Borderline Personality Disorder

Borderline Personality Disorder

There are more than 3 million people diagnosed with BPD in the US every year

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What Is It?

A condition characterized by difficulties regulating emotion. This means that people who experience BPD feel emotions intensely and for extended periods of time, and it is harder for them to return to a stable baseline after an emotionally triggering event.

The Science Behind It

In addition to environmental factors — such as a history of child abuse or neglect — borderline personality disorder may be linked to:

  • Genetics. Some studies of twins and families suggest that personality disorders may be inherited or strongly associated with other mental health disorders among family members.
  • Brain abnormalities. Some research has shown changes in certain areas of the brain involved in emotion regulation, impulsivity and aggression. In addition, certain brain chemicals that help regulate mood, such as serotonin, may not function properly.

Brain cans revealed that in many people with BPD, 3 parts of the brain were either smaller than expected or had unusual levels of activity. These parts were:

  • The amygdala – which plays an important role in regulating emotions, especially the more "negative" emotions, such as fear, aggression and anxiety
  • The hippocampus – which helps regulate behaviour and self-control
  • the orbitofrontal cortex – which is involved in planning and decision making

It's thought that many people with BPD have something wrong with the neurotransmitters in their brain, particularly serotonin.Neurotransmitters are "messenger chemicals" used by your brain to transmit signals between brain cells. Altered levels of serotonin have been linked to depression, aggression and difficulty controlling destructive urges.

Warning Signs

  • Frantic efforts to avoid real or imagined abandonment by friends and family.
  • Unstable personal relationships that alternate between idealization (“I’m so in love!”) and devaluation (“I hate her”). This is also sometimes known as "splitting."
  • Distorted and unstable self-image, which affects moods, values, opinions, goals and relationships.
  • Impulsive behaviors that can have dangerous outcomes, such as excessive spending, unsafe sex, reckless driving, or misuse or overuse of substances.
  • Self-harming behavior including suicidal threats or attempts.
  • Periods of intense depressed mood, irritability or anxiety lasting a few hours to a few days.
  • Chronic feelings of boredom or emptiness.
  • Inappropriate, intense or uncontrollable anger—often followed by shame and guilt.
  • Dissociative feelings—disconnecting from your thoughts or sense of identity or “out of body” type of feelings—and stress-related paranoid thoughts. Severe cases of stress can also lead to brief psychotic episodes.

Common Misconceptions

BPD is not treatable

BPD is often treated with a combination of medication and psychotherapy

All people with BPD are victims of childhood abuse

The cause of BPD is generally seen as a combination of biological and environmental factors, rather than linked to any one cause.

Treatments

  • Psychotherapy—such as dialectical behavioral therapy (DBT), cognitive behavioral therapy (CBT) and psychodynamic psychotherapy—is the first line of choice for BPD. Learning ways to cope with emotional dysregulation in a therapeutic setting is often the key to long-term improvement for those experiencing BPD.
  • Medications may be instrumental to a treatment plan, but there is no one medication specifically made to treat the core symptoms of BPD. Rather, several medications can be used off-label to treat various symptoms. For example, mood stabilizers and antidepressants help with mood swings and dysphoria. And for some, low-dose antipsychotic medication may help control symptoms such as disorganized thinking.
  • Short-term hospitalization may be necessary during times of extreme stress, and/or impulsive or suicidal behavior to ensure safety.

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Medical Disclaimer: Brain Health Bootcamp aims to promote education and awareness of mental health conditions among adolescents, families, and educators. We publish material that is researched, cited, and drawn from sources reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.