Can You Have BPD and Bipolar Disorder Together?

Can you have bipolar and BPD (borderline personality disorder)? The answer is yes. Bipolar disorder and BPD can often co-exist and even worsen each other. But why does this happen, and what is the road ahead in your healing journey? Let us learn this and more in the article below.

Bipolar disorder, or BD, is a mood disorder that is characterized by manic/hypomanic (highs) and depressive episodes (lows).

Borderline personality disorder, or BPD, is a cluster B personality disorder that impacts how you relate to yourself and others. It is characterized by a fear of abandonment and unstable relationships that can affect daily functioning and well-being.

Dr. Ryan Peterson, a highly experienced physician at the NuView Treatment Center, informs us that, “Nearly 4.4% in the U.S. will experience bipolar disorder sometime in their lives, while nearly 1.6% will experience borderline personality disorder in their lifetime. Unfortunately, bipolar and borderline personality disorder can often overlap, complicating the symptoms and recovery.”

If you are wondering, can you have both bipolar and BPD at the same time, then the answer is yes. The National Library of Medicine reports that nearly 10% of those with bipolar I disorder and 20% of those with bipolar II disorder also receive a diagnosis of BPD.

“Borderpolar” - the co-existence of bipolar and BPD is challenging to diagnose. Typically, bipolar disorder is diagnosed first, as the recurring highs and lows do indicate a very distinctive type of mood pattern. This makes BPD challenging to diagnose, just in case.

Depending on the type of bipolar disorder, BPD can overlap in terms of:

• Impulsivity and risky behaviors
• Mood patterns, especially the depressive episodes
• Suicidal thoughts and behaviors.

If anybody is experiencing suicidal thoughts or ideation, please contact national helplines like 9-8-8 immediately. This can be a life-saving move.

The co-existence of these disorders has led some scholars to suggest that both of these conditions lie on a spectrum, but others have advocated for the separation of the two.

While bipolar and BPD have overlapping symptoms, the distinctive patterns are as follows:

Bipolar Disorder

• Elevated and depressive mood patterns, with relative stability between manic/hypomanic and depressive episodes.
• Mood shifts are triggered by internal events.
• Atypical depressive features, like seasonal patterns and mood reactivity.
• Lower prevalence of trauma and self-harm history.
• Responds well to mood stabilizers and antipsychotics.

Borderline Personality Disorder

• Fears of abandonment and a history of unstable relationships.
• Instability is mainly in the context of interpersonal relationship stressors.
• Maladaptive emotion regulation patterns and a history of self-harm behaviors.

When it comes to bipolar disorder, most likely the person will seek treatment for depression. However, to diagnose bipolar disorder, these steps are followed:

• You will need to have at least one manic/hypomanic and depressive episode.
• Your doctor will ask you about your symptoms, mood episodes, the duration of these episodes, and your family history.
• Blood tests and body scans will be conducted to rule out other physiological conditions that may mimic bipolar disorder, like hyperthyroidism.

Meanwhile, BPD is diagnosed on the basis of the following nine criteria:

• Fear of real or imagined abandonment
• Unstable and intense relationship patterns that alternate between idealization and devaluation.
• Unstable identity and sense of self.
• Impulsive behaviors in two areas of life that are self-destructive.
• Anger or temper concerns.
• Mood swings that are triggered by external reasons.
• Feelings of emptiness.
• Stress-induced paranoia/dissociative symptoms
• Repetitive self-harm and suicidal behaviors.

At least five of the above-mentioned nine symptoms must be present for a diagnosis of BPD.

Bipolar disorder and BPD can co-exist as borderpolar, but these conditions are treated separately, as they are distinct conditions. The treatment looks something like the following:

Bipolar Disorder Treatment

• Medication: Medications for bipolar disorder typically involve mood stabilizers and antipsychotics. Sometimes, it also involves antidepressants and anti-anxiety medications.
• Psychotherapy: Therapy involves cognitive behavioral therapy, dialectical behavior therapy, interpersonal and social rhythm therapy, family-focused therapy, and group psychoeducation.
• Alternative Treatments: If a person is not responding to the first line of treatment, then alternative treatments like electroconvulsive therapy (ECT) can be used.

Borderline Personality Disorder Treatment

Meanwhile, BPD is primarily treated with dialectic behavior therapy, cognitive behavioral therapy, schema-focused therapy, and others.

As medications can sometimes worsen suicidal symptoms, medications are not recommended for BPD.

Both of these conditions are severe, and hospitalization may be required for bipolar I disorder and BPD, especially if the person is at risk of harming themselves or others.

Dr. Peterson says, “Neither bipolar disorder nor BPD can be ‘cured,’ but symptoms can significantly reduce over time. In our observations, bipolar disorder shows over a 50% reduction in symptoms with medication and therapy, while BPD treatment can lead to more than a 60% improvement.”

If you or a loved one is struggling with both bipolar and BPD symptoms, we can understand how challenging it is. But you do not have to carry this on your own. Reach out to NuView today - we provide a full continuum of outpatient care that is personalized to meet you where you are.

Please contact us at (323) 307-7997 to speak with our experts today!

1. Can you have bipolar and BPD at the same time?

Yes, bipolar and BPD co-occur at a high prevalence rate.

2. Why do bipolar and BPD co-exist so often?

Why bipolar and BPD co-exist so often is not clear, but bipolar is strongly linked with genetics, while BPD is linked with trauma.

3. Can bipolar or BPD be prevented?

No, unfortunately, bipolar or BPD cannot be prevented. Both are intricately linked with genetics and environment.

4. Can bipolar and BPD be treated?

Yes, bipolar and BPD can be treated with medication and therapy.

5. How much does bipolar and BPD treatment cost?

Integrated treatment option costs for bipolar and BPD can vary depending on the treatment center and type of program. However, these costs are typically covered by your insurance policy.