5 Symptoms That Are Often Confused With Borderline Personality Disorder (BPD) | Guest Post by Marcela De Vivo

Please welcome guest blogger Marcela De Vivo and her post, "Symptoms That Are Often Confused With BPD." TW: This post contains content that may be triggering for some readers.

Mental illness can be difficult enough for friends and loved ones to detect at all, but distinguishing among similar conditions is even more of a challenge. In particular, Borderline Personality Disorder (BPD) can be easily mistaken for other conditions, most often Bipolar Disorder.

It goes without saying that an accurate diagnosis is crucial: not only will the wrong treatments and medications fail to relieve suffering, they threaten to make things worse (and in some cases can induce bouts of psychosis).

Unlike fully somatic diseases— such as cancer or lupus, for example—BPD and other mental illnesses can’t be diagnosed through a blood test or MRI, therefore, accurate analysis depends on the observation of behavior over time. Due to the fact that BPD tends to distort its victims’ self-image, the insights of friends and family can be essential in accurately assessing BPD and detecting it in its early stages. So, let’s take a look at what BPD is—and what it is not.

Borderline Personality Disorder (BPD)

While BPD and Bipolar Disorder both tend to affect one's ability to have harmonious relationships with others, BPD’s overall symptoms have different hallmarks that can be spotted under careful scrutiny.  Please note that not all people with BPD experience the same symptoms or express the same behaviors. This is a general overview of some of those symptoms and behaviors experienced by some people who have BPD. Only a qualified, licensed psychiatric professional can accurately diagnose any condition. If you think you have Borderline Personality Disorder, Bipolar Disorder, or any other health issues, contact a qualified provider for evaluation.

· BPD issues often center on personal self-image and relationships with others. In combination with other criteria, unstable relationships, such as bouncing from one high-drama romance to the next is a classic indicator of BPD, as are poor self-esteem and/or self-loathing. An all-or-nothing desire to be validated by a partner and an intense dislike of being alone can often be observed among BPD sufferers. In addition, maladaptive "manipulative" behaviors, often developed as survival behaviors in childhood, may still surface in adulthood in order to secure emotional attention or avoid feeling abandoned. These, along with other maladaptive behaviors, can be unlearned through treatments like DBT (Dialectical Behavior Therapy), as Debbie Corso has experienced.

· Self-destructive, impulsive behavior. Going hand-in-hand with problems of self-worth, BPD sufferers sometimes act out on the intensely negative feelings they harbor towards themselves through impulsive behavior. They may demonstrate patterns of self-harm (cutting, inflicting cigarette burns) or even suicidal ideations. Similarly, sharp bouts of addictive behavior may be a manifestation of a BPD sufferer’s negative feelings, which may manifest in a number of ways, such as over-spending, binge eating, drug and alcohol, and gambling.

· Intense, rapid cycles. Perhaps the most reliable indicators of BPD revolve around rapid, intense cycles of emotion and behavior. For example, if a minor change in plans or an unguarded comment from a boyfriend or girlfriend sends someone into a tailspin of anger or depression—a fit of emotion that ends just as abruptly as it begins—there is a strong possibility of BPD. Likewise, BPD can provoke grandiose, sudden changes in goals. For example, if an individual makes out-of-nowhere announcements about career changes, only to renounce them the next day, he or she may be contending with BPD.

Bipolar Disorder

· A more even cycling between extremes. Although both BPD and Bipolar sufferers exhibit intense states of emotion, bipolarity (or manic depression, as it used to be called), is an oscillation between high-highs and low-lows. In the manic/”high” stage, a Bipolar individual may show excessive energy, irritability and difficulty sleeping. When the depressed pole manifests, look for social withdrawal and possible suicidal expressions.

Again, while on the surface these mood swings in BPD and bipolarity can look the same, BPD fluctuations may only last a few hours, while bipolar swings can last weeks.

· Less dependency on external triggers. Because BPD often hinges on an unhealthy equation between oneself and others, outbursts are often produced by outer stimuli. On the other hand, bipolar disorder tends to go up and down according to an internal track. Looking for trigger-patterns in problem behavior can be one of the keys a professionals often look to when differentiating between the two.

Again, since any one of these symptoms alone is not ample proof of any disorder, be sure to turn to a qualified clinician who can look for clusters of these indicators, make an accurate diagnosis, and suggest appropriate treatment options.

Irritability and impulsive behavior, both hallmarks of BPD and bipolar, are also signs of ADHD and Asperger’s. Furthermore, it’s not unheard of that people suffer from more than one disorder at the same time, making a clear diagnosis even trickier. In any case, if you witness at least a few of these indicators, gently, but assertively, take steps to encourage get your friend or relative the professional help they need.

Marcela De Vivo is a freelance health & wellness writer from California. She specializes in a number of topics, from alternative medicine to pharmaceuticals, fitness, and special needs issues.


  1. Thank you for this! I am sharing it!

    1. So glad you found it helpful, Sierra, and thanks for sharing! ♥

  2. What if you are dealing with an individual with possible BPD, but they refuse to find out for sure; to admit there is an issue?

    1. That is a tricky one. In my personal experience, the person in need of help must be ready and willing to seek it. ♥ I do want to say that I know how tough this can be on loved ones who are watching the person in pain and suffering in the process. That's when it's important to reach out for support and self-care for YOU. For example, Teresa Lynne of Essence Happens works with family members and loved ones of those with BPD.

  3. If there is no definite diagnosis, though, isn't that a problem?

    Of course if it's mentioned to the one with possible BPD that they need help of some form, the one suggesting help is accused of playing doctor and trying to diagnose.

    1. Hi Bonnie, this really is a difficult situation. Fortunately there are people out there like Teresa Lynne (of Essence Happens) who specializes in supporting family members in coping with these issues. You don't have to do it alone. Thank you for commenting. ♥

  4. I've noticed a lot of people asking about this lately. I was just looking for posts on this today. What perfect timing! Am definitely sharing this! Thank you so much!

    Joyce. <3

    1. So glad that this article was of help, Joyce. Huge hugs! ♥

    2. I was recently diagnosed from my family Doctor that she thought I had BPD. I am in a difficult position in life (severe O.A.) the pain I feel each day is hard to put into words. I feel she was not right to say this to me when I, like many people felt they could share and open up to their family doctor. Not saying I should seek psychiatric help...just that I have BPD!!! I have many friends...though not in the city where I live unfortunately but this says I have no support or dramatic or sad...doesn't everyone in their life at one time or another feel this way? I live in Kelowna, British Columbia..is there anyone who would be able to see someone like me for a proper evaluation? Or do I just take the prescription for anti-depressants get dug out of the garbage?!?! ;) I feel as if I was put into a basket I don't fit into...it is not good, in my opinion, for an "Family practicing Doctor" to decide. I have read many pages today on this subject...I know someone who fits into it...but not myself?! I do resent the diagnosis...lol...By saying this..do I have BPD? Sincerely, Macalan

  5. To Macalan,
    First of all, a "family doctor" is unable to make such a diagnosis with one session. The defining traits of borderlines are extreme anger, extreme mood swings (not lasting more than a few hours) and extremely unstable relationships (in all aspects) Also, medication is NOT recommended for Borderlines as their defining trait is anger not depression. Definitely get a new doctor, they have no right to say that to someone without doing a thorough evaluation such as using the five-factor model for diagnosing.



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