Attention-deficit hyperactivity disorder (ADHD) and borderline personality disorder (BPD) are both known to cause impulsivity and emotional dysregulation. Understanding the similarities and differences between these conditions can help ensure that you get the right care for your needs.
ADHD involves problems with attention and hyperactivity and is typically diagnosed in childhood. BPD is usually diagnosed in adulthood and is known to cause relationship challenges and, at times, safety concerns.
For co-occurring BPD and ADHD treatment to be effective, both conditions must be addressed. This typically involves therapy, medication, or a combination of both.
Attention-deficit hyperactivity disorder (ADHD) and borderline personality disorder (BPD) are two mental health conditions that share several overlapping traits. When co-occurring ADHD and BPD are present, it can be even harder to tell the difference between the two. Both conditions can involve challenges like impulsivity, emotional intensity, and difficulty regulating attention or behavior.
Many people live with both ADHD and BPD, which can make diagnosis and treatment more complex. Understanding how the two conditions interact — and the ways they can be identified and treated — is an important step toward getting the right kind of support.
Fortunately, experts today have a clearer understanding of ADHD, BPD, and how they can overlap. With better diagnostic tools and more effective treatments, people living with one or both conditions can find the help they need to manage symptoms and improve their quality of life.
ADHD vs. BPD: How to tell the difference
BPD is a personality disorder that affects how people relate to others, view themselves, and manage their emotions. It often leads to impulsive actions and unstable relationships.
ADHD, on the other hand, is a neurodevelopmental disorder that primarily affects focus and attention. It can make it challenging for people to stay organized and manage their impulses, impacting their daily functioning and development.
So both conditions involve impulsivity, but they show up differently in each one. According to these insights, the most prevalent similarity between BPD and ADHD is impulsivity.
For people living with either of these conditions, impulsivity can take many forms, including:
Doing things without stopping to consider the consequences first
Frequent conflict with others, especially when someone criticizes impulsive behaviors
Frequent angry outbursts due to not being able to control one’s emotions
Having trouble sticking to things when there’s not an immediate reward
Frequent mood swings and emotional instability
Impatience, like difficulty waiting one’s turn or frequently interrupting
Intense emotional reactions to everyday stressors
As you can see, there is a decent amount of symptom overlap between BPD and ADHD. But there are some important differences between these conditions too.
ADHD symptoms that are not typically shared by people with BPD:
Disorganization
Hyperactivity
Problems with executive functioning
Low inhibition
BPD symptoms that are not typically shared by people with ADHD:
Feelings of emptiness
Dissociation
Non-suicidal self-injury (like cutting)
Chronic suicidality*
Another key difference between BPD and ADHD is the age of onset. ADHD is most often diagnosed in childhood. However, BPD is usually diagnosed during late adolescence or young adulthood. Despite these diverging timelines, it’s still possible for BPD to be misdiagnosed as ADHD and vice versa. That’s why getting an evaluation from a qualified mental health professional is so important.
*The 988 Suicide and Crisis Lifeline provides 24/7, confidential support with trained crisis counselors. If you or a loved one is in emotional distress or having a suicidal crisis, please call or text 988. If you’re experiencing a life-threatening emergency or need immediate help, please call 911.
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Can you have ADHD and BPD?
Research shows that many people who have BPD would have met the clinical criteria for ADHD as children. This connection — often called comorbidity — suggests that the two conditions can coexist, but it doesn’t mean that ADHD causes BPD. Instead, ADHD may increase the risk of developing BPD later in life — especially when combined with stress or early trauma.
When ADHD and BPD co-occur, symptoms can feel stronger and more difficult to manage. Both conditions also tend to run in families, which means having a relative with either condition can make it more likely you’ll experience one or both. This overlap shows how genetics, environment, and life experiences can work together to shape emotional and behavioral health.
Treatment and co-treatment strategies
No matter the mental health conditions(s) you’re living with, getting an accurate diagnosis is a critical first step in ensuring that you get the right care for your needs. While this can get a bit more complicated when you have co-occurring conditions, treating BPD and ADHD at the same time is possible.
An effective treatment plan for both BPD and ADHD might include an individualized combination of any of the following approaches:
Dialectical behavioral therapy (DBT): DBT is considered the most effective form of talk therapy for BPD. But because it focuses on things like emotional regulation, distress tolerance, mindfulness, and interpersonal skills, it can also be helpful for ADHD.
Cognitive behavioral therapy (CBT): CBT can help you identify and interrupt unhelpful thought and behavior patterns and learn alternative ways to cope with stress. This form of care has been proven effective in supporting people living with BPD and ADHD.
Transference-focused psychotherapy (TFP): TFP encourages you to explore how your BPD or ADHD symptoms influence the way you feel about your therapist. This insight can help you better navigate relationships and other challenges outside of therapy.
Couples therapy: Often, BPD and ADHD can impact your important relationships. Couples therapy can help you and your partner improve your communication, increase your empathy, and resolve conflicts more effectively.
Crisis planning: Since BPD can lead to safety concerns like suicidality, your treatment plan may include a crisis plan that you co-create with your therapist. Typically, crisis planning isn’t included in standard ADHD treatment. But it may be necessary if you have both BPD and ADHD.
Medications: Several different types of medications are used to treat ADHD, and you can talk to your provider about which one might be right for you. There aren’t any approved medications for treating BPD on its own, but there are medications that can help manage individual symptoms.
ADHD and BPD can overlap in ways that make it hard to tell them apart. You might see yourself in both, which can feel confusing. Understanding how the two can coexist is an important step toward understanding yourself and getting the right kind of support.
Brandy Chalmers, LPC
Clinical reviewer
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ADHD and BPD are two distinct mental health conditions. However, they have some things in common. Both are known to cause problems with impulsivity and emotional dysregulation. They also coexist frequently, making diagnosis and treatment more complex.
Fortunately, experts have deepened their understanding of what BPD and ADHD have in common and what sets them apart in recent years. And today, people living with both conditions can access effective, individualized care that reflects their unique needs.
When you need support for your mental health, Rula’s extensive network of therapists is just a few clicks away. With our therapist-matching program, you can find a provider who takes your insurance and schedule your first appointment for as soon as tomorrow. And thanks to our digital platform, you can see your therapist via a convenient online appointment at a time and place that works best for you.
Liz Talago
Liz Talago, M.ed. is a mental health professional turned content writer and strategist based in the Detroit metro area. As an independent consultant for mental health organizations, Liz creates meaningful connections between brands and their audiences through strategic storytelling. Liz is known for championing diverse perspectives within the mental health industry and translating bold ideas into inspiring, affirming digital experiences.
In her free time, you can find her hiking with her two German Shepherds, puttering around her dahlia garden, or spending time with her family.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
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