Along with borderline personality disorder, I am also diagnosed with bipolar II disorder. The difference between the two is so subtle that they are often misdiagnosed as each other. Most of the time it’s impossible to tell whether my symptoms are caused by bipolar or BPD. But if you look closely, there are some key differences between the two disorders. Understanding these differences is important in making sure I get the correct treatment.
Bipolar disorder primarily affects my mood and energy levels, whereas BPD affects my personality and interpersonal relationships. Bipolar episodes are a departure from my typical baseline personality and aren’t characteristic of what I would normally do. On the other hand, BPD symptoms are always present and are a part of who I am, no matter whether I’m having a bipolar episode or not.
I’ll address depression first. Depression can be particularly severe in both bipolar II and BPD; I will lose interest and motivation to do things I used to enjoy doing, replacing them with suicidal thoughts instead. This can be triggered by either a traumatic event or seemingly nothing at all. If it lasts hours, I usually attribute it to BPD. If it lasts for weeks or months, however, that’s more indicative of bipolar disorder. The negative voice of BPD feeds upon my depression, though, and will tell me awful things like “everyone hates you,” “people are just going to leave you,” “you’re ugly and worthless,” etc. Hypomania is dramatically different from a regular good mood with BPD, so here’s how I differentiate between the two:
I usually get about six or seven hours of sleep a night, but when I start staying up all night researching new ideas and feeling fine the next day without any tiredness, I know I’m on the brink of hypomania.
Normally, my energy level is about average, with a few sluggish days here and there. When I’m hypomanic, however, my energy level goes way up and I feel extremely restless and “wired.” I become a lot more active than usual and begin to talk so fast about different things that people find it hard to keep up. Sometimes, I will feel irritable and snap at people if they get in the way of what I want to do. I become goal-oriented.
Generally, my self-esteem is average at best, fluctuating between very low and normal when I’m not hypomanic. During hypomania, however, it will inflate to the extreme and I will feel exceptionally confident and have grandiose thoughts about how special I am. This might seem like a good thing on the surface, but looking back after an episode, the entitlement and conceitedness that goes along with a false sense of high self-esteem is less than flattering.
This is a prominent symptom for me in both disorders, which makes it even more challenging to deal with since it is consistently ongoing, not just within an episode. Gambling, reckless driving, unsafe sex, spending sprees, binge eating, drug and/or alcohol abuse, or sabotaging success by suddenly quitting a good job or ending a positive relationship are all impulsive and risky behaviors I’ve had major problems with currently or in the past. I’m relatively impulsive by nature, but during a hypomanic episode, it’s like my impulsiveness is on overdrive with absolutely no regard for consequences.
This is a rather taboo symptom that tends to be swept under the rug, but it’s extremely common in bipolar disorder, and when my sex drive skyrockets from its average level, it’s one of the main signs I’m becoming hypomanic. Mix this symptom with impulsiveness and an inflated sense of confidence and you have a recipe for disaster. Sexual indiscretions can also be a symptom of BPD, so this area has been a struggle for me to say the least.
Making big plans:
When I’m hypomanic, I have an intense urge to completely overbook myself and/or make outrageous, unattainable plans I would never rationally make. I know I’m in the midst of a hypomanic episode when I suddenly want to drop everything and go to Vegas or commit to joining a band. I will also take up several random hobbies that I’ve taken a sudden interest in, only to drop them not long after, leaving half-completed projects laying around the house.
Bipolar disorder is commonly treated with medication, so now that I have those symptoms under control, I’m left with my BPD symptoms, for which I’m in therapy. Because those traits are so ingrained in my personality, such as fear of abandonment and an unstable sense of identity, it’s difficult to manage, but I’m definitely making a lot of progress, so I’m proud of how far I’ve come.
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Thinkstock photo by finwal