Bipolar and Borderline Personality Disorder Dual Diagnosis

Is a dual diagnosis possible?

Bipolar disorder covers a spectrum of mood disorders characterized by major mood swings. The mood swings can range from manic or hypomanic high moods to depressed low moods. Borderline personality disorder (BPD), on the other hand, is a personality disorder marked by instability in behaviors, functioning, mood, and self-image.

Many of the symptoms of bipolar disorder and borderline personality disorder overlap. This is particularly the case with type 1 bipolar disorder, which involves intense manic episodes. Some symptoms shared between bipolar disorder and BPD include:

  • extreme emotional reactions
  • impulsive actions
  • suicidal behaviors

Some argue that BPD is part of the bipolar spectrum. However, most experts agree that the two disorders are separate.

According to a review on the relationship between BPD and bipolar disorder, about 20 percent of people with type 2 bipolar disorder receive a BPD diagnosis. For people with type 1 bipolar disorder, about 10 percent receive a BPD diagnosis.

The key to differentiating the disorders is looking at them on the whole. This can help determine if you have one disorder with tendencies of the other disorder, or if you have both disorders.

What symptoms occur when a person has both conditions?

When a person has both bipolar disorder and BPD, they’ll display symptoms unique to each condition.

Symptoms unique to bipolar disorder include:

  • manic episodes causing extremely high feelings
  • symptoms of depression within manic episodes (sometimes known as a “mixed episode”)
  • changes in quantity and quality of sleep

Symptoms unique to BPD include:

    • day-to-day emotional changes related to factors such as family and work stress
    • intense relationships with difficulty regulating emotions
    • signs of self-harm, such as cutting, burning, hitting, or injuring themselves
    • ongoing feelings of boredom or emptiness
    • outbursts of intense, sometimes uncontrollable anger, most of the time followed by feelings of shame or guilt

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