Can You Have Bipolar Disorder + Borderline Personality? |Here’s Why It Matters

hi I'm dr. Tracy marks a psychiatrist and I make mental health education videos 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 border polar and this isn't an official term but it's one coined by professionals in the field psychiatrists and therapists it's kind of like an inside term used by people who keep up with the research on this issue so now you have some inside lingo I've explained in a previous video the difference between borderline personality disorder which I'll call BPD and bipolar disorder and you can watch this video for a longer explanation in that video I considered borderline personality disorder as your hardwiring similar to the climate of the area where you live I compared bipolar disorder to a storm that comes in and lasts for a period of time and then goes away the climate or your hardwiring affects the kinds of storms that you have one of the key places that BPD and bipolar disorder overlap is in the mood instability with BPD you get rapidly shifting mood states that lasts hours or a day whereas episodes of mania or depression lasts for a minimum of four days for hypomania in two weeks for depression some experts have debated whether or not BPD should really be part of the bipolar spectrum I talk about bipolar spectrum in this video but the latest reviews on this issue have concluded that they're very distinct entities but what the latest research has shown is that 20% of people have both disorders so 20% of people with bipolar disorder also have BPD and 20% of people with BPD also have bipolar disorder now in medicine 20% is still a low frequency it's less than half but even so people who have both of these things going on at the same time tend to have more severe illness they tend to have more mood episodes which means less time for stable despite being on a good medication regimen they have an earlier age of onset of bipolar disorder more suicidality either in attempts or thoughts more aggression and hostility more substance misuse more comorbid diagnoses this means co-occurring illnesses like PTSD and OCD people with both disorders tend to have more unemployment and hospitalizations so what does it look like if you have both you have your episodes of depression and mania that can come and go but then you can still have this level of distress sadness or dissatisfaction with life that doesn't seem to change even when your depression or mania have passed in fact it may be hard to tell if your depression or mania have passed if you're still feeling emotionally unstable that can lead to over medication another thing you have to remember is that with BPD you get the fears of being rejected or abandoned by people that you care about and this wreaks havoc on your relationships as you test people or sabotage the relationship to keep them from leaving you and this is behavior that you can have even when you're not in a depression or mania then add in the impulsive 'ti and poor judgment of hypomania that can cause you to make really bad decisions even worse than you would have made if you had pure mania without the personality issues the feelings of emptiness really ramped up if you crash into a depression and this is one of the reasons why there tends to be more suicidality with bored or polar than with either BPD or bipolar alone using self-harm as a coping mechanism is not really a feature of bipolar disorder but this can really get out of control in a border polar person who's either depressed or manic so it can get complicated to recognize the interplay of both problems for the clinician a clue is probably in how you are behaving in your relationships over time and we call this getting a longitudinal history the behavior that happens within a depression or manic episode tend to be more of a slice and time look versus long-standing patterns of behavior that you engage in over the course of your life even when you weren't depressed or manic that's something that your doctor or therapist would consider in determining whether you have both disorders why does this matter it matters with the treatment you get the primary treatment for bipolar disorder is medication first in 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's something else to treat like depression anxiety or ADHD just to name a few the gold standard therapy for borderline personality disorder is dialectical behavior therapy so if you have both disorders you really need medication and DBT or some other comparable therapy for your borderline personality disorder medication alone is probably not going to be enough and I think that's why we see more people with border poler having poor treatment outcomes if you try and address the unstable view of self and the relationship instability with medication you're not going to get far then the instability leads to more depressed or angry emotions emptiness hopelessness suicidal thoughts and then really poor coping mechanisms like self-harm so that's boarder polar or the combination of bipolar disorder and borderline personality disorder and this isn't the only combination of disorders you can have you can have any personality disorder along with bipolar disorder anxiety unipolar depression or even schizophrenia this combination has earned its own name because of the similarities between the two disorders thanks for watching I'll see you next time

Channel: Dr. Tracey Marks

Views: 95,724

Keywords: mental health channel, mental health education, dr tracey marks, bipolar disorder, borderline personality disorder, mental health, mental illness, borderline personality, bipolar vs borderline

Id: G8JHjN2AaxA

Length: 6min 37sec (397 seconds)

Published: Wed May 20 2020

Reddit Comments

[u/iamillll]

Love her channel! Really good videos on mental health.

[u/[deleted]]

I was diagnosed with both twice. I was in therapy for several years to combat borderline and no longer have symptoms. When I was assessed again, I was diagnosed only bipolar.

[u/Tfmrf9000]

I’m actually surprised more people aren’t calling it this in posts. When I first joined, lots did, now it’s bpd + bp

[u/xyz20023]

I had 3 psychiatrists diagnose me with BPD. My current psychiatrist says I have bipolar 2 as well.