bipolar v borderline

MrChicagoRN, RN · Jan 29, 2014

They are indeed very, very different. One is related to brain chemistry, the other is a personality D/O

What do you see as the similarities, or differences? I think it's important we know where your knowledge is at before giving long, detailed answers.

Cackalacky · Jan 30, 2014

All I can say is when you see people with each diagnosis, it's pretty easy to see the differences. Bipolar is a chemical disorder, while borderline is a personality disorder and many believe that though it can be genetic, there are environmental factors, meaning it may be a learned behavior.

Here is a VERY BROAD example: A person with bipolar may have weeks of depression - refusing to bathe, refusing to eat, not communicating with people, suicidal thoughts. Then, the person will have a complete turn around and may be hyper religious with gradiose thoughts and impulsive behavior such as extreme shopping and won't sleep for days. There may even be some "normal" days in there for a period of time.

A person who has borderline personality disorder might love you today, but hate your guts tomorrow! They do something called "splitting," where whoever they're talking about or interacting with is either wonderful or awful and there is no in between. This can change from day to day or hour to hour. They have unstable relationships with people and often have reckless or impulsive behavior.

Now that I'm typing this out, I can see why it could be so confusing if you've never seen it! People who are manic might display the same behaviors as those who are borderline personality.

Cackalacky · Jan 30, 2014

Also, I realize that I posted as a very new nurse and based my post off of personal observations. Please don't yell at me if I'm not correct! :-D

edie1 · Feb 2, 2014

Cackalacky

thank you!

i dont care about the cause ie genetic or whatever - i was simply looking for what i might see - its a personal situation and sometimes its hard to be intellectual / objective when dealing with family / friends - thank you so much!

edie1 · Feb 2, 2014

MrChicagoRN

unstable behavior, moody, difficult to be around, takes no responsibility for consequences of behavior etc and i do think they are similar no matter what the cause - i have never been around a borderline person so i was simply asking for what i might see/feel as opposed to the clinical picture which i could google

"would one or both of them make you start to question your own sanity when dealing continously with the ups and downs and would the person never be wrong about anything and somehow be able to turn everything back on to you?"

this is what i got per psych central

borderline -

Frantic efforts to avoid real or imagined abandonment

A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

Identity disturbance, such as a significant and persistent unstable self-image or sense of self

Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)

Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

Emotional instability due to significant reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

Chronic feelings of emptiness

Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

Transient, stress-related paranoid thoughts or severe dissociative symptoms

bipolar -

During a manic phase, symptoms include:

heightened sense of self-importance

exaggerated positive outlook

significantly decreased need for sleep

poor appetite and weight loss

racing speech, flight of ideas, impulsiveness

ideas that move quickly from one subject to the next

poor concentration, easy distractibility

increased activity level

excessive involvement in pleasurable activities

poor financial choices, rash spending sprees

excessive irritability, aggressive behavior

During a depressed phase, symptoms include:

feelings of sadness or hopelessness

loss of interest in pleasurable or usual activities

difficulty sleeping; early-morning awakening

loss of energy and constant lethargy

sense of guilt or low self-esteem

difficulty concentrating

negative thoughts about the future

weight gain or weight loss

talk of suicide or death

TerpGal02, ASN · Feb 4, 2014

They can actually be quite similar. Both can he manipulative, staff split, etc. The difference is the timing of the mood swings. In a true bipolar the mood phases last for a good while (ie the person is exhibiting depressive sx for days/weeks and manic sx for days). With a borderline they can look very depressed in the morning and be acting bright and happy within HOURS, not days. A lot of times, the suicidal thoughts are triggered by frustration whereas a unipolar/biploar depressive episode, they will be pretty consistently with feeling suicidal. Wanna make it even more confusing? Bipolar and borderline can he comorbid. Now that's good times.

akulahawkRN, ADN, RN, EMT-P · Feb 4, 2014

Another way to think about borderline personality is that they have no emotional filter so they experience their emotions full-throttle then back off as they realize they reacted too much. For instance, if they have a sad event happen, they feel really, really sad and may have suicidal tendencies for a short while and once they have a chance to process it, they no longer feel suicidal. Or they get really, really happy about something and do something impulsive and later realize they went too far. If you meet someone when they're at the extremes, it can look a lot like bipolar. Most of the time, they "hang out" in the middle of the range that we call "normal." It's just the mood swings can happen really, really fast, as is the return to baseline.