eli5: What are the differences between Bipolar and Borderline Personality Disorders?
In: Biology
Bipolar is a mood disorder, having to do with what are called mood “episodes.” An episode is a period of time, at least several days but usually 1-2 weeks or longer, where you have significant, persistent alterations in your overall mood from a normal, well-functioning baseline. A depressive episode is what will be more familiar to most people, because they basically have all the features of major depressive disorder (in fact MDD is a.k.a. “unipolar depression” in contrast to bipolar). The other pole is what are called manic episodes, during which the person with the disorder has at least several days of either very elevated or expansive mood, though often in a very unstable way; they typically also have overall increased activity, starting unrealistic projects and acting very impulsive. They may also be paranoid and develop severe delusions, and usually feel like they have a decreased need for sleep. Sometimes mania feels GREAT to the sufferer while they’re in a manic state, and they can put themselves in real danger because of the delusions and impulsivity that come with it.
Borderline personality disorder is a bit less understood, and while the DSM does have a fairly stable description of it there is a bit more criticism and some alternate ideas. But, as we understand it currently, BPD is a personality disorder: whereas we believe bipolar is caused by issues with the brain’s functioning that leads to mood episodes emerging, BPD is more about habits, relationships, and cognition. To oversimplify, we think bipolar is more about “brain” and borderline is more about “mind.” The characteristics of BPD are a lack of a strong sense of self, extreme fear of abandonment (and concomitant extreme reactions to real or perceived abandonment), unstable emotional reactions and impulsivity. People with BPD tend to alternate quickly between extremes of emotion, not having a stable middle ground between despair and euphoria, and often seem to change their personality on a whim. As opposed to the mood episodes of bipolar, which are characteristically multiple days long at *least,* mood swings in BPD can be *extremely* rapid, with the sufferer going from euphoria to despair and back sometimes within the space of a single conversation.
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