Clinical Differentiation of Bipolar II Disorder From Borderline Personality Disorder

Adam Bayes; Gordon Parker; Kathryn Fletcher


Curr Opin Psychiatry. 2014;27(1):14-20. 

In This Article

Self-identity and Relationships

Differences in self-identity are observed in both conditions. Those with BPD generally experience a disruption to their sense of self[5] with core elements including 'painful incoherence' (i.e. emotional pain related to a fragmented sense of self) and 'role absorption' (i.e. loss of identity).[31] By contrast, those with BP II tend to experience self-deficits only when depressed and a grandiose self when hypomanic, with stability of self-identity when euthymic.[33]

Assessment of the individual's capacity to have meaningful relationships can assist diagnostic clarification.[9] A tendency towards idealization and devaluation, as well as severe abandonment fears is suggestive of BPD.[71,72] Those with BPD experience severe and ongoing discrepancies in their assessment of self and others, have ongoing interpersonal conflicts and evidence immaturity in their views of others.[9] By contrast, when euthymic, those with bipolar are unlikely to show pathological relationships and tend to maintain stable relationships.[9]