When you’re wondering whether the symptoms you’re experiencing may be diagnosable, it’s easy to get lost in all of the possible diagnoses. A lot of them can sound similar, especially if you’re watching videos from people who talk about their experiences.
BPD vs OCD can feel confusing. If you’re trying to find answers about what’s going on with you, then you want the answers clear-cut. You want to know the difference between two disorders that may or may not apply to you.
That’s why we’ve created this blog. It includes the information you need to know backed up with reputable sources for further research if you’re interested.
Check out the main three differences we’ve highlighted below. We’ve also included a few general overviews we’ve added to provide you with some context.
This post is all about BPD vs. OCD.
Borderline Personality Disorder
Borderline Personality Disorder is a mental illness characterized by unstable interpersonal relationships, self-image, and affect. According to the Diagnostic Statistical Manual of Mental Disorders, this instability must be present since adolescence or early adulthood.
It also must be present in multiple contexts. In other words, if you present symptoms for BPD only around family members, then that behavior might better be explained by family dynamics rather than a mental health disorder on your part.
To identify instability, look for frantic behavior in relation to perceived or real threats of abandonment.
You may also experience fluctuation between idealization and devaluation in relationships, impulsivity that could also be self-damaging, suicidal behavior, unstable mood due to reactivity, feelings of emptiness, intense, inappropriate anger, or dissociation.
To receive an accurate diagnosis and treatment, always refer to mental health professionals and seek out professional help through therapy to help with the symptoms of BPD.
Obsessive-Compulsive Disorder
Obsessive Compulsive Disorder is characterized by two main, common symptoms of OCD: obsessions and compulsions, as the name suggests. These obsessions look like recurring, intrusive thoughts that cause you anxiety and significant distress.
Oftentimes, these obsessions are distressing to the person with OCD because they feel uncontrollable, unwelcome, and unnatural.
In other words, obsessions can feel so distressing because they originate from your mind without feeling they are your thoughts or they originate from you. Compulsions follow obsessions.
They are the actions you take to avoid or reduce the stress caused by your obsessive thoughts. These compulsions are often carried out to avoid a perceived distressing or painful situation from occurring.
To determine whether you meet the diagnostic criteria and to ensure you receive a proper diagnosis, it’s important to visit a licensed psychotherapist and receive treatment that aligns with the distress you’re experiencing.
BPD VS. OCD:
BPD and OCD can often look the same. This is especially true when you observe someone suffering from either one of these mental illnesses without proper treatment. Both disorders experience lots of anxiety that they try to reduce through various tactics.
Therefore, it’s easy to forget they are distinct mental health conditions. You can draw parallels between BPD and OCD since they appear to have similar symptoms and significant overlap.
However, the cause of the anxiety that people with BPD symptoms and people with OCD symptoms is truly what differentiates between the disorders. Both disorders are chronic in nature, requiring consistent effort over time to treat symptoms.
They also both impact daily life, though in very different ways. And, while it might be confusing, it’s possible for someone to have both at the same time.
It’s possible for people with OCD to have a comorbid personality disorder, like avoidant personality disorder, antisocial personality disorder, and more. It’s also possible to develop a substance use disorder as a result of having either BPD or OCD.
Both disorders cause intense distress and require treatment to fully achieve a comfortable standard of living with the disorders. Now that we’ve addressed some of the similarities between the disorders, let’s clarify how they differ and how they are, in fact, distinct disorders.
1. Cause of anxiety: the fear of abandonment vs. intrusive thoughts
Borderline Personality Disorder
In BPD, the fear of abandonment drives many of the impulsive, possibly self-harming, and reckless behaviors. If someone with BPD thinks that someone in their life will leave them, whether this is based on reality or not, they will act out.
You can refer to those original thoughts as “perceived threats,” which indicates they are at least partially fabricated by the mind of the person with BPD.
The self-sabotaging behaviors ultimately come from the person with BPD likely growing up in a family or situation that caused them to struggle with abandonment issues. While the exact cause of BPD is still unknown, it’s thought that childhood trauma of abandonment is at the root.
This can affect their attachment issues and crippling fear. Maybe they couldn’t rely on their parents to support them emotionally, therefore, they now struggle to trust anyone will stay in their life. In other words, BPD can often develop out of a need to survive.
It’s too difficult to deal with the pain of abandonment repeatedly. So, they develop patterns of behavior, consistent with BPD, that disrupt the pattern of abandonment.
This can mean leaving the person before they leave them. Or they may cause the other person to leave because of impulsive behavior or a sense of superiority.
Obsessive-Compulsive Disorder
In OCD, people experience obsessive thoughts. These thoughts may be related to a perceived threat that then becomes exaggerated in their mind.
For example, say someone with OCD is preparing dinner and they’re holding a knife. Their brain may tell them that they’re going to murder their entire family with that knife. Clearly, this is a terrifying thought to have.
This is true especially when you begin to wonder if the thought came from some part of you that truly wants to kill your family no matter how antithetical that feels to who you are. The thing about intrusive thoughts is they are always uninvited.
Plus, they typically leave the person experiencing them anxious. They experience anxiety for three reasons. First, they don’t want to experience these thoughts. Second, they wonder why they’re thinking this uninvited, uncomfortable thought to begin with.
Lastly, they worry about the thought becoming real. Even if they don’t believe the thought on a rational level, their disorder will not allow them to not believe the thought.
Therefore, they experience anxiety on multiple levels when experiencing unwanted thoughts. Their intrusive thoughts, or obsessions, will eventually lead to compulsions, or repetitive behaviors they do to reduce anxiety.
2. Response to anxiety: impulsive actions and devaluation of loved ones vs. repetitive behaviors
Borderline Personality Disorder
In people with BPD, the fear of abandonment is paramount, as we mentioned earlier. Once that fear has been triggered in someone with BPD, their actions become sporadic and often inappropriate.
In other words, they will act in ways that are contrary to their sense of self. In this case, sense of self refers to the way they think of themselves or the way they want to act.
So, if someone with BPD, for any reason, starts to believe their partner will leave them, they may start devaluing their partner and developing a sense of superiority.
If you imagine yourself in this position, it’s easy to see how you could then start acting in ways that feel wrong to your authentic self. You may demean your partner verbally. Or you may just have thoughts about how much they’re beneath you and they don’t deserve you.
Whether you actively hurt your partner in the process by verbally abusing them or not, you would still start to question your own sense of self. That’s why someone with BPD will develop both unstable interpersonal relationships and an unstable self-image.
They respond to the anxiety they feel about their fear of abandonment being triggered with actions that try to avoid that abandonment ever coming to fruition, which then leads to instability in their life.
Obsessive-Compulsive Disorder
With OCD, when you experience a terrifying intrusive thought, you respond in a way that will reduce that anxiety you’re currently feeling. Since OCD is a disorder, the way that you respond to that anxiety to lessen it may not be the way to reduce it in the long term.
It also will not likely be healthy without treatment. Therefore, OCD patients respond to their intrusive thoughts with compulsive behavior. These compulsive behaviors often are completely unrelated to the anxiety that causes them.
However, they still reduce that anxiety as a result of it being caused by both a disorder (OCD) and an exaggerated threat. So, let’s return to our example of someone preparing dinner with a knife and experiencing an intrusive thought that says they’re going to murder their family.
In this case, let’s say this person lives alone, which means this thought is completely unfounded (this is a real example!). Even in the case this person does live with their family, they know rationally they would never hurt their family. However, their OCD tells them otherwise.
It’s worth noting that OCD obsessions can often be completely implausible and easily “debunked” or rationalized. The fact that they have OCD unfortunately makes that process very difficult to trust if not impossible.
Regardless, if someone experiences that thought while holding a knife, they may then lead their OCD to compel them to unlock and re-lock the door fifteen times or wash their hands several times.
Their behaviors can be more aligned to the thought they experience. However, the goal is to reduce anxiety around the thought and not necessarily to rationally take actions to reduce the likelihood of the thought becoming true.
3. Impact on daily life: inappropriate angry outbursts vs. time-consuming compulsions
Borderline Personality Disorder
When people are driven by fear, they can often become irritable and increasingly anxious. So, if we apply that logic about human behavior to BPD patients, we can start to understand why they may experience unexpectedly intense outbursts of anger.
If someone with BPD thinks their partner will abandon them, they will take every possible action to avoid that happening. This can easily lead to angry outbursts that push people away. Still, it gives the person with BPD some agency over their partner leaving.
This happens even if their partner was never truly going to leave in the first place. Often, the perceived threat was unrealistic.
Ultimately, these angry outbursts, coupled with related symptoms like an unstable self-image and devaluation, can lead to unstable romantic relationships and a lack of relationships overall.
People with BPD, when untreated, can become very lonely, empty, and depressed due to their fear of abandonment manifesting in an expected way.
We call it unexpected because, despite every action that people with BPD take to avoid abandonment, they may end up being abandoned as a result of the actions they take.
Obsessive-Compulsive Disorder
On the surface, the idea that someone with OCD can manage their anxiety with compulsive behaviors may sound like a blessing in disguise. However, these compulsions do not alleviate the anxiety and they are time-consuming.
Some compulsions can be incredibly disruptive to not only the routine of the person with OCD but also the people around them. Say you’re getting ready in the morning and you have an intrusive thought that a plane is going to crash into your home while you’re at work.
The only way that you can guarantee that won’t happen, in the context of OCD, is to brush your teeth five times and you have to do it perfectly.
In other words, if you get distracted or forget to brush one part of your mouth as thoroughly as you brushed the rest of it, then you have to restart that round of teeth brushing. Full disclosure, these examples are fabricated based on research on the personal experience of people with OCD.
Therefore, if you have OCD, you may experience it slightly differently. The goal here is to make the symptoms and distress of OCD as tangible as possible by providing examples that are as close to realistic and real-life as possible.
The Next Step
Diagnosis and Treatment
Searching for the right diagnosis for you can be daunting. Not only is there an unfortunate stigma around mental illness but you may scared to receive certain diagnoses.
A BPD diagnosis can be especially stigmatizing. It’s often misunderstood as well as unpredictable, and people naturally get scared of things that they don’t understand for whatever reason.
However, the fact that you’re here and reading this blog says that you are ready to take the next best step for yourself. As always, we recommend getting treatment for your symptoms.
It doesn’t matter whether they are obsessive-compulsive symptoms, borderline symptoms, or symptoms from something else entirely.
Disclaimer
Please note that we try to break down the rationale behind mental illnesses, even though mental illnesses are by definition not rational, to help people understand themselves and the people around them better.
Having said that, we never intend to make these illnesses so explainable and understandable that people either stop seeing them as disorders or start exaggerating their own symptoms to fit the diagnosis of BPD or OCD. What makes BPD and OCD disorders is the distress they cause the individual.
This distress can take the form of disrupting social relationships that the person values, making them question their identity or sense of self, and causing them to struggle at work or in other contexts.
Remember that you can exhibit some symptoms of BPD and OCD without meeting the requirements to be diagnosed with either of the disorders. It’s still important to seek treatment for any symptoms you experience, especially if those symptoms are diagnosable as BPD or OCD.
Lastly, whether you have BPD or OCD or not, you can achieve a better quality of life. You can develop a strong self-awareness through the hard work that therapy can provide.
Maybe you focus your work on interrogating your intrusive thoughts. Or maybe it’s identifying when your fear of abandonment has been triggered. Either way, you can feel better.
When seeking out treatment, it’s worth noting that Dialectical Behavior Therapy has been known to be effective in treating BPD. Additionally, Cognitive Behavioral Therapy has been shown to be effective in treating OCD.
