Can you have bipolar disorder and borderline personality disorder at the same time? I’ve been asked this question several times and the answer is yes. In fact, some people will refer to this as borderpolar. This isn’t an official term but one that’s coined by professionals in the field. One of the key places bpd and bipolar disorder overlap is in the mood instability.
With bpd, you can get rapidly shifting mood states that last hours or a day. Whereas episodes of mania or depression last a minimum of 4 days for hypomania and 2 weeks for depression. The latest research has shown is about 20% of people have both disorders. Twenty percent is still a low frequency, it’s less than half. But even so, the people who have both of these going on at the same time tend to have a more severe illness course. This matters with the treatment you get.
The primary treatment for bipolar disorder is medication first and therapy second. Helpful therapies are social rhythm and interpersonal therapy, cognitive behavior therapy, psychodynamic therapy, and dialectical behavior therapy. For borderline personality disorder, the primary treatment is therapy first and maybe medication if there is something else to treat like depression, anxiety or ADHD just to name a few.
The gold standard therapy for borderline personality disorder dialectical behavior therapy. If you have both disorders, you need medication and DBT or some other comparable therapy for your borderline personality disorder. Medication alone is probably not going to be enough. This is something your doctor or therapist could help you navigate and determine the best course of treatment.
Reference
Patel RS, Manikkara G, Chopra A. Bipolar Disorder and Comorbid Borderline Personality Disorder: Patient Characteristics and Outcomes in US Hospitals. Medicina (Kaunas). 2019;55(1):13.
Hello. I have been through many psychiatrists and was first diagnosed with bipolar disorder. Then I hadn’t had a full blown manic episode in a while so it was change to bp2 then once when it was hospitalized the doc said I don’t believe u have BPi believe u have bpd. Then when I got home they said I have both and it started making sense. Can you tell me if the symptoms are known to ever be at the same time because sometimes I can feel manic for a day or 2 and then I have many mood swings or symptoms at the same time. Like feel happy and depressed at the same time or depressed than happy many changes through out the day. And I’ve always wondered if this means I wasn’t truly manic, it was bpd symptoms since it wasn’t 4 or 7 days or whatever and one counselor said I was rapid cycling but Google says rapid cycling is more than 4 episodes a year not many in the same day. So can you be feeling “mostly ” manic or depressed but ur bpd symptoms acting up at the same time? Or is it always a full blown manic or hypomanic epidisode or depressive episode aka BP and then when you are not having those episodes bpd acts up in between? Or can u have symptoms of both at the same time? I’ve always wondered and my therapist doesn’t seem to know and my current nurse practitioner of psychiatry doesn’t want to label what I have and just treat the symptoms. I’m so confused!
Omg I have the same confusion. I’m 43 was diagnosed with bipolar at 24 but pretty sure it started at 9. But the last few years me and my fiance have started to wonder if there is some borderline in there and I just saw my medical records from my mental health and a couple of my mental health providers have also made quite a bit of comments about borderline but I swear most the time I cycle throughout the day a lot. And also feel like sometimes I have both at the same time but never neither it’s a comfort that I’m not the only one experiencing this because apparently it makes it very hard to treat I have been on so many meds time and time again to the point where I just shoot for not having bad side effects. If you have found out any more information I would love to talk to you since your condition sounds almost exact to mine. I felt hopeless for years I’m always seeking treatment seeking a way to fix anything in I feel like I never get anywhere.
Thank you. It’s so agonizing to deal with these mystery symptoms. The slightest things can make or break. This really hurts.
Thanks so much!!! U have finally clarified what I’ve been going through for 35 years, when none of of my psychiatrists ever realized that I had both bipolar 1 AND borderline personality disorder. I am now on mood stabilizers and antipsychotics for my depression and have just started DBT for BPD. THANKS. MAYBE THERE’S HOPE FOR ME YET.
You’re welcome Krista! So glad you’re getting some good treatment.
So I was watching your video on YouTube where you explain the differences between borderline personality disorder and bipolar disorder. I have 7/9 of the signs of borderline personality disorder. I have been through ALOT as a child and I have been going to mental health since I was a child still to this day I go. I have been diagnosed with manic bipolar that’s just one of the things I’ve been diagnosed with. I have been on so many meds that there is literally only one medication left for me to try if this one doesn’t do the job and I’m on a VERY high dosage. Is it harder to treat someone that is borderpolar?
Yes it can be. I mention that near the end of the video. It’s important to address the bipolar with medication and the borderline with therapy. I have a video coming up in several weeks talking using the right medications with bipolar disorder. Stay tuned