BPD vs CPTSD: What’s the Difference?

What Is the Difference Between BPD and CPTSD?

BPD is a personality disorder, whereas cPTSD is a trauma disorder. Although they share some overlapping symptoms, they have more differences. 

BPD Symptoms

Symptoms of Borderline Personality Disorder include:

• Intense, rapidly shifting emotions
• Fear of abandonment and frantic efforts to avoid it
• Unstable or chaotic relationships
• Impulsive or risky behaviors
• Chronic feelings of emptiness
• Intense anger or difficulty controlling anger
• Identity disturbance or unstable self-image
• Self-harm or recurrent thoughts of suicide

BPD deals with matters of identity. People with BPD have a poor sense of self and instead rely on other people to inform their identity for them, leading to rapidly shifting emotions and issues with interpersonal relationships. BPD can also lead to high levels of self-sabotage, often thought to be caused by an insatiable relationship with their childhood caregiver. 

You can learn more about the symptoms of BPD here. 

CPTSD Symptoms

Symptoms of cPTSD include:

• Persistent emotional dysregulation
• Overwhelming shame, guilt, or worthlessness
• Difficulty with trust and maintaining relationships
• Negative self-perception and chronic self-criticism
• Flashbacks, nightmares, or intrusive memories of trauma
• Hypervigilance and exaggerated startle response
• Avoidance of reminders of trauma
• Dissociation or feeling disconnected from yourself or reality

The core issue of cPTSD is the trauma or series of traumas you endured. Although it also has ties to identity, the symptoms center around trauma and how it affects you. Isolation, distrust, and avoidance behaviors all stem from this trauma. 

cPTSD is similar to PTSD, with a few key differences. Complex PTSD arises from repeated exposure to traumatic events. Traumas like poverty, neglect, and abuse are more likely to cause cPTSD than isolated incidents like a car accident or medical emergency. 

BPD vs CPTSD: Similarities

BPD and cPTSD do share many similarities. Among these are: 

• Caused by chronic or early-life trauma, often childhood neglect or abuse
• Issues with emotional dysregulation
• Difficulty maintaining stable relationships 
• Feelings of dissociation or feeling disconnected
• Lashing out or pushing people you care about away
• Intense feelings of emptiness and shame. 
• Comorbidity with anxiety, depression, self-harm, and substance abuse

From the outside, BPD and cPTSD may look very similar. That’s why they are often misdiagnosed as each other. 

The things that may cue you into cPTSD and BPD are also often the same. Issues with relationships, difficulty with emotional instability, a traumatic past, and struggling with anxiety, depression, self-harm, or substance abuse are all common reasons for seeking help. 

Although the external symptoms are often the same, a good therapist will be able to notice the differences between BPD and cPTSD. They do not share the same internal mechanisms and therefore require a different treatment method. 

BPD vs cPTSD: Differences

The inner workings of BPD and cPTSD are different. Some differences include:

• BPD will involve rapidly shifting emotions and self-image. One minute they may be happy and confident, and a few minutes later be drowning in self-hate. cPTSD lacks this intense emotional shifting. Instead, feelings of guilt, shame, and low self-esteem are more constant. 
• People with BPD will try to form close attachments with others and then self-sabotage them. People with cPtSD are more likely to exhibit avoidance behaviors and close themselves off to others. 
• People with cPTSD will have strong reactions to trauma triggers. These could be a certain smell, sound, or interaction. Trauma responses could be emotional but they could also involve flashbacks, panic attacks, and intrusive memories. These sorts of trauma symptoms are mostly lacking in BPD. 
• People with BPD have a strong fear of abandonment; it is one of the defining traits of BPD. Although people with cPTSD may also have this trait, it is not as strong. Instead, they will fear getting close to people out of fear of getting hurt.
• People with cPTSD are more likely to experience dissociation and numbness, whereas people with BPD are more likely to experience quickly changing and heightened emotions.  
• Impulsivity is more common in BPD than c-PTSD.
• Nightmares, flashbacks, and panic attacks related to trauma are more common in CPTSD. 

Noticing the difference between cPtSD and BPD can be difficult, but it’s important. The treatment plans for each will be different. 

Do I Have BPD or CPTSD: A Quick Test

This test is not a substitute for a licensed professional assessment. If you think you have BPD or cPTSD, schedule with a licensed therapist to receive a diagnosis. 

These questions can help you determine if you have BPD or cPTSD:

• Are your emotional reactions:
  • A: Intense, out of proportion to the situation, and rapidly changing. (You could change emotional states multiple times in one day depending on what’s happening.)
  • B: Intense and prolonged. If something triggers a bad mood, it can take you hours or even days to get out of it. 
• What are your relationships with others like?
  • A: Chaotic, with a lot of highs and lows. I tend to get close to people and then push them away.
  • B: It’s hard for me to form close relationships. I don’t like to be vulnerable/trust people/ I have a fear of getting hurt. 
• How do you feel about yourself? 
  • A: It depends on the day. Sometimes I think I’m amazing, and sometimes I think I’m the worst person ever.
  • B: Generally pretty poorly. I deal with a lot of guilt and shame. I constantly feel like I have to prove myself. 
• How do you handle stress?
  • A: With reckless, impulsive decisions. 
  • B: With emotional numbing. 
• Do you struggle with feelings of abandonment? 
  • A: Yes. Being abandoned feels like the worst possible outcome of a situation. 
  • B: Sometimes, but I’m more afraid of getting hurt, and I’m not afraid to do the abandoning if it means I’m protecting myself. 
• Do you experience flashbacks or nightmares?
  • A: Sometimes, but they’re not tied to any one specific event. 
  • B: Yes. The event can change, but there is a central theme related to something that happened in my past. 
• How often do you dissociate? 
  • A: Sometimes, especially when I’m very stressed.
  • B: Often. It is one of the first things that happens when I feel any heightened emotion. 
• How do you view others and the world around you?
  • A: It depends. Sometimes I think the world is great and everyone in it amazing, and other times I don’t think I can trust anyone. 
  • B: Generally very bad. People are generally untrustworthy and dangerous. 

If you answered A to most of these questions, you likely struggle with Borderline Personality Disorder. If you answered B to most of these questions, you likely struggle with complex Post-Traumatic Stress Disorder.

If you feel like you are related to both A and B answers, you could be struggling with both BPD and cPTSD. Although this combination is rarer, it is possible. 

Next Steps

Therapy is the recommended treatment approach for both cPTSD and BPD. They are both chronic conditions that are unlikely to go away on their own. A combination of therapy, medication, and support is the most effective treatment plan. 

To talk to a therapist about either BPD or cPTSD (or both), contact Lifebulb. We are now accepting new clients. Our therapists take most major insurances. 

Find Your Therapist