Exploring The Connection: ADHD And BPD
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Attention-deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) are two distinct mental health conditions, but they can share a number of overlapping symptoms. They can also occur simultaneously in the same individual in some cases. In order to understand the connection between BPD and ADHD, it can be helpful to understand the unique characteristics of each as well as their similarities, which we’ll outline here.
Understanding the symptoms: ADHD vs. BPD
Symptoms of ADHD
ADHD is classified as a neurodevelopmental disorder, meaning that it affects the brain and nervous system. According to the official Center for Disease Control (CDC) definition, “people with ADHD show a persistent pattern of inattention and/or hyperactivity/impulsivity that interferes with functioning or development.” While childhood ADHD symptoms are often more easily recognized, ADHD can remain present through adulthood. It can manifest differently depending on the individual and the “presentation” or type (primarily inattentive, primarily hyperactive/impulsive, or a combination), but some common symptoms include:
Inattention
Such as difficulty sustaining attention, “careless” mistakes, forgetfulness, and difficulty organizing tasks
Hyperactivity/impulsivity
Which can manifest as restlessness, impatience, and a tendency to interrupt others
Difficulties with executive functioning
Like poor time management and trouble planning and initiating tasks
Challenges with emotional regulation
Which can include mood swings, difficulty managing frustration, and impulsivity in emotional reactions.
Forgetfulness and disorganization
Such as frequently misplacing items and trouble maintaining an organized space
Difficulty with follow-through
Like initiating tasks but struggling to complete them and frequently shifting focus between unfinished tasks
Interpersonal challenges
That can include things like difficulty sustaining attention in conversations, impulsivity in social interactions, and relationship difficulties due to forgetfulness
Symptoms of BPD
Though borderline personality disorder officially falls under the category of personality disorders, it’s also considered a neurocognitive condition. BPD is one of ten identified personality disorders according to the DSM-5, and its primary symptoms can be defined as “hypersensitivity to rejection and resulting instability of interpersonal relationships, self-image, affect, and behavior.”
BPD symptoms can vary, but a diagnosis is typically based on an individual having consistently experienced at least five or more of the following:
Intense and unstable relationships
Due to a fear of abandonment, leading to intense efforts to avoid real or perceived abandonment. Rapid and extreme shifts in relationships (such as idealizing and then devaluing people) may also occur.
A distorted self-image
Due to an unstable self-identity and a lack of a clear sense of self. As a result, individuals with BPD may experience frequent and abrupt changes in goals, values, and vocational aspirations.
Emotional instability
Including intense and rapidly changing moods, frequent feelings of emptiness, difficulty managing anger, and intense and inappropriate displays of emotion
Impulsivity or reckless behavior
In areas like spending money, substance misuse, sex, or driving as well as more generally making impulsive decisions without considering the consequences
Self-harming behaviors
Such as recurrent cutting or suicidal gestures or engaging in impulsive and risky activities without concern for personal safety
Chronic feelings of emptiness
Which may manifest as persistent feelings of boredom and difficulty finding a sense of purpose or fulfillment
Difficulty trusting others
Which can lead to intense and unstable relationships marked by mistrust and a fear of being betrayed as well as a tendency to view others as either all good or all bad
Dissociation
Or a temporary disconnection from one's thoughts, identity, or sense of reality, especially during stressful situations
Paranoid thoughts
In the form of brief, stress-related paranoia or severe dissociative symptoms under stress
Similarities between ADHD and BPD
Again, ADHD and BPD are separate conditions. However, it is possible to be diagnosed with both: One 2019 paper suggests that 14% of those diagnosed with ADHD in childhood will be diagnosed with BPD in adulthood and that 18–34% of adults with ADHD are estimated to also have BPD.
Even for those who only have one condition or the other, some symptoms may overlap, which sometimes makes it tricky to distinguish between these distinct conditions. Some symptoms that may appear in both those with ADHD and those with BPD can include:
Impulsivity
Which can be behavioral and/or emotional
Emotional dysregulation
Like mood swings that can be difficult to manage
Trouble sustaining relationships
As a result of impulsivity, emotional dysregulation, and communication challenges
Difficulty focusing
Whether due to attention deficits as with ADHD or emotional intensity as with BPD
Stress-induced symptoms
As stress tends to exacerbate the signs of both illnesses
That said, since treatment for these two conditions can be different, it’s important for clinicians to distinguish between them and provide an accurate diagnosis or diagnoses.
Treatment options for ADHD vs. BPD
Both ADHD and BPD are typically treated with psychotherapy, sometimes in combination with medication, but the specific types can differ. Therapeutic interventions for ADHD may include cognitive behavioral therapy (CBT), interpersonal therapy, group therapy, or coaching. Medications for ADHD—either stimulants or non-stimulants—usually aim to enhance brain chemicals supporting attention. In contrast, BPD medication usually targets specific symptoms like mood swings. Dialectical behavioral therapy (DBT), which focuses on mindfulness, is often recommended for individuals with BPD to help with emotional regulation.
If you’re looking to get the support of a licensed therapist for symptoms of ADHD, BPD, or another mental health challenge, you have options. For those who prefer to receive treatment from the comfort of home without having to commute to an office, online therapy may be worth considering. Research suggests that meeting with a licensed therapist virtually can be as effective as in-person treatment in many cases, so it may be a more convenient option for those who prefer this format.
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