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Grace E. Wasson

Prof. Cassel

English 1201

6 May 2021

Research Essay

Many people believe that borderline personality disorder and bipolar disorder are put the

same category, even some doctors identify borderline personality disorder as a part the spectrum

of bipolar disorder due to them being both mood disorders. Bipolar disorder is a mood disorder

that makes an individual experience manic and depressive episodes, as well as changes in

thinking, how the person acts, energy level, and sleep schedule. Borderline personality disorder

is a mood disorder that impacts the way that someone feels about themselves, how they react to

others, and what leads their actions. Mood disorders such as these can make a person reach 15%-

19% more likely to commit suicide. This is the main reason these disorders should not be

grouped together because some things from one disorder can severely affect someone with a

different disorder if wrongfully diagnosed. Bipolar disorder and borderline personality disorder

should remain their own separate disorders because they show different symptoms, they affect

the individual differently, and the treatment is vastly different from the other disorder.

Bipolar disorder has been around for thousands of years. It has been discovered even in

ancient Egyptian papyruses. In Kostas Fountoulakis’ book: “Bipolar Disorder: An Evidence-

Based Guide to Manic Depression.” it talks about the originality of bipolar disorder and how it

was originally discovered in 3000BC in ancient Egypt. It even talks about how they saw bipolar

disorder as a heart disease rather than something the brain causes. This shows that the disorder
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has been around for an extremely long time, yet doctors are still learning more about it. The

disorder was originally called manic depression due to those being the prominent symptoms of

the disorder. Borderline personality disorder has a bit of a history as well. Kristalyn Salters-

Pedneault does a wonderful job at explaining the history of this disorder in her article, "History

of the Term ‘Borderline’ in Borderline Personality Disorder.”. In the article, it discusses what the

original symptoms were and how borderline was more referred to when talking about

schizophrenia. The article talks about how borderline personality disorder was finally announced

as a disorder in 1980, as well as prominent symptoms that still appear for those with the disorder

today.

Another thing to know prior to getting into the differences between borderline personality

disorder and bipolar disorder, it would be a good to factor in the distinct types of bipolar

disorder. The different types that are currently known are bipolar I, bipolar II, and cyclothymic

disorder. Bipolar I disorder causes an individual to have extreme highs to the point where the

individual may need to seek medical attention, and extreme downs that can happen from a

minimum of 2 weeks. Bipolar II disorder has unpredictable highs and lows, but not to the extent

as bipolar I disorder. In the rarer of the three, cyclothymic disorder, an individual has periods of

highs and lows. Although not to the extreme compared to the other types, individuals with this

disorder can have episodes lasting at an average time of a year. These types all play a role in

things like what symptoms show, how a person acts, and how it can be treated. The chart below

shows an idea of what the types of bipolar disorder look like compared to each other.
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Bipolar disorder can make a person go to extreme levels of emotions when they enter an

episode. In manic episodes, people with the disorder are more likely to participate in risky

behavior. Things like reckless driving, gambling, less sleep, and becoming more impulsive.

People with bipolar disorder also deal with depressive episodes, which make the individual have

less energy and motivation. They get feelings of worthlessness, not being able to concentrate, not

enjoying what they once did, and sometimes even getting to the point of thinking about suicide.

On the outside, borderline personality disorder may look similar to bipolar disorder, but these

disorders are quite different. People with borderline personality disorder have symptoms like fear

of abandonment to extremes, periods of paranoia based on stress, fast changes in self-image,

intense unstable relationships, participating in risky behavior such as gambling, wide mood

swings, and even suicidal thoughts. Rather than just having mood swings between highs and
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lows, this disorder makes the individual feel more lows; a mix between sadness, irritability, and

anger if you will. These two disorders should remain different because of how different the

symptoms are. There is some brief history of the two disorders, now let’s get into some

differences between the disorders that prove that they should remain separate.

With these different symptoms each person with different disorders, it makes them act

completely differently. With bipolar disorder, some things like stress can trigger someone into

going into an episode. A bipolar person in a depressive episode could not feel motivated to do

the work that you are obligated to do. Some people can sleep for days when a depressive episode

happens. When someone goes into a mania, they would do some outrageous things during that

episode. My aunt talked about her manias, saying “Initially, I had a lot of insomnia, so I would

often just leave the house and go for a walk on the court or around the bigger block.... except it

was usually at 3 in the morning.” (Wasson 1). She talks about how if she were in a normal space

in mind, she would have realized that this was dangerous. This can be seen with many other

cases in mania in other people as well. The way that someone with bipolar disorder also depends

on what type of the disorder they have. Someone who has bipolar I disorder can act way worse

during manic states of mind than someone who has a different type. Borderline personality

disorder on the other hand, symptoms can make individuals act in ways that some deem “self-

destructive". Due to the rapid emotions these people feel, they may lean onto drugs or alcohol.

Another thing that can be seen as common is self-harm. Due to the sort of anger and emptiness

some people with borderline personality disorder have, they feel they need to do drastic things

like abuse substances, self-harm, or have unhealthy attachments with people in their lives. For

example, during the 2012 YouTube documentary “Back from the Edge”, one woman says, “You

know when I was sending letter of blood to people, written in blood, one could say that was a tad
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manipulative. One the other hand, you could just as easily say I had no clue about what I was

doing.” (New York - Presbyterian Hospital 10:57-11:11). What this is saying is an individual

cannot control their actions during this period of uncontrolled emotion, just as must as someone

with bipolar disorder who goes into an episode. This shows that although it seems like something

manipulative, the woman argues that she does not think of that moment and lets her emotions

control her actions temporarily.

Treatment for the two disorders can vary. Bipolar disorder typically requires medication,

especially in more severe types like type 1. The types of medication vary depending on the

individuals' symptoms. The types of medication typically are mood stabilizers, antidepressants,

anti-anxiety medication, antipsychotic medication, sleep medicines, or even antidepressant-

antipsychotic medication. In the email interaction mentioned previously in the essay, Melissa

talks about medication saying, “A person finds a medication that works for them, and it stays that

way for a long set of years. I have a friend who has been on the same medication for about 18

years... it still works for him.” (Wasson 1). She purposely says “set of years” rather than saying

“for the rest of their life”, this is because your body and mind changes as you age, your

medication will have to change eventually as well. Borderline personality disorder on the other

hand typically is treated through psychotherapy, although can be treated by medication if

requested to so by medical professional. Because individuals who have borderline personality

disorder experience mood swings based on things that happen in their environment, it may be

better for those to go through psychotherapy. Their mood swings aren’t caused by the brain as

much as they are bipolar disorder. If a patient gets misdiagnosed as the other disorder, this may

become dangerous for the individual. Although these symptoms are similar, both disorders also

have more symptoms that can be very different. For example, an episode for someone who has
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bipolar disorder can last from days at a time to months at a time. Episodes for those with

borderline personality disorder last between hours to days at a time. Although borderline

personality disorder doesn’t require medication, some medication like antidepressants can help

with some of the symptoms. As mentioned previously, the symptoms for these disorders are very

different besides the previously stated from the article. Sudden depression or mood swings are

what define these disorders as mood disorders. Another thing mentioned in the previous

paragraph is treatment. Treatment is very different for the two disorders, and it can become

dangerous if they are misdiagnosed or given the wrong type of treatment.

Although some medical professionals believe that borderline personality disorder and

bipolar disorder should be under the bipolar spectrum, many others disagree with this because of

how different the disorders really are. In WebMD’s article “What is Bipolar Spectrum?”, it talks

about overlapping symptoms that certain mood disorders have that would match bipolar disorder

symptoms. The article talks about how the bipolar disorder can share main symptoms with other

disorders. This is the case for bipolar disorder and borderline personality disorder. This statement

mentions that bipolar disorder and borderline personality disorder have some symptoms in

common, such as impulsivity, prolonged irritability, high energy, or depression with sudden

mood swings.

In conclusion, bipolar disorder and borderline personality disorder are their own disorders

and should remain as such. Although these disorders both have similar standing out symptoms,

classifying them as mood disorders, borderline personality disorder should not be on the bipolar

spectrum. This should be the case because they have different symptoms, they affect the

individual very differently, and the treatment for each disorder is unique. I was recently

diagnosed with bipolar disorder and am finally getting treated for that. This has caused me a lot
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of annoyances in the few months, but this essay allowed me to investigate something I have. I

was able to find more out about the disorder, as it allowed me to realize I do have this specific

disorder. In a way, it allowed me to explore myself.

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Works Cited

Bhargava, Hasna. “Bipolar Disorder.” WebMD, 16 Jun. 2020. https://www.webmd.com/bipolar-

disorder/mental-health-bipolar-disorder. Accessed 4 May 2021.

Bhandari, Smitha. “What Is the Bipolar Spectrum?” WebMD, 11 Jun. 2019.

https://www.webmd.com/bipolar-disorder/guide/bipolar-spectrum-categories#2-4.

Accessed 4 May 2021.

Borda, Juan. “Self over time: another difference between borderline personality disorder and

bipolar disorder.” Journal of Evaluation in Clinical Practice, 3 May 2016.

https://pubmed.ncbi.nlm.nih.gov/27144989/. Accessed 5 May 2021.

Fountoulakis, Kostas N. Bipolar Disorder: An Evidence-Based Guide to Manic Depression.

Springer, 2015.

Hansson, C, et al. “Risk factors for suicide in bipolar disorder: a cohort study of 12 850

patients.” Acta Psychiatrica Scandinavica, 3 Aug. 2018.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/acps.12946. Accessed 1 May

2021.

Isometsä, Errki. “Suicidal Behavior in Mood Disorders- Who, When, and Why?” National

Institute of Health, Mar. 2014.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC407239/#:~:text=Lifetime%

20Risk%20of%20Suicide%20in,of%20patients%20die%20by%20suicide.

Accessed 5 May 2021.

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NewYork-Presbyterian Hospital. "Back From the Edge" - Borderline Personality Disorder -

Call us: 888-694-2273. YouTube, 2 Feb. 2012, https://youtu.be/967Ckat7f98. Accessed 5 May

2021.

Only Human. Bipolar: Flying & Crashing (Mental Health Documentary) | Only Human |.

YouTube, 9 Dec. 2016, https://youtu.be/EgKCFe9H16U. Accessed 4 May 2021.

Salters-Pedneault, Kristalyn. “History of the Term ‘Borderline’ in Borderline Personality

Disorder.” verywellmind, 10 Apr. 2020. https://www.verywellmind.com/borderline-

personality-disorder-meaning-425191. Accessed 5 May 2021.

Scaini, Giselli, et al. “Neurobiology of bipolar disorders: a review of genetic components,

signaling pathways, biochemical changes, and neuroimaging findings:” Brazilian

Journal of Psychiatry, 3 Apr. 2020.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524405/. Accessed 1 May 2021.

Wasson, Melissa. “Grace’s Interview.” Received by Grace Wasson, 5 May 2021.

The email interaction I had with my aunt is the opinion piece I used for my essay. I

contacted my aunt with questions talking about bipolar disorder and what it is like living with the

disorder, because that was my original question after all. I mainly asked her because I knew I

obviously couldn’t use myself as a reference for the essay, so I went with the next best thing. I’m

glad that I had her response I could refer to. It gave me an idea as to what life is like for someone

with the disorder. In the email, it discussed things from her specific situation like when she was

officially diagnosed, her initial and more current symptoms, the general stigma of getting

diagnosed at the time, coping with the disorder, and how life was different for her compared to
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everyone else. I was diagnosed with the disorder not too long ago. Looking back, I can see

certain periods of my life where I had certain episodes, but it is harder to pick out my manias.

Having someone else talk about this sort of thing really helped me. In the end, I am very grateful

that my aunt allowed me to interview her for this sort of thing.