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Borderline personality disorder (BPD) is a serious mental health issue that affects at least an estimated 1.6% of all American adults. It is a mental illness that affects a person’s ability to control their own emotions, which can result in impulsive behaviors, poorly developed relationships with others, and poor self-esteem. It is an issue that affects all aspects of their lives and can negatively interfere with everyday life.
One of the significant factors that can bring on the development of BPD is trauma. Experiencing physical or sexual abuse, experiencing emotional neglect, being abandoned, or living through other hardships during childhood can cause a person to develop borderline personality disorder later in life.
What is Borderline Personality Disorder?
A borderline personality disorder is a mental illness that impacts a person’s feelings about themselves and others and makes it difficult to control their emotions and manage their behavior. They will experience intense emotions, poor self-image, and impulsivity. This causes serious problems in everyday life and makes it difficult to maintain friendships and relationships.
A person with a borderline personality disorder is someone who “may go to great lengths to avoid being abandoned… display inappropriate intense anger, or have ongoing feelings of emptiness,” according to an article on psychiatry.org.
Key Symptoms of BPD
Some of the key borderline personality disorder symptoms are:
- Fear of abandonment.
- Risky or impulsive behaviors like shopping sprees, gambling, or drug abuse.
- Unstable relationships are due to intense shifts in perception about the other person.
- Stress-related paranoia.
- Feelings of emptiness.
- Intense and inappropriate periods of anger.
- Getting into physical fights.
- Rapid changes in self-identity, like shifting values or goals.
- Seeing oneself as “bad” or “unworthy.”
- Self-injury and suicidal behavior often when the thread of rejection or separation is imminent.
- Intense mood swings.
Suppose a person had been abandoned, neglected, or abused as a child. In that case, they may have internalized negative perceptions about themselves while learning maladaptive ways to show that they care for somebody. There is some conjecture by researchers that affective and cognitive development is also affected by abuse and neglect, meaning the brain may have developed in different ways than normal due to traumatic events.
The Underlying Causes of BPD
While there are no borderline personality disorder causes that can be linked to every single person, some of the main risk factors for developing this mental health disorder include:
- Hereditary predisposition (genetic factors): If a close relative has BPD, you are at higher risk of having it due to similar genetic factors.
- Stress and trauma in childhood (environmental factors): There is a close connection between abuse and neglect and those with BPD.
- Brain structure (neurobiological) differences: People with BPD have differences in the parts of the brain that control impulses and emotion regulation.
How Trauma Triggers BPD
While further research is necessary better to understand the relationship between trauma and borderline personality disorder, it is suspected that early trauma can trigger BPD because experiencing hardship, abuse, or neglect as a child affects different biological systems in the brain. This includes neurotransmission mechanisms, gray matter volume, white matter connectivity, and the HPA axis. There may even be genetic changes due to environmental factors.
Along with physical changes from trauma, children who live through trauma struggle with abandonment fears and depression because their emotional and psychological development is arrested there. They may develop particular coping strategies and beliefs during that time about themselves and others, making it difficult to behave in healthy ways during stressful or emotional times.
Therapeutic Interventions for Trauma-Related BPD
Standard borderline personality disorder treatments include:
- Hospitalization, staying as an inpatient for intensive treatment to manage symptoms.
- Psychotherapy (talk therapy), especially dialectical behavior therapy and cognitive behavioral therapy.
- Medications may be used to treat specific symptoms or co-occurring disorders like anxiety but do not treat BPD directly.
Dialectical behavior therapy (DBT) is the most popular of the borderline personality disorder therapies. It was developed using a mix of cognitive behavioral therapy with Zen Buddhism techniques to help patients understand the relationship between their emotions, thoughts, and behaviors. It uses mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation, teaching patients how to stay in the moment, stay grounded, self-soothe, advocate for themselves, and build healthy relationships with others and with themselves.
Cognitive behavioral therapy (CBT) is also used in BPD treatment. CBT is another type of psychotherapy that teaches patients to see how their thoughts and beliefs affect how they feel and behave. This therapy can help patients to change their core beliefs that come from inaccurate perceptions of the world around them. It is an effective therapeutic methodology and can reduce anxiety symptoms, suicidal behaviors, and mood swings.
Frequently Asked Questions About the Impact of Trauma on Borderline Personality Disorder
How prevalent is trauma among individuals with BPD?
Studies have shown that somewhere from 30 to 80 percent of people who have borderline personality disorder have had trauma-related or adverse experiences in their past.
Can trauma directly cause BPD, or does it just exacerbate symptoms?
A borderline personality disorder is caused by a combination of factors, so experiencing trauma alone will not likely cause BPD to develop. That said, those with the genetic makeup and the brain structure that would foster BPD are much more likely to develop the mental illness if they are traumatized.
Are there specific traumas associated with BPD?
Yes, growing up with instability and abuse would be more likely to cause a child to grow up and develop borderline personality disorder. This can include invalidating and unsupportive parents, feeling afraid and upset often, experiencing violence, sexual abuse, or verbal abuse, and living with parents or caregivers with a substance use disorder.
How is trauma-induced BPD different from other cases?
Some researchers believe that trauma-induced BPD can be put on the same spectrum of disorders as post-traumatic stress syndrome. Still, it is also possible to develop the disorder without having a history of traumatic life events. In most cases, the trauma-induced type will be more severe and may be accompanied by other comorbid mental health issues like depression or anxiety.
What are the primary treatments for someone with trauma-induced BPD?
Dialectical behavior therapy is the number one therapy for BPD, using emotional regulation techniques, mindfulness, interpersonal effectiveness training, and distress tolerance to help the individual learn healthier and more productive ways to interact with their environment. Some other therapies that may be utilized are schema-focused therapy, mentalization-based therapy, transference-focused therapy, and systems training for emotional predictability and problem-solving.
How do therapies for BPD address underlying traumas?
Some therapies for those who have experienced trauma may be incorporated into BPD treatment, like EMDR. This effectively addresses the underlying issues, helping reduce symptoms while the person continues their treatment program.
Can early intervention post-trauma prevent BPD development?
It is not possible to guarantee that intervention will stop BPD from developing because it is a complex disorder that can occur even if a person has not experienced any trauma at all. Even if it does not stop the development of borderline personality disorder, the post-trauma intervention will help the individual and stop other mental health conditions from worsening, like PTSD.
To find out more about BPD treatment or to begin your personal recovery journey, please call Alter Health Group at 949-996-9518.