Bordering on bipolar: the overlap between borderline personality and bipolarity

Area of Science:

• Psychiatry
• Neuroscience
• Psychology

Background:

• Borderline personality disorder (BPD) and bipolar disorder (BD) share overlapping symptoms, leading to diagnostic challenges.
• Emotional dysregulation and impulsivity are core features in both BD and BPD, often making differentiation difficult.

Purpose of the Study:

• To investigate potential differentiating factors between BPD and BD.
• To explore the distinct manifestations and etiological underpinnings of emotional dysregulation and impulsivity in BPD and BD.

Main Methods:

• A literature search was conducted using MEDLINE and PubMed.
• Studies examining emotional dysregulation, impulsivity, childhood trauma, and neurobiological substrates in BD and BPD were identified.

Main Results:

• Limited research exists comparing BD and BPD using self-report measures, and no studies have examined their neurobiological underpinnings concurrently.
• Childhood trauma emerges as a potential differentiating variable, influencing the expression and course of both disorders, particularly in rapid cycling BD.

Conclusions:

• An integrated approach considering behavioral, etiological, and neurobiological factors is proposed for investigating the relationship between BPD and the bipolar spectrum.
• Childhood trauma plays a significant role in modulating the clinical presentation of bipolar illness, potentially distinguishing it from BPD.