BPD is not Bipolar

Jen
Apr 14
3 min read

Let's talk about BPD (Borderline Personality Disorder) and Bipolar Disorder. This post will reference the DSM-5 and draw on my own personal experiences. These disorders are heavily stigmatised and misunderstood. This post will aim to clear up misconceptions and create clarity around these illnesses.

BPD stands for Borderline Personality Disorder, a condition categorised as a cluster B personality disorder. People with Borderline Personality Disorder experience an instability of relationships and self. Often linked to impulsive behaviour, and to be diagnosed the person must meet 5 or more of the 9 characteristics listed in the DSM-5.

(Page 663, DSM-5)

Borderline Personality Disorder (BPD), has intense mood episodes that last between a few hours and a few days. Episodes in BPD rarely occur for longer than a day, and changes are sudden. Mood episodes can include rage, euphoria, depression, despair, anxiety, and/or dysphoria.

Suicide rates are high with a 10% completed suicide rate among those with BPD. Suicide attempts and threats are very common and frequent. BPD is often self damaging and those with the disorder will often engage in at least 2 areas of self destructive behaviours. For example, gambling, unsafe sex, self harm, disordered eating, substance abuse, or unsafe driving.

BPD has no medication. Therapy is highly stigmatised. And support is limited. Medication such as antipsychotics or mood stabilisers may be used to mask symptoms, however these medications are not a cure. DBT or Dialectic Behaviour Therapy is the main Therapy used in BPD, however the access and ongoing costs of this treatment impact on its benefits.

From my own personal experiences, hospitals and healthcare look down on BPD and use the label as a cop-out when the doctors don't know how to help. Rather that acknowledge the gap in the field for those living with BPD, clients are shamed, labelled, and discarded.

Bipolar Disorder, or BD, is a completely different illness. Bipolar is not a personality disorder like Borderline. Bipolar is a Complex Mood Disorder, characterised by intense long episodes of mood.

There are 3 main types of Bipolar Disorder. Bipolar type 1- Episodes of Mania, with possible psychosis. Episodes of Major Depression.

Bipolar type 2- Episodes of Hypomania. Episodes of longer Major Depression.

Cyclothemia- Experiences with Hypomanic and Depressive symptoms that do not meet the criteria for a Bipolar diagnosis.

One of the main parts taken into account when diagnosing a Bipolar Disorder is time. The length and intensity of an episode will determine what type of Bipolar a client may have. Symptoms during these time frames must be present most of each day, everyday, consecutively.

Bipolar 1- Manic Episodes lasting a minimum of 1 week. Hypomania lasting a minimum of 4 days. Major Depression Epidode lasting a minimum of 2 weeks.

Bipolar 2- Hypomanic Episode lasting a minimum of 4 days. Major Depression Episode lasting a minimum of 2 weeks.

Cyclothemia- A 2 year period of Hypomanic and Depressive symptoms. Individual must not be without symptoms for longer than 2 months at a time.

(Page 123, DSM-5)

Treatment for Bipolar Disorder is longterm Mood Stabilisers and Antipsychotics. Therapy in many forms can be helpful, CCT, ACT, and CBT to name a few. Bipolar is a chemical imbalance in the brain and has no cure.

From my own experiences with Bipolar type 2, I have found the healthcare system to be very hesitant around diagnosis, yet very keen on pushing medications. Most people with Bipolar type 2 are incorrectly diagnosed with Major Depressive Disorder, and incorrectly medicated. This is very dangerous as the treatment for MDD is Antidepressants, which can aggravate Hypomanic symptoms, increase rapid cycling, and lead to increased suicide rates.

The main key difference between BPD and Bipolar is time, and mood.

BPD is shorter, quicker, and emotion based.

Bipolar is longer, slower, and mood based.

BPD experience euphoria and depression.

Bipolar experience Mania/Hypomania and Major Depression.

Mania and Euphoria are not the same. Major Depression and Depression are not the same.

Both of these disorders are highly stigmatised and misunderstood by even health professionals. This needs to change. This is why we talk about it.

I hope that this post was helpful in understanding the differences between these 2 disorders. Thank you so much for reading and supporting my blog.

-Jen xx