Post-traumatic stress disorder (PTSD) and borderline personality disorder (BPD) are both mental health conditions that significantly impact a person’s quality of life. While the disorders do have many of the same symptoms, there are also some major differences between PTSD vs BPD to be aware of, too.

Post-traumatic stress disorder stems from a major trauma and an individual’s efforts to come to terms with the traumatic event (or series of events) they experienced, such as childhood trauma, sexual abuse, etc. Borderline personality disorder, on the other hand, affects how someone feels about themselves. While BPD can be triggered by trauma, it can also exist without it. The same can not be said about PTSD.

To accurately distinguish the two, it’s important to look at the symptoms, causes, and types of treatment that are available for borderline personality disorder and post-traumatic stress disorder.

Symptoms of PTSD vs BPD

Because several symptoms are common in both PTSD and BPD, diagnosis can be challenging. For this reason, it’s important to address all aspects of someone’s condition before making any sort of diagnosis and to go to a licensed healthcare provider for diagnosis. 

Symptoms that can occur in both PTSD and BPD include:

  • Difficulty with emotion regulation
  • Experiencing mood swings
  • Extreme anger
  • Episodes of rage
  • Fear of abandonment
  • Dissociation 

“Both PTSD and BPD present with some similar symptoms. The similarities revolve around the heightened arousal, “fight, flight, and freeze” and can all be components of these diagnoses.  PTSD is focused on an extremely traumatic incident or a series of incidents and the symptoms tend to be outwardly noticeable, whereas BPD revolves around the fear of abandonment and tends to be inwardly displayed (self-harm, self-deprecation, self-doubt).” 

Talkspace therapist Meaghan Rice PsyD., LPC

PTSD symptoms

Symptoms of PTSD can vary from person to person. However, a hallmark sign is the classic “fight or flight” response to a perceived threat. People with PTSD also might be hypervigilant and feel as if they need to be ready for danger at every corner. 

Flashbacks and unexpected, unwanted thoughts of the trauma are common. Difficulty sleeping and finding it hard to focus on tasks are additional symptoms many people experience. Because people living with PTSD have all this turmoil going on, they might isolate themselves from others. It’s not uncommon for people with PTSD, especially men, to attempt to self-medicate with drugs and alcohol.

Common symptoms of PTSD might include:

  • Flashbacks
  • Nightmares
  • Startling easily
  • Avoiding things, places, people, or events that remind them of the traumatic event
  • Feelings of shame or guilt
  • Extreme fear
  • Finding it hard to have a positive reaction to things

Experiencing some of these symptoms? Take a PTSD test to learn more.

BPD symptoms

BPD is classified as a personality disorder. It causes thoughts, feelings, and behaviors that are problematic and typically start in early adulthood or during the adolescent years. For this reason, it’s important to identify signs and symptoms of BPD early on so you can seek treatment.

Common symptoms of BPD might include: 

  • An intense fear of abandonment
  • Feeling empty
  • Issues with personal relationships and self-image
  • Mood swings
  • Intense anger
  • Stress-related paranoia
  • Unstable relationships
  • Finding it challenging to control anger
  • Self-harm
  • Suicidal thoughts

Like those with PTSD, individuals with BPD are more likely to indulge in risky and impulsive behavior.

Experiencing some of these symptoms? Take a BPD test to learn more.

Causes of PTSD vs. BPD

The causes of these mental health conditions can seem similar, but at the same time, they’re very different. We have a better understanding of what causes PTSD, although research continues to give us more insight into what might contribute to BPD.

Simply put, PTSD is caused by a trauma, like being the victim of a crime, or by a series of traumatic events, such as living through war. 

BPD, on the other hand, stems from feelings of abandonment that often starts in childhood and progresses over time.

“PTSD is typically caused by trauma, identified by the individual experiencing the trauma, as “too much.” The brain has difficulty managing the degree of trauma that has triggered the individual. BPD is caused by perceived feelings of abandonment. Typically, the abandonment involves abuse, neglect, or a combination of factors that has led to an intense level of insecurity in relationships.”

Talkspace therapist Meaghan Rice PsyD., LPC

PTSD causes

There are a number of situations and experiences that can cause PTSD, yet not all people who live through trauma will develop it in response. The most commonly associated trauma with PTSD is being in the military in a combat area. However, that’s just one of many traumatic events that can trigger PTSD. Others include being the victim of a sexual assault, being in an abusive relationship, or being injured in a car accident.

Complex PTSD (C-PTSD) is a subset of PTSD that occurs when someone is exposed to trauma over an extended period of time. This might be when working in a war zone or from growing up in an abusive household. This type of PTSD is thought to come from feeling powerless over escaping the traumatic situation. 

A key difference between PTSD vs BPD is that the former generally occurs as a result of prolonged trauma, whereas BPD is a personality disorder that often involves dissociative episodes.

BPD causes

The cause of BPD is not fully understood. However, it’s widely accepted that the condition might stem from childhood neglect or long-term trauma. It’s likely that a combination of environmental and genetic factors are at play. 

Differences in Treatment

Treatment for PTSD vs BPD can differ somewhat. However, people with both C-PTSD and BPD can benefit from a form of talk therapy known as cognitive behavioral therapy (CBT), medication, and other types of psychotherapy. For those who are interested in healing from PTSD naturally, there are also some natural treatments that therapists recommend.

Generally, a combined treatment approach is the most effective (meaning, medication and therapy used together). People with both disorders can also benefit from learning self-soothing techniques like meditation, yoga, and other holistic self-care practices. 

Of course, everyone is unique and will respond to treatment differently. Thus, treatment plans should always be tailored to specific symptoms and needs.

“PTSD treatment will focus its efforts on working through the traumatic incident itself. A combination of EMDR, exposure therapy, and medications leave individuals with the highest probability of success. Dialectical Behavioral Therapy (DBT) is effective with BPD clients as they can address the heightened state of crisis while medication helps to decrease the intense fear, anger, or self-loathing that tends to resurface when there is interpersonal conflict with others.”

Talkspace therapist Meaghan Rice PsyD., LPC

PTSD treatment

People living with PTSD will greatly benefit from various forms of cognitive behavioral therapy, including cognitive processing therapy (CPT), which was specifically developed to treat veterans with PTSD.

Exposure therapy is yet another form of CBT that’s a proven treatment technique for PTSD. Especially for people who experience flashbacks, exposure therapy can be very helpful in learning to control responses to stimuli and triggers that take them back to their harrowing experience. 

BPD treatment

BPD is primarily treated with psychotherapy (talk therapy), although BPD medication and, in extreme cases, hospitalization might also be suggested. Several forms of talk therapy have been successful in treating symptoms of BPD. 

Dialectical behavior therapy (DBT) was developed specifically for BPD, and it’s commonly a first approach. Traditional CBT is another effective form of therapy that can help people with BPD learn to change their thought processes and engage in healthier behavior.

Finding The Right Support

PTSD and BPD are mental health conditions that can have a severe impact on quality of life, relationships, and overall happiness, but with treatment and support it is possible to manage symptoms and live a peaceful, full life. If you are showing symptoms of either condition, reach out to a licensed therapist at Talkspace today to get a formal diagnosis.