Bipolar vs Borderline Personality Disorder – How to tell the difference

Bipolar

disorder

versus

borderline

personality

disorder

. What is the

difference

or how can you

tell

the

difference

? This is what I'm going to talk about today. It's actually based on a question from a viewer. If you are new to my channel, I am dr. Tracey, a psychiatrist, and I publish weekly videos on mental health education and self-improvement. So if you don't want to miss an episode, click Subscribe and the notification button to know when the next videos are coming out. The viewer question comes from Paper Parade and says: can you explain the difference between

borderline

depression and

bipolar

disorder?

I'll focus on the difference between

bipolar

disorder and borderline

personality

disorder because depression is actually part of bipolar disorder. There is a big difference between personality disorders and psychiatric illnesses such as depression, anxiety, schizophrenia, and bipolar disorder. Personality or your personality is your fixed connection and diseases are your condition at that moment. Another analogy is to compare your personality to the climate of a region, and an illness like depression is the climate you are currently experiencing. I grew up in Florida which has a warm climate and we basically had two seasons: hot and not hot. But then we will have hurricanes that can come through and completely disrupt the environment.

But once hurricane season ends, we'll still be left with warm weather. The weather affects how the weather manifests at that time, and also the makeup of your personality affects how your illness manifests. Going back to the geographic example, Russia has a very cold climate and that affects the type of storms you see there. So there are blizzards in cold climates, sand storms, desert climates, and tropical storms in tropical climates. So if a person with, say, a narcissistic personality disorder becomes depressed, they will look different than the person with a dependent personality disorder who becomes depressed. The narcissistic person may appear angry and self-loathing due to their self-centeredness, while the dependent person may become pitiful and helpless due to neediness if they become too depressed.

Now, these are just broad stroke examples. Going back to borderline personality disorder, it's actually a very broad topic, but I'm just going to briefly define the disorder for you and use our Diagnostic and Statistical Manual of Mental Disorders in the Fifth Edition. I'm going to read the definition. Borderline personality is therefore defined by the following: a pattern of unstable relational self-image and emotional expression characterized by impulsivity, beginning in early adulthood and occurring in different contexts, as indicated by five or more of the following. It is important that you realize that there are five or more of these characteristics.

So what you don't want to do is pull one out and say, "I have this," does that mean I have borderline personality disorder? Not unless you have several of these things. Number one is frantic efforts to avoid real or imagined abandonment. An example of this is the person who seems to read things too easily. The things you say are interpreted to mean that you are done or that you are quitting in some way. Number two: a pattern of instability in intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. In this type of relationship, one moment the person with borderline personality disorder may think that you are the best thing ever and that you can do nothing wrong and the next moment or the next day you are the worst thing ever, exactly the opposite. .

The number three is an identity disorder. Has a clearly persistent or unstable self-image or sense of self. This type of identity disorder occurs at a deep level and should not be confused with not being sure whether you are destined to be a teacher or an astronaut. It is a confusion about fundamental identity issues such as your gender, your sexuality or even your spirituality. Now I'm going around because I don't want you to go away thinking that anyone who wants to change gender has a personality disorder like the one I mentioned before. It is important to remember that diagnosis is based on grouping. of the symptoms of the things I listed.

So you need five of them, and it's not like someone who is angry has a personality disorder. Everyone who has ever cut themselves should have boundaries. The point is that there are several things that fall into this category and that are a problem for you in many ways, not just in a relationship. Number four is impulsivity in at least two areas that are potentially self-destructive. Some examples of this could be reckless spending or reckless sexuality, drug or drinking abuse. Number five is repetitive suicidal behavior, gestures or threats or even self-mutilating behavior. And that would be things like cutting yourself or taking overdoses of pills, even though you don't really want to die, you're just responding to an internal anguish and that's why you do these things.

Number six would be an unstable and reactive mood, and would be things like episodic bad mood, irritability, or anxiety that usually last a few hours or a few days. And this is one of the main differences between borderline personality and bipolar disorder, and I will expand on it further after going over the criteria. Number seven is chronic feelings of emptiness. And this is one of the reasons why people with borderline personality disorder cut. It's a coping mechanism to help them feel real. However, some people will cut themselves to relieve tension. The number eight is intense and inappropriate anger or difficulty controlling anger.

And this can look like anger, constant rage, or physical fighting. The number nine and last are related to momentary stress, paranoid thinking or severe dissociative symptoms. Doctors sometimes call them micropsychotic episodes. They're not a full-blown psychosis, but they're close and if you don't know what psychosis is, I'll have a link in the corner to a video where I talked about or defined psychosis, but let me explain what dissociation is. Dissociation occurs when someone disconnects from the current situation, and this disconnection can be from the current environment or their thoughts, or even from themselves, and an example of this is a person who has been subjected to repeated physical or sexual abuse and One of the ways they cope with the act at the time is to simply mentally withdraw as if it were not actually happening to them.

And this is one of the ways they can deal with it. Well, with borderline personality disorder, dissociation happens a lot in different circumstances. These are the criteria for borderline personality disorder. There are many things, so it's not about taking out one of these things and saying that I have to be on the limit because I have isolated myself, you have to have at least five of these nine things that I follow at the same time. . or in general these are the kinds of things you do or feel. So going back to borderline personality disorder and bipolar disorder, they look very similar because you can have mood swings and impulsivity, but in the case of borderline personality disorder, you're more likely to have mood swings that can change in the passing of the hour. of the day.

In bipolar disorder, the set of symptoms, not just low or high moods, but the set of symptoms that make up an episode, should last at least two weeks if you are depressed and one week if you are manic. . So you don't go in and out of states hour after hour. The feeling of fear of abandonment and unstable identity are things that have more to do with your physical wiring and are also influenced by your environment. It's kind of a nature versus nurture theory of how much of who you are is based on genes versus how you were raised in your formative years.

And these problems are not part of bipolar disorder. Think of mania as a hurricane that comes and goes, leaving the warm weather behind. And some other examples of practical differences are that bipolar disorder doesn't make you do manipulative things. Manipulative behavior is related to your personality. People who are manic or depressed at the moment don't just hurt because of their mood. When you get depressed, the coping skills you use at the time have to do with your personality, not the depression itself. So depression may drive you to do something that is self-harming, but it is your personality type or your personality capacity that reacts to depression with self-harm.

The treatment of borderline personality disorder and bipolar disorder is very different, but they can overlap. The main treatment for borderline personality disorder is a psychotherapy called dialectical behavioral therapy or DBT. It is a branch of cognitive behavioral therapy that was developed specifically for borderline personality disorder and, when implemented by someone trained in DBT, is very effective and is usually a combination of group and individual sessions. The main treatment for bipolar disorder is medication management. Sometimes depressive episodes, if they are mild to moderate, can respond quite well to cognitive-behavioral therapy. But manic episodes often require medication. People with borderline personality disorder can still have a mood disorder, so you may have both problems.

If someone with borderline personality disorder also becomes depressed, she may need medication to overcome the depression. Sometimes the mood swings of borderline personality disorder may respond well to mood stabilizers, although this is not considered bipolar disorder. So mood stabilizers are mood stabilizers and they can help people with borderline personality disorder who have a lot of moods or a lot of anger, but the reason you would use the mood stabilizer is to treat the mood instability that accompanies personality disorder. and that doesn't automatically mean you have bipolar disorder. It can be confusing, there are a lot of nuances to this.

That is why the best treatment should be determined by a doctor who has evaluated you. But the bottom line is that there is an overlap between borderline personality disorder and bipolar disorder. Sometimes people with borderline personality disorder need the same type of medication that a person with bipolar disorder would need, but bipolar disorder is more episodic, like bad weather, while borderline personality disorder has quite a set. consisting of behaviors that rise and fall intensely. and they tend to stay for a long time. That's it for this topic, if you're new to my channel, it can be a little tricky to go to other videos to get more information, and that's kind of by design because I don't want these videos to be so epic.

It's extensive with all these definitions and going through all these criteria and then it gets difficult, I mean, it's hard enough to go over the criteria just for one deviation. You see, you had to read that long list, but I think the best way to get a good understanding of one of these topics is to do it in small chunks at a time. That's why I developed playlists to help you with different illnesses, to help you little by little, and as I continue to make more videos, I will continue to develop the playlist so that you can start with one and better understand different psychiatric illnesses. . affairs.

Thanks so much for looking. Share this video with someone you think would benefit and feel free to send me a comment, even if it's just to say hello. See you next time