Borderline Personality Disorder and Bipolar Disorder are two of the most misunderstood — and most misdiagnosed — mental health conditions. In this episode of The Real Mental Health Podcast, psychiatrists Dr. Mike Mah and Dr. Michael Kanell break down the real differences, overlapping symptoms, how misdiagnosis happens, and what effective treatment actually looks like.

If you or someone you love struggles with mood swings, emotional instability, or rapid shifts in thinking and behavior, this episode offers a clear, compassion-driven framework for understanding what’s really going on — and why getting the diagnosis right matters.

🔍 What We Cover:
• The true differences between Borderline Personality Disorder and Bipolar Disorder
• Why these two conditions get confused so often
• How mood episodes differ from emotional dysregulation
• Effective medications vs. treatments that don’t work
• Evidence-based therapies that help (DBT, schema, ACT, psychodynamic, etc.)
• What recovery looks like from both disorders
• How clinicians actually diagnose these conditions
• Compassionate strategies for supporting loved ones

0:00 | Introduction: Borderline Personality Disorder (BPD) and Bipolar Disorder Overlap
1:29 | Defining Borderline Personality Disorder (BPD)
4:17 | The Unstable Sense of Self in BPD (and Narcissism)
8:45 | BPD and Fear of Abandonment; DSM-5 Criteria for BPD
10:47 | History of the Term "Borderline"
11:29 | Development of BPD and Childhood Trauma (ACE Scores)
13:28 | Maladaptive Childhood Survival Templates
16:35 | Origin of the Term "Borderline" (Neurotic vs. Psychotic)
21:11 | Defenses in BPD: Splitting and Projection
25:57 | Why BPD Patients Split: Fear and Control
33:29 | Unconscious Nature of Splitting/Projection
37:50 | Projective Identification: Eliciting Feelings in Others
42:44 | Core Fears in BPD: Abandonment vs. Intimacy/Engulfment
48:51 | Negative Urgency and Distress Intolerance in BPD
52:17 | Prognosis for BPD
55:27 | Defining Bipolar Disorder and Manic Episodes
1:04:08 | Historical Overlap between BPD and Bipolar Disorder
1:05:48 | Differentiating BPD Emotional Dysregulation from Bipolar Mood Episodes
1:11:41 | Anxiety and Fear Component in BPD vs. Manic Fearlessness
1:13:00 | Borderline Personality Disorder (BPD) vs. Complex PTSD (CPTSD)
1:20:51 | Treatment for BPD: Therapy is Primary
1:22:37 | Dialectical Behavior Therapy (DBT) and Dialectics
1:29:50 | Other BPD Therapies: Mentalization-Based and Transference-Focused Psychotherapy
1:36:39 | Blocking Projections in Therapy (Countertransference as Gold)
1:46:57 | Medications for BPD and Bipolar Disorder
1:52:50 | Sleep as a Risk Factor for Manic Episodes
1:53:41 | Seroquel (Quetiapine) Dosing and Side Effects
1:56:58 | Lithium and Weight Gain
1:59:21 | Other Antipsychotics (Abilify, Latuda) for BPD
2:04:00 | Differentiating Feature: Anosognosia (Lack of Insight)
2:06:03 | Differentiating Feature: Identity Disturbance and Chronology
2:08:50 | Conclusion and Contact Information


Dr. Michael Kanell's Practice: https://www.eospsychiatry.com/
Dr. Mike Mah's Practice: https://www.centurycitypsychiatry.com/

Disclaimer:
The content presented in Dr. Mike Mah’s videos is intended for general informational and educational purposes only. It should not be considered a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Dr. Mike Mah’s videos do not establish a doctor-patient relationship and should not be relied upon for personalized medical guidance. If you are experiencing a medical emergency, please call 911 or your local emergency number immediately.

For inquiries: [email protected]
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