a combination of therapy and medications. However, beyond that, the treatment plans differ quite a bit for bipolar and BPD.
Bipolar Disorder
The first-line treatment for bipolar disorder is a solid bipolar medication regimen.
Therapy can be beneficial for people with bipolar disorder. The most effective therapies for bipolar disorder include Interpersonal and Social Rhythm Therapy (IPSRT) and cognitive behavioral therapy (CBT).
Borderline Personality Disorder
Medications are usually not specifically recommended as a primary treatment for BPD. Doctors may prescribe people with BPD medications, but these are usually prescribed for co-occurring conditions like depression.
The first-line treatment for BPD is therapy. Dialectical behavioral therapy (DBT), in particular, is especially effective for BPD.
If you are struggling with mood swings or intense emotions, professional support can help you feel more grounded.
Get started with online therapy ›Frequently Asked Questions (FAQs)
Bipolar disorder Vs. borderline personality disorder: Here’s what people are asking about.
Can Someone Have Both Borderline Personality Disorder and Bipolar Disorder?
Yes, research indicates that about 10 percent of people with bipolar I have borderline personality disorder. Around 20% of those with bipolar II also have BPD.
Which Is Worse: Bipolar or BPD?
Both borderline personality disorder and bipolar disorder are serious conditions that require lifelong treatment. Both also vary in severity. So, one is not necessarily worse than the other.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Association Publishing.
Lenzenweger, M. F., Lane, M. C., Loranger, A. W., & Kessler, R. C. (2007). DSM-IV personality disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 62(6), 553–564. https://doi.org/10.1016/j.biopsych.2006.09.019
National Institute of Mental Health. (2022). Bipolar disorder. https://www.nimh.nih.gov/health/statistics/bipolar-disorder
Novick, D. M., Swartz, H. A., & Frank, E. (2010). Suicide attempts in bipolar I and bipolar II disorder: A review and meta-analysis. Bipolar Disorders, 12(1), 1–9. https://doi.org/10.1111/j.1399-5618.2009.00786.x
Patel, R. S., Manikkara, G., & Chopra, A. (2019). Bipolar disorder and comorbid borderline personality disorder: Patient characteristics and outcomes in US hospitals. Medicina, 55(1), 13. https://doi.org/10.3390/medicina55010013
NewYork-Presbyterian. (n.d.). Understanding Borderline Personality Disorder. https://www.nyp.org/bpdresourcecenter/borderline-personality-disorder/understanding-bpd
APA PsycNet. (2025). https://psycnet.apa.org/record/2024-44926-001
