James Donaldson on Mental Health - BPD vs Bipolar: Why They Are Often Confused

How risk-taking differs in bipolar disorder and BPD Both disorders can involve impulsive or risky behavior, which is why parents often struggle to tell them apart.

But the motivations behind the behavior are different.

“Often these symptoms in BPD are used to regulate how they feel,” Dr.

“A teen might think, ‘I don’t feel attractive or lovable, so I’ll sleep around to change how I feel.’” In mania, however, risk-taking stems from elevated mood and grandiosity.

“It’s not to change anything,” he says.

“It’s because they already feel great.” Understanding the purpose behind a behavior helps clinicians distinguish the two disorders.

Misdiagnosis and its impact Misdiagnosis is common , particularly when teens with BPD are labeled as having bipolar disorder.

“They come to us on a lot of medications,” Dr.

“They’ll say, ‘These medications aren’t helping me.’ And they often feel worse because the side effects, like weight gain, add to their unstable sense of self.” When teens learn about DBT, many of them look up what DBT is and see that it is a treatment for BPD.

“Then they look up borderline personality disorder and say, ‘This actually makes more sense than bipolar to me,’” he says.