June 30, 2022

Borderline Personality Disorder vs. Antisocial Personality Disorder

By: Design
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Medicially Reviewed By:
Dr. Priya Chaudhri
credentials here

When looking at borderline personality disorder vs. antisocial personality disorder, they may at first seem to be the same illness. However, even though there is some overlap, these are two distinct mental health disorders.

Both borderline personality disorder (BPD) and antisocial personality disorder (BPD) are grouped within the Cluster B type of personality disorder. Cluster B disorders feature intense emotions, so people with one of these disorders tend toward high drama. There are some unique variables that distinguish BPD from ASPD. Keep reading to learn more about these challenging mental health disorders.

What is Borderline Personality Disorder?

Someone with BPD often has low self-esteem and lacks confidence. They also tend to be fearful about being abandoned and overreact when they feel they have been slighted. Here are the symptoms of BPD:

  • Moody
  • Feel empty inside.
  • Black or white thinking.
  • Judgmental
  • Low self-esteem.
  • Poor impulse control.
  • Deep fear of abandonment.
  • Unstable relationships.
  • Engage in self-harming behaviors.
  • Engage in risky sexual behaviors.
  • Binge eating.
  • Substance abuse.
  • Poor money management.
  • Suicidal ideation.

What is Antisocial Personality Disorder?

Someone with ASPD has little to no regard for other people or for social norms and rules. They are often hostile, disrespectful, and aggressive. There is an overlap with sociopathy in ASPD. Here are the symptoms of ASPD:

  • Aggression; often getting into fights.
  • May torment people or animals and feel no remorse.
  • Highly impulsive.
  • Hostile, irritable.
  • Deceitful behaviors.
  • Blame others when things go wrong.
  • No regard for the safety of others.
  • Destructive of property.
  • Engages in criminal behaviors.
  • Difficulty sustaining relationships.
  • Exploits others.
  • Neglects obligations.
  • Substance abuse.
  • At heightened risk for suicide.

What Causes BPD or ASPD?

While there is no clear-cut cause of either BPD or ASPD, there are some risk factors that have been identified. These are conditions that may increase the chances of a person developing these Cluster B disorders:

  • Family history. Someone with a family member who struggles with BPD or ASPD may have an increased risk of developing these disorders.
  • Life events. Adverse life events, such as abuse, trauma, abandonment, attachment disorder, neglect, general adversity, or cruel parenting can increase the risk.
  • Brain factors. Brain imaging studies have shown structural and functional changes in the limbic region where impulse control and emotions are regulated.

Key Differences Between Borderline Personality Disorder vs. Antisocial Personality Disorder

When comparing BPD and ASPD, you will notice some things in common between the two disorders. For instance, both of these Cluster B disorders share impulse control problems and both tend to be manipulative types. They are both at higher risk for substance abuse and suicide as well.

But even though similar, these two disorders are really quite different. Note these key ways that BPD and ASPD differ from each other:

  • BPD is more common in females, whereas ASPD is more common in males.
  • Those with BPD tend to direct their aggression toward themselves via self-harming, whereas ASPD directs aggression toward others.
  • Those with BPD have higher rates of depression.
  • People with BPD are more interested in forming relationships than those with ASPD.
  • Low self-image is more prevalent among people with BPD as compared to ASPD.
  • People with ASPD have a harder time forming attachments than those with BPD.
  • People with ASPD are more egocentric than those with BPD.

Psychiatric Treatment Options for Cluster B Personality Disorders

Cluster B personality disorders include BPD, ASPD, narcissism, and histrionic personality. All of these are difficult to treat, as these disorders cause a high amount of inflexibility. Those with Cluster B disorders do not believe they have a problem, which can lead to problems at work and within relationships.

Cluster B disorders share common traits, such as poor impulse and emotion control. These individuals tend to be highly emotional, unpredictable, and dramatic.

Cluster B disorders, including BPD and ASPD, can be managed through a combination of medication, therapy, and life skills training.

Outpatient treatment options include receiving treatment from a private practice doctor or therapist, or enrolling in a day program. A day program is the highest standard of outpatient care. They involve meeting several times a week for therapy, classes, and group support.

Inpatient treatment provides a higher level of care than outpatient, as the programs offer 24-hour support. These programs are especially helpful if the person is suicidal or self-harming. They also provide a more intensive treatment milieu, with daily therapy, group sessions, and holistic activities.

Managing BPD and ASPD

When it comes to treating these two disorders, it will vary somewhat. Different modes of therapy can target certain challenges that each present. Consider these treatment methods:

BPD Treatment:

  • Psychotherapy. Evidence-based therapies for BPD include DBT, CBT, schema-focused therapy, mentalization-based therapy (MBT), and acceptance and commitment therapy.
  • Group therapy. DBT skills training and practicing CBT techniques are key aspects of group therapy sessions.

ASPD Treatment:

  • Psychotherapy. CBT is very helpful for those with ASPD, as it can help them change disordered thought and behavior patterns. Contingency management is another useful therapy, because it rewards the person for good behavior choices.
  • Group therapy. Group sessions that focus on practicing anger management and communication skills are helpful.

People with either BPD or ASPD will benefit from stress-reducing methods, such as mindfulness, yoga, deep breathing, or meditation. These methods can be useful as a way of regulating emotions when feeling frustrated or angry.

While there are no drugs for either BPD or ASPD, relief is often found through off-label use of antidepressants, mood stabilizers, or anti-psychotic meds. Support groups and ongoing outpatient therapy are also helpful in managing these disorders.

Elevation Behavioral Health Provides Residential Mental Health Treatment

Elevation Behavioral Heath is a mental health treatment program located in a private residential setting. This intimate treatment venue allows for more customized and personalized support for those struggling with a mental health disorder. If you are in need of specialized care for BPD or ASPD, contact us today at (888) 561-0868.

Our team of experts is here to help you.