Can You Have Bipolar and BPD at the Same Time?

Living with a mood disorder can be overwhelming. For some people, that experience may include both bipolar disorder and borderline personality disorder (BPD). The combination, called a dual diagnosis, adds layers of emotional, behavioral, and psychiatric challenges.

Understanding how these two mental disorders interact is key to getting the right mental health treatment and support.

What Is Bipolar Disorder?

Bipolar disorder is a mood disorder defined by shifts in mood, energy, and behavior. It includes episodes of mania, hypomania, and depression.

There are different types: bipolar I disorder, bipolar II disorder, and cyclothymia. Each type varies by frequency, intensity, and type of episode.

Bipolar I vs. Bipolar II vs. Cyclothymia

Bipolar I disorder includes full-blown mania that can lead to psychosis, racing thoughts, or hospitalization. Bipolar II disorder involves hypomania and major depressive episodes but no full mania.

Cyclothymia is a milder form of bipolar with frequent mood swings that don’t meet full criteria for mania or depression. These cycles still cause distress and impair daily health and function.

What Is Borderline Personality Disorder?

Borderline personality disorder is a personality disorder marked by instability in mood, self-image, interpersonal relationships, and impulse control.

People with BPD often struggle with chronic feelings of emptiness, fear of abandonment, impulsivity, suicidal ideation, and emotional reactivity.

Emotional Dysregulation in BPD

BPD causes intense shifts in feeling within hours or even minutes. Sadness can turn to anger, guilt, or shame rapidly.

These mood changes are typically triggered by relationship stress or identity crises, unlike bipolar disorder, which features longer mood episodes not always tied to life events.

So Can You Have Bipolar and BPD at the Same Time?

Yes, you can have both bipolar disorder and borderline personality disorder. This condition is known as comorbidity or dual diagnosis.

Studies show that many patients with bipolar—especially bipolar II disorder—also meet diagnostic criteria for BPD.

Comorbidity Statistics and Prevalence

According to the American Psychiatric Association, about 10–20% of people diagnosed with bipolar disorder also have BPD.

This overlap creates complications in diagnosis, management, and therapy. A careful psychiatric evaluation is essential to identify both conditions accurately.

Shared Symptoms and Confusion

Both disorders involve mood instability, impulsivity, emotional distress, and relationship dysfunction. However, they differ in how symptoms appear and persist over time.

In bipolar disorder, mood episodes (mania, hypomania, or depression) can last days or weeks. In BPD, mood shifts may occur multiple times in a single day.

Key Symptom Differences

Diagnosis and Psychological Evaluation

Accurate diagnosis requires structured assessment by a qualified mental health professional or clinician.

This includes reviewing the patient’s medical history, behavior, family dynamics, substance use patterns, and emotional responses.

Diagnostic Tools and Considerations

Clinicians use psychological evaluation forms and insight assessments to separate bipolar features from BPD traits.

For example, mania often includes reduced sleep, high energy, and pressured speech. BPD mood shifts usually include intense fear, shame, and feelings of mental distress.

Patients may also present symptoms overlapping with major depressive disorder, panic disorder, or anxiety disorder, requiring detailed screening.

Risk Factors and Causes

The development of bipolar disorder or BPD may involve genetic predisposition, trauma, and brain-based temperament.

Exposure to neglect, sexual abuse, emotional invalidation, or early loss can increase the risk of both disorders.

Trauma and Temperament

Many people with BPD have a history of childhood trauma, emotional abuse, or unpredictable caregiving. Temperament and attachment patterns shape personality and behavior.

In contrast, bipolar disorder is more strongly linked to biological factors like brain structure and neurotransmitter imbalance.

Genetics plays a role in both conditions. Family history of schizophrenia, major depressive disorder, or other mood disorders can increase susceptibility.

Substance Abuse and Dual Diagnosis

Substance abuse is common in both conditions and often masks psychiatric symptoms. Alcohol, stimulants, or sedatives may be used to self-medicate depression or anxiety.

However, substance abuse worsens instability, impulsivity, and suicidal ideation. It increases the risk of relapse and interferes with sleep, mood, and energy regulation.

Common Substances Involved

Drugs such as benzodiazepines, cannabis, and cocaine may disrupt emotional regulation. These substances can also trigger psychosis in vulnerable individuals.

Managing addiction is vital to treating dual diagnosis cases. Substance use must be addressed alongside psychiatric symptoms.

Mental Health Treatment for Bipolar and BPD

Treatment for bipolar disorder and BPD requires a multifaceted approach. A mental health professional may use medication, therapy, lifestyle changes, and psychiatric monitoring.

Treatments should focus on emotional regulation, mood stabilization, and impulse control.

Mood Stabilizers, Antipsychotics, and More

Mood stabilizers like lithium help manage mania and depression in bipolar patients. Antipsychotic medication may be used for episodes of psychosis, paranoia, or severe agitation.

Patients with both diagnoses may also be prescribed antidepressants cautiously, under supervision of a doctor of medicine or psychiatrist.

Some patients may require electroconvulsive therapy (ECT) during severe depressive episodes or when medication fails to relieve symptoms.

Dialectical Behavior Therapy (DBT)

DBT is a proven therapy for BPD. It helps patients build distress tolerance, improve emotional insight, and reduce suicidal behaviors.

DBT also improves social skills, coping ability, and emotional resilience. It’s often used alongside medication for bipolar disorder.

Therapy helps patients process trauma, improve interpersonal relationship patterns, and build identity stability.

Stress Management and Lifestyle Changes

Managing sleep, nutrition, and physical activity supports brain function and mood stability. Sleep deprivation can trigger both mania and BPD episodes.

Stress management is key. Patients may use mindfulness, structured routines, and behavior tracking to reduce emotional reactivity and avoid relapse.

Role of Caregivers and Support Systems

Support from caregivers, family members, and community groups reduces loneliness and fear. Education about both conditions helps others respond with understanding.

Peer support groups can also reduce shame and promote self-awareness and identity rebuilding.

Daily Coping Strategies

Daily strategies such as journaling, mindfulness, and tracking moods help improve emotional regulation. Patients benefit from setting healthy boundaries and monitoring triggers.

Regular follow-ups with a health professional help reinforce progress and reduce relapse frequency.

Suicide Prevention and Emergency Support

Individuals with both bipolar and BPD have higher rates of suicidal ideation and behavior. Emergency support and psychiatric stabilization may be needed during a mental health crisis.

Suicide prevention includes regular check-ins, 24/7 crisis access, and therapy that targets emotion regulation.

When to Seek Emergency Help

Signs like severe insomnia, racing thoughts, dissociation, euphoria, panic disorder symptoms, or psychosis indicate immediate need for psychiatric intervention.

If a patient is experiencing suicidal thoughts or planning self-harm, call emergency services or go to a hospital right away.

Long-Term Management and Monitoring

Managing comorbid bipolar disorder and BPD is a long-term commitment. Ongoing therapy, medication adherence, and self-monitoring are essential.

Patients often work with multiple specialists in psychiatry, psychology, and primary care to monitor treatment success.

Recovery Outlook and Progress

Recovery is possible with consistent care. Patients learn to identify emotional triggers, prevent relapse, and build healthier relationships.

Mental health professionals use structured tools to evaluate functioning across domains including sleep, interpersonal skills, nutrition, and stress levels.

Insurance often covers dual diagnosis treatment including therapy, psychiatry, and medication. Regular appointments help track mood changes, energy levels, and behavioral shifts.

Why Choose Revival Mental Health

Revival Mental Health provides dual diagnosis care for individuals with bipolar disorder, borderline personality disorder, and substance abuse issues.

Our programs combine psychiatric evaluation, therapy like DBT, medication support, and emotional regulation training. Patients receive care from licensed health professionals who specialize in mood and personality disorders.

We support adult patients experiencing mental distress, identity struggles, or suicidal ideation. Treatment focuses on long-term mental health improvement and relapse prevention.

Revival Mental Health also offers support for co-occurring conditions like anxiety disorder, major depressive disorder, postpartum depression, and addiction.

Our clinicians and physicians build personalized mental health treatment plans to address the whole patient—not just their diagnosis.