BPD Etiology

The Etiology of Borderline personality disorder

BY AUTUMN WINKLER

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index

Treatment

Introduction

Psychotherapy Expanded

Cause #1

Cause #2

Conclusions

References

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What is Borderline Personality Disorder?

• Borderline personality disorder (BPD) is a condition that affects how people feel about themselves and others
• The daily lives of those who suffer are affected by feelings of impulsiveness and extreme actions

Symptoms

• Fear of abandonment
• Stress-related paranoia
• Thoughts of self-harm or suicide
• Wide mood swings

Daily Impacts

• Unstable interpersonal relationships
• Quick shifts in goals and values
• Loss of contact with reality for minutes up to hours
• Risky behaviors include:
• Fast driving, unsafe sex, drug misuse, sabtoging success

INTRODUCTION to BPD

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• Explanation of Biological Vulnerabilities
• BPD is a hereditary condition that can be passed from mother to child
• The heritability of BPD is estimated to be 40%

• Connection to BPD Development
• Inheritance combined with genetic vulnerabilities and additional influences can lead to an increased likelihood of developing BPD
• One way DNA becomes vulnerable is through DNA methylation
• DNA methylation is a chemical process that adds methyl to a gene, changing how it is expressed

From Source 1

Cause #1 - Genetic Factors

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Fact

Cause #2 - Childhood Trauma

• Explanation of Trauma as a Risk Factor
• Intense or repetitive trauma can lead to the brain doing several things to try and protect itself
• The hypothalamic-pituitary-adrenal axis (HPA) releases cortisol as a stress response
• Overuse of the HPA can lead to suppression of the cortisol response, called "adrenal fatigue"
• With a reduced stress response, comes an increased vulnerability to stress-related conditions such as BPD
• In individuals who are already have BPD, it can worsen symptoms and cause additional disorders

• Explanation of Trauma as a Risk Factor Pt. 2
• Forms of transmission for neurotransmitters (hormones) can become altered
• Critical hormones for early childhood that cause brain development do not work in the same way
• Fewer synapses are formed when the brain does not develop properly
• Synapses are places where chemical and electrical messages can connect and communicate

• With fewer synapses and less ability to communicate, BPD symptoms can develop and worsen

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From Source 2

• Psychotherapy (Talk Therapy)
• Psychotherapy is the primary form of treatment for BPD
• Talk therapy allows the patient to:
• Focus on functionality
• Learn to manage emotions
• Reduce impulsiveness

• Several types of talk therapy are used based on each patient's needs
• DBT, CBT, Schema Therapy, MBT, etc.
• Medications
• Medications may help with symptoms but do not work for many
• Medications such as antidepressants, antipsychotics, and mood-stabilization drugs
• Hospitalization
• Hospitalization can occur when a person with BPD has suicidal thoughts or behaviors

Treatment

Fact

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Psychotherapy Expanded

Cognitive Behvaioral Therapy (CBT)

Dialectical Behvaior Therapy (DBT)

CBT helps people identify their negative thoughts and provides self-help strategies

DBT helps people accept themselves, teaches interpersonal skills, and helps them make life chnages

Mentalization Based Therapy (MBT)

Schema Therapy

MBT was developed for BPD. MBT helps people see how their behavior affects others through various perspectives

Schema therapy helps people identify unhealthy patterns (schemas) and focuses on accepting and rescripting their behavior

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Conclusions

Of BPD

BPD is a complex condition that has many genetic predisposition, environmental factors, and vulnerabilities at play

Genetics and childhood trauma are two factors that can contribute to the development of BPD. Both factors are effects the bodies system on a very deep level, and can even change how a person's body works

Effective treatment can vary from patient to patient. One of the most important things is to check up on those with BPD and helping them find someone to talk with if they are struggling

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1Ansari, D., Lakkimsetti, M., Olaleye, K. T., Bhullar, J. V. K., Shah, R. Z., Arisoyin, A. E., Nadeem, H., Sacal Slovik, S. C., Habib, F. Z., Abdin, Z. U., & Zia Ul Haq, M. (2023, August 18). Genetic influences on outcomes of psychotherapy in borderline personality disorder: A narrative review of implications for personalized treatment. Cureus. https://pmc.ncbi.nlm.nih.gov/articles/PMC10505449/ 2Cattane, N., Rossi, R., Lanfredi, M., & Cattaneo, A. (2017, June 15). Borderline personality disorder and childhood trauma: Exploring the affected biological systems and mechanisms - BMC psychiatry. SpringerLink. https://link.springer.com/article/10.1186/s12888-017-1383-2 3Kernberg, O. F., & Michels, R. (1970, May 1). Borderline personality disorder. American Journal of Psychiatry. https://psychiatryonline.org/doi/full/10.1176/appi.ajp.2009.09020263 4Mayo Clinic Staff. (2024, January 31). Borderline personality disorder. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/borderline-personality-disorder/symptoms-causes/syc-20370237

Sources Cited

FACT

Anywhere from 30 to 90% of patients diagnosed with borderline personality disorder are said to have some form of childhood trauma (Cattane, 2017).

Fact

Of the patients with borderline personality disorder who take medication, approximately 30% of patients respond positively over an extended period. This means around 70% of patients with BPD are not able to feel better while only taking medication (Otto, 2009).