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BPD vs OCD: Difference in Borderline & Obsessive-Compulsive

* I generally write using the pronouns he/him when referring to narcissists, but females are just as likely to be narcissists or exhibit narcissistic traits. So please don't think just because article uses the word him or he that it could not be a woman in that same role.

Approximately 1.6% of the U.S. population has borderline personality disorder (BPD). About 2.3% deal with obsessive-compulsive disorder (OCD). These numbers mean around 7 million people face ongoing challenges.

Even though BPD and OCD can share some symptoms, it’s crucial to treat them differently. Renowned psychologist Dr. R. Y. Langham stresses this distinction. Differentiating between the two is vital to helping those affected.

bpd vs ocd

Key Takeaways:

  • BPD and OCD can be mixed up and wrongly diagnosed.
  • Both disorders bring about significant distress, but in different ways.
  • Getting the correct diagnosis is crucial for managing mental health well.
  • It’s important to recognize the unique features of BPD and OCD.
  • Different approaches to diagnosis and treatment are necessary for each disorder.

What is Borderline Personality Disorder (BPD)?

Borderline personality disorder (BPD) is a tricky mental health issue that normally emerges in youth, typically in early adulthood. People with BPD find it hard to maintain stable moods, struggle with impulsive behavior, have difficulties with self-image, and experience challenges in maintaining healthy relationships.

This makes daily life challenging and social situations harder.

borderline personality disorder

Symptoms of Borderline Personality Disorder (BPD):

People with BPD show a wide variety of symptoms. They can act on impulse, fear being abandoned a lot, and have big mood swings. They also don’t see themselves clearly. This can make it challenging to stay in healthy relationships and do well every day.

Some individuals with BPD may also struggle with self-harm or suicidal thoughts, as well as intense feelings of emptiness and worthlessness. They may have difficulty controlling their anger and may experience periods of dissociation.

Despite these challenges, with proper treatment and support, individuals with BPD can learn to manage their symptoms and lead fulfilling lives.

Therapy options like dialectical behavior therapy (DBT), medication such as antidepressants, and participation in support groups can all help manage the symptoms of BPD and improve the overall quality of life.

Causes and Risk Factors of BPD

We’re not sure exactly what causes BPD. But family traits, brain differences, and a rough childhood can increase one’s chances of developing it. 

Marsha M. Linehan developed dialectical behavior therapy (DBT), a form of cognitive-behavioral therapy that teaches individuals skills to manage their emotions, improve relationships, and cope with distress.

What is obsessive-compulsive disorder (OCD)?

Obsessive-compulsive disorder (OCD) is a mental health condition. It is characterized by intrusive thoughts that cause anxiety and compulsive behaviors that individuals feel driven to perform to alleviate the anxiety.

These can make daily activities hard. Sometimes, people need unique understanding and care.

obsessive-compulsive disorder

Symptoms of Obsessive-Compulsive Disorder (OCD):

People with OCD have obsessions, which are intense and repetitive thoughts. They cause a lot of anxiety. To deal with this, people have compulsions. These are actions like washing hands over and over. They aim to reduce anxiety, but they can take a lot of time during their daily routine.

Fear of contaminationExcessive cleaning or handwashing
Unwanted aggressive thoughtsChecking locks or appliances
Intrusive thoughts about harmCounting or repeating phrases

Causes and risk factors of OCD

OCD’s causes are many. They include genes, environment, stress, and trauma. Family history can make you more likely to get OCD. Also, how your brain works can play a big part. Learn more from the NIMH about OCD.

Some individuals may also develop OCD as a way to cope with unresolved trauma or emotional distress. Additionally, certain personality traits, such as perfectionism or a tendency toward high levels of anxiety, may also contribute to the development of OCD.

It is important for individuals with OCD to seek professional help in order to manage their symptoms and improve their quality of life properly.

BPD vs OCD Key Differences:

The main differences between borderline personality disorder (BPD) and obsessive-compulsive personality disorder (OCPD) are:

Emotional Regulation

BPD is characterized by extreme difficulty regulating emotions, leading to intense mood swings, negative emotions, and impulsive behavior.

People with OCPD tend to be emotionally constricted and have better control over their intense emotions, though they may experience anger when things don’t go as planned.

Interpersonal Relationships  

Those with BPD have an intense fear of abandonment and unstable relationships.

While perfectionistic traits in OCPD can strain relationships, people with this disorder do not have the same level of interpersonal turmoil as BPD patients.

Obsessive thoughts and compulsions

The core feature of OCPD is a preoccupation with orderliness, perfectionism, and control over situations, but without true obsessions or compulsions.

BPD does not involve clinical obsessions or compulsions, though individuals may ruminate excessively.


Impulsive behaviors like substance abuse, binge eating, and self-harm are common in BPD.

Those with OCPD are generally overcontrolled rather than impulsive.

Poor Insight

People with BPD often lack insight into how their own behavior impacts others.

Those with OCPD usually have good insight and can acknowledge their perfectionist tendencies, even if changing them is difficult.

In conclusion, while both disorders involve rigid thought patterns, impulsivity, unstable emotions, and relationships are characteristics of BPD.

In contrast, OCPD involves an overconcern with orderliness and control without the interpersonal impairments of BPD. Additionally, individuals with BPD may struggle with identity issues and fear of abandonment.

Diagnosing Borderline Personality Disorder (BPD) and Obsessive-Compulsive Disorder (OCD):

It’s vital to know how to diagnose BPD and OCD for an accurate diagnosis. Their symptoms can overlap, yet they are distinct mental health conditions.

A comprehensive mental health assessment is essential for an accurate diagnosis and to determine the most appropriate treatment plan.

Diagnosing Borderline Personality Disorder

Finding at least five symptoms helps to diagnose BPD. These can include being up and down emotionally and acting on impulses. Professionals look at how these symptoms affect daily life during the diagnosis.

The process often involves talking to the person and using special tests, which help determine the details of the disorder.

Diagnostic Criteria

  • The mental health professional determines if the person meets the diagnostic criteria for BPD outlined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders).
  • This includes having at least five of the nine symptoms, such as unstable relationships, impulsivity, emotional instability, chronic feelings of emptiness, etc.
  • The symptoms must cause significant distress or impairment and onset in early adulthood.

Diagnosing Obsessive-Compulsive Personality Disorder

Obsessive-Compulsive Personality Disorder (OCPD) is diagnosed based on clinical criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The critical aspects of diagnosing OCPD are:

Clinical Evaluation

  • A comprehensive clinical interview and psychological evaluation are conducted to assess the individual’s thoughts, behaviors, and personality patterns.
  • The mental health professional gathers information from the patient and reports from family and friends about the person’s longstanding behavior patterns.

Diagnostic Criteria

According to the DSM-5, a diagnosis of OCPD requires:

  • A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility and efficiency.
  • Presence of at least four of the following traits: excessive devotion to work, preoccupation with details and rules, perfectionism that interferes with task completion, excessive conscientiousness, inability to discard worthless objects, reluctance to delegate tasks, miserly spending habits, and rigid thinking.
  • The personality traits are inflexible and maladaptive and cause significant distress or functional impairment.
  • The pattern is long-standing and can be traced back to early adulthood or adolescence.

Differential Diagnosis

OCPD must be differentiated from other disorders, like:

  • Obsessive-Compulsive Disorder (OCD) involves true obsessions and compulsions rather than a pervasive personality style.
  • Other personality disorders, like schizoid or avoidant PD, are based on the motivations behind behavior patterns.
  • The behaviors cannot be better explained by another mental disorder or medical condition.

A thorough assessment helps distinguish OCPD from perfectionist traits or conventional behaviors by evaluating the degree of impairment and inflexibility caused by personality patterns across multiple life areas.

Commonalities between BPD and OCD

When diving into mental health, similarities between borderline personality disorder (BPD) and obsessive-compulsive personality disorder (OCD) stand out.

These conditions have many shared symptoms and risk factors. This mutual ground can help us find better ways to deal with and beat these illnesses.

Shared Symptoms

Both BPD and OCD have similar emotional signs. People with these disorders can be very afraid of getting too close to others and have self-doubt.

These fears show up as obsessive thinking in OCD and fear of being left in BPD. They often bring along troubling emotions that make ordinary life hard.

Similar Risk Factors

Beyond symptoms, BPD and OCD connect through common factors that raise the risk of getting these ailments. Genes have a big say in whether someone might develop these disorders. Also, experiences like early trauma and feeling ignored can push someone toward developing them.

Seeing how BPD and OCD are alike helps us create better treatment plans. Getting the right help matters a lot.

If not, these disorders can harm not just your mental well-being but your relationships too. Considering these shared traits is key to improving how we tackle them.


What is the difference between borderline personality disorder (BPD) and obsessive-compulsive disorder (OCD)?

BPD is characterized by unstable moods, turbulent relationships, impulsive behaviors, and an intense fear of abandonment. On the other hand, OCD is characterized by unwanted thoughts and repetitive behaviors.

What are the common symptoms of borderline personality disorder (BPD)?

BPD causes impulsive actions, a dread of people leaving, mood swings, and a mixed-up self-view. These can make it hard to connect with others.

What causes Borderline Personality Disorder (BPD)?

The causes of BPD are not completely clear. But genes, how the brain works, and the environment play a big role in its development.

What are the symptoms of obsessive-compulsive disorder (OCD)?

OCD shows through unwanted thoughts and the urge to do certain things. These can really mess with day-to-day life.

What causes obsessive-compulsive disorder (OCD)?

A mix of things, from genes to stress, can cause OCD. Brain structure differences also come into play.

How is Borderline Personality Disorder (BPD) diagnosed?

BPD is diagnosed by spotting at least five key symptoms. Things like constant mood swings and doing things without thinking are looked at. A deep psychological test is usually needed to be sure.

How is obsessive-compulsive disorder (OCD) diagnosed?

To say someone has OCD, they need both recurring thoughts and habits. Detailed mental checks are key to knowing for sure.

What are the similar risk factors between BPD and OCD?

Both disorders are linked to genes and certain life events. Feeling like your emotions or thoughts don’t matter can also play a role.

What are the treatment options for Borderline Personality Disorder (BPD)?

Dialectical Behavior Therapy (DBT), developed by Marsha M. Linehan, focuses on teaching individuals skills to manage emotions, improve relationships, and cope with distress.

What are the common treatment approaches for obsessive-compulsive disorder (OCD), including cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs)?

The primary treatment for OCD involves cognitive behavioral therapy (CBT), specifically exposure and response prevention (ERP). Additionally, healthcare providers may recommend selective serotonin reuptake inhibitors (SSRIs) to help manage symptoms.

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