There are ten major personality disorders. All ten disorders are categorized into three distinct clusters:
- Cluster A
- Cluster B
- Cluster C
Borderline personality disorder falls under the Cluster B group as does antisocial personality disorder. Given that they are both part of the same cluster, it is easy to confuse some of their overlapping symptoms. That is why it is important to understand the key differences between antisocial personality disorder vs borderline when seeking a diagnosis or treatment plan.
What is Antisocial Personality Disorder?
Antisocial personality disorder is a mental health disorder that is characterized by patterns of disregard for the rights or emotions of others, a violation of those rights, and a complete lack of remorse for things that are done.
What is Borderline Personality Disorder?
A borderline personality disorder is characterized by an inability to regulate emotions. Someone struggling with borderline personality disorder will have extreme mood swings, unstable relationships, and problems with impulsivity.
Antisocial Personality Disorder vs Borderline Personality Disorder
So, what are the key differences between borderline antisocial personality disorder?
When looking at antisocial and borderline personality disorder, key differences manifest in:
- Emotional regulation
- Interpersonal relationships
- Empathy and remorse
- Impulsivity and risky behaviors
- Self-perception and identity
Emotional Regulation
Someone with ASPD will have a lot of problems with emotional regulation, and that leads them to irresponsibility, especially when it comes to financial or work responsibilities; deceitfulness, especially when it can help them gain something personally; aggressive behavior toward others; recklessness, and a lack of guilt.
Someone with BPD will have a lot of problems with mood stabilization, and that emotional dysregulation means they’ll have extreme reactions when they feel rejected or abandoned. They will also have rapid mood shifts that might last hours or days as well as angry outbursts.
Interpersonal Relationships
ASPD makes it difficult to maintain relationships as individuals might have superficial charm but they are often manipulative and aggressive toward other people, which interferes with the formation of any semblance of a healthy relationship.
BPD causes many interpersonal problems because individuals have intense relationships that they devalue almost immediately in large part tied to their fear of abandonment. Someone with borderline personality disorder might behave recklessly or impulsively because of their intense efforts to avoid any type of perceived abandonment.
Empathy and Remorse
Someone with antisocial personality disorder has difficulty with empathy. They often don’t understand how other people feel, nor do they care. This also influences remorse, so individuals with ASPD don’t have remorse for their actions, and they don’t have remorse for any harm that their actions may have caused other people.
Someone with borderline personality disorder can have problems with empathy and remorse because of their difficulty with emotional regulation.
Impulsivity and Risky Behaviors
ASPD manifests in individuals with a lot of impulsivity but not because of a desire to avoid a negative feeling like abandonment, but rather because of a lack of concern over consequences. This means someone will make impulsive decisions that put themselves and other people at risk without any thought as to the consequences. That risky behavior can cause serious issues for the individual and those around them, often leading to criminal behavior like:
- Substance abuse
- Theft
- Violence
BPD manifests with a lot of impulsivity in many people that can look the same as ASPD, including substance abuse, but also extending to risky driving or gambling. It is not uncommon for someone with BPD to cause self-harm, sometimes with the goal of that self-mutilation keeping a relationship and circumventing perceived abandonment by gaining attention from another person.
Self-Perception and Identity
Someone with antisocial personality disorder might give off a superficial form of charm, where others view them as persuasive at the start, but then the way they behave will often contradict the way they speak with manipulative or exploitative behaviors or aggressive, both verbal and physical, behaviors.
Someone with borderline personality will have an unstable sense of their self-identity. Often, that same person will feel like they are observing their own life or that they aren’t connected to themselves. These feelings can cause low self-worth, often attaching self-worth to other relationships. However, as soon as an individual perceives potential rejection or abandonment within those relationships, it can cause angry outbursts and impulsivity.
Overlapping Symptoms and Misdiagnosis
So, what are the key similarities between borderline personality disorder vs antisocial personality disorder that cause confusion?
Similarities That Cause Confusion
Some of the key similarities that cause confusion with borderline antisocial personality disorder is the impulsivity and problems with relationships.
For example:
- Margaret has a borderline personality disorder, so she has difficulty managing her impulsive behaviors, which leads her to a lot of risk-taking behaviors and impulsive behaviors that might later cause remorse or interfere with her relationships.
- Tony has antisocial personality disorder. So, he has problems with impulsivity as well, but his impulsivity is often something that is mixed with a disregard for social norms and manipulation and causes harm to others. That harm might be emotional harm, and after the fact, Tony doesn’t feel remorse for what he’s done, nor does he take responsibility for the consequences of his impulsivity. It is all of these aspects combined that interfere with his relationships.
So, while both conditions might manifest with things like impulsivity and difficulty maintaining relationships, there is much more to those overlapping symptoms that can distinguish
antisocial and borderline personality disorder.
Importance of Accurate Diagnosis
With antisocial personality disorder and borderline personality disorder, it is important to get an accurate diagnosis so that you can find the right treatment. There are different clinical approaches for borderline personality disorder vs. antisocial personality disorder despite the fact that they have overlapping symptoms.
Treatment Options
When comparing antisocial personality disorder vs borderline, you have very similar treatment options, although what symptoms they treat and how will vary.
Treatment for Antisocial Personality Disorder
Antisocial personality disorder is best treated with things like cognitive behavioral therapy and mentalization-based therapy.
Both of these therapies can help individuals learn to better manage their thoughts and behaviors especially when it comes to social behaviors. During these sessions, individuals will work with therapists to learn how to reduce impulsivity and prevent their condition from getting worse.
In some cases, democratic therapeutic communities can be used to reduce impulsivity and the risk of relapse for certain behaviors, especially antisocial behaviors that lead to criminality.
Beyond that, there are treatments in the form of support groups that can be an ongoing source of support from local communities as well as for family members.
Medication can be used, including:
- Mood stabilizers
- Antipsychotics
- Antidepressants
All of the medication prescribed is often designed for co-occurring disorders, so it helps individuals with antisocial personality disorder to better control other symptoms that might be contributing to or exacerbating their behaviors.
Treatment for Borderline Personality Disorder
With borderline personality disorder vs. antisocial personality disorder, there are three main forms of therapy, including cognitive behavioral therapy to help individuals better understand the negative thought patterns that are contributing to their symptoms, as well as dialectical behavior therapy, which can help individuals improve their relationships in better regulate emotions, and finally, schema-focused therapy. The latter is there to help individuals understand childhood experiences that might contribute to their symptoms.
As far as medications are concerned, the same medications are used for antisocial and borderline personality disorder, with mood stabilizers there to help reduce impulsivity, antidepressants there to help emotional stability, and antipsychotics there to manage severe symptoms on a case-by-case basis, such as psychosis or paranoia.
One key difference between antisocial personality disorder and borderline personality disorder is treatment for BPD can include skills training like:
- Stress management
- Problem-solving
- Assertiveness
Support groups are another way to provide validation and understanding as well.
Prognosis for Each Disorder
For antisocial and borderline personality disorder, the prognosis is based on how effectively an individual continues their treatment plan. BPD and ASPD both require ongoing support and long-term monitoring. Follow-up appointments are a necessary way for individuals to maintain their progress and to alter treatment plans on an individual basis based on preferences, needs, and symptoms.
Summing Up
When you look at antisocial personality disorder vs borderline, there is a high propensity for misdiagnosis because both conditions fall under Cluster B for personality disorders. That said, getting a professional diagnosis and understanding the similarities that cause confusion can make it easier for you to look at antisocial and borderline personality disorder as two separate conditions an,d from there, get the right type of treatment.
