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.
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:
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.