Elyn R. Sakes, a professor at the University of Southern California Gould Law School, once said, “No one would ever say that someone with a broken arm or a broken leg is less than a whole person, but people say that or imply that all the time about people with mental illness.” And it’s true. There’s this negative stigma surrounding mental illness that people with mental illnesses are broken machines, never being able to function properly again. However, mental illness is just like any other debilitating illness. Diabetes. Cancer. Cystic fibrosis. The list goes on. And just like physical illnesses, there are a multitude of mental illnesses, each coming with its own package of symptoms and struggles. Two of the most common ones are bipolar disorder and borderline personality disorder.
To first understand what these disorders are, one must understand how mental illnesses work as a whole. What is mental illness? According to the National Alliance on Mental Illness, it is “a condition that impacts a person’s thinking, feeling, or mood and may affect their ability to relate to others and function on a daily basis.” It usually causes suffering and is not developmentally or socially normative. A wide range of conditions affect mood, thinking, and behavior. Each person will have different experiences, even those with the same diagnosis. Or the opposite could happen: some people may have similar experiences, even those with different diagnoses. This is the story of bipolar disorder and borderline personality disorder.
The two are often confused for one another and it is understandable why that happens. According to the National Institute of Mental Health, bipolar disorder (also known as manic-depressive disorder), is a “brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Borderline personality disorder is “a serious mental illness marked by unstable moods, behavior, and relationships.” Both can “result in damaged relationships, poor job or school performance, and even suicide” or other co-occurring disorders and behaviors such as “depression, anxiety disorders, substance abuse, and eating disorders” as well as self-mutilation. Other similarities include impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, or reckless driving. Both disorders may also possess “explosiveness” and irritability during mood swings or psychosis. However, that is probably where the synonymy ends. As stated before, each comes with its own package of symptoms and struggles.
For someone with bipolar disorder, they may experience unusually intense emotional states that occur in distinct periods called “mood episodes”. Each mood episode represents a drastic change from their usual mood and behavior. An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a depressive episode. Sometimes, a mood episode can include symptoms of both mania and depression. This is called a mixed state. Both symptoms of bipolar disorder include mood changes and behavioral changes. Someone going through mania or a manic episode experiences a long period of feeling “high”, or an overly happy or outgoing mood to extreme irritability. They may talk very fast, jump from one idea to another, have racing thoughts, be easily distracted, have increased productivity in actions and take on new projects, be overly restless, sleep little or not be tired, have an unrealistic belief in their own abilities, and engage in pleasurable, high-risk behaviors. Someone going through depression or a depressive episode experiences an overly long period of feeling sad or hopeless to a loss of interest in activities once enjoyed, including sex. They may feel tired or “slowed down”, have problems with concentration and memory and decision-making, be restless or irritable, change eating or sleeping or even other habits, and think of death or suicide. Currently, there are four recognized basic types of bipolar disorder: bipolar I disorder, bipolar II disorder, bipolar disorder not otherwise specified (BP-NOS), and cyclothymic disorder or cyclothymia. Bipolar I disorder is defined by manic or mixed episodes that last at least seven days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Bipolar II disorder is defined by a pattern of depressive episodes and hypomanic episodes, but no full-blown manic or mixed episodes. BP-NOS is diagnosed when symptoms of the illness exist but do not meet diagnostic criteria for either bipolar II or II. However, the symptoms are clearly out of the person’s normal range of behavior. Cyclothymia is a mild form of bipolar disorder. People with cyclothymia have episodes of hypomania as well as mild depression for at least 2 years. However, the symptoms do not meet the diagnostic requirements for any other type of bipolar disorder. A severe form of the disorder is called rapid-cycling bipolar disorder. This occurs when a person has four or more episodes of major depression, mania, hypomania, or mixed states, all within a year.
On the contrary, while bipolar disorder has episodes of contrasting mood swings lasting from a week to more, borderline personality disorder (BPD) has intense and highly changeable moods lasting from a few hours to a few days and are often triggered by events unlike the randomness of bipolar disorder. People with borderline personality disorder often experience extreme reactions – including panic, depression, rage, or frantic actions – to abandonment, whether real or perceived. They also have a pattern of intense and stormy relationships with family, friends, and other loved ones, often veering from extreme closeness and love (idealization) to extreme dislike or anger (devaluation). Having a distorted and unstable self-image or sense of self-image of sense of self is also another common symptom, usually resulting in sudden changes in feelings, opinions, values, or plans and goals for the future (such as school or career choices). Chronic feelings of emptiness and/or boredom and inappropriate, intense anger or having problems controlling anger are other common symptoms. Those with BPD, in addition, have stress-related paranoid thoughts or severe dissociative symptoms, such as feeling cut off from oneself, observing oneself from outside the body, or losing touch with reality. Seemingly mundane events may trigger symptoms. For example, people with BPD may feel angry and distressed over minor separations – such as vacations, business trips, or sudden changes of plans –from people to whom they feel close. Studies show that people with this disorder may see anger in an emotionally neutral face and have a stronger reaction to words with negative connotations than people who do not have the disorder.
Whilst both disorders have possess their own traits and characteristics, it is important to remember that help is often available and can be easily provided. Medications such as mood stabilizers will help with the mood episodes and therapy will aid in mending unstable relationships. The most important thing one ought to remember is that it is perfectly all right to talk about mental illness, whether it’s bipolar disorder or borderline personality disorder. No one should be embarrassed about it. Mental health writer Natasha Tracy once said, “Mental illness is the only disease that can make you deny its own existence. Certainly, the idea that the brain can deny its own illness is a frightening thought.” But we as a society must combat this stigma and eviscerating thought process. We must rise above mental illness like a phoenix from its ashes. Only then can we truly make a difference in the lives of the mentally ill.
If you have a mental illness or think you may have a mental illness, please contact your nearest psychologist or psychiatric hospital for a proper diagnosis and/or treatment. In you live in the United States, find your local NAMI by calling the helpline 800-950-NAMI or emailing the organization at info@nami.org. The two services are open Mondays through Fridays, from 10 A.M. to 6 P.M. Eastern Standard Time.
