Borderline Personality Disorder and Attention Deficit Hyperactivity Disorder

Borderline personality disorder, or BPD, and attention deficit hyperactivity disorder, or ADHD, share overlapping symptoms, yet they are two different mental health conditions. BPD is a disorder that involves a longstanding pattern of mood instability, relationship struggles, and issues with self-image that interferes with life. ADHD is a condition that is present since childhood; it involves symptoms relating to excessive attention challenges, excessive hyperactivity, or both, which can also lead to impulsivity.

Despite their differences, both ADHD and BPD have symptoms of impulsiveness, difficulty regulating emotions, and challenges with interpersonal interactions and relationships. The overlap between the two conditions can sometimes make the diagnosis and treatment of them more challenging.

Learn more about the similarities and differences between BPD and ADHD and how the two conditions are treated.

Borderline Personality Disorder (BPD) and Attention Deficit Hyperactivity Disorder (ADHD)

BPD and ADHD are two different mental health conditions with some unique symptoms. However, the ADHD and BPD relationship is somewhat complex. Some of their symptoms overlap, making the conditions more challenging to diagnose and treat. It is important to understand the symptoms of each condition individually to better understand their relationship.

Symptoms of Borderline Personality Disorder

Symptoms of BPD include:

• Mood swings
• Abandonment avoidance
• Extreme relationship pattern shifts between love and hate
• Trust issues with other people
• Feeling disconnected
• Self-image or self-esteem uncertainty
• Extreme views
• Quickly changing views or opinions
• Self-harm
• Thoughts of suicide
• Feeling empty
• Anger management challenges

Symptoms of Attention Deficit Hyperactivity Disorder

Symptoms of ADHD include:

• Difficulty with attention
• Difficulty following instructions
• Organizational challenges
• Time management issues
• Careless mistakes or missed details
• Responding before the appropriate time to respond
• The appearance of not listening
• Avoidance of lengthy tasks or projects
• Forgetfulness
• Difficulty sitting still
• Fidgeting
• Restlessness
• Being inappropriately active
• Impulsivity
• Excessive talking
• Difficulty with quiet activities
• Difficulty with patience and waiting
• Inappropriately interrupting
• Emotional regulation challenges
  

Overlapping Symptoms

The symptoms that overlap between BPD and ADHD are those related to impulsiveness, difficulty regulating emotions, and challenges with interpersonal interactions and relationships. BPD and ADHD may also be comorbid, which means they occur together in the same person at the same time. This may make it even more difficult to distinguish between the two, but there are differences in the way the overlapping symptoms present.

The Difference Between BPD and ADHD

While people with BPD and people with ADHD may both struggle with impulsiveness, difficulty regulating emotions, and challenges with interpersonal interactions and relationships, these symptoms tend to be more severe in BPD. For example, people with borderline personality disorder are more likely to harm themselves.

There are also differences in the ways people with BPD and people with ADHD struggle with these symptoms and how they respond to those struggles. For example, they are generally not impulsive in the same ways. People with BPD tend to struggle with responding appropriately while stressed. People with ADHD, on the other hand, struggle more with thinking before acting when they are not focused.

Treatment

The primary treatment for borderline personality disorder is psychotherapy, or talk therapy. This can be challenging with comorbid BPD and ADHD because people with ADHD often struggle to stay focused for talk therapy. A combination of medication and psychotherapy is often used to treat both together.

Medications

When BPD and ADHD are present together, a combination of medication and psychotherapy is often used for treatment. Stimulant medications such as methylphenidate (MPH) are often a first-line treatment for ADHD. One study found MPH effective in treatment of comorbid (co-occurring) ADHD and BPD. However, there is limited research about medicinal treatments for comorbid ADHD and BPD.

Psychotherapy

For talk therapy, there are several psychotherapies for BPD. These include dialectical behavioral therapy, or DBT, transference-focused psychotherapy (TFP), and mentalization-based therapy (MBT). Cognitive behavioral therapy (CBT), psychoeducation, and DBT are used for both conditions. In addition to medications and talk therapy, coaching is also an option to focus on behaviors related to ADHD. Family therapy and parenting skills training may be used with children who have ADHD and their families.

Summary

Borderline personality disorder, or BPD, and attention deficit hyperactivity disorder, or ADHD, are both mental health conditions. Although they are different, they do have some overlapping symptoms and may occur together in the same person at the same time.

People with ADHD and people with BPD both struggle with impulsiveness, difficulty regulating emotions, and challenges with interpersonal interactions and relationships. However, the way they experience and respond to these struggles is different, and they tend to be more severe in BPD.

Though the relationship between BPD and ADHD makes it more difficult for them to be diagnosed and treated, there are treatment options available. People who suspect or have been diagnosed with BPD, ADHD, or both can effectively manage symptoms with the help of a mental health professional such as a psychologist or psychiatrist.

A Word From Verywell

It can be challenging to be diagnosed with borderline personality disorder or attention deficit hyperactivity disorder, and even more challenging if it is both. If you or someone you know has BPD or ADHD, or if it is suspected, support is available. Talk to your primary care or family doctor, or a psychologist or psychiatrist, about treatment and coping options. It is possible to manage symptoms and live well with these conditions.