Differences Between Depression and Borderline (BPD)

If you’re starting to understand that mental health conditions are far more complex than you first realized, thank you for joining us here to seek better understanding. The differences between depression and borderline personality disorder (BPD) need recognition.

Many people don’t get that BPD is a devastating mental condition that is very different from depression. True, many symptoms overlap so it is easy to grasp why this confusion is happening. However, these two conditions can be comorbid, meaning they are both present for an individual.

We will explore the differences between depression and borderline personality disorder, because the chances you or someone in your life has a mental health condition affecting them are pretty high. Whether wanting to better understand yourself or someone you care about, we hope this helps.

Note: This information and other content provided in this article are not intended and should not be considered, or used as a substitute for, medical advice, diagnosis or treatment. If you are not sure how to find help, visit here: National Institute for Mental Health.

Why Is It Important to Know The Differences Between Depression and Borderline?

When we are able to discern the two conditions, a door opens to better avenues of healing and help. Ultimately the causes of depression and borderline vary so finding the root cause is crucial for recovery.

Managing different symptoms and recovery depends on which mental health condition one deals with. But remember, as you or someone else you know moves through the journey of healing, there is no one-size-fits-all. Be patient, things can improve.

First, let’s review each mental disorder individually for a baseline understanding of the two. Then we can look at the differences between depression and borderline personality disorder.

We will also review how depression and BPD can both be present together in an individual. People with a mental illness often have a comorbidity, meaning they are actually dealing with more than just one condition.

Major Depressive Disorder (MDD)

Chronic depression (or major depressive disorder) is defined by Cleveland Clinic as “a persistently low or depressed mood and a loss of interest in activities that you used to enjoy. The symptoms must last for at least two weeks to receive a diagnosis.”

Ironically, the emptiness of depression is a weight that will not lift even through lots of effort and time. Management is achievable through talk therapy using a method called cognitive behavioral therapy. 

In conjunction, antidepressant medications can be prescribed to regulate an imbalance in brain chemistry which is causing the depressive symptoms. Other treatment plan options can include stimulation therapies.

The outlook for recovery varies from person to person so individual review is necessary to evaluate potential. One critical need for anyone with a mental health condition is their desire for improvement. 

Ultimately the severity of their condition and the treatment that individual is seeking will determine their success. This means don’t give up if what you are attempting is not working, because you can try something different. 

There are numerous options for proper treatment and don’t be afraid to consult more than one therapist or specialist for help. Everyone is different and each person’s special needs are so important to explore.

Borderline Personality Disorder (BPD)

BPD is characterized by Cleveland Clinic as “extreme mood swings, unstable relationships and trouble controlling their emotions. They have a higher risk of suicide and self-destructive behavior.”

Someone with borderline personality disorder will find a range of emotions larger than what someone with only depression will experience. Therefore, that emptiness could be constant but found at times accompanied by feelings of hatred or despair.

The dysregulation of emotions someone with BPD experiences is often confused with bipolar disorder but again, very important to differentiate. Depressive symptoms and manic episodes associated with bipolar disorder are longer lasting and someone with bipolar will have longer spans of time of stable mood.

Borderline personality mood swings do not last as long, although are very intense. Their environment and what is happening around them molds them. This means those affected by BPD are at higher risk for impulsive behaviors and substance abuse to soothe these mood swings.

Someone with BPD has a fluctuating self-image that they mold to their circumstances for stability. Many individuals, but not all, will have experienced some form of abuse or trauma as a child.

Factors such as genetics and brain structure can also contribute to development of borderline personality disorder. A family history of BPD can increase those chances, as well as poor communication of behavioral and emotional regulation within the brain.

Although few medications seem to help relieve borderline personality symptoms, there is encouraging evidence in psychotherapy. More specifically, a form of therapy called dialectical behavior therapy seems to be very helpful for those with BPD.

Dialectic behavioral therapy provides BPD patients a method to find acceptance and understanding of their strong emotions. Skills are taught to help manage these emotions and in turn more positive behaviors lead to successful life changes.

Comorbidity of Depression and Borderline Personality Disorder

The prevalence of depression affecting those with borderline personality disorder is quite high. However, the key to this issue is if only the depressive symptoms are treated, the depression with BPD does not improve.

Treatment of BPD specifically will help these individuals most, as symptoms of depression in those with BPD wane as a person receives BPD treatment. This can seem like a daunting task but BPD is treatable.

Some combinations of mood stabilizing medications with psychotherapy may be helpful, however this is not effective for everyone. Like for BPD, psychotherapy is a good option for treatment and not only limited to dialectical behavior therapy. 

Differences Between Depression and Borderline

It seems most people associate the persistent feeling of hopelessness and anguish with depression. These symptoms also haunt those with borderline personality disorder but the representation is different.

This and many other symptoms of each of these mental health disorders are easy to overlap. Here we’ll break down the causes of depression compared to those of borderline personality. Mental health professionals can assist in understanding diagnostic criteria more closely.

Also in these differences between depression and borderline, we’ll examine the varied symptoms experienced by each. First we’ll see which depressive symptoms and bpd symptoms are common, then make a comparison.

Treatment options will look a bit different for each mental health condition and proper mental health professionals should guide this. The key is finding the method that works best for you even if those overlap with other mental disorder managements.

Causes of Major Depressive Disorder

Chronic depression can be a result of many risk factors mainly of which are genetic, environmental, biological and social. It has been found there is a genetic component passed down through families which will put someone at higher risk of developing depression throughout their life.

Also, stress early in life can alter the neurotransmitter functions and cerebral cortex structure of someone’s brain, predisposing them to depressive episodes. Certain sensitivities, or lack thereof, can be conditioned throughout a person’s youth.

Environmental and social factors can also influence whether a person will develop depression. Exposure to lack of healthy interpersonal relationships and modeled behaviors of helplessness prior to adulthood can create a higher risk of MDD development.

Causes of Borderline Personality Disorder

Similarly to depression, BPD has numerous factors which contribute to its presentation in a person. Specifically, if you were to have a family member who has/had borderline you are at higher risk of having it yourself.

Again, undue stress during childhood can be a significant factor. More specifically, BPD is linked to childhood neglect or abuse (mental, emotional, physical). This with other factors means someone with BPD will always be on high alert and their brain is working overtime to protect them.

The social and environmental factors associated with BPD include unstable family situations and/or abandonment. This can also include avoidant behaviors and poor communication within close relationships as well as exposure to family members struggling with substance abuse.

Cause Differences Between Depression and Borderline

One of the biggest differences between these mental health conditions is the childhood history. Of course there are individuals who live through horrific life events without struggling mental illnesses but there are many who do.

Borderline personality disorder seems to have a stronger link to unstable family living conditions than depression does. Many of our behaviors are learned and for someone with borderline, they learned these behaviors for survival, not just comfort.

Additionally, the frequent evidence of neglect or abandonment in someone’s youth is most seen in those with BPD than in depression. This results in the BPD person’s aptitude to flex their identity around those that can provide them belonging and security.

Symptoms of Major Depressive Disorder

• Long-lasting sadness or emptiness
• Lack of interest in hobbies or activities, particularly ones that used to be fun
• Feeling worthless or guilty
• Trouble sleeping or too much sleeping
• Changes in appetite which may cause weight loss or gain
• Decreased energy levels, feeling heavy or tired constantly
• A slowing of activity/thought/speech, or the opposite with irritability
• Difficulty making decisions &/or concentrating
• Thoughts of self-harming, suicide, or death

If you are experiencing thoughts of self-harm or suicide please call or text 988. “The 988 Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week in the United States.”

Symptoms of Borderline Personality Disorder

• Ever-changing/unstable self-image, or sense of self
• Fear of abandonment
• Impulsive and sometimes self-destructive or dangerous behaviors
• Unstable &/or emotionally intense relationships
• Quick and extreme mood shifts
• Feelings of emptiness/meaninglessness which persist
• Times of dissociation – loss of touch with, or understanding of, reality
• Intense feelings of anger
• Self-harmful or suicidal thoughts or behaviors

If you are experiencing thoughts of self-harm or suicide please call or text 988. “The 988 Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week in the United States.”

Symptom Differences Between Depression and Borderline

Although people with MDD can experience intense emotions, those with BPD feel them more as reactions to external factors. Someone with BPD can often describe things as feeling like triggers which set them off like a fuse was lit.

The persistent feelings of sadness and emptiness which accompany both are set apart in how a person with BPD will more quickly find ways to soothe this. Someone with BPD will change their interests, opinions, and feelings for acceptance by someone else.

In this too, BPD individuals can struggle with a sense of belonging and will become angry quickly if someone shows signs of withdrawal. Someone with depression may turn to blaming themselves and feeling guilty for that person’s desire to pull away.

While those with depressive disorders may lack a spark or drive to be involved in life, a BPD person ties their identity and value to what brings them security. As a depressed person cannot seem to make a decision the BPD person tends to make rash decisions which are sometimes destructive.

There are more differences between depression and borderline but it is important to recognize these symptoms look different for everyone. Do not put yourself or someone else in a box, allow your view of these different symptoms to be a guide rather than a checklist.

Treatment for Depression

Fortunately depression, a mood disorder, has numerous types of medications available for treatment. These medications range from changing the way our brains manage serotonin to increasing neurotransmitters that help regulate mood.

A healthcare provider needs to guide careful medication choice because the risks can outweigh the benefits. And, with so many options for medication management, it is so important to be patient until finding the right balance.

The best outcomes for those with depression occur when antidepressant/mood medication combine with psychotherapy. These include cognitive behavioral therapy and interpersonal therapy.

Other options for depressive disorder treatment include electroconvulsive therapy, vagus nerve stimulation, and transcranial magnetic stimulation. There are a lot of resources available in communities as well for those with depression.

Treatment for Borderline Personality

First and foremost, BPD is treatable! There is a misconception among the general population that a person with BPD is doomed to instability their entire lives. 

While some people with BPD may not be open to learning about themselves enough to heal, it is absolutely possible. Do not give up hope on yourself or someone else if you suspect BPD. Create boundaries around yourself or others as needed and seek professional help.

With time, patience, and intentional hard work by the person with BPD they can bridge that gap to finding self-worth and stability. Sometimes this means changing our environment or transforming our behaviors which can be hard, but so so worth it.

Psychotherapy is THE MOST effective treatment for those struggling with BPD. This is usually most beneficial if it is dialectical behavior therapy but other therapies like group therapy and cognitive behavioral therapy can be helpful as well.

Occasionally, mood stabilizers or other medications can help relieve certain symptoms while the root of BPD is being addressed. 

The tendency for BPD to present along with other mental health conditions, like depression or an anxiety disorder, is high. Please explore other mental health  issues which may be contributing with an appropriate healthcare provider.

Treatment Differences Between Depression and Borderline

Because these two mental health disorders have different causes, it is vital they receive different treatment. If you or someone you are close to is seeking help, please continue to research the best method of treatment with your trusted health professionals.

Remember, medication management is rarely effective for those with BPD. However, it can be a key component of improvement for someone with depression. This is why an accurate diagnosis is so vital for someone struggling with their mental health.

Psychotherapy is almost exclusively the option for a BPD patient while someone with depression has more options. A person with MDD can trial many medications while pursuing various other types of therapy for symptom relief. Those with BPD should not lose hope however, recovery is possible for both.

Final Thoughts on Differences Between Depression and Borderline (BPD)

It is remarkable how similar these two conditions present themselves in individuals. But, with careful evaluation by proper individuals, the differences between depression and borderline are distinct.

Please keep in mind the importance of this information as a guide to understanding rather than a criteria to meet. The best choice we can make in regards to mental health is choosing to learn about it with an open mind. 

Ultimately, each person will experience life in their own unique way. Let us give each other room and support to discover ourselves and the opportunity of growth for a better quality of life.

About the Author

Anna is a twenty-something living in the south. She’s passionate about family, crafting, and continuing her education beyond her college degree.