(This is obviously not about PTSD, but I will write a post about that soon. I have also already written a post about bipolar and BPD before, Episode 26 – BPD vs. Bipolar. This will address a few other differences with more knowledge and experience on my part.)
I think I’ve mentioned before that bipolar mood symptoms and borderline personality disorder mood symptoms are quite similar, regularly leading to BPD patients being misdiagnosed as having bipolar or perhaps vice versa. Oftentimes these two disorders don’t coexist because their causes are different, with BPD being rarer at approximately 1.6% of the US population (bipolar is approximately 2.8%–about 7 million adults experience bipolar annually). However, the numbers for BPD are questionable, as it is suspected that this disorder is more common than it is diagnosed. Some experts believe the percentage of Americans suffering from BPD is closer to 6%, but due to misdiagnosis as well as not seeking medical treatment among other factors, the true number is not accurately known.
About 20% of bipolar cases, with an especially strong relation to bipolar II, overlap with BPD–mine is one of those (though remember my diagnosis is technically schizoaffective disorder bipolar type, with a leaning toward bipolar II tendencies). The same percentage of BPD cases overlap with bipolar.
Both bipolar and BPD are heavily characterized by unstable mood–shifts from one extreme mood to another. The causes in each are typically different, and the emotional high that one experiences might feel different. As someone who experiences both, I’m going to address that difference once again in a different way.
In that past post, I discussed differences in the emotions experienced in bipolar and BPD–bipolar highs being a sense of euphoria with BPD highs being more irritability, bipolar moods lasting from a few days up to months or even years and BPD moods lasting anywhere from minutes to a few days. I also discussed differences in causes–bipolar mood shifts often not having a cause, BPD mood swings often being an irrational reaction to a specific cause.
For example: I have recently, in the last couple months, been experiencing more random depressive episodes again. At first, it may have been due to some emotional turbulence I was going through, or at least so I thought. However, the depressive episodes have only continued to get more frequent. The last week has been especially bad. For a while now they’ve been occurring every day, often when I first wake up, and usually lasting throughout most of the day. When the depressive episode starts to dampen a bit, I tend to just be neutral. If this were mood cycling or BPD, you would expect it to go to an extreme–irritability or anxiety. There would be more random anxiety spikes, which I regularly have at night, even when my mood is not cycling. Typically, when my depressive episodes are involved in mood cycling or BPD, I want to self-harm–I have not been having that urge too often during these depressive episodes. Instead, it is flat and dark. However, since it doesn’t always persist through the whole day but has been so persistent overall, lasting over months even after a period of taking my PRN antidepressants, I decided to wait until my appointment today with my psychiatrist before making any more decisions.
He agreed with me that these depressive episodes are likely best addressed by an increase in my lithium dose. He described these episodes as “mild depression,” which I agree with, and agreed that they are most likely related to the bipolar aspect of my illnesses rather than the BPD, due to the lack of irritability, anxiety, mood cycling, or known causes. Thus an increase in lithium is the best course of action.
I have experienced extreme BPD symptoms throughout my life, which are accompanied by irritability, anxiety, and mood cycling. Sometimes my mood would go up and down so much in one day that I would be physically sick. In short, bipolar and BPD can definitely coexist, making treatment potentially very difficult, especially without a competent psychiatrist. The differences are in how the extreme emotions of each feel, what thoughts and urges they make a person have, how long they last and how persistent they are.
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