What are the differences between ADHD and Borderline Personality Disorder?

Both ADHD and BPD can cause problems in your life but it's important to tell them apart.

Some mental health diagnoses look very similar to each other, like Attention Deficit Hyperactivity Disorder (ADHD) and Borderline Personality Disorder (BPD). It can be confusing to tease out what symptoms you’re having and which diagnostic category they might fall into. This post focuses on two diagnoses that can look the same, but that are different in root causes and some features. If you’re curious about what the differences and similarities are between ADHD and Borderline Personality Disorder, read on.

Where do I get my information about mental health?

You might be wondering about your mental health and wanting to understand your behaviors, thoughts, and emotions better. These days, many people rely on the internet or social media, which is a gamble sometimes. Many people without adequate education or training exist on TikTok and other platforms, which in itself isn’t bad, unless they pretend to know or diagnose themselves and others without adequate information and understanding.

It's commendable that you’re seeking the information, but please take what you read online with a grain of salt and consider the source of the information. Lived experience of a disorder is important, but has the author received a formal diagnosis, or have they just taken a screening quiz online? Does the author of the information have knowledge, experience and training as a mental health provider or researcher? These are important factors to consider. Unfortunately, some people assume that they have a certain disorder because of something they "discovered" somewhere, and they think they match the symptoms, which spreads misinformation sometimes. Misdiagnosis can lead to treatment attempts that fail, including taking medication that is not appropriate or necessary for what’s actually troubling you.

Common symptoms between ADHD and Borderline Personality Disorder

It’s easy at first glance to confuse ADHD and BPD, because both disorders can cause you to be impulsive and have difficulty handling your emotions appropriately. Your mood may shift quickly from one state to another, and you might find it hard to control your behavior when you’re angry or upset. You may often find yourself being irritable and seeking out new situations or experiences.

Additionally, it might be hard to relate well to others and to yourself. Your self-esteem might suffer and you might have rejection sensitivity when dealing with others. Maybe you say or do hurtful things to others when you’re upset, which you later regret. But by then, it’s too late. They might have cooled the relationship or ended it altogether. You might “speak your mind” only to find that others are not receptive to your opinions.

Your coping might reflect the same impulsive tendencies. You might develop an eating disorder or abuse drugs and alcohol to cope with your distress.

With all these common symptoms, it can be hard to distinguish the two. However, their causes and other cardinal features are different.

What’s unique about ADHD?

ADHD is a neurodevelopmental disorder that is present from childhood on. The American Psychiatric Association says that if you have ADHD, you may be primarily inattentive, primarily hyperactive, or have symptoms that are a combination of both features.

ADHD tends to run in families, but the genetic pattern is complex. If you have family members with it, there’s a chance for you or other people to also have it. There are differences in brain structure and function with ADHD. Additionally. our neurotransmitters (chemicals in your brain like norepinephrine and dopamine that affect your mental functioning) are different from people who don’t have ADHD. These factors make the following mental tasks difficult:

·         Concentration

·         Organization

·         Continuing to work on boring or hard tasks

·         Getting motivated to start tasks

·         Knowing where to start and how to prioritize which thing to tackle first

·         Focusing the right amount; you might focus too much on it to the exclusion of other important things – hyperfocus – or not at all

·         Paying sustained attention to one thing at a time

·         Hyperactive behavior (e.g., you can’t sit still, speak and move quickly, interrupt people)

·         Unlike BPD, you’re impulsive regardless of whether you’re under stress.

ADHD can interfere with scholastic, work, and social situations.

What symptoms are present in BPD but not ADHD?

Do you fear abandonment from others? Do you frantically try to get people to meet your emotional needs? Do you feel empty inside and lack a clear sense of identity? Are your relationships unstable and volatile? These are characteristics of BPD that don’t overlap with ADHD. You might harm yourself when you’re under stress, both to self-soothe and to demonstrate how you feel. At times, you might harm yourself to ensure that people don’t end relationships with you (although you might not be aware of this motivation at the time).

You tend to see the world in all-or-nothing terms. It can be hard to guide your behavior when situations are ambiguous. You tend to see people in all-good (idealized) or all-bad (devalued) ways, which creates intense, unhealthy relationships. While you yearn to be with other people, you sometimes push them away abruptly. Both BPD and ADHD can lead to social isolation, but it’s a key feature of BPD.

Researchers at NIMH and elsewhere are studying BPD and whether  differences in brain structure, function, neurotransmitters, genes explain the disorder. So far, the results are mixed and haven’t been conclusive. A history of trauma, especially in childhood,  influences BPD development. This is not to say that having ADHD can’t lead to trauma, but trauma is a secondary effect of the ADHD symptoms, not a contributing factor.

What do you do with this information about ADHD and Borderline Personality Disorder?

There’s so much more to know about this topic, and I hope you dive deeper into reputable and accurate sources like the National Institute of Mental Health and APA. I know that this review is not comprehensive. However, I hope it clarifies the key differences and similarities.

If you’re interested in learning more, you can get psychological testing and seek therapy for your condition. Trauma therapy like EMDR therapy can help resolve some of the symptoms of BPD. I have seen many clients with ADHD who have trauma as well. Please call if you’re interested in pursuing trauma therapy.