The Relationship Between BPD and Bipolar Disorder

Taylor Shaw
September 23, 2025
Authored by: Taylor Shaw, B.S.
Edited by: Anand Mehta, LMFT
Bipolar Disorder and Borderline Personality Disorder (BPD) may look very similar at first glance, due to the impulsive and extreme mood shifts. They are very often misdiagnosed for one another, as mood swings, impulsive behavior, and suicidal thoughts can be characteristic of both BPD and Bipolar Disorder, causing even mental health professionals to sometimes be unable to note the key differences without extensive attention. However, there are key differences between those diagnosed with BPD and Bipolar Disorder. For example, when a person who is diagnosed with Bipolar Disorder is not experiencing a depressive or manic episode, the individual is more likely to be able to maintain emotionally stable relationships. Additionally, because Bipolar Disorder is more biologically-based and more easily managed with medications like mood stabilizers, antidepressants or antipsychotic medications, a person with Bipolar Disorder will remain more emotionally stable between episodes, with more random and less frequent triggers. Meanwhile, in a person with BPD, environmental factors can be more triggering, and these triggers come “from a combination of an emotionally charged temperament and the lack of a solid sense of self.”1 BPD is more psychologically centered, and a person triggered into an episode with BPD will engage in impulsive behavior, unstable self-image, emotionally high-risk interpersonal relationships, and mood instability. These mood episodes may look like overlapping symptoms at first glance, but the disorders are very much different, with a possibility of comorbidity.
can you have bpd and bipolar

BPD

Borderline personality disorder is a personality disorder that is characterized by mood swings and impulsive behavior that can be related to self-image and that can result in suicidal ideation, unstable relationships and self-harm. People with BPD tend to have relationships that can be chaotic and intense, veering between a desperate neediness for others and fear of abandonment to an intense anger or dismissal of others when feeling rejected, even in situations where the other person may in fact be neutral or even positive.2 Additionally, people struggling with BPD and mood changes may be at increased risk of harm to themselves or others. If you are looking for a specialized treatment plan for BPD, our admissions team at AMFM Mental Health Treatment is ready to help.

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Bipolar Disorder

Bipolar Disorder is defined by the American Psychological Association as a “serious mental illness in which common emotions become intensely and often unpredictably magnified.”3 Bipolar disorder is often characterized by drastic mood swings from high-energy, happiness and productivity to lows of sadness, exhaustion and major depression, and the shift between these two phases can grow to be so intense that an individual may consider suicide. Studies have shown that individuals living with Bipolar Disorder are at increased risk to attempt suicide at least once in their life, by 25-60%.4 If you or a loved one are looking for a specialized treatment plan for Bipolar Disorder, our admissions team at AMFM Mental Health Treatment is ready to help.

Bipolar I vs Bipolar II

Bipolar I Disorder is considered the most severe form of Bipolar Disorder, and is diagnosed when an individual enters a manic state, characterized by an intense mood swing “up”, consisting of high-energy, uncomfortable irritability, racing thoughts and impulsivity. While Bipolar II Disorder is also characterized by manic episodes, they may be shorter or less severe, referred to as hypomania. A person struggling with Bipolar II will experience depressive episodes, while an individual struggling with Bipolar I may or may not experience depression.

Can You Have Both Bipolar Disorder and BPD?

Comorbidity is the existence of two mental health conditions that exist in the same individual simultaneously. Studies have show that “comorbid BPD and BD are associated with marked psychosocial disability, with patients being more impulsive and aggressive than those with BPD and BD alone.”5  Additionally, studies have also found that: 
  • Approximately 10% of patients with BPD had bipolar I disorder and another 10% had bipolar II disorder. 
  • Approximately 20% of bipolar II patients were diagnosed with BPD, 
  • Though only 10% of bipolar I patients were diagnosed with BPD. 
  • While comorbidity rates are substantial, each disorder is nonetheless diagnosed in the absence of the other in the vast majority of cases (80% to 90%).6
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Inpatient Treatment for Bipolar Disorder & BPD

Inpatient Treatment for Bipolar Disorder refers to residential, or live-in mental health care programming in a facility. Inpatient treatment allows you or your loved one to engage in interpersonal therapy with licensed therapists and group therapy sessions, while healing in a safe and supportive environment. Inpatient mental health programming for anxiety usually also provides the highest level of care, with 24/7 clinical care, psychiatry and medication management, and personalized treatment plans for lasting well-being.

Outpatient Treatment for Bipolar Disorder & BPD

Outpatient Treatment (IOP or PHP) programs offer comprehensive mental health care at a more flexible schedule, with both in-person and virtual options available. Unlike residential care, intensive outpatient treatment can offer online therapy and programming, but without 24/7 clinical teams on staff. Outpatient treatment plans still offer a combination of individual and group therapy, through a holistic approach, but in a less structured environment.

 

If you have been struggling with one or more of the anxiety symptoms we have mentioned, know that you’re not alone. A Mission For Michael Mental Health Treatment has admission counselors available around the clock to help determine which treatment options can assist you in managing anxiety. Contact us today to begin your confidential and free mental health assessment.

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A Mission For Michael (AMFM) provides treatment for adults experiencing various conditions. Bipolar Disorder support is a phone call away – call 866-478-4383 to learn about our current treatment options.

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AMFM Mental Health Treatment offers a combination of holistic mental health services‌ and evidence-based therapies like the following:

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Flayton, L. (2024, November 19). Understanding the difference between bipolar and borderline personality disorder. NewYork-Presbyterian. https://healthmatters.nyp.org/understanding-difference-bipolar-borderline-personality-disorder/ 

Lopes LM, Matias M, Marques M, Lopes IM, Reis J. Bipolar Disorder and Borderline Personality Disorder: A Diagnostic Challenge. Eur Psychiatry. 2023 Jul 19;66(Suppl 1):S701. doi: 10.1192/j.eurpsy.2023.1467. PMCID: PMC10661435.

American Psychological Association. (n.d.-b). American Psychological Association. https://www.apa.org/topics/bipolar-disorder 

Novick DM, Swartz HA, Frank E. Suicide attempts in bipolar I and bipolar II disorder: a review and meta-analysis of the evidence. Bipolar Disord. 2010 Feb;12(1):1-9. doi: 10.1111/j.1399-5618.2009.00786.x. PMID: 20148862; PMCID: PMC4536929.

Zimmerman M, Morgan TA. The relationship between borderline personality disorder and bipolar disorder. Dialogues Clin Neurosci. 2013 Jun;15(2):155-69. doi: 10.31887/DCNS.2013.15.2/mzimmerman. PMID: 24174890; PMCID: PMC3811087.

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