Bipolar personality disorder

There is no such thing as bipolar personality disorder.

(And NO, this not one of those anti-psychiatry sites!)

Please look around the website. You will see we take bipolar disorder very seriously, are emphatic about complying with bipolar medications, and specialize in following the latest research on bipolar disorder.

So what do I mean by “no such thing”?

I mean that bipolar disorder is NOT a personality disorder and that “bipolar personality disorder” is an expression that shows a fundamental, very flawed misunderstanding of both “bipolar” and “personality.”

REPEAT: Bipolar disorder is NOT a personality disorder.¹

Bipolar (manic-depressive illness) is an episodic mood disorder.

It is characterized by abnormally high moods (mania) and in some cases, abnormally low moods (depression).

It is because of this cycling that bipolar disorder was previously known as manic-depressive illness.

One of the core features of bipolar disorder is that it is an EPISODIC illness, meaning that symptoms occur during discrete periods of time.

Reminder

Bipolar disorder is a mood disorder – NOT a personality disorder.

This means that in between episodes of mania and depression, someone may experience periods of wellness where their moods are level.

Personality does not come and go – it is far more stable.

According to the Diagnostic and Statistical Manual of Mental Disorder (DSM-5) by the American Psychiatric Association, personality traits are “ENDURING
patterns of perceiving, relating to, and thinking about the environment and oneself . .”

So combining “bipolar” and “personality” makes no sense.

(It irritates me almost as much as the weird misspelling where “bi-polar” is hyphenated, but that is another story.)

Personality disorders are a class of mental disorders characterized by long-lasting rigid and dysfunctional patterns of thought and actions. This is a stark contrast to the episodic nature of bipolar disorder.

Further, bipolar usually does not develop until late teens/early twenties whereas personality begins to develop much earlier in life.

So why do so many people make such a basic mistake?²

How did this oxymoronic phrase “bipolar personality” get so much traction?

It seems to me there are three main reasons:

1. Popular culture has latched on to “bipolar” as an adjective with a perjorative, but not necessarily a clinical, meaning. Anyone we consider obnoxious, especially if they display passion, energy, or eccentricity is classified as “bipolar”.

2. Laziness/Vagueness/Half-knowledge: We know bipolar is a mental health issue. We know “personality disorder” is mental health terminology. So they must go together, right?

3. Misdiagnosis: Research has shown the MOST COMMON misdiagnosis of bipolar disorder is to diagnose someone with bipolar when they really have Borderline Personality Disorder. In other words, that person who is telling you they have bipolar disorder has been MISDIAGNOSED and REALLY DOES HAVE A PERSONALITY DISORDER!

The notion of bipolar personality disorder has traction because of the confusion between Bipolar Disorder and Borderline Personality Disorder.

Bipolar vs Borderline Personality

According to the Mayo Clinic:

“Borderline personality disorder (BPD) is an emotional disorder that causes emotional instability, leading to stress and other problems. With borderline personality disorder your image of yourself is distorted, making you feel worthless and fundamentally flawed. Your anger, impulsivity and frequent mood swings may push others away, even though you desire loving relationships.”So from this it seems there is strong common denominator – MOOD SWINGS.

BUT – bipolar mood swings ARE DIFFERENT from borderline personality mood swings!

However, even though it may sometimes be difficult to distinguish bipolar disorder from borderline personality disorder, results from a long-term study indicate that borderline personality disorder and bipolar do NOT commonly coexist.

Relationship Between Borderline Personality Disorder And Bipolar Disorder, Long-Term Study explains this clearly. Further, it makes the real point. The confusion between the two conditions is dangerous and problematic because treatment requirements are so different.

Bipolar treatments are still focused very much on mood stabilizing medications. However, as yet there is no medication that is proven to alleviate borderline personality disorder. Instead, psychosocial interventions and “talk therapy” must be used.

This raises the worrisome risk of people with bipolar disorder not getting critical medication which their lives may depend on, and people with borderline personality disorder being prescribed powerful drugs with serious side effects that will not in any way help them with their problems.

Confusion about so called “bipolar personality disorder” is not just sloppy thinking and expression – it is a dangerous misunderstanding.

¹https://www.nami.org/Blogs/NAMI-Blog/June-2017/Borderline-Personality-Disorder-and-Bipolar-Disord
²https://www.psychiatrictimes.com/bipolar-disorder/borderline-or-bipolar-can-3-questions-differentiate-them

Some comments by Carolina Estevez, Psy.D.

Bipolar Disorder is a chronic illness that people will likely struggle with for most of their lives. As a result of the chronicity of the disorder and the impact it has on overall functioning, people will likely develop certain personality traits or characteristics as a result of coping with this disorder. There is no specific Bipolar personality, but let me explain this concept using an entirely different chronic health problem: Diabetes.

People who have diabetes will likely develop certain personality characteristics as a result of struggling with the illness. They may avoid certain intimate social gatherings due to having to go to the restroom or other private setting to inject insulin or check their blood glucose, away from onlookers. These individuals may also become panicked if they forget their medication or glucose meter at home when they go out or may have disrupted sleep because they get dangerous hypoglycemia at night. The point is that the factors that a diabetic person must cope with throughout their lives will inevitably impact their personality. They may be irritable with others as a result of these stressors or may develop a negative overall coping style. The same applies for people with Bipolar Disorder. Although personality represent ‘fixed’ characteristics, our experiences throughout the lifespan will affect and change our ‘way of being and interacting in our environment,’ in other words, our personality.

Regardless of how Bipolar Disorder impacts people’s personality, it is still critical for it to be differentiated from Borderline Personality Disorder (BPD). The two disorders require entirely different treatment approaches. Specifically, people with BPD often respond well to certain antidepressants, which is certainly not the case for people with Bipolar I Disorder. Another important differentiation is that people with BPD demonstrate severe dysfunction in interpersonal relationships. Although people with Bipolar Disorder will struggle with relationships due to the effects of the illness and inevitably during episodes of mania, hypomania, or depression, relationship deficits are not a central feature of the disorder. An experienced clinician can assess symptoms and easily differentiate between the two disorders.

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Bipolar personality disorder

TABLE OF CONTENTS

There is no such thing as bipolar personality disorder.

Reminder

Bipolar vs Borderline Personality

Some comments by Carolina Estevez, Psy.D.

Join the Bipolar Community !

Bipolar personality disorder

TABLE OF CONTENTS

There is no such thing as bipolar personality disorder.

Reminder

Bipolar vs Borderline Personality

Some comments by Carolina Estevez, Psy.D.

Join the Bipolar Community !

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