BPD and bipolar disorders

The co-occurring diagnosis of BPD and bipolar disorder is not unusual since many of the symptoms for both disorders present in similar ways.

Common traits of BPD and bipolar disorders include:

  • Suicidal thoughts or actions
  • Episodes of impulsive, self-destructive behavior (risky sex, reckless driving, or compulsive shopping)
  • Depression and self-hatred
  • Irritability and angry outbursts
  • Unstable personal relationships
  • Substance abuse
  • Feelings of emptiness or worthlessness

Those with comorbid bipolar disorder II and BPD demonstrate a compounding effect, in particular for emotion regulation deficit, impulsivity and difficulty for goal-directed behaviours more so than having BP or BPD singly. This is clinically important, as this may mean there is a greater risk for self-harm or suicidal behaviours.

Recommended treatment for comorbid bipolar disorders and BPD is to adopt a multi-tiered model that involves treating the bipolar disorder with mood stabiliser to optimise state-related emotion regulation deficits and then making a long-term commitment to address the emotion regulation deficits contributed by the BPD and the bipolar disorder trait domain by engaging in evidence-based psychotherapies. It is important that there is a right balance in order for for effective treatment to manage stress and control symptoms of both conditions.

For more information

BPD Treatment – Living with BPD and Bipolar: What to do

Healthy Place – Bipolar disorder and comorbid BPD

Current Psychiatry – Borderline, bipolar or both? Frame your diagnosis on the patient history


Emotional dysregulation in those with bipolar disorder, borderline personality disorder and their comorbid expression.

OTTO KERNBERG – BPD and how it’s different from a mood disorder

To see more interview footage of BPD and related disorders see Borderliner Notes.