Borderline personality disorder (BPD) and bipolar disorder are both complex mental health conditions that are characterized by dramatic shifts in how a person thinks, feels, and acts. Since they are so similar, how can you tell the difference between BPD vs. bipolar disorder?
At North Atlanta Behavioral Health, we are committed to maintaining a safe and respectful environment where adults with BPD and bipolar disorder can receive the personalized care they deserve.
Learn more about treatment for BPD and bipolar disorder in Atlanta or verify your insurance now.
Symptoms of BPD vs. Bipolar Disorder
The similarities between BPD and bipolar disorder can be so strong that even experts often have trouble differentiating between the two conditions.
Highlighting the difficulty, a November 2009 study in the Journal of Psychiatric Research found that about 40% of people with borderline personality disorder were initially misdiagnosed with bipolar disorder.
BPD Symptoms
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists nine symptoms for borderline personality disorder.
To be diagnosed with BPD, a person must have at least five of these symptoms:
- Frantic efforts to avoid being abandoned, even if there is no reason to suspect that this might occur
- A pattern of intense but unstable personal relationships
- Persistently unstable self-image or sense of self
- Impulsivity in at least two areas that can be harmful to them, such as spending sprees, unsafe sex, reckless driving, substance use, and binge eating
- Recurrent suicidal thoughts, gestures, or behaviors and/or acts of self-harm
- Brief but intense periods of anxiety, irritability, or dysphoria, which is a sense of deep dissatisfaction or unease
- Chronic feeling of emptiness
- Excessive, uncontrolled anger, which may include displays of extreme temper and frequent physical violence
- Paranoid ideation or severe dissociation, which is the sense of being detached from your body and mind or separated from the world around you
Bipolar Disorder Symptoms & Episodes
Bipolar disorder can cause three types of symptoms, which often occur in episodes:
- Manic: Common characteristics of manic episodes include increased energy, decreased need for sleep, talkativeness, racing thoughts, restlessness, impulsivity, distractibility, and inflated self-esteem or grandiosity. These symptoms will be present most of the day, nearly every day, for a period of at least one week.
- Hypomanic: Hypomanic episodes are similar to manic episodes, but they only last for four days.
- Major depressive: During a major depressive episode, a person will experience symptoms such as pervasive sadness, low energy and motivation, difficulty focusing and concentrating, indecisiveness, feelings of worthlessness, and recurrent thoughts of death. These symptoms will be present most of the day, most days, for at least two consecutive weeks.
Bipolar disorder is often discussed as a single condition. But there are actually three types, which are differentiated by the types of episodes or symptoms a person has.
What Are the 3 Types of Bipolar Disorder?
The 3 types of bipolar disorder are:
- Bipolar I disorder: To be diagnosed with bipolar I disorder, a person must have manic episodes. They may also have major depressive episodes, but depression is not a requirement for this diagnosis.
- Bipolar II disorder: People with bipolar II disorder will have both hypomanic and major depressive episodes.
- Cyclothymic disorder: Those with cyclothymic disorder will have recurring periods of hypomanic and major depressive symptoms, but these symptoms will not persist long enough at any one time to qualify as episodes.
Key Differences Between BPD vs. Bipolar Disorder
Key differences between BPD vs. bipolar disorder include symptom triggers and duration, sense of self, and prevalence.
Triggers
Triggers are circumstances that can cause the onset or intensification of symptoms:
- BPD: Symptoms of borderline personality disorder are more likely to be influenced by external factors such as conflicts with loved ones or stressful situations at work.
- Bipolar disorder: The symptoms of bipolar disorder seem to be triggered primarily by biological factors such as changing levels of certain brain chemicals, not outside influences.
Symptom Duration
The frequency of symptom shifts is another key difference between BPD vs. bipolar disorder:
- Bipolar disorder: Symptoms frequently occur for extended periods, such as at least a week for manic episodes and at least two weeks for major depressive episodes.
- BPD: Symptoms frequently change much more quickly, sometimes on a daily or hour-by-hour basis.
Self-Image
Even though their mood can shift considerably depending on which type of episode or symptom they are currently experiencing, people with bipolar disorder typically retain a consistent sense of who they are and what their core values and beliefs are.
Shifting self-identity is one of the fundamental characteristics of borderline personality disorder, and it can be an ongoing source of distress for people with this condition.
Prevalence
According to the National Institute of Mental Health (NIMH), bipolar disorder affects about twice as many people as BPD does:
- Bipolar disorder: About 2.8% of adults in the U.S. had symptoms of bipolar disorder in the previous 12 months.
- Borderline personality disorder: The past-year prevalence of BPD among U.S. adults is 1.4%.
The gender ratio of bipolar disorder is relatively balanced. For decades, BPD diagnoses were much more common among women, though that may be changing:
- Bipolar disorder: The International Bipolar Foundation has reported that girls and women account for about 52% of all bipolar cases, while boys and men make up the other 48%.
- BPD: The DSM-IV, which was published in 2003, reported that 75% of cases involve women. However, according to a March 2026 review in Personality Disorders: Theory, Research, and Treatment, the gender ratio of BPD is likely closer to 57% women and 43% men.
Learn More About Treatment for BPD & Bipolar Disorder in Atlanta
North Atlanta Behavioral Health offers personalized outpatient care for adults who have borderline personality disorder, bipolar disorder, and other mental health concerns. We also provide dual diagnosis programming for clients with co-occurring substance use disorders.
Treatment at our center in Atlanta, GA, includes a partial hospitalization program (PHP) and an intensive outpatient program (IOP).
Both programs are staffed by experienced professionals who are committed to providing customized services in a safe and highly supportive environment.
Call 770-230-5699 today to learn more or verify your insurance now.
