Should borderline personality disorder be placed on the bipolar spectrum?

Abstract

Bipolar disorder (BD) is a mood disorder characterized by changes in activity levels, mood, and energy. These categories can range from elation during manic episodes to depression during depressive episodes. BD affects 2-3% of the population. Borderline personality disorder (BPD) is the diagnostic label assigned to individuals who struggle with unstable personal relationships, hypersensitivity to rejection, or an unstable self-image. 1.6% of the general population has this disorder and 20 percent of those in the psychiatric population have BD. Given that BD and BPD share features, such as rapid mood swings, impulsive actions, and suicidal behavior it is sometimes difficult for practitioners to readily and accurately differentiate between these two disorders. These issues with diagnosis have led to the idea BPD should belong on the spectrum of bipolar disorders. The current paper compares the disorders, including their clinical presentation and symptoms, the effect of genetic and environmental factors on the development of these disorders, and treatments for each disorder. The aforementioned topics represent factors underlying the resolution to the question of whether BPD belongs on the bipolar spectrum. Answering this question would allow researchers and clinicians to better understand the relationship between these disorders and the best treatments for BPD and BD.