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By Stephanie Castillo

Borderline personality disorder (BPD) deserves as much attention as bipolar disorder (BD), says a study published in the British Journal of Psychiatry.
"The level of psychosocial morbidity and suicidality associated with BPD is as great, or greater, than that experienced by patients with [BD]," Dr. Mark Zimmerman, director of outpatient psychiatry at Rhode Island Hospital and director of the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, said in a press release. "From a public health perspective, improving the detection and treatment of BPD is as imperative as diagnosing and treating bipolar disorders."

According to Current Psychiatry, BPD and BD often co-occur; they have “considerable symptomatic overlap.” BPD is “characterized by an enduring and inflexible pattern of thoughts, feelings, and behaviors,” whereas BD is considered “a clinical disorder or brain disease commonly understood as a ‘broken mood thermostat.’” Patients with either disorder can experience a certain mood for weeks at a time, yet patients with BPD also “cope with intense bouts of anger, depression, and anxiety that are short in duration.”

The fact symptoms overlap, with BPD possibly being a risk factor for the BD, causes healthcare providers to mix up, thus misdiagnose, the illnesses. It doesn’t help either BPD is more stigmatized than BD. The mental health stigma isn’t only applicable to BPD — and it’s something many are actively fighting to reduce in order to create better opportunities for mental health care. For example, nine out of 10 California residents with mental illness reported instances of prejudice and discrimination.

BPD, too, may be more common than anyone realizes. The National Alliance on Mental Illnesscited about one in 20 or 25 individuals will live with this condition. Like BD, recovery is an ongoing process. NAMI added patients with BPD “will experience significant and long-lasting periods of symptom remission in their lifetime.”

In the past, BPD was believed to be more common in females, while more recent research suggests males are more frequently diagnosed with BPD. Whatever the case, Zimmerman believes it’s imperative the mental health community puts a greater focus on the illness.

"Despite the clinical and public health significance of both of these disorders, it sometimes seems as if BPD lives in the shadow of bipolar disorder," Zimmerman said. "Bipolar disorder is a widely researched, well-publicized, well-funded topic. By contrast, BPD is seldom discussed and it is not included in the Global Burden of Disease study, a comprehensive registry that quantifies diseases by cost, mortality, geography, risk and other factors."

Source: British Journal of Psychiatry. 2015.

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