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  • Mental Health Issues
    • Anxiety
    • ADHD
    • Bipolar Disorder
    • Depression
    • Grief
    • OCD
    • Personality Disorders
    • PTSD
  • Relationships
    • Dating
    • Marriage
    • Sex & Intimacy
    • Infidelity
    • Relationships 101
  • Wellness
    • Anger
    • Burnout
    • Stress
    • Sleep
    • Meditation
    • Mindfulness
    • Yoga
  • Therapy
    • Starting Therapy
    • Types of Therapy
    • Best Online Therapy Services
    • Online Couples Therapy
    • Online Therapy for Teens
  • Medication
    • Anxiety Medication
    • Depression Medication
    • ADHD Medication
    • Best Online Psychiatrist Options
  • My Mental Health
    • Men
    • Women
    • BIPOC
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    • Parents
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  • About Us
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    • Advertising Policy
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    • Join Our Free Directory
  • BPD DefinitionBPD Definition
  • ADHD DefinitionADHD Definition
  • SimilaritiesSimilarities
  • DifferencesDifferences
  • TreatmentTreatment
  • How to CopeHow to Cope
  • ConclusionConclusion
  • ResourcesResources
  • InfographicsInfographics

BPD & ADHD: Is There a Link?

Headshot of Hailey Shafir, LCMHCS, LPCS, LCAS, CCS

Written by: Hailey Shafir, LCMHCS, LPCS, LCAS, CCS

Headshot of Dr. Maria Simbra, MD, MPH

Reviewed by: Maria Simbra, MD, MPH

Published: May 9, 2023
Headshot of Hailey Shafir, LPCS, LCAS, CCS
Written by:

Hailey Shafir

LPCS, LCAS, CCS
Headshot of Dr. Maria Simbra, MD, MPH
Reviewed by:

Dr. Maria Simbra

MD, MPD

ADHD and borderline personality disorder (BPD) have many overlapping symptoms and risk factors.1,2,3 Moreover, those with co-occurring ADHD and BPD are more likely to experience severe symptoms and impairment and require specialized treatment to target both conditions.1,3 Fortunately, therapy can help someone with either condition learn to manage their symptoms and lead a full life.

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What Is Borderline Personality Disorder (BPD)?

Borderline personality disorder (BPD) is a mental health condition characterized by intense fears of abandonment, mood swings, impulsivity, and relationship instability. People with BPD often struggle to regulate their emotions, make healthy decisions, and think in rational ways when upset. This can sometimes lead to self-destructive behaviors, including engaging in drug and alcohol misuse and self-harm.4

Common symptoms of BPD include:4

  • A pattern of instability in life and relationships
  • Fears of abandonment
  • Frequent mood swings
  • Impulsivity and reckless decision making
  • Black-and-white thinking (all-or-nothing thinking)
  • An unstable identity or sense of self
  • Chronic feelings of emptiness
  • Uncontrolled anger and outbursts
  • Trust issues
  • Self-harm behavior or suicidal ideation

What Is Attention-Deficit/Hyperactivity Disorder (ADHD)?

ADHD is a neurodevelopmental disorder that affects someone’s ability to focus, remember things, and control impulses. People with ADHD also struggle with hyperactivity, which can cause them to feel restless, agitated, hyper, and unable to sit still for long periods of time.4

Common symptoms of ADHD include:4

  • Trouble paying attention
  • Making careless mistakes or overlooking details
  • Not following instructions or following through on tasks
  • Difficulty organizing tasks and activities
  • Avoidance of tasks that require sustained attention
  • Fidgeting or trouble sitting still
  • Difficulty staying quiet
  • Often being ‘on the go’ or acting as if ‘driven by a motor
  • Trouble waiting, taking turns, or interrupting others
  • Challenges with emotional regulation
  • Time management issues or time blindness

Similarities Between BPD & ADHD

While different disorders, BPD and ADHD both involve symptoms of impulsive behavior and emotional regulation issues.

ADHD & BPD Overlapping Symptoms 

Overlapping symptoms of ADHD and BPD include:

  • Impulsiveness: Compulsive behavior without thinking about consequences.
  • Emotional dysregulation: Severe mood swings, high highs and low lows.
  • Executive dysfunction: The inability to do a task that you know you need to do (or even want to do).
  • Relational challenges: Some of the symptoms involved in both conditions can make building and maintaining relationships difficult.
  • Lack of self-directedness: Challenges with managing self and controlling behaviors.

Causes & Risk Factors

Similar possible causes between BPD and ADHD include:

  • Experiencing trauma: Trauma changes the brain and can lead to symptoms that are seen in both BPD and ADHD.
  • Genetic factors: A positive family history of BPD and/or ADHD are risk factors for developing either of these disorders in an individual.

Differences Between BPD & ADHD

Despite the fact that there are considerable similarities between ADHD and BPD, there are also some important differences between the two. ADHD is not a personality disorder like BPD and is characterized by inattentiveness and hyperactivity. BPD tends to cause more problems with emotional control and interpersonal relationships.1,4 Additionally, people with BPD are more likely to engage in self-destructive behaviors.2,3

Differences in the Nature of the Impulsivity

While impulsivity is a feature of both conditions, people with ADHD are impulsive in different ways and for different reasons than those with BPD. Those with ADHD often fail to fully think through things before acting, while a person with BPD may behave impulsively due to poor emotion regulation.2,9

Abandonment Issues in Those With BPD

Intense abandonment issues are a key symptom of BPD, which often triggers angry or emotional outbursts that lead to relationship challenges. A person with ADHD doesn’t necessarily struggle with these same fears, and therefore less likely to experience similar emotional turmoil.2

Age of Onset

Lastly, the age of onset is different between both conditions, as ADHD is usually diagnosed in childhood. On the other hand, BPD is more readily diagnosed in adolescence or early adulthood.2,6

Can You Have BPD & ADHD?

ADHD and BPD can overlap, but it is rare. It is more likely that a childhood diagnosis of ADHD can be linked to a higher chance of developing BPD later in life, however the two conditions are not usually misdiagnosed for one another as there are distinct differences between each disorder. However, a childhood history of ADHD can make adult BPD symptoms more severe.

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How Are Comorbid ADHD & BPD Treated?

With most co-occurring disorders, treatment requires a two-pronged approach that can target the specific symptoms of each disorder–this is also the case with comorbid ADHD and BPD.1 People with both conditions often require a combination of medication and therapy to improve and manage their symptoms.

Treatment options for comorbid ADHD and BPD may include:

Therapy

Psychotherapy is considered a frontline treatment for most mental illnesses and is often combined with medication for optimal results in treating both ADHD and BPD. One of the most effective therapies for BPD is dialectical behavioral therapy (DBT).6,10

Therapy options for co-occurring ADHD and BPD include:

  • Dialectical behavioral therapy (DBT): DBT for BPD and ADHD teaches people how to regulate their emotions using mindfulness, communicate more effectively, and think in healthy ways when distressed. It can be offered in both individual or group therapy sessions.
  • Mentalization-Based Therapy (MBT): This approach to therapy helps people learn about how their emotions and thoughts intersect and how these intersections impact their actions.
  • Schema Therapy: This approach to therapy focuses on upgrading our automatic thoughts, and challenges us to change our perspective and normalize healthier behaviors.
  • Transference-focused therapy: This approach to therapy leans into understanding the varying emotions that can stem from BPD, learning more about them, and finding a place for them.
  • Cognitive Behavioral Therapy (CBT): This approach to therapy focuses on how thoughts become actions and how to redirect our thoughts.

Medications

In some cases, medications for BPD and ADHD may be incorporated into a comprehensive treatment plan. Medication is typically recommended in the treatment of adult ADHD, often in the form of stimulants that can help improve one’s focus and concentration. Examples of common stimulants used for ADHD include Adderall, Vyvanse, and Ritalin. Other times, a non-stimulant ADHD medication, like Strattera, may be recommended instead.

There aren’t any FDA-approved medications for BPD, but SSRIs or mood stabilizers may be advised in order to treat mood instability. Less commonly, antipsychotic medications may help reduce the symptoms of BPD.6 Medications for BPD are typically only recommended in combination with therapy, not as a stand-alone treatment.

Before you begin or end any medication, it is important that you talk to your psychiatrist or physician. Adderall can be risky for someone with these two conditions, as it can make BPD symptoms worse. Adderall is an amphetamine and can exacerbate symptoms; and long term use of them can lead to brain damage.

ADHD Management Tools

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How to Cope With Comorbid ADHD & BPD

In addition to seeking help from a licensed therapist, there are also some things that people living with comorbid ADHD and BPD can do to manage their symptoms on their own. Adopting healthy habits and coping skills can help to reduce the impact of BPD and ADHD symptoms in a person’s daily life.

Here are some tips on how to cope with comorbid BPD and ADHD:

  • Practice mindfulness: Mindfulness for anxiety or mindfulness for BPD can help reduce stress, improve focus, and regulate moods. It can allow people to feel more stable and calm.
  • Maintaining physical activity: Being physically active helps to improve mood and energy levels, reduce stress and anxiety, and boost mental clarity and focus.
  • Engage in something creative: Journaling and finding a creative outlet can help people express their thoughts and feelings in ways that are healthy while also boosting self-awareness.
  • Utilize organization tools: Staying organized with a schedule, maintaining a routine, and making a to-do list can help people limit the impact of BPD and ADHD on productivity, work, and daily tasks.
  • Adopt impulse control skills: Thinking before acting or speaking can help to reduce the negative impact of impulsivity on a person’s life, work, and relationships.
  • Practice stress management: Stress management can help to keep symptoms of BPD and ADHD under control and also reduces the risk of making impulsive decisions.
  • Join a support group: Finding a support group can help people with BPD and ADHD connect with others who can relate to the difficulties of managing mental illnesses, as well as provide a safe and supportive space to vent and share tips on how to cope.

Final Thoughts

Living with BPD and ADHD can make life more challenging–but there are several different treatment options that can help. Therapy (sometimes in combination with medication) can help people manage their symptoms and improve their overall quality of life. Finding a therapist who is skilled and experienced in treating both conditions is important, and will help to ensure that treatment addresses your symptoms effectively.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

ADHD Management Tools

Inflow App Inflow is the #1 science-based app to help you manage your ADHD. Their support system helps you understand your neurodiverse brain, and build lifelong skills. Free Trial

Virtual Psychiatry

Talkiatry Get help from a real doctor that takes your insurance. Talkiatry offers medication management and online visits with top-rated psychiatrists. Take the online assessment and have your first appointment within a week. Free Assessment

Online Therapy 

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For Further Reading

  • The Brain and Behavior Research Foundation
  • Best ADHD Podcasts
  • Best Books on BPD
  • Inflow ADHD App Review

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If you’re familiar with obsessive-compulsive disorder (OCD) and borderline personality disorder (BPD), you might be aware of some similarities that the conditions can share, at least on the surface: deeply-rooted doubts about oneself and one’s relationships, difficulty tolerating anxiety related to these fears, and lasting damage to relationships and self-esteem. Read More

This content is sponsored By NOCD.

ADHD & BPD Infographics

Connection Between ADHD and BPD Can You Have BPD and ADHD? How Are Comorbid ADHD and BPD Treated?

Sources Update History

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Matthies, S. D., & Philipsen, A. (2014). Common ground in attention deficit hyperactivity disorder (ADHD) and borderline personality disorder (BPD)–review of recent findings. Borderline personality disorder and emotion dysregulation, 1(1), 1-13.

  • Weiner, L., Perroud, N., & Weibel, S. (2019). Attention deficit hyperactivity disorder and borderline personality disorder in adults: a review of their links and risks. Neuropsychiatric disease and treatment, 15, 3115.

  • Ditrich, I., Philipsen, A., & Matthies, S. (2021). Borderline personality disorder (BPD) and attention deficit hyperactivity disorder (ADHD) revisited–a review-update on common grounds and subtle distinctions. Borderline Personality Disorder and Emotion Dysregulation, 8(1), 1-12.

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

  • NIMH. (2022).  Attention Deficit/Hyperactivity Disorder (ADHD). Department of Health and Human Services. https://www.nimh.nih.gov/health/statistics/attention-deficit-hyperactivity-disorder-adhd

  • Chapman, J., Jamil, R.T., Fleisher, C. (May 2, 2022). Borderline Personality Disorder. . StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430883/

  • Philipsen, A., et al. (2008). Attention-deficit hyperactivity disorder as a potentially aggravating factor in borderline personality disorder. The British journal of psychiatry, 192(2), 118-123.

  • Philipsen, A. (2006). Differential diagnosis and comorbidity of attention-deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) in adults. European archives of psychiatry and clinical neuroscience, 256(1), i42-i46.

  • Linhartová, P., et al. (2020). Impulsivity in patients with borderline personality disorder: a comprehensive profile compared with healthy people and patients with ADHD. Psychological medicine, 50(11), 1829-1838.

  • Society of Clinical Psychology. (2016). Psychological Diagnoses and Other Targets of Treatment. American Psychological Association. https://div12.org/diagnoses/

Show more

We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

May 9, 2023
Author: No Change
Reviewer: No Change
Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources. Added “Similarities Between BPD & ADHD” and “Can You Have BPD & ADHD?”, revised “How Are Comorbid ADHD & BPD Treated?”. New material written by Silvi Saxena, MBA, MSW, LSW, CCTP, OSW-C and reviewed by Kristen Fuller, MD.
November 22, 2022
Author: Hailey Shafir, LCMHCS, LPCS, LCAS, CCS
Reviewer: Maria Simbra, MD, MPH
Show more

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