Understanding BPD and Bipolar Disorder in Teens
What Is Borderline Personality Disorder (BPD) in Teens?
BPD is a mental health condition that causes a deep fear of abandonment, self-harm, and severe mood swings.
Often diagnosed between the ages of 14 and 16, BPD is complicated as the symptoms overlap with some normal teen behavior, such as mood swings.
However, teens struggling with BPD experience symptoms that are significantly more severe than ordinary teen challenges. For example, teens with BPD commonly make frantic efforts to avoid rejection, experience inappropriate anger, and have an unstable self-image.
What Is Bipolar Disorder in Teens?
Bipolar disorder is a mental health disorder that causes a teen to fluctuate between lasting depressive episodes and manic episodes.
Commonly, bipolar disorder, also called manic depressive disorder, causes adolescents to experience mood swings between manic highs, euphoria, and extremely high energy, and depressive lows, persistent sadness, and low energy.
The type of bipolar disorder a teen is struggling with may also affect their mood. For example, teens with bipolar II will experience hypomania, which is less intense than mania experienced in bipolar I.
While teens commonly experience mood shifts, bipolar disorder in teens is distinguished by these mood fluctuations being more extreme.
Why Are BPD and Bipolar Disorder Often Confused?
BPD and bipolar disorder are often confused, as they can both cause impulsive behaviors, mood swings, suicidal thoughts, and unstable relationships.
Both BPD and bipolar disorder in adolescence have some overlap with normal teen behavior. Still, they are more extreme versions of these behaviors that do not resolve over time and require treatment. As a result, they are both seen as mental health disorders that look like an amplification of normal behavior.
However, these mental health conditions are treated differently. The distinction is important for caregivers and mental health professionals to provide the most effective treatment for a teen.
Key Differences Between BPD and Bipolar Disorder
How Do Mood Swings Differ in BPD vs. Bipolar Disorder?
Mood swings in BPD change rapidly and are tied to an unstable sense of self, while mood swings in bipolar disorder last longer.
In BPD, mood swings occur throughout the day, and a teen’s mood can shift in hours or days. Additionally, they are commonly triggered by stress, most commonly surrounding rejection or abandonment.
Teens with bipolar disorder also experience mood swings. However, their manic or depressive states tend to last longer, shifting after weeks or months of a certain mood.
How Do Triggers and Patterns Help Distinguish the Two Conditions?
The triggers and patterns in mood changes are important aspects of diagnosing BPD and bipolar disorder in teens, as they help to differentiate the two mental health disorders.
Common triggers in BPD include rejection, criticism, and changes in routine. In addition, patterns of mood changes occur as a result of these triggers. They result in a teen experiencing rapid changes in their mood in hours or days.
However, teens with bipolar disorder are more likely to be triggered by sleep disruption, high stress, and seasonal changes.
How Do Teens Experience Emotional Regulation Differently With Each Condition?
Teens with BPD experience significant emotional dysregulation, making emotional regulation significantly more difficult, while teens with bipolar disorder experience longer episodes, making them less emotionally reactive to external changes.
BPD causes teens to be highly reactive to their environment, making it very difficult for them to regulate their emotions. They experience distinct and significant shifts in mood, making emotional regulation challenging on a daily basis.
Teens with bipolar disorder experience slow changes in their symptoms, and their mood changes slowly as their mood episode shifts. Therefore, their experiences differ in challenges with emotional regulation depending on their current state. Manic episodes cause more impulsivity, making it more difficult to regulate their emotions.
Symptoms That Overlap — and Symptoms That Don’t
Which Symptoms Are Common in Both Conditions?
Common symptoms in both BPD and bipolar disorder include impulsivity, self-harm, suicidal behavior, and challenges with interpersonal relationships.
While these symptoms vary for each individual teen, the existence of overlapping symptoms makes diagnosis more challenging.
What Symptoms Are More Specific to BPD?
Symptoms that are more specific to BPD include an intense fear of abandonment, an unstable self-image, and intense feelings of emptiness.
The symptoms that are more specific to BPD are centered around a teen’s sense of self. They are constantly and frantically seeking to avoid being abandoned and to hold onto their self-image.
What Symptoms Are More Specific to Bipolar Disorder?
Bipolar disorder is distinctive in the presence of prolonged mania or hypomania.
Adolescents with bipolar disorder experience periods of time where they have extremely high energy levels. This is followed by prolonged periods of low energy levels. Mania is a sustained high-energy mood, where a person feels exuberance and excitement.
What Causes BPD vs. Bipolar Disorder in Teens?
How Does Family History Influence Each Condition?
A family history of either BPD or bipolar disorder greatly increases a teen’s likelihood of developing the mental illness.
How Do Environmental or Emotional Stressors Play a Role?
Environmental factors such as childhood trauma or an unstable home life increase the risk of both BPD and bipolar disorder.
These factors, combined with a genetic predisposition, greatly increase the risk of BPD and bipolar disorder. BPD is more closely linked to trauma related to abandonment and relational trauma, while bipolar disorder is more likely to be triggered by highly stressful events.
Can ADHD, Anxiety, or Substance Use Make Diagnosis More Complicated?
Both ADHD and anxiety, as well as substance use, make a diagnosis more complex, as more factors are impacting a person’s mood and energy levels.
ADHD has overlapping symptoms, such as impulsivity and emotional regulation. Anxiety disorders impact mood and are also associated with impulsivity and emotional regulation. Substance use has a significant impact on mood and mental functioning, which can hide or exacerbate symptoms of mental illness.
How BPD and Bipolar Disorder Affect Daily Life
How Do Mood Shifts Impact School, Friends, and Activities?
The rapid shifts in mood found in BPD and the extended periods of high or low moods found in bipolar disorder make it more difficult for people with BPD and bipolar disorder to participate in everyday activities.
When a teen experiences a shift in their mood, their desire to engage and their ability to regulate their emotions will also change.
For people with BPD, this is a rapid shift, which makes it very difficult to participate in social activities and build relationships. Those with bipolar disorder struggle in a similar manner, as they are less likely to want to engage when they are in a depressive state.
How Do Teens Describe Their Emotional Experiences?
Teens describe their emotional experiences with BPD and bipolar disorder as being incredibly frustrating and difficult to manage.
Shifts in mood make daily life more difficult, and while a teen wants to build relationships, they commonly lack the tools to manage their impulsivity and mood in a manner that facilitates this.
How Can These Conditions Affect Family Relationships?
BPD and bipolar disorder are frustrating for both teens and their families, causing stress and distance in family relationships.
While a teen is struggling, their loved ones also face challenges as they strive to support their teen. However, without tools that help with communication, these relationships often suffer.
How Mental Health Professionals Diagnose the Difference
What Does an Accurate Diagnosis Involve?
An accurate diagnosis for BPD and bipolar disorder involves working with a mental health professional.
A mental health professional asks for detailed information on the teens’ and the family’s experience, gathers information regarding symptoms and patterns, asks about family history, and considers physical illnesses that may be creating or contributing to symptoms.
How Do Clinicians Distinguish Mood Episodes From Emotional Instability?
Clinicians separate mood episodes, found in bipolar disorder, from emotional instability, common in BPD, by considering the triggers, patterns of episodes, intensity, and duration.
Emotional instability differs in that the duration of a mood is caused by an environmental trigger, is very intense, and has a shorter duration.
Why Are Teens Sometimes Misdiagnosed?
Some teens are misdiagnosed because of the overlapping symptoms and normal teen hormone changes impacting symptoms.
Evidence-Based Treatment Options for Teens
What Treatments Help Teens With Bipolar Disorder?
A combination of psychotherapy and medication management helps teens with bipolar disorder manage their symptoms.
Medications like mood stabilizers, lithium, and antipsychotics are common in medication management. Psychotherapy, including cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), helps teens manage their moods and improve their well-being.
What Treatments Help Teens With BPD Traits (Emotional Dysregulation)?
Treatments that help teens with BPD include programs that focus on mood stabilization through psychotherapy, especially dialectical behavior therapy.
In dialectical behavior therapy, teens learn to stabilize their mood through emotional management, awareness, and improved distress tolerance.
What If a Teen Shows Symptoms of Both?
If a teen shows symptoms of both BPD and bipolar disorder, it is important for them to see a mental health professional.
While these two mood disorders have overlapping symptoms, effective treatment should be tailored to the mental illness present to be effective. Getting a diagnosis is only possible through a qualified mental health professional.
How Parents Can Support a Teen Showing Severe Mood Changes
What Warning Signs Should Parents Look For?
While teens commonly have mood swings, parents should look for extreme mood swings, combined with high impulsivity, irritability, and self-harm.
If the emotional instability or mood swings seem to go beyond normal teen behavior, it is time to seek help.
How Can You Talk to Your Teen About Their Emotions?
Discussing emotions with your teen is difficult and most effective if you approach the conversation with open curiosity and support.
When talking to your teen, try asking questions. Look to understand their behavior and experience, and ask them about what they need support with. Doing an activity can also help make the conversation more effective and help your teen open up about their emotions.
What Steps Can You Take If Your Teen Is at Risk of Self-Harm?
If your teen is at risk of self-harm, open up a safe space to talk, and set up a mental health team where they can find support.
Getting your teen’s support can look like opening up a safe space at home and building a healthcare team that helps you and your teen get the support you need.
How Mind Works Supports Teens With Complex Mood and Emotional Symptoms
How Mind Works Provides Accurate Diagnostic Assessments for Your Teen
Mind Works offers an in-depth assessment process that looks at the teen’s stated symptoms and reports from their family to understand the pattern of mood changes.
This in-depth information gained from the assessment allows Mind Works to accurately assess and diagnose a mood disorder.
Getting the correct diagnosis is vital to getting proper treatment. Mind Works supports teens with complex mood and emotional symptoms with a holistic approach that includes assessment, medication management, and therapy.
How Our Session-Based Therapy Helps Teens Build Emotional Regulation Skills
Session-based therapy helps teens learn new internal skills, such as identifying, understanding, and managing intense feelings as they arise.
Emotional regulation is a skill that all teens have to learn. However, teens with bipolar disorder or BPD have more difficulty due to the increase in impulsivity and lack of emotional control.
How Our Collaborative Care Model Supports Teens With Mood Instability
The Mind Works team helps teens with mood instability to better manage their emotions through medication management, assessment, and therapy.
In the collaborative care model, support is provided for both teens and parents as they learn skills that help them to increase their well-being and improve their mental health.
Frequently Asked Questions
Can a teen have both BPD traits and bipolar disorder?
Yes, a teen can have both BPD traits and bipolar disorder.
When a teen has both, more complex treatment is necessary, and the combination can amplify symptoms.
How long do mood swings last in each condition?
Mood swings of BPD are short and a reaction to a stimulus, while mood swings in bipolar disorder can last weeks or months.
Why are teens often misdiagnosed with one instead of the other?
Teens are often misdiagnosed because symptoms of BPD and bipolar disorder overlap.
In addition, symptoms of both can also overlap with other mental health disorders and normal hormonal changes in teens.
Can DBT and CBT help both conditions?
DBT and CBT help teens to be more aware of their internal landscape, manage emotions, and understand triggers for themselves.
While DBT and CBT differ, they both provide teens with the skills of awareness and emotional regulation. For teens who have mood swings, impulsivity, and a lack of emotional regulation, these skills are vital.
Should parents worry if their teen has racing thoughts or impulsive behavior?
It is normal for teens to have racing thoughts and impulsive behavior.
However, if they start to become problematic in their ability to function and/or fit a pattern of mental illness, then it is time for them to see a mental health professional.
How does Mind Works help families navigate confusing or overlapping symptoms?
Mind Works communicates and collaborates with the loved ones of teens to ensure they understand the process and how the symptoms they see in their teen fit into that specific diagnosis.
The team at Mind Works understands that family members are not experts in mental illness. Therefore, they aim to educate and provide guidance. With the help of mental health professionals, families learn to understand their teens’ symptoms and learn how they can support them in healing.
Having a teen who is struggling with their mental health is challenging. Parents may not know how to help their teen gain the skills they need to manage their mental health. Mind Works can help teens and their loved ones through a combination of assessment, medication management, and therapy. To learn more, reach out to the Mind Works team at (210) 366-3700.