advancedborderline personality disorderbipolar II differentialmood instabilitypersonality disordersBPDdiagnostic reasoning
A 30-year-old female presents with mood instability, intense and unstable relationships, chronic feelings of emptiness, and recurrent self-harm (cutting when emotionally overwhelmed). She reports mood shifts lasting hours to a day, often triggered by interpersonal conflict. She has been diagnosed with "bipolar disorder" by a previous provider. Which feature MOST differentiates borderline personality disorder from bipolar II disorder?