Is borderline personality disorder hereditary

Causes - Borderline personality disorder

There's no single cause of borderline personality disorder (BPD) and it's likely to be caused by a combination of factors.

Genetics

Genes you inherit from your parents may make you more vulnerable to developing BPD.

A study found that if 1 identical twin had BPD, there was a 2-in-3 chance that the other identical twin would also have BPD.

However, these results have to be treated with caution, and there's no evidence of a gene for BPD.

Problem with brain chemicals

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.

Problem with brain development

Researchers have used MRI to study the brains of people with BPD. MRI scans use strong magnetic fields and radio waves to produce a detailed image of the inside of the body.

The scans 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

Problems with these parts of the brain may well contribute to symptoms of BPD.

The development of these parts of the brain is affected by your early upbringing. These parts of your brain are also responsible for mood regulation, which may account for some of the problems people with BPD have in close relationships.

Environmental factors

A number of environmental factors seem to be common and widespread among people with BPD. These include:

being a victim of emotional, physical or sexual abuse
being exposed to long-term fear or distress as a child
being neglected by 1 or both parents
growing up with another family member who had a serious mental health condition, such as bipolar disorder or a drink or drug misuse problem

Page last reviewed: 4 November 2022
Next review due: 4 November 2025

Is Borderline Personality Disorder Genetic?

While BPD symptoms are often present during adolescence, the disorder frequently remains undiagnosed until adulthood, perhaps because personality traits fluctuate during adolescent years, according to one study. (7)

Having a child evaluated early can be invaluable in getting them on the path toward wellness sooner by identifying symptoms in childhood that may predict a personality disorder diagnosis. (8) This early intervention can help kids learn to manage their emotions in effective, healthy ways rather than self-destructive ones, and can assist caregivers in providing a supportive environment.

No matter their age, when a loved one has BPD, it’s common for others to feel that their loved one is out of control. “They may seem unreasonable, irrational, or that they’re deliberately and willfully behaving in a way just to try to get a rise out of you,” says Dr. Oldham. But the wrong response is to tell them to just knock it off or get a grip — as if that’s easy.

“For the person in the overemotional state, their ‘emotional brakes’ don’t work. And it’s very distressing for them. This is illness-driven behavior, they’re not just being a jerk,” Oldham adds. It’s a key thing for family and friends to keep in mind, particularly when you’re trying your best to get them help.

The Best Treatments and Therapies for Borderline Personality Disorder

There are certain types of treatment that are more appropriate than others for those with BPD. Treatment tends to focus on psychotherapy — specifically dialectical behavior therapy (DBT) — not medication. DBT is an evidence-based treatment where people learn skills to regulate their emotions and handle stress, explains Adam Carmel, PhD, a clinical professor of psychiatry and behavioral sciences at the University of Washington School of Medicine in Seattle. The treatment involves team classes, phone coaching, group skill coaching, and individual therapy.

To date, there are 36 randomized controlled trials of DBT, Dr. Carmel points out. “It’s the most researched treatment for BPD,” he says. Other evidence-based treatments for BPD include transference-focused psychotherapy (TFP) and mentalization-based treatment (MBT), as well as a general approach called good psychiatric management (GPM). (9)

Because one of the causes of BPD is thought to be brain changes (people with the diagnosis have different brain structure and function that impairs the ability to control emotions and impulses, as well as make decisions), therapy aims to rebuild those neural connections that allow people to develop social smarts.

And research suggests that’s one way it works. A 2017 study on females found that after 12 weeks of DBT, patients had increased volume in brain regions that regulate emotions compared with those who underwent the control therapy. (10)

One problem is that those with BPD have deep-seated trust issues. “They will fire their friends, they will fire their therapists,” Carmel says. As their loved one, you’ll have to offer continuous support so they can stay the course. It’s also common for them to assume they’re not the one with the problem: you are. Unfortunately, BPD is severely undertreated. As NIMH points out, only 42.4 percent of people with the illness report having received any treatment over the past year.

To get them in the door, employ a little strategy when talking to them about therapy. “You have to respond to someone with BPD neutrally. As a therapist, we know that they’ll try to do something to get us angry,” says Gladys Frankel, PhD, a clinical psychologist in New York City. Respond to them neutrally, factually, and respectfully, she advises. If the conversation gets out of control, you can respond with “I don’t think this conversation is productive, maybe we should stop right now and come back in a few minutes,” says Dr. Frankel.

Causes, Symptoms and Treatments

Borderline Personality Disorder (abbreviated as BPD ) is increasingly common among children today. The pathogenesis of this type of psychopathy is usually accompanied by a complex of unfavorable factors.

It is quite difficult to recognize this type of disease in everyday life. Often, it is confused with narcissism or simply the bad character of the individual, since the behavior of the "border guards" can be characterized by an extreme degree of unpredictability and hysteria, as well as a tendency to manipulation. For example, they confess their love to a partner, and after a couple of hours they leave “forever”, they can sincerely sympathize with someone, and then hit. It is also very common for patients of this type to constantly violate the boundaries of other people, shifting their problems onto them, and avoiding responsibility. Consider the symptoms of borderline in more detail.

Symptoms of borderline personality disorder (BPD)

The main symptomatic difference of this type of disorder is prolonged abnormal behavior of the patient .

While in many other psychopathy periods of instability alternate with remission, in the case of BPD the patient behaves destructively over a long period of time. In the field of psychological anomalies are such manifestations as:

aggressive behavior leading to problems in relationships,
unstable emotional background and inadequate self-image,
high anxiety,
total fear of loneliness and permanent feeling of boredom,
dichotomous thinking and changeable mood, dividing the world only into "black and white" (today I love, but tomorrow I hate).

Also among the main symptoms can be noted: sociopathy and fear of society associated with low self-esteem and, as a result, separation anxiety (it is experienced by a person when separated from home or loved ones). Patients often exhibit reckless irresponsible "risky" behavior, the extreme form of which may be self-harm or suicide attempt.

Types of spontaneous actions that accompany mental borderline personality disorders

Due to difficulties in self-identification, lack of one's own opinion and a tendency to polarity, spontaneous destructive actions are characteristic of BPD sufferers.

Panic fear of loneliness and lack of an inner core pushes them into contact with sociopathic personalities who are characterized by destructive behavior: gambling, theft, vandalism, promiscuous relationships, drug addiction. This also includes self-harm, which was mentioned above.

One of the reasons for this uncontrolled behavior is the problem with holding the inner impulse. The level of impulsivity is so high that a person is not able to control it.

Besherednichenko Andrey Nikolaevich

Chief physician of the Narcakov Medical Center network, psychiatrist-narcologist

Experience for more than 12 years

Consultation

Records for reception

Emotionally unstable personality disorder in the ICD of the 10th review of the 10th review of the 10th revision personality disorder is defined as "Emotionally unstable personality disorder (F60.3)". In the clinical community on the territory of the Russian Federation, this name is used quite often and is used due to the fact that the main symptom, as described above, manifests itself in the form of an emotionally unstable mental state of a person.

BPD pathogenesis

In the pathogenesis of the disease lies an incorrectly or incompletely formed intrapersonal self-awareness, in other words, “self-identification”. Border guards hardly realize how they relate to the main areas of life. They have problems with the concept of their opinions, interests, hobbies, and their character as well. Hence the more common definition of the disorder - "borderline". In this aspect, it means maneuvering on the verge between psychopathy and a stable state. The word "borderline" in a particular case means a precarious state between the norm and deviation, as if a person lives on the verge between "mental illness" (psychosis) and "mental health". That is why, the slang name for patients of this type is “borderliners” (from the English expression “border line”, which literally translates as “border”).

In classical psychiatry, borderline personality disorder is also classified as a type of ego syntonic disorder. Ego syntonicity implies that the patient does not assess his condition as painful, is not critical of him and calmly accepts deviations in behavior, not believing that they harm him in any way. Moreover, the patient, as it were, “defends” his symptom, preventing his own cure due to the difficulty in identifying his own “I”.

Causes of BPD

The underlying causes of BPD are currently not clearly defined, however, like most other disorders, BPD is caused by a group of factors.

Hereditary (genetic determinism), physiological (disturbances in the brain) and social factors (low stress resistance and psychological traumatic factor).

Unfavorable social environment

According to statistics, groups of people exposed to an unfavorable social environment, for example, in the family, are more susceptible to the disease. These include:

difficult childhood,
abuse,
tyranny,
physical or emotional domestic violence,
early loss of parents.

It is worth noting that "borderliness" occurs 3 times more often among women than among men.

Post-traumatic stress disorder (PTSD) , as a variation of an unfavorable social factor, can act not only as a cause, but also as a concomitant individual disease that is in a pathogenetic relationship with the diagnosis in question.

Childhood chronic emotional trauma can contribute to the development of BPD, but in rare cases it is the only cause. Personal qualities that are responsible for the ability to cope with a stressful situation in this aspect also play a big role. Here it is worth noting that, according to statistics, an injury received in childhood (especially before the age of 10) can lead to a subsequent disorder much more likely than an injury received at an older age. Also, scientists note that situations not associated with direct violence, such as natural disasters or catastrophes, are less likely to lead to the development of post-traumatic syndrome.

Physiology

Another group of factors considers a possible cause of the development of the disease - a disruption in the functioning of neural brain connections, namely the destruction of the functioning of the frontal limbic neurons

Heredity

diagnosis. It is quite difficult to achieve clear indicators in this vein, however, according to European studies, BPD is located in 3rd place out of 10 in terms of the genetic determinant among personality disorders. It is logical to note that deviations in the work of certain parts of the brain can be inherited and lead to a number of psychological problems, the development of which is aggravated by the social factor. Most studies show that most often borderlineness is transmitted from the mother.

Borderline state of the psyche in psychiatry and the severity of personality disorders

In clinical psychiatry, three levels of mental disorder are traditionally distinguished:

Neurotic . These include neuroses of a different nature, implying reversible temporary conditions that can be treated.
Psychopathic level . In its plane lie personality disorders, which include anomalies in the nature of various pathogenesis or painful changes in its features, with which nothing can be done, since they relate to the personality structure of the individual.
Finally, the deepest lesion of the psyche manifests itself at the psychotic level . This includes such manifestations as delirium, hallucinations, twilight consciousness.

Modern psychoanalysis distinguishes 4 levels of deviations. Between the state of psychosis and neurosis, it is conditionally located just “ borderline level”, also called borderline state . A borderline state can mean both the disorder itself and the designation of the level of mental damage.

How to reliably identify borderline personality disorder (BPD)

Borderline personality disorder is extremely difficult to diagnose and differentiate, as it has a high level of comorbidity, in other words, it is combined with a large number of concomitant disorders. For example, panic anxiety, eating disorders, bipolar affective disorder, attention deficit disorder, sociopathy, and so on. In connection with the above, the patient has to undergo a long diagnostic process and special tests.

Borderline personality disorder BPD test

One of the fairly popular tools for detecting the presence of psychopathy are tests, which are, in fact, a personality questionnaire. Used in modern clinical psychology, a test for screening for the bright signs of BPD was developed in 2012 by a group of scientists. In their work, the authors relied on the basic criteria for differentiating borderline disorder.

The questionnaire edited by them is a fairly effective tool for diagnostic verification and confirmation of symptoms. It is used both in psychiatric and general clinical, and in other practices that are not directly related to medicine.

The test itself consists of 20 questions and asks the subject to answer only yes or no. For each answer, the system counts a certain number of points. The probability of diagnosing BPD appears if the respondent scored more than 25 points.

Treatment of borderline personality disorder (BPD)

Cherednichenko Andrey Nikolaevich

Chief doctor of the network of medical centers "Korsakov", psychiatrist-narcologist

Experience over 12 years

Consultation

Appointment

Like most other mental disorders, borderline disorder is not treated at home and requires complex occupational therapy, including both medication (taking antidepressants and antipsychotics) and psychotherapy. And only a psychiatrist, often in tandem with a clinical psychologist, can competently develop an effective course of treatment.

The drug course is developed in accordance with the individual characteristics of the patient's body and includes the following drug groups:

Selective inhibitors of are aimed at preventing depressive episodes and reducing anxiety/panic/borderlines.
Mood stabilizers .
One of the most popular remedies is Lamotrigine. It is also used to neutralize depression, mood lability and impulsivity.
Atypical antipsychotics .
Now the 2nd generation of drugs of this cluster has already been developed, which have proven themselves well in neutralizing the symptoms of the cognitive sphere, such as: aggression, distortion of perception of reality, paranoia, dichotomy of thinking and disorganization.

As for the group of benzodiazepines and stimulants, they are used in modern therapy extremely rarely due to the high risk of dependence and, accordingly, overdose.

Thus, the main task of drug therapy in borderline personality disorder is to reduce the severity of symptoms and alleviate the general condition of the patient.

It is worth noting that BPD is the most difficult to treat due to the patient's ego syntony, which we discussed above. It is the patient with BPD who is the most difficult to respond to any therapy due to the rigidity of the psyche and the clear conviction that everything is generally normal with them.

However, when it comes to Selective Inhibitors, Dialectical Behavioral Therapy (DBT), one of the varieties of Cognitive Behavioral Therapy (CBT), is considered the most effective method in the modern clinical community. As part of the treatment, the patient is taught to look at the problem from different points of view and evaluate the causal relationship in different ways. Due to satisfaction with their symptoms and rigidity, "border guards" are difficult to treat, so the psychotherapeutic process can be lengthy.

Most often, relatives suffer the most from relationships with patients with BPD, so another parameter that the specialist works on is the patient's socialization and adaptation, aimed at developing basic life skills and developing an adequate behavior for the situation. In psychiatry, this type of technique is called STEPPS (System Training Emotional Predictability & Problem Solution) and in translation means Systematic Training in Emotional Predictability and Problem Solving.

One of the well-established methods are meditation techniques aimed at teaching a person to control their emotions and the ability to relax.

Another effective method when working with a psychotraumatic factor is the gelstat technique, during which the patient returns to a stressful situation and looks at it from the other side, rebuilding the scenario or acting it out again. The task of a specialist in this aspect is to remove the negative emotional charge from the memory.

Ability to be aware of the fact of self-harm in borderline personality disorder

Author: Claudia M.

Elsig, MD

An estimated 2% to 6% of the general ¹ population and 20% of psychiatric patients suffer from borderline personality disorder (BPD). ² At the same time, a staggeringly large number of such people - 65-80% - have non-suicidal self-harmful behavior (NSBP) in one form or another. ³ In this blog you will find a lot of information about what it's like to live with this condition and research why self-harm plays such an important role in this complex disorder.

What is borderline personality disorder?

Each person has his own personality. However, some develop rigid, inflexible, or maladaptive behavior patterns. Borderline personality disorder (also known as emotionally unstable personality disorder (ENPD)) is a mental disorder that affects how a person thinks, feels, behaves, and interacts with others. People with BPD are almost unable to learn from their own mistakes (which is vital for "normal" psychological development).

Symptoms of BPD include emotional instability, increased sensitivity to rejection by others, impulsive and self-injurious behavior. People with BPD may experience extreme mood swings for short periods of time, and their relationships with others are often emotional but unstable. ⁴

A person with BPD often experiences momentary intense emotions such as rage, sadness, shame, panic and horror, as well as feelings of emptiness or loneliness. A person with BPD does not feel stable in anything. Factors such as self-esteem, goals, and even likes and dislikes can seem confusing and unclear. People with BPD have "rigid and unhealthy thinking." ²

BPD is often accompanied by multiple comorbidities such as affective, anxiety, obsessive-compulsive, eating, dissociative, addictive, psychotic and somatoform disorders. ⁵

The impact of BPD on a person's life

Living with BPD creates many problems, especially in relationships with other people. A person suffering from BPD experiences intense emotions and is unable to reduce the intensity of their feelings. Such people are able to be angry or upset almost all the time. They often act recklessly, impulsively and are always ready to enter into conflict.

UK's leading mental health charity MIND describes the profound impact of BPD on everyday life. Person with BPD:

Fear of being abandoned
Experiences very strong emotions that can last from several hours to several days
Possesses low self-esteem; this feeling may change depending on who the person is with at the moment
Difficulty starting and maintaining stable relationships
Has a strong sense of emptiness
Does reckless behavior, such as overeating, using drugs, or driving badly
Self-injury
Experiencing intense rage that is difficult to control
Experiencing paranoia or dissociation ⁶

What causes BPD?

Borderline personality disorder is a complex disorder. This condition can develop for a variety of reasons, but is usually associated with childhood trauma. Research shows that childhood trauma, parental mental illness, and early life poverty are strong triggers for BPD. ⁵ People who have been sexually, physically or emotionally abused, neglected or abused as children are at high risk. Separation from parents during childhood also increases this risk. This does not mean that BPD is at risk for everyone who has had a similar experience, but such people are more likely to develop the disorder.

Genetic predisposition may also be a relevant factor. BPD is often inherited. "There is increasing evidence of interactions between genes (eg, FKBP5 polymorphisms and CRHR2 modifications) and environment (physical and sexual abuse, emotional neglect)." ⁷

Dysregulation of brain chemicals (particularly the neurotransmitter serotonin) is also associated with several psychopathological conditions, including BPD.

Serotonin is one of the most important neurotransmitters influencing mental health, and its optimal regulation determines a mentally normal personality and acts as a mood stabilizer. ⁷ Studies confirm that altered serotonergic activity is associated with various mood disorders. ⁸

Most likely, BPD develops due to a combination of all these factors: childhood trauma, genetics, and differences in brain chemistry.

Why do people with BPD injure themselves?

Self-harm is considered a serious problem in some psychiatric disorders, but it is especially prevalent in borderline personality disorder. Research shows that people with BPD report more frequent, severe, and varied cases of NSPP compared to those who injure themselves without suffering from BPD. ⁹ People with BPD also report more suicidal thoughts.

So why do people with BPD injure themselves?

Self-injurious behavior is often used to manage emotions or reduce dissociation. The main functions of self-harm in all cases (not just in BPD) are "mood regulation, anti-dissociation, self-punishment, interpersonal influence, anti-suicide, interpersonal boundaries, and thrill seeking". ⁹

In BPD, the inability to regulate emotions is most associated with self-injurious behavior. ⁹ A person suffering from BPD uses self-injurious behavior as a form of control.

BPD self-injury has several functions. It is the regulation of dysphoria (deep dissatisfaction and dissatisfaction), getting rid of stress, a means of expressing emotions and a way to cope with a state of dissociation. ⁹

Treatment at CALDA Clinic

Personality disorders, and BPD in particular, are chronic conditions that require skilled management. Traditional methods of treatment often include various psychotherapeutic procedures, as well as medication. Such treatment takes a lot of time, often does not bring the desired results or threatens with relapses.

The comprehensive therapeutic program offered at the CALDA clinic is very effective in the treatment of personality disorders. Individual therapy tailored to your specific needs in accordance with the CALDA concept. We use evidence-based classical medicine and hypnotherapy combined with carefully tested alternative medicine, traditional Chinese medicine (TCM) and orthomolecular medicine therapies. Our practice proves that amazing results can be achieved in a short time, and without the use of medicines!

Contact us for more information about our treatment programs. All our clients pay for their own stay in the clinic, and maintaining secrecy is of the utmost importance to us. Therefore, you can be sure of your complete confidentiality.

References/sources:

Brickman L.J. and others (Brickman, L.J. et al.) (2014). Link between "https://bpded.biomedcentral.com/articles/10.1186/2051-6673-1-14" non-suicidal HYPERLINK "https://bpded.biomedcentral.com/articles/10.1186/2051-6673-1-14" self-harm and symptoms of borderline personality disorder: a sample of "https://bpded.biomedcentral.com/articles/10.1186/2051-6673-1-14" college students. "Borderline personality disorder and emotional dysregulation" (Bord personal disord emot dysregul), 1, 14.
Chapman J. et al. (January 2022). Borderline personality disorder. [Updated January 25, 2022]. Q: StatPearls [Internet].
Brickman L.J. (Brickman, L.J.), Emmerman B.A. (Ammerman, B.A.), Luk A.E. et al. (Look, A.E. et al.) (2014). Association between "https://bpded.biomedcentral.com/articles/10.1186/2051-6673-1-14" non-suicidal "https://bpded.biomedcentral.com/articles/10.1186/2051-6673-1-14" self-harm and symptoms of borderline personality disorder: a sample of college students. "Borderline personality disorder and emotional dysregulation" (Bord personal disord emot dysregul), 1, 14.
UK Community Health System (NHS) website. Symptoms - borderline personality disorder [as of April 11, 2022].
Bozzatello, P. et al. (September 2021). The role of trauma in the early onset of borderline personality disorder: "https://www.frontiersin.org/articles/10.3389/fpsyt.2021.721361/full" biopsychosocial HYPERLINK "https://www.frontiersin.org/articles/10.3389/fpsyt.
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