ADHD vs BPD (Borderline Personality Disorder): How They Differ

Short answer: ADHD and borderline personality disorder (BPD) can look alike, because both can involve intense emotions and impulsive behaviour.¹²³ But they are different conditions. ADHD is a neurodevelopmental condition that begins in early childhood,⁴ while BPD is a mental health condition affecting thoughts, emotions and behaviour, with features that can include fear of abandonment, feelings of emptiness and self-harm.³ Having one doesn’t rule out the other, and both can be treated.³⁵

What is BPD?

Borderline personality disorder is a mental health disorder that affects how a person thinks, feels and behaves. It is a real condition, and it can be treated.³

Features of BPD can include:

• overwhelming emotions, anger, irritability or unstable moods
• feeling empty, or having low self-esteem
• anxiety about relationships, and trying hard to avoid being abandoned
• impulsive, risk-taking behaviour, such as unsafe sex or alcohol or drug use
• self-harm and suicidal thoughts.³

About 1 in 100 adults live with BPD. It is diagnosed more often in women, although men may experience it at similar rates.³

What ADHD and BPD have in common

Intense emotions

In BPD, emotions can feel overwhelming and moods can be unstable.³ In ADHD, emotion dysregulation is prevalent across the lifespan and is a major contributor to the problems the condition causes.⁶ A 2020 meta-analysis of 13 studies (2,535 adults) found much more emotion dysregulation in adults with ADHD than in adults without ADHD — especially emotional lability, or quick shifts in mood — and more severe ADHD symptoms went with more dysregulation.¹ The Australian ADHD Guideline says emotion regulation difficulties affect up to 40–50% of children with ADHD and are also common in adults.⁷

Read more in ADHD and emotional dysregulation. If criticism or rejection hits you especially hard, see ADHD and rejection sensitive dysphoria.

Impulsive behaviour

In ADHD, impulsivity is one of the official symptom areas, along with inattention and hyperactivity, and interrupting or intruding on others is one example.² In adults it can also look like excessive spending, risk-taking and conflict with others.⁸ In BPD, impulsive and risk-taking behaviour can include unsafe sex and alcohol or drug use.³

ADHD vs BPD: key differences

Shared features don’t make them the same condition. ADHD is diagnosed using two lists of symptoms: inattention (such as being easily distracted or forgetting daily tasks) and hyperactivity-impulsivity.² It’s a neurodevelopmental condition that starts in childhood, and an adult diagnosis needs evidence that symptoms began then.⁴ Feeling empty, anxiety about relationships and being abandoned, and self-harm or suicidal thoughts are features of BPD,³ but they aren’t part of the official ADHD symptom lists.²

	ADHD	BPD
Type of condition	Neurodevelopmental, beginning in early childhood4	A mental health condition affecting thoughts, emotions and behaviour3
Typical features	Inattention, hyperactivity and impulsivity2	Overwhelming emotions, emptiness, fear of abandonment, self-harm3
Emotions	Quick shifts in mood are common16	Anger, irritability or unstable moods3
Impulsive behaviour	For example, interrupting, impulsive spending or risk-taking28	For example, unsafe sex, or alcohol or drug use3
Relationships	Conflict with others can be one sign of adult impulsivity8	Anxiety about relationships and efforts to avoid abandonment3
Main treatment	Medication is the most effective treatment for core symptoms, with non-medication support9	Psychological therapy, such as DBT, with medicine in a secondary role3

If relationships are where you notice problems most, see ADHD and relationships.

Where trauma fits in

BPD usually develops from a combination of genes and life experiences, and many people with BPD, though not all, have a history of childhood abuse, neglect or trauma.³ That is never the person’s fault. If you’ve been through trauma, you can share as much or as little as feels right with your doctor; it can help them understand the full picture and suggest the right support.

Can you have ADHD and BPD?

Yes — having one doesn’t rule out the other. The Australian ADHD Guideline notes that some personality disorders, those grouped as cluster B and cluster C, are more common in adults with ADHD.⁷ A 2022 systematic review also found personality disorders were more common in adults with ADHD than in those without.¹⁰ In the general-population studies it reviewed, between 0.31% and 33.8% of adults with ADHD had a personality disorder, compared with 0% to 3.9% of adults without ADHD — a very wide range, partly because the studies used different diagnostic tools.¹⁰ These figures cover all personality disorders, not BPD alone.

If you have one diagnosis and recognise yourself in the other, raise it with your doctor. The Australian ADHD Guideline notes that a co-occurring condition can lead to ADHD being missed, or can itself be missed when ADHD symptoms are present.¹¹

Can ADHD be misdiagnosed as BPD?

It can happen, particularly for girls and women. An international expert consensus statement notes that girls with ADHD often go unrecognised, often mask their difficulties with compensatory behaviours, and are more likely to be diagnosed first with a personality disorder or with an internalising condition such as anxiety or depression, delaying their ADHD diagnosis.¹² (See ADHD and depression.)

Australia’s 2023 Senate inquiry into ADHD heard that girls and women are commonly misdiagnosed with other mental health conditions first.¹³ One submitter told the inquiry that women in their 30s and 40s have been through a difficult process of misdiagnosis with conditions such as bipolar disorder and BPD.¹³ That is one person’s view, not a finding of the committee. For how ADHD and bipolar disorder differ, see ADHD vs bipolar disorder.

None of this means a BPD diagnosis is likely to be wrong — BPD is a real condition, and you can have both. What matters is that each condition is properly assessed. Read more about undiagnosed ADHD in women.

Treatment for ADHD and BPD

Both conditions can be treated:

• BPD: psychological therapy is the main treatment — for example, dialectical behaviour therapy (DBT) or psychodynamic therapy — with medicine playing a secondary role.³
• ADHD: the Australian ADHD Guideline recommends medication as the most effective treatment for core symptoms, with non-medication treatments adding support.⁹ Cognitive behaviour therapy (CBT) can also help you develop strategies and skills.⁵

When conditions occur together, the guideline recommends best-practice treatment for each co-occurring condition,⁹ and guidelines generally suggest treating the most impairing one first.¹⁴ The details are for you and your doctor to work through. Make sure everyone involved in your care knows about both conditions and any medicines you take, and don’t start, stop or change a medicine without talking to your doctor or pharmacist.

Getting support

If you’re thinking about self-harm or suicide, or you feel overwhelmed, you don’t have to wait for an appointment. Call Lifeline on 13 11 14, any time of day or night, or text 0477 13 11 14.¹⁵ Beyond Blue is available 24/7 on 1300 22 4636. In an emergency, or if you or someone else needs help now, call 000.¹⁶

Frequently asked questions

What’s the difference between ADHD and BPD?

ADHD is a neurodevelopmental condition that begins in childhood and involves problems with attention, hyperactivity and impulsivity. BPD is a mental health condition that affects thoughts, emotions and behaviour, and its features can include a fear of being abandoned, feeling empty and self-harm.

Can you have ADHD and BPD at the same time?

Yes, having one doesn’t rule out the other. Personality disorders in general are more common in adults with ADHD than in adults without it, although estimates vary widely between studies.

Can ADHD be misdiagnosed as BPD?

It can happen. Experts note that girls with ADHD are more likely to be diagnosed with another condition first, sometimes a personality disorder, which delays recognition of their ADHD. A BPD diagnosis isn’t necessarily wrong, though, so talk it through with your doctor.

Is emotional dysregulation a sign of ADHD or BPD?

It can be part of either. Difficulty managing emotions is common in adults with ADHD, and overwhelming emotions and unstable moods are features of BPD. Looking at the whole picture, including whether problems began in childhood, helps tell them apart.

How is BPD treated?

Psychological therapy, such as dialectical behaviour therapy (DBT), is the main treatment, while medicine has a secondary role. If you also have ADHD, each condition is treated in its own right.

Next steps

Read ADHD symptoms in adults and how to get an ADHD assessment in Australia, or start with the free ADHD self-assessment.

This article is general information only and is not medical advice. Only a qualified health professional can diagnose ADHD. ADHD GP is a private telehealth clinic staffed by AHPRA-registered Australian GPs.

Book your ADHD assessment

References

1. Beheshti A, Chavanon ML, Christiansen H. Emotion dysregulation in adults with attention deficit hyperactivity disorder: a meta-analysis. BMC Psychiatry. 2020. PubMed PMID 32164655 — Meta-analysis of 13 studies (2,535 participants): adults with ADHD had much greater emotion dysregulation than controls (Hedges’ g 1.17), with emotional lability the largest effect (g 1.20).
2. American Psychiatric Association. What is ADHD?. 2025. www.psychiatry.org — ADHD is one of the most common mental disorders affecting children; symptoms must be present before age 12; an estimated 8.4% of children and 2.5% of adults have ADHD; listed symptoms include fidgeting, feeling restless (in adults), talking too much and forgetting daily tasks.
3. healthdirect (Australian Government). Borderline personality disorder (BPD). 2024. www.healthdirect.gov.au — BPD is a treatable condition affecting about 1 in 100 adults; features include overwhelming emotions, unstable mood, fear of abandonment, impulsivity and self-harm; psychological therapy such as DBT is the main treatment.
4. healthdirect (Australian Government). Attention deficit hyperactivity disorder (ADHD). 2025. www.healthdirect.gov.au — ADHD is a neurodevelopmental condition that begins in early childhood; around 1 in 20 people in Australia has ADHD; it is partly genetic; an adult diagnosis requires evidence that symptoms began in childhood; learning difficulties can occur alongside it.
5. healthdirect (Australian Government). Treatment for ADHD. 2025. www.healthdirect.gov.au — Stimulants are usually the first medicine prescribed; non-stimulant medicines are available for people who experience side effects; CBT can help develop strategies and skills.
6. Shaw P, Stringaris A, Nigg J, Leibenluft E. Emotion dysregulation in attention deficit hyperactivity disorder. American Journal of Psychiatry. 2014. PubMed PMID 24480998 — Emotion dysregulation is prevalent in ADHD throughout the lifespan and a major contributor to impairment.
7. Australian ADHD Professionals Association. About ADHD (Australian ADHD Guideline). 2022. adhdguideline.aadpa.com.au — ADHD affects 6–10% of Australian children and 2–6% of adults; heritability 70–80%; symptoms begin before 12 though diagnosis may come later; 60–86% persist into adulthood; inattentive presentation most prevalent; up to 80% of adults have another mental health condition, such as depressive, bipolar, anxiety or substance use disorders, and cluster B and C personality disorders are more common; describes executive-function difficulties (working memory, planning, sustained attention, inhibitory control), brain-maturation and dopamine differences.
8. Healthy Male (funded by the Australian Government). Adult ADHD diagnosis in Australia: What you need to know. 2026. healthymale.org.au — In adults, impulsivity can look like excessive spending, risk-taking, conflict with others, interrupting and talking excessively; managing finances and meeting work deadlines can be difficult; some adults ‘hyperfocus’ for hours on activities that interest them, and hyperactivity can show as feeling restless and unable to relax.
9. Australian ADHD Professionals Association. Australian ADHD Guideline — summary of recommendations. 2022. adhdguideline.aadpa.com.au — Medication is the most effective treatment for core symptoms, with non-medication treatments adding support (3.1.1); diagnosing clinicians should be registered and trained in ADHD assessment (2.1.1); the diagnosis must be confirmed before starting medication (5.1.2); CBT should be offered to adults (4.2.11); stimulants are first-line for impairing adult ADHD, with heart rate, blood pressure, weight, sleep, mood and anxiety monitored during titration; co-occurring conditions get best-practice treatment.
10. Choi WS, Woo YS, Wang SM, et al. The prevalence of psychiatric comorbidities in adult ADHD compared with non-ADHD populations: A systematic literature review. PLoS One. 2022. PubMed PMID 36331985 — Review of 32 studies: substance use, mood, anxiety and personality disorders were more common in adults with ADHD; in general-population studies depression affected 8.6–55% with ADHD vs 1.2–12.5% without, bipolar disorder 4.5–35.3% vs 0.2–3.6%, and personality disorders 0.3–33.8% vs 0–3.9%.
11. Australian ADHD Professionals Association. Australian ADHD Guideline — Chapter 2: diagnosis. 2022. adhdguideline.aadpa.com.au — Clinicians should know which conditions commonly co-occur with ADHD, as a co-occurring condition may result in a missed ADHD diagnosis, or a missed co-occurring condition when ADHD symptoms are present.
12. Young S, Adamo N, Ásgeirsdóttir BB, et al. Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/hyperactivity disorder in girls and women. BMC Psychiatry. 2020; 20:404. PubMed PMID 32787804 — Expert consensus: the gap between males and females diagnosed with ADHD is due at least in part to lack of recognition and referral bias in females; many girls with ADHD are likely to remain unidentified and untreated, often mask with compensatory behaviours, and are more likely to first be diagnosed with an internalising or personality disorder, delaying the ADHD diagnosis.
13. Parliament of Australia — Senate Community Affairs References Committee. Assessment and support services for people with ADHD — Chapter 3: barriers to assessment and diagnosis. 2023. www.aph.gov.au — Almost all adult ADHD assessment and diagnosis in Australia is done through the private sector, and cost is a barrier to diagnosis. The committee heard that gender bias has led to under- and misdiagnosis of ADHD in girls and women, who are commonly misdiagnosed with other mental health conditions first and often learn to mask their symptoms; a survey cited by the committee found 86% of more than 570 respondents had tried to mask or hide their ADHD at school or work.
14. Katzman MA, Bilkey TS, Chokka PR, et al. Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC Psychiatry. 2017. PubMed PMID 28830387 — Adult ADHD often co-occurs with mood and anxiety disorders, with strong familial and neurobiological links; overlapping symptoms complicate diagnosis; guidelines advise treating the most impairing condition first.
15. Lifeline Australia. Lifeline home page. 2026. www.lifeline.org.au — Lifeline offers 24-hour crisis support on 13 11 14 (or text 0477 13 11 14); if life is in danger, call Triple Zero (000).
16. healthdirect (Australian Government). Mental health helplines. 2025. www.healthdirect.gov.au — Lifeline (13 11 14) offers 24-hour crisis support and Beyond Blue (1300 22 4636) is available 24/7; if someone is in crisis and needs help now, call triple zero (000).

Sources were last checked on 5 October 2026. See all sources used on this site on our Sources page.