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Learn the differences between borderline personality disorder and bipolar disorder. Both disorders involve unstable moods, but getting the correct diagnosis can lead to a treatment plan and resources.
Borderline personality disorder (BPD) and bipolar disorder are two distinct conditions that are sometimes mistaken for each other. Both conditions can involve unstable moods as well as intense emotions. For instance, if you have BPD, you might go from feeling happy and excited to enraged or depressed within hours. On the other hand, if you have bipolar disorder, you might have weeks where you feel energetic and elated—maybe even invincible—followed by intense sadness and fatigue. Impulsive behavior can also potentially be a part of either disorder, depending on mood shifts.
Despite those similarities, BPD and bipolar disorder have different causes and different paths to treatment. Understanding the differences allows you to get the help you need to manage the disruptive symptoms.
Borderline personality disorder is a chronic mental health condition that affects your ability to regulate your moods and results in unstable relationships and a distorted self-image. Common symptoms include an intense fear of abandonment, impulsive behavior, intense emotions, and chronic emptiness.
If you have this personality disorder, you might go through life feeling a lack of control. You often ruminate about whether your loved ones will desert you, and seemingly minor conflicts make you lose your temper and send you into emotional spirals. You likely see yourself and those around you as being either entirely good or entirely evil, a mental process known as splitting.
Bipolar disorder (sometimes called manic depression) is a mood disorder that features cycles of depressive lows and manic highs. During manic episodes, you experience elevated mood, impulsivity, and a decreased need for sleep. During depressive episodes, your mood dips, and you feel hopeless and exhausted. The episodes are so intense that they make it hard for you to function in daily life and maintain relationships.
Bipolar disorder can be broken into different types, depending on the pattern of the mood swings. With bipolar I disorder, you experience a manic episode and sometimes a depressive episode as well. With bipolar II disorder, you experience depressive episodes and hypomania—a less intense form of mania.
BPD and bipolar disorder differ in many ways, including how and when the symptoms show up and their root causes.
In BPD, mood swings tend to be rapid and often dependent on how you perceive other people are treating you. Various intense emotions, such as euphoria, anger, and despair, might wash over you within hours.
In bipolar disorder, episodes of mania, hypomania, or depression can last at least several days to several weeks in a row. Unlike BPD, bipolar disorder symptoms might subside for periods of time. During these periods, known as euthymia, you feel neither manic nor depressive, but rather neutral and in control.
An intense fear of abandonment underlies BPD. Feeling rejected, criticized, or invalidated can send you into an emotional spiral and lead to self-destructive behavior. Arguments, stressful events, and reminders of past trauma can also worsen your symptoms.
In bipolar disorder, situational issues like stress and lack of sleep can worsen symptoms. However, the mood swings often follow a cycle that’s not connected to external problems. So, it’s important to recognize the early warning signs of an impending episode. For instance, irritability or a sudden loss of focus might indicate that a manic episode is about to start.
Symptoms of borderline personality disorder often include an unstable self-image and feelings of deep emptiness. Relationships are also unstable. You may rapidly alternate between idealizing your partner and perceiving them as a bad person, resulting in turbulent interactions.
Core symptoms of bipolar disorder include manic and depressive episodes. Each episode comes with distinct changes in your thoughts, mood, energy levels, and behavior.
BPD treatment options involve types of psychotherapy, such as dialectical behavioral therapy (DBT) and schema therapy. The core symptoms of BPD can’t be treated with medication. However, medication might be used to treat co-occurring issues, such as depression.
Bipolar disorder is treated with a combination of medication and therapy. Mood stabilizers, such as lithium, are often prescribed to treat disruptive mood swings. Approaches such as cognitive behavioral therapy (CBT) may also help.
| Bipolar disorder | Borderline personality disorder |
| A mood disorder that may have periods of euthymia—a “normal” state between manic and depressive episodes | A personality disorder that causes persistent emotional instability |
| Manic and depressive episodes can last days or weeks, at least | Changes in mood occur rapidly, sometimes within hours |
| Bipolar mood swings can be due to biological factors as well as external factors, such as stress | BPD mood swings are often caused by external, often interpersonal issues, like perceived rejection |
| Treated with medication and therapy | Treated primarily with psychotherapy |
BPD and bipolar disorder have several overlapping signs that can lead to a misdiagnosis. For example, both disorders can include the following:
Impulsivity: If you have BPD, you are prone to making sudden and often self-destructive decisions, such as abusing drugs or driving recklessly. This can also happen if you have bipolar disorder, especially during manic episodes, as you feel a surge of energy and excitement.
Irritability: In BPD, intense and misguided anger is a key symptom. In bipolar disorder, hypomanic and manic episodes can make you irritable for days or weeks.
Mood swings: Both disorders involve sudden changes in mood. BPD mood swings tend to occur more frequently and in response to external events like receiving criticism.
Self-harm: Both disorders can come with self-harming or suicidal behavior. In bipolar disorder, this might happen during your low points, when you feel especially hopeless.
Substance abuse: You might turn to substance abuse to self-medicate and cope with the intense highs and lows of either disorder.
It’s possible to have both BPD and bipolar disorder. In fact, some research suggests that about 20 percent of people with BPD have either bipolar I or bipolar II.
Having both disorders can make treatment more difficult. Maybe a depressive episode drags down your ambition to continue therapy sessions. Or perhaps your impulsive actions lead you to abuse drugs and push away your social support. That said, working with a mental health expert to get a diagnosis and develop an individualized care plan can be a life-changing step, no matter how difficult things feel.
After learning about these disorders, you might feel confident making a self-diagnosis. However, a formal diagnosis can be more accurate and lead to more treatment options. So it’s essential to find a qualified therapist to assess your symptoms.
To reach a diagnosis for either disorder, a mental health expert will likely:
Despite some apparent overlap in symptoms, the diagnostic criteria for BPD and bipolar disorder I and II are very distinct. A clinician can reach the correct conclusion after a thorough evaluation.
Because they have different root causes, bipolar disorder and BPD are treated with different types of interventions.
The go-to approach to treating BPD is psychotherapy. Dialectical behavior therapy (DBT) in particular has been proven effective in improving the lives of people with BPD. Designed specifically to manage BPD symptoms, DBT teaches you skills to regulate your intense emotions, control impulsive urges, and improve your relationships.
DBT isn’t the only option. Other types of helpful therapies include schema-focused therapy, cognitive-behavioral therapy, and mentalization-based therapy. To find a therapist who can help you manage your symptoms, see our review of the best online therapy platforms.
Certain medications might also be prescribed to help you manage co-occurring issues like depression. However, they can’t cure the core symptoms of the personality disorder.
Bipolar disorder is managed through a combination of medication and therapy. Mood stabilizers, such as lithium, and antipsychotic drugs can reduce the intensity of mood swings. Antidepressants might also be helpful, but they have to be prescribed with caution because they could potentially lead to manic episodes.
Browse our list of reviews to find the best online psychiatrist for you.
While medication can improve your symptoms, a therapist can help you identify warning signs of a change in mood and develop coping strategies. Lifestyle changes, such as getting enough sleep and reducing drug and alcohol use, can also go a long way in stabilizing your mood.
National Education Alliance for Borderline Personality Disorder
Digital Shareables on Borderline Personality Disorder – National Institute of Mental Health
Digital Shareables on Bipolar Disorder
Depression and Bipolar Support Alliance
Last updated or reviewed on November 24, 2025
Some researchers categorize BPD into four distinct types, each with its own unique characteristics. Learn more about each subtype.
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