Causes of Borderline Personality Disorder
Around 71% of individuals diagnosed with BPD have a history of trauma, and there may also be genetic and biological factors that contribute to the development of the disorder.
BPD is characterized by frequent mood swings, intense emotional experiences, and feelings of disconnection or dissociation.
BPD is a prevalent mental health condition, with an estimated 1-3% of the population affected by it, making it one of the most commonly diagnosed personality disorders.
People with BPD often experience uncertainty about their self-identity and place in the world, along with a fear of abandonment and feelings of emptiness.
The exact causes of BPD are not fully understood, but it is believed that a combination of environmental, genetic, and neurological factors may contribute to its development.
Environmental causes of BPD
To develop BPD, individuals may have experienced traumatic events in their life, such as child abuse, neglect, or ongoing fear and distress.
It is believed that BPD may be a neurodevelopmental condition resulting from maladaptive responses to trauma and stress, according to some experts.
A review of various studies found that individuals with BPD are significantly more likely to have experienced childhood trauma compared to those without BPD, with a 13-fold increase in the likelihood of reporting such experiences.
Additionally, the link between childhood trauma and BPD appears to be stronger than the link between trauma and other mental health conditions, including personality disorders, mood disorders, and psychosis.
At least one traumatic childhood experience was reported by 71.1% of individuals with BPD among a sample size of over 5,000 people.
Individuals with BPD reported comparable childhood events and experiences, such as:
- physical neglect (48.9%)
- emotional abuse (42.5%)
- physical abuse (36.4%)
- sexual abuse (32.1%)
- emotional neglect (25.3%)
Early life stress can interfere with the development of certain areas of the brain, which may result in further challenges with:
- cognition
- emotional stability
- coping skills
- impulse control
- interpersonal skills.
Although childhood abuse is a significant risk factor for developing BPD, some parenting styles that are harsh or invalidating may also increase the risk of developing the disorder, even in the absence of abuse. When combined with genetic factors such as temperament, these parenting styles can further increase the risk.
Genetic causes of BPD
BPD appears to have a significant genetic aspect and tends to be familial. As a result, individuals with BPD may be more prone to specific temperamental qualities.
There are certain temperamental traits that have been associated with BPD, which may be inherited from family members. These include a propensity for seeking out new experiences, lower levels of self-direction, a higher likelihood of wanting to avoid harm, and lower levels of cooperation.
If you have a first-degree relative such as a parent or sibling with BPD, your risk of developing the disorder may increase.
One study that examined the genetic basis of BPD in families of twins found that genetic material on “chromosome 9” was strongly associated with the disorder. The study involved 711 pairs of twins and 561 parents.
The study’s results are expected to provide more insights into the genetic roots of BPD and may aid in developing more effective treatments for the condition.
Another study explored the potential genetic components of BPD and examined whether gender plays a role in the likelihood of developing the disorder.
The study discovered that genetic factors account for 42% of the symptoms of BPD across three countries. The remaining 58% of symptoms were associated with environmental factors.
The transmission of BPD through genes was similar in both males and females, and younger adults exhibited more signs of BPD than older adults.
BPD in the brain
Several research studies have found that BPD is associated with specific brain differences related to both structure and function.
These differences mainly involve areas of the brain related to emotion regulation and impulse control, suggesting a possible link between these brain regions and the symptoms of BPD.
According to research, individuals with BPD have reduced brain volume in specific areas, such as the hippocampus, amygdala, and medial temporal lobes. These areas are associated with emotions, memory, and impulse control.
These parts of the brain are especially important for managing stress and emotions.
These regions of the brain play a crucial role in regulating stress and emotions. People with BPD have been found to have elevated levels of cortisol, commonly known as the stress hormone. This could be attributed to significant life stressors, with many individuals with BPD having experienced childhood trauma.
Critical parenting styles that cause anxiety and stress may also contribute to BPD in similar ways.
Anxious and stressful parenting styles may also contribute to BPD in similar ways as child abuse. Long-term changes in the brain caused by child abuse can involve overstimulation of the hypothalamic-pituitary axis (HPA), which includes the hypothalamus, pituitary gland, and adrenal glands.
When the HPA axis is overactive, it results in excessive release of cortisol, which can lead to stress responses that resemble the behavior patterns observed in BPD. Moreover, chemical imbalances in the brain, such as in neurotransmitters like serotonin and dopamine, could affect both emotional and physical well-being and contribute to BPD.
Diagnosing BPD
To address the symptoms of BPD or any other related conditions, the initial step is to consult with a mental health specialist.
To ensure an accurate diagnosis, a mental health professional may conduct a series of evaluations including asking you questions about your symptoms, conducting a physical exam to eliminate other potential causes, and reviewing your medical, family, and mental health history.
BPD diagnosis can be challenging due to its potential co-occurrence with other mental health conditions and shared symptoms with other disorders.
Some of the mental health conditions that may have symptoms similar to BPD include:
- Depression
- Anxiety disorders
- Substance use disorders
- Eating disorders
- Post-traumatic stress disorder (PTSD)
According to the DSM-5, some key signs and symptoms of BPD include:
- Frantic efforts to avoid real or imagined abandonment
- Patterns of unstable and intense interpersonal relationships, alternating between idealization and devaluation
- Identity disturbance: unstable self-image or sense of self
- Impulsivity in at least two areas that are potentially harmful (e.g., spending, sex, substance abuse, reckless driving, binge eating)
- Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
- Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety, usually lasting a few hours and only rarely more than a few days)
- Chronic feelings of emptiness
- Inappropriate, intense anger or difficulty controlling anger
- Transient, stress-related paranoid ideation or severe dissociative symptoms
Individuals diagnosed with BPD have a higher likelihood of experiencing suicidal thoughts, with up to 69-80% of individuals in psychiatric treatment for BPD reporting such thoughts.
Another study showed that individuals with BPD in inpatient care reported higher levels of suicidal ideation than those with other mental health diagnoses.
When it comes to treatment, therapy is one of the most commonly recommended approaches for BPD. This therapy can be conducted individually or in a group setting. Group therapy can be particularly beneficial for those with BPD because it can help establish trust and foster friendships.
Getting help for BPD
BPD is viewed as a chronic disorder because it is a personality disorder. However, recent therapies based on evidence have been beneficial in managing symptoms and improving well-being for many BPD patients.
Seeking support is the first and most critical step. A therapist can assist someone with BPD in breaking down deeply ingrained patterns of behavior and thought.
Additionally, finding a therapist who specializes in treating BPD can provide tailored support to meet specific needs.
Two common therapies for BPD include dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT).
Dialectical behavior therapy (DBT) is a widely used treatment approach for individuals with BPD. The goal of DBT is to help individuals understand how their emotions are related to their environment, and to provide them with tools and skills to manage strong emotions and avoid self-destructive behaviors.
It emphasizes mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness.
CBT is another therapy that can help individuals with BPD to understand how their beliefs affect their behavior and interactions with others.
Through CBT, people can change their negative beliefs to more positive and productive ones. Medications may also be used to address specific symptoms such as depression or anxiety. It is also recommended to join a support group or an online forum to connect with others who have BPD and share similar experiences.
This can provide a helpful and understanding community.
Let’s recap
BPD is a multifaceted personality disorder with various symptoms and potential causes, such as childhood trauma, genetics, and brain differences.
Although it may be challenging to manage BPD symptoms, there are numerous treatment options and resources available to help individuals along their journey.
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