BPDFamily.com

This was a very big concern of mine because I have two young sons with my BPD ex husband.  I think it's the age old question of "nature vs. nurture".  And I think right now because they are so young (2 and 1), even if they are prone to BPD in terms of genetics, there is a possibility that with the right form of parenting, they could lead somewhat normal lives.  I noticed that my mother in law always catered to my husband's BPD nature (maybe even if she wasn't quite aware of it).  When he threw a fit, everyone would cave in to his needs.  She did this more so when he was a child.  She started to do that with my oldest son when he started the whole terrible two temper tantrum thing.  I think impulse control is learned behavior.  In my opinion most BPD's lack this.  So I think it's a mixture of genetics, environment and "learned behavior"...  

I believe it is a mixture of genetics and trauma or abuse.  Other risk factors that have been noted are being adopted, early parental loss (or inadequate infant bonding),head injuries and untreated ADHD.  ( 50% of those with "untreated" ADHD develop the borderline disorder and also, 50% of borderlines also have ADHD)

Our doctor, who specializes in treating those with the borderline disorder, has also treated a high number of Amish with the disorder.  This seems to indicate that there is a genetic disposition to the disorder since the Amish do not intermarry with outsiders. And therefore, any genetic disorders would be passed on more frequently among themselves.

 

BPD doesn't always develop in someone who has the predisposition.  Being raised in a mentally healthy environment without abuse and good self esteem have been recommended (and treating any mental disorders of the parents) to greatly reduce the chance of developing BPD.

My husband was diagnosed with BPD and ADHD a year and a half ago.  Our 24 year old daughter and 14 year old son show no signs of having the disorder.  They are however, both being treated for ADD.  My husband was adopted so I don't know anything about his biological family background.

One comment I would like to add to something gypsy darkeyes said.  Although I do agree that in many instances impulse control is a learned behavior, for someone with ADHD the impulse problems are not something that can be controlled (outside of medication greatly reducing or eliminating the impulsiveness).  Many children who are ADHD are blamed for something that they can not control.  There are even several psychiatrists and psychologists that I know of who have ADHD and are also knowledgeable and experienced in treating ADHD who can attest to this both from knowledge and personal experience.

 

Abigail

Borderline psychopathology in the first-degree relatives of borderline and axis II comparison probands.

The purpose of this study was to assess the prevalence of each of the nine DSM criteria for borderline personality disorder and the prevalence of the disorder itself in the first-degree relatives of borderline probands and Axis II comparison subjects. Four hundred and forty-five inpatients were interviewed about familial borderline psychopathology using the Revised Family History Questionnaire--a semistructured interview of demonstrated reliability. Of these 445 subjects, 341 met both DIB-R and DSM-III-R criteria for BPD and 104 met DSM-III-R criteria for another type of personality disorder (and neither criteria set for BPD). The psychopathology of 1,580 first-degree relatives of borderline probands and 472 relatives of Axis II comparison subjects was assessed. Both DSM-III-R and DSM-IV BPD were found to be more common among the relatives of borderline than Axis II comparison probands. However, five of the criteria for BPD (inappropriate anger, affective instability, paranoia/dissociation, general impulsivity, and intense, unstable relationships) and all four sectors of borderline psychopathology (affect, cognition, impulsivity, and interpersonal relationships) were found to be both more common and discriminating than the BPD diagnosis itself. Taken together, the results of this study suggest that the subsyndromal phenomenology of BPD may be more common than the borderline diagnosis itself.

---

Zanarini MC, Frankenburg FR, Yong L, Raviola G, Bradford Reich D, Hennen J, Hudson JI, Gunderson JG.

J Personal Disord. 2004 Oct;18(5):439-47. Related Articles, Links  

The Laboratory for the Study for Adult Development, McLean Hospital, and the Department of Psychiatry, Harvard Medical School, Belmont, MA 02478, USA. zanarini@mclean.harvard.edu

 

I don't understand.  What point are you making?  Looks like about one-third of close relatives turn out to be BPD themselves.  Is that what we need to know?

Wow. I find a minimum of 18 family members with symptoms of BPD or other PD.  It is not that I want to be diagnosing everyone, I just could not believe the abuse that exists within our family and I wanted to take a closer look at the symptoms I have been seeing for years.  

I only included relatives of blood and never counted the married into which would really bring the count up.

A point of the study which I think is important is that a lot of relatives have features of BPD even if they don't meet the full diagnostic criteria.

A child is six times more likely to develop BPD if a parent has the disorder.

You also need to consider that your children are at risk for developing the disorder if their mother has it.  

There are some things you can do to lessen the risk that they will develop it.  Build up their self-esteem, make sure that you are mentally healthy and treat any mental health problems that they may develop, in particular, ADHD.  Untreated ADHD is one of the risk factors for developing BPD.  

 Abigail

 

I was wondering about the 6x more likely to develop BPD if the child had a BPD parent.  Knowing that the thinking is that it is 50% genetic and 50% environmental, is that 6x for a child who is genetically predisposed to BPD to develop BPD vs. another child who is predisposed (i.e. not including children not genetically predisposed)?

I'm not sure.  

I just found a great article on borderlinepersonalitydisorder.com called "Etiology of BPD by John G. Gunderson, MD".  It helps explain how both genetics and environment contribute to BPD.

It is not easy to develop BPD. I expect that only a small fraction of the people who have the genetic disposition go on to develop it. Parenting is sometimes dysfunctional, but villains are truly rare. We need far more research to understand the contributions of both genes and environment.

the etiology of the borderline personality disorder (BPD) involves both genes and environment. The genetic component, which has been underappreciated, is substantial. It is not, however, the disorder itself which is inherited. Rather, what is inherited are forms of temperament that predispose a child to develop this disorder. The predisposing temperaments (aka phenotypes) for BPD are Affective Instability, Impulsivity, and Needy/Fearful Relationships.

Each of these temperaments predisposes to other disorders as well as BPD; Affective Instability also predisposes to mood disorders, Impulsivity also predisposes to substance / alcohol abuse, bulimia, and conduct disorder, and Needy/Fearful Relationships also predispose to histrionic, dependent, and avoidant personality disorders. The presence of these inherited temperaments helps explain why patients with BPD are often co-morbid with these other disorders.

Early caretaking relationships are significantly shaped by the child. This contrasts with the more widely recognized belief that parental interactions significantly shape the child. Thus, the easily upset, needy/fearful, hyperactive child who possesses the predisposing temperaments for BPD will pose special problems for parents. Such a child will benefit from forms of parenting that may not come natural to their parents.

The easily upset child may need an unusually calm and patient caretaker. In its absence their emotions may be poorly integrated and disturbing to them. The needy/fearful child may require a consistently involved reassuring caretaker. In its absence, their fears of abandonment may become unrealistic. An impulsive child may need parenting marked by predictability and non-punitive limit setting. In its absence, they may not develop self-controls.

Regardless of the early childcare, the child with predisposing temperaments for BPD will be far more easily undone by traumatic events. Most children with trauma grow up without sequelae. Those who suffer enduring consequences from trauma have both a predisposing temperament and -- perhaps due to problematic early caretaking -- will often have failed to disclose and process the event with their caretakers.



www.borderlinepersonalitydisorder.com/notes-gunderson.shtml (http://www.borderlinepersonalitydisorder.com/notes-gunderson.shtml)

It's also important to remember that not all people with BPD have a history of abuse/neglect/abandonment.  

That's hard to see, because the perspective of BPD is often one of victimization (e.g. they perceive they've been victimized all the time - current and past).  Personality disorders, in general, are a condition where there isn't a clear path of "disease" like:  a + b = personality disorder.  Maybe someday, as brain research gets better.

Molly

So, one of the new and interesting developments in recent science is the field of Epigenetics. What researchers have discovered that environment influences gene expression. This means that there are alot of genes that are more like switches, with two or more positions and that they can be switched on and off by environmental factors. This is may be why some abused people and up ok and others end up with a personality disorder.

So it appears that environment and genetics are two interdependant factors, that may even be flexible throughout life.

BPD results from the combination of a sensitive emotional nature (inborn) along with an invalidating environment.  The environment does not have to be abusive in order to be invalidating.  The parent and child may simply be a poor fit.

My niece, for instance, was diagnosed with BPD.  There was some sort of trauma at her birth... .a lack of oxygen.  She was developmentally slow, but the doctors did not really acknowledge it.  Anyway, I'm saying she was 'different' and it was difficult to be validating for her.  Just your normal, run of the mill environment was invalidating for her... .because she was different from the get go and this was never appropriately addressed and compensated for.

This has been alluded to in this thread, but I'm not sure it has been stated outright.  Environment affects physiology.  Children brought up in more stressful situations, with abuse, war, violence around them, actually produce different (or different amounts of) neurotransmitters and hormones.  Those neurotransmitters and hormones do affect their bodies physiologically and usually permanently.

www.ncbi.nlm.nih.gov/pubmed/17988414 (http://www.ncbi.nlm.nih.gov/pubmed/17988414?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum)

Heritability of borderline personality disorder features is similar across three countries.

Distel MA, Trull TJ, Derom CA, Thiery EW, Grimmer MA, Martin NG, Willemsen G, Boomsma DI.

Department of Biological Psychology, VU University, Amsterdam, The Netherlands. ma.distel@psy.vu.nl

BACKGROUND: Most of our knowledge about borderline personality disorder features has been obtained through the study of clinical samples. Although these studies are important in their own right, they are limited in their ability to address certain important epidemiological and aetiological questions such as the degree to which there is a genetic influence on the manifestation of borderline personality disorder features. Though family history studies of borderline personality disorder indicate genetic influences, there have been very few twin studies and the degree of genetic influence on borderline personality disorder remains unclear.

METHOD: Data were drawn from twin samples from The Netherlands (n=3918), Belgium (n=904) and Australia (n=674). In total, data were available on 5496 twins between the ages of 18 and 86 years from 3644 families who participated in the study by completion of a mailed self-report questionnaire on borderline personality disorder features.

RESULTS: In all countries, females scored higher than males and there was a general tendency for younger adults to endorse more borderline personality disorder features than older adults. Model-fitting results showed that additive genetic influences explain 42% of the variation in borderline personality disorder features in both men and women and that this heritability estimate is similar across The Netherlands, Belgium and Australia. Unique environmental influences explain the remaining 58% of the variance.

CONCLUSION: Genetic factors play a role in individual differences in borderline personality disorder features in Western society.

Many mental disorders is based on a stress-diathesis model - a combination of risk factors involving genetic, biological factors and environmental stressors eventually reach a "tipping" point where the development of a mental disorder occurs.  

One can have a lot of biological factors and not need many environmental stressors to develop and another individual might have a lot of environmental stressors without quite as many biological factors and still develop the disorder.  

 Abigail

Wanted to add this recent information to the discussion:

Possible Genetic Causes Of Borderline Personality Disorder Identified

ScienceDaily (Dec. 20, 2008) — According to the National Institute of Mental Health, borderline personality disorder (BPD) is more common than schizophrenia or bipolar disorder and is estimated to affect 2 percent of the population. In a new study, a University of Missouri researcher and Dutch team of research collaborators found that genetic material on chromosome nine was linked to BPD features, a disorder characterized by pervasive instability in moods, interpersonal relationships, self-image and behavior, and can lead to suicidal behavior, substance abuse and failed relationships.

“The results of this study hopefully will bring researchers closer to determining the genetic causes of BPD and may have important implications for treatment programs in the future,” said Timothy Trull, professor of psychology in the MU College of Arts and Science. “Localizing and identifying the genes that influence the development of BPD will not only be important for scientific purposes, but will also have clinical implications.”

In an ongoing study of the health and lifestyles of families with twins in the Netherlands, Trull and colleagues examined 711 pairs of siblings and 561 parents to identify the location of genetic traits that influences the manifestation of BPD. The researchers conducted a genetic linkage analysis of the families and identified chromosomal regions that could contain genes that influence the development of BPD. Trull found the strongest evidence for a genetic influence on BPD features on chromosome nine.

In a previous study, Trull and research colleagues examined data from 5,496 twins in the Netherlands, Belgium and Australia to assess the extent of genetic influence on the manifestation of BPD features. The research team found that 42 percent of variation in BPD features was attributable to genetic influences and 58 percent was attributable to environmental influences, and this was consistent across the three countries. In addition, Trull and colleagues found that there was no significant difference in heritability rates between men and women, and that young adults displayed more BPD features then older adults.

“We were able to provide precise estimates of the genetic influence on BPD features, test for differences between the sexes, and determine if our estimates were consistent across three different countries,” Trull said. “Our results suggest that genetic factors play a major role in individual differences of borderline personality disorder features in Western society.”

Journal references:

   1. Distel et al. Chromosome 9: linkage for borderline personality disorder features. Psychiatric Genetics, 2008; 18 (6): 302 DOI: 10.1097/YPG.0b013e3283118468

   2. Distel et al. Heritability of borderline personality disorder features is similar across three countries. Psychological Medicine, 2008; 38 (9): DOI: 10.1017/S0033291707002024

Great information Skip. Thanks!

Very helpful Skip!  Is there research data that has measured the prevalance of BPD in children born to BPD mothers?

Of course there are individual cases of BPD children with BPD mothers, but I was wondering if there was national data that provides a % number.

Interesting study, Skip,  I often wonder given the distortions of facts by those with BPD if the trauma that they were exposed to as children is real or imaginary.  I suppose that imaginary trauma can be damaging also.  

We don't know if she experienced trauma at her mothers house or if her mothers rejection has caused it.  We do know that she received a lot of love and support also.  It is very frustrating that we are the ones she "can't be around" now.  

She is an adult now and responsible for her choices regardless of the wounds of her childhood... .just like all of us.

Not an abusive environment, an Invalidating one.

There does not have to be abuse... . It is said that BPD develops as the result of a combination of an Inborn Sensitive Nature and an Invalidating Environment.  Not an abusive environment, an Invalidating one.

It can be fairly subtle... .perhaps the family is merely stressed during crucial stages of the child's early development (especially infancy).  Perhaps the mother has an extended illness, or one of the other children become seriously ill, or there are financial hardships.  If the family system becomes too stressed, the child's needs are not met.  BPD is especially associated with early separations.  If the mother may have had to give the infant to someone else to care for for an extended period while she was having a difficult time.  That sort of thing.

There are many scenarios.  And many are unintentional.  Sometimes it is a poor fit between the temperament of the mother and the child.

I have two theories:

Spiritual malady  Definitely yes to the idea of a spiritual malady.  No doubt in my mind that many who are afflicted with this disorder is a direct link to their shameful and sinful patterns and choices.  Because of their impulsive behaviors they are often full of regret later and are embarrassed internally.  That embarrassment is the motivation for so much of what we see in them, anger, anxiety, odd thinking, unusual perceptions, substance abuse, sexual deviance.  A masking of sorts to numb and dull the shame and guilt.      

Emotional developmental issue  I also feel that BPD is also an emotional developmental issue.  I think that a borderline suffers from a lack of growing up emotionally, hence why we see such child-like behaviors from them.  For whatever reasons (i.e. environmental, dysfunctional parents, trauma, abuse, etc.) they were never able to bridge that gap into adulthood which allows them to have healthy interpersonal skills.  My interactions with my ex feels like I am dealing with a child.  

OFO

In my opinion it is not a spiritual problem since personality is formed before the age of accountability.

I also don't think that genetics play as important of a role. Genetics would put more of the emphasis on neurotransmitters, development of the brain, etc.

In my experience, ASPD, NPD, and BPD have always had an environmental factor. That factor might not be the parents or anyone within their FOO. IMHO, it only takes the right circumstance at a critical moment in development and the child to continue in that pattern of response (internally) to allow it to become part of their coping mechanisms and later personality.

From my own personal life, I can identify many early developmental points at which (by happenstance, providence, or whatever) my reaction and subsequent reactions to similar lead away from PD instead of towards it. Very easily I could have reacted differently and if repeated over time it could have lead to the maladaptive behavior that we label as a personality disorder.

Confusion about the role a particular genetic fingerprint plays in the development of disease

I'm a scientist doing medical research, so my post is more in that vein.

I think there is some confusion about the role a particular genetic fingerprint plays in the development of disease.  For some diseases there is a very clear relationship between a genetic defect (mutation, lack of a gene, etc) and the disease.  And it is deterministic: if you have the mutation or lack the gene, you get the disease.    There is no middle ground.  For example, Huntington's disease is a single-gene disease.  If you have a mutation to the gene that produces the protein Huntington, you get Huntington's disease.  That's it.  :)own's syndrome is a chromosal disease (still a genetic disorder).  You have 3 copies of chromosome 21, you have Down's syndrome.    

However, for most medical problems genetics are not nearly as deterministic.  Instead, they are multi-factorial, meaning they are influenced by a variety of factors including your particular genetic fingerprint and environment.  

First, let's talk a bit about genes and phenotype.  Phenotype is an observable trait of an organism (green eyes for example) and it is governed by genotype (the particular genetic code of an organism).  There are variations in phenotype (we have different colored eyes) because there is variation in genotype;  there are different alleles for each gene.  So while we all have genes for eye color, my gene specifies brown eyes (the brown eye allele), while your gene specifies blue eyes (the blue eye allele).  Thus, although we have the same genes, because we have a different genotype we have a different phenotype.  (This is a simplication but will do :))

We also need to understand gene expression.  What are genes, really?  They are instructions for the cell, telling it to make a particular protein that the cell needs.  This process is highly regulated both in time and cell type, i.e. both the time that the cell starts making protein from a gene and the place where it starts making protein from gene is important.  Your eyes, for example, have the genes or instructions to make new arms and legs, but we don't have arms and legs growing from our eyes because those genes are turned off.  (Again, a simplification, but go with me).  Environmental influences can affect the regulation of these processes.  It can also affect what the cell would normally do with a properly made protein, disrupting the normal protein processes.

Now we can understand the role of genes and environment in disease and why, for example, some of us can have BPD parents but not be BPDs themselves and others of us can be non-BPD parents with BPD kids.  

For many diseases, your particular genotype can influence the chances you might develop a disease (a phenotype), but not PRE-DETERMINE that you will have a disease.  This is because these are multi-factorial diseases that do not result from a single genetic mutation, such as Huntington's disease, but result from a combination of your particular genotype and the effects of your particular environment on the genotype.  Further complicating the issue is that many different combinations of these factors can result in disease.  Consider a simple case where say 10 genes influence you chance of getting a disease.  Well, what if you have 8 of the 10 alleles that influence towards disease?  7, 6, 4?  What can we say about your likelihood of getting disese?  What about environment... .so many little variables in environment.  The complexity and difficulty of understanding the role of genes and environment becomes clearer... .

Such appears to be the case with BPD.  Let's consider some examples.  You may inherit certain alleles from your BPD parent and certain alleles from your non-BPD parent.  So now you have a different genotype from your BPD parent and it is possible that your particular genotype does not make you as susceptible to BPD as theirs did, because your personality is such that you are less sensitive, for example, as a result of your particular genotype.  It may be that in fact your particular genotype makes you more able to handle a challenging environment.  Or you may have exactly the same genotype as your BPD parent (really unlikely, but for the sake of argument) but because you environment was different its affects on things like gene expression were different and therefore you don't develop BPD.  If you're the child of non-BPD parents, you may simply have inherited a combination of alleles that, given the environment you grew up in, make you more susceptiblet to BPD, even though you had non-parents. What kind of environment would that be?  An invalidating environment, certainly, but this does not necessarily mean we could look at any particular environment and say, well, surely, their environment was fine so why did they develop it?  Their parents were wonderful and they had a great childhood, and their parents don't have BPD, so where's the genetic/environmental influence?  The point is we can't make those judgement about environment as it is not always that clear-cut.  There are many variables in environment and just because it seems good doesn't mean there weren't factors that influenced the development of BPD, factors that are subtle and not obvious to us.  These diseases are extremely complicated and we have a very poor understanding of the connection between genotype and environment precisely because of this - many genes play a role and environment is so varied and uncontrolled that it is very difficult to be able to say - if you have this gene or this environment, you have BPD.  

In my opinion, a neurochemical problem falls into the bins of genetic or environemtal cause of disease.  A genetic problem can cause a neurochemical problem (neurochemicals are simply proteins created from the instructions in genes, after all) or an environmental one (some perturbation to the environment has disrupted the process of protein production or the processes in which the protein is used).  This is why drugs can treat neurochemical problems such as bi-polar disorder.  However, the multi-factorial nature of a disease like BPD may be a reason why the drugs are not too effective with a BPD.  You've treated one part of the problem but its easy to imagine that the BPD will continue if you don't treat many of the things leading to the problem.  What if the BPD is not that sensitive to the part of the problem you've treated, i.e. yes, you've identified a factor influencing BPD but it's not the MAIN factor, or one of the most SIGNIFICANT factors?  What if there are compensatory processes that counteract the treatment you've provided (the cell is highly regulated and this is certainly a realistic possibility)?  What if there is no main factor but a bunch of genes that have subtle influences on your likelihood to get BPD, that in total give you a greater likelihood?  Without considering the combinatorics it's quite difficult to treat the multi-factorial disorders.  Paradoxically, the combinators also make it extremely difficult to understand the root cause of a disorder.  This is one of the reasons why drug research in general is facing problems right now.  

Scientific studies show that there are likely genetic components to BPD.  But that's all it is - a component.  All it means is that genes can influence the likelihood that you get the disease.  They don't pre-determine whether you get the disease.  No one could look at your genotype and say, ah, this is the BPD genotype.  They could say (theoretically) that you might have a higher likelihood of getting it if the environment were "favorable" for developing BPD (not that it's a good thing to develop BPD), but they cannot predict that you will or won't get it.  And environment is such a complicated thing to define that it is unlikely we could ever predict who would get BPD or not.  We can say that an invalidating environment leads to BPD, but we can't precisely define every environment that everone lives in.  Yes, sometimes it's obvious.  I can point to my own childhood and pretty definitively say it was invalidating, as can many members here.  But what about more subtle cases?  There is a range, right?  How do we define an environment making a person susceptiblet to BPD?  It's not clear-cut.  And these complications are the reason why kids can have BPD but their parents don't and vice versa.  But the science seems relatively clear - there are genetic components.  But they are not DETERMINISTIC components.    

Does this help at all or is it just confusing?

 


Exactly. Excellent post!   


Very clear and to the point.

oneflewover:  I think there is something going on spiritually, too.  

boarderchic: Thank you for such an intelligent and comprehensive reply!  My goodness.   :)

A genetic (nature) predisposition (predisposition only, not predeterminer) that hones into one of a myriad/spectrum of psychological (mal)adaptations dependent upon complex environmental factors (nurture) during critical psychosocial developmental stages.

Genetic predisposition -> invalidating/traumatic/inconsistent environments around critical developmental stages -> reinforced behavior (stimulii <-> reward) -> personality somewhere on a spectrum (including Cluster B and disorders such as PTSD, ADHD, etc)

Genetic predisposition might be focused around adrenal medulla which arises from neural crest cells (IIRC).

What is considered psychological resilience might actually be, in part, a reflection of adrenal efficiency, adaptability, or overall adrenal health.


At least that's been my best guess so far... . 

In short, both nature and nurture (yes to the genetics) and in each person the combo is a bit different. As far as the nuture goes, it's not just parenting, but the total environment.

Please God in heaven, do not let BPD have a genetic component   .  I have two beautiful, perfect, light of my fun life, little baby boys with uBPDh.  Please let his BPD stem from the abuse and fighting he witnessed as a child and being abandoned by his nut job mother, as a young boy.  I am serously scared about this and staying in prayer.

Here's my hypothesis, and it's about brain structure.  We (and all primates) have a structure in our brains that causes us to internally mimic or replay events performed by those close to us.  This seems key to establishing social bonds.  Severe autistics have absence or significant deficiency of that structure, I've read somewhere.  Now I wonder, do BPD's also have a problem with that structure?  

The three disorders each probably have other brain defects that result in their unique manifestations (such as perhaps in the emotion-laden amygdala), but they all might have this common thread.

I guess it could be resolved by MRI'ing samples of the suspect population.  

fwiw, this is my borderline timeline  :)

my blood family maternal history = alcoholism and ocd (my biomom's a hoarder & semi-agoraphobic)--->  

biomom smoked whilst pregnant with me, and possibly drank (tho she denies) --->  

link between prenatal smoking and ADD [= brain damage, especially if paired with FAE/FAS] --->  

adopted at 3 weeks old after 2 week stay in hospital [=attachment issues/break in bonding(?)] --->  

anxious, caretaker adoptive mother and emotionally distant adoptive father with anger issues --->  

emotionally/physically abusive older brother, very little protection from parents --->  

traumatic events at puberty lead to depression, loss of innocence --->  

difficult personality because of untreated ADD & depression estranges parents further and paradoxically triggers controlling behaviors in them as a reaction (they're teachers) --->  

alcohol abuse in adolescence possibly "switches on" addictive genes or damages brain further --->

promiscuity brought on by unwise substance use causes self-esteem issues and health issues --->

being "abandoned" again at beginning of adulthood when my parents moved overseas and I had to leave my childhood home --->

distructive, unhealthy, unstable romantic relationships --->

stopping of substance abuse after biological uncle's suicide (even with periods of non-sobriety) --->

staying in therapy and learning new skills like CBT (even with periods of not going)--->

faithfully taking my medication for years (even with periods of non-compliance) --->

hitting "rock bottom" after failed relationship one too many, getting properly diagnosed as BPD vs. Bipolar/depression --->

learning new coping mechanisms besides cutting/burning and using them consistently (exercise, proper sleep and nutrition, journaling) --->

mourning childhood losses and traumas (coming to terms, finding peace) --->

reaching out to others with BPD and learning interpersonal skills and some DBT --->

reaching out to those affected by BPD and making "abstract" amends and accepting personal responsibility ( bpdfamily.com!) --->

reaching out to those I hurt with my BPD behavior and making real-life amends --->

forgiveness of my parents' limitations and gratitude at the new relationship we've forged together --->

making good, healthy friends in real life --->

trying dating and setting boundaries (although still with people with some issues, too) --->

starting to forgive myself and learn self-acceptance and self-esteem --->

So, the next step ? --->  maybe getting involved in the world as my true self, not a false facade I constructed around me to protect myself. So, courage to be a real human being.

Wish me luck... .

Good luck oceanheart! Your journey is inspiring to us Non's who think their BPDs or exBPDs will never recover. It takes a lot of courage and fortitude to get there. |iiii xoxox

the information i have read suggests that BPD are born with a predisposition to the disorder.  it can/may be set off by a traumatic experience and/or the onset of puberty.

in my BPD13's case she was a very happy child and we were a close family.  she was never abused, neglected, controlled or abandoned.  her problems started when she was 10 and had a very bad school year with a wacky teacher.  my mistake was not taking her out of the private school soon enough.  this was also the year when puberty began to set in.  she was dx with odd during this year as i took her to counseling to help her work through issues.

with the full onset of puberty at nearly 12 she was dx with BPD.

she had 2 head injuries as a toddler.  both resulted in trips to the er where no x rays were done.  they just sent us home after a 2-3 hour wait.  i will never know if this is where it all started or not.  

will be happy to answer any questions that you have if i am able.

i would advise you to remember that this board is for parents of BPD children and we are very sensitive about our children.  we know we are not perfect, as no one is, and we also know that we aren't guilty of causing our children to have BPD.  you are certainly welcome to post anywhere that you like, please understand that this particular board is a little different than the others.

good luck on your quest for understanding.

lbjnltx

I, too, am inclined to believe the above.  I believe our granddaughter is beginning to show the traits of BPD.  I believe she was born with this mental health "defect" (inherited from her maternal side) and her disorder was "set off" by a trumatic event.  In our case, the "trauma" was school.  Our granddaughter was selectively mute in school for several years - her emotional and cognitive development was so deep and advanced UNTIL she began school; then it was as if everything stopped.  At this point she appeared to have no opinions, empathy or even conscience.  I believe trauma is involved but "trauma" does not necessarily mean "abuse".  In our granddaughter's instance, I believe the "trauma" was the extreme stress of school caused by her severe anxiety (which was being treated professionally at the time).  Today, she is a teenager but thinks and acts much, much younger.  By the way, her BPD "traits" have increased and intensified since puberty.  Such a tragedy!  Anyway - just another opinion ... .

The prevailing thought is that there is not a “cause” of BPD. Instead, there are a number of risk factors that create the likelihood that the disorder will develop. A risk factor is just what it sounds like: something that, when present, increases the risk that something else will happen. Risk factors can be both biological and environmental. The more risk factors that a person has for some type of physical or mental illness, the greater the chance he will develop that condition.BPD opinions tend to reflect the occupation of the expert... Sexual abuse counselors think sexual abuse causes it because that's their patient load. Psychiatrists focus on neurons and synapses. Attachment therapists see a poor child-mommy connection. Marsha Linehan sees an invalidating environment. Someone on another thread sees a head injury, and another the effects of artifical sweetener. A parent with one BP child and one undisordered child is sure it must be genetic, too. A severly abused BP who has a web site attracts many other BPs who have been sexually abused. I spend three years investigating this issue. I spoke with the top experts at the National Education Alliance for Borderline Personality Disorder. My main source was Dr. Robert Friedel. Genetics and the BrainOne gene alone is responsible for a rare, incurable disorder called Huntington’s disease. If you have the gene, you’ll come down with Huntington’s eventually. But most inherited medical problems need several genes to converge before the disease develops. For example, more than twenty genes can play a role in diabetes. Typically, someone who inherits four or five of them becomes diabetic. The different ways in which those genes combine can influence how severe a particular person’s diabetes is, how easily it can be treated, and so on.BPD itself isn’t passed from one generation to the next. What are inherited are two to four traits that define this complex disorder. Two parents, neither of whom have BPD, might still have some of the genes that can lead to traits associated with BPD, such as•   aggressiveness•   depression•   excitability•   quickness to anger•   impulsivity•   a susceptibility to addiction•   cognitive (thinking, reasoning) impairmentsIs genetics a form of destiny? Yes and no. Psychologist Pierce Howard sees genetics as a seed, and personality as something that develops from that seed in response to its environment—sun, water, fertilizer, and so on. So genes play a role, but environment and lifestyle choices have a great impact as well.[7] OK, now let's talk about the environment and abuse:

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Environmental Risk FactorsThe following environmental factors play a role in the development of BPD.Abuse: Myths and RealitiesIf you’ve researched borderline personality disorder for any length of time, you’ve read that abuse causes BPD. This belief partly comes from the Diagnostic and Statistical Manual of Mental Disorders (DSM), which states that 75 percent of people with BPD have been abused.The data, however, has a few flaws. First, if abuse causes BPD, than how do you explain the fact that one out of four BPs has not been abused? Second, a correlation is not necessarily a cause. Robert O. Friedel, MD, director of the BPD program at Virginia Commonwealth University, says, “None of the environmental risk factors I’ve discussed [early separation or loss, trauma, ineffective parenting, and adverse social customs] has been show to cause borderline disorder. Many people who are exposed to the same abuse, separations, and bad parenting do not develop borderline disorder, and some borderline patients have not experienced any of these environmental risk factors.its association with BPD].[11]Family and Peer InfluencesMany other environmental circumstances favor the development of BPD.All of our personalities are shaped by the surroundings we grew up in. Some influences are positive, such as a caring older brother, a good school system, and a family with good financial resources.Then there are negative influences: losing a grandfather, getting pneumonia, or living in a dangerous neighborhood—not to mention the “normal dysfunction” we all grow up in. Our culture—its norms and expectations—influence us, too.Some life circumstances may present a higher risk for the development of BPD. Some doctors refer to these as “environmental burdens” that can trigger the condition. They include•   emotional, physical, or sexual abuse•   ineffective parenting—or perceived ineffective parenting—of the borderline individual. This can mean anything from poor parental skills to a parent’s mental illness or substance abuse.•   an unsafe and chaotic home situation•   a poor match between the temperaments of parent and child•   the sudden loss of a parent or a parent’s attention (sometimes perceived by the child as abandonment). This can arise from the death of a parent, a divorce, or even the birth of a new baby.You might be thinking that this describes 99 percent of families. (About 50 percent of marriages end in divorce.) It probably does, so don’t feel guilty if this looks familiar. Also keep in mind that many people who are exposed to the same abuse, separations, and ineffective parenting do not develop BPD.Research is beginning to tell us that relationships with peers are crucial to the development of our personality—interesting, considering that most parents in the Welcome to Oz community say their child had a hard time making friends and lacked social skills. This could be because, compared to others seeking psychological help, people with BPD are especially likely to misinterpret or misremember social interactions.[12] With their deep fear of abandonment, people with BPD may need and expect more from friendships, even at a young age.Staying on the topic of the environment, let's take a look at Marsha Linehan's “Invalidating Environments” as a Factor in BP. This is more from The Essential Family Guide to Borderline Personality Disorder: New Tools and Techniques to Stop Walking on Eggshells .Marsha Linehan, the creator of dialectical behavior therapy (DBT), a method used to treat BPD and other disorders ) developed a “biosocial” model about the causes of BPD. The “bio” refers to biology and the “social” to the environment.She agrees with research that shows that people with BPD are hardwired to react more intensely to stress. Their emotional peaks are more pronounced. Once the stress is over, they take a longer time than most to calm down. Linehan calls this tendency “emotional vulnerability.” BPD, she says, can develop when an emotionally vulnerable child is raised in an “invalidating environment.” An invalidating environment is one in which caregivers•   tell children that their feelings and experiences are wrong or untrue•   find fault with children who fail to perform to the expected standard and caregivers make comments such as “you weren’t motivated enough”Children raised in this environment learn not to trust their own gut reactions and look to others to tell them how to feel and to solve their problems for them.But wait--there's more! Lots and lots of parents with BP kids are not bad parents.  There may be a Poor Parent/Child Fit.Perry Hoffman, president of the National Education Alliance for Borderline Personality Disorder, says that one risk factor for BPD is a poor match between a biologically vulnerable child and her caregivers who, for whatever reason, find it overwhelming to meet the child’s needs.For example, perhaps the mother develops post-partum depression or the family’s going through a crisis. Another example is a single mother who, for economic reasons, takes two jobs that limit the time she can spend with her child.Now let's go back in history and tell you the story of a man who changed the way we think about the development of personality for all time. Once again, this is from The Essential Family Guide to Borderline Personality Disorder: New Tools and Techniques to Stop Walking on Eggshells--a book I spent three years writing. Warning: this is a bit graphic. Think "CSI" here and shattered brain (not things like neurotransmitters, but the wrinkled grey stuff). Ignore the numbers, which are my footnotes.

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The Physical BrainWe’ve known for more than a century that our wrinkled gray cells have a large role in shaping personality. This was demonstrated in the mid-1800s when an unfortunate railway worker named Phineas Gage was the victim of a freak accident that’s still discussed in science books today. (Warning: the next paragraph is graphic.)Gage was packing a load of explosives into the ground when the charge accidentally went off. The iron tamping rod he was using (4’ long and 1¼” in diameter) was propelled though his left cheek and brain and exited through the top of his skull. Incredibly, he walked away from the accident and lived another thirteen years.But the accident radically altered his personality. Gage’s physician, John Harlow, wrote:Before his injury, Gage possessed a well-balanced mind and was looked upon by those who knew him as a smart businessman, energetic and persistent. After the accident, Gage was fitful, irreverent, indulging in the grossest profanity (which was not previously his custom), exhibiting little deference for his fellows, and at times impatient, obstinate, capricious, and vacillating. . . . His mind was so decidedly changed that his friends said he was “no longer Gage.Yet MORE about the brain: this time the AMYGDALA (a physical structure inside the brain) and NEUROTRANSMITTER (problems which can be passed down genetically). This is from a NIMH website:AMYGDALANIMH-funded neuroscience research is revealing brain mechanisms underlying the impulsivity, mood instability, aggression, anger, and negative emotion seen in BPD. Studies suggest that people predisposed to impulsive aggression have impaired regulation of the neural circuits that modulate emotion.10 The amygdala, a small almond-shaped structure deep inside the brain, is an important component of the circuit that regulates negative emotion.In response to signals from other brain centers indicating a perceived threat, it marshals fear and arousal. This might be more pronounced under the influence of drugs like alcohol, or stress. Areas in the front of the brain (pre-frontal area) act to dampen the activity of this circuit. Recent brain imaging studies show that individual differences in the ability to activate regions of the prefrontal cerebral cortex thought to be involved in inhibitory activity predict the ability to suppress negative emotion.11NeurotranmittersSerotonin, norepinephrine and acetylcholine are among the chemical messengers in these circuits that play a role in the regulation of emotions, including sadness, anger, anxiety, and irritability. Drugs that enhance brain serotonin function may improve emotional symptoms in BPD. Likewise, mood-stabilizing drugs that are known to enhance the activity of GABA, the brain's major inhibitory neurotransmitter, may help people who experience BPD-like mood swings. Such brain-based vulnerabilities can be managed with help from behavioral interventions and medications, much like people manage susceptibility to diabetes or high blood pressure.

Check this out with respect to developing a root cause theory. In the news two days ago,was a short mention about help for autism using oxytocin. The talk about problems with empathy, trust and social interactions triggered my interest. I did a brief search. This is fascinating in how it relates to BPD traits and abandonment.



'Cuddle chemical' could treat mental illness

Maia Szalavitz

IT has been called the love hormone, the cuddle chemical and liquid trust. It peaks with orgasm, makes a loving touch magically melt away stress and increases generosity when given as a drug. Oxytocin is the essence of affection itself, the brain chemical that warmly bonds parent to child, lover to lover, friend to friend, and it could soon be unleashing its loved-up powers far and wide.

Oxytocin has long been used to induce labour and assist the let-down of milk in breastfeeding. Now there is growing interest in its potential as a therapy for mental illnesses characterised by "people problems" - autism, personality disorders, depression, social phobia, psychosis and even impotence. Some tout it as an elixir that makes you more likeable, trustworthy and attractive. Decoding its mysteries could even lead to the development of a powerful new recreational drug that makes ecstasy look like a mild dose of cheerfulness.

Oxytocin was discovered in 1909, when British pharmacologist Henry Dale found that a substance extracted from the human brain could cause contractions in pregnant cats. He named it using the Greek for "quick birth", and for decades it was known only for its role as a pregnancy hormone, promoting contractions and aiding breastfeeding.

In the 1970s it started to become clear that oxytocin was more than just a hormone... .

Read more:  www.oxytocin.org/cuddle-hormone/review.html

Low Emotional Intelligence Emotional intelligence (EI) is a measure of qualities such as self-awareness; personal motivation; empathy; and the ability to love and be loved by friends, partners, and family members. The concept of emotional intelligence helps explain why people with BPD can have multiple doctorates and be Mensa members in good standing, yet be unable to sense what other people are feeling. EI theories weren’t developed with BPD in mind. Nonetheless, it sure looks as if the social scientists who theorized about EI and those who formulated the concept of BPD must at least have been connected by two tin cans and some string. The best seller Emotional Intelligence: Why It Can Matter More Than IQ revolutionized the way we think about why some people live happy, successful lives and some don’t. In the book, the author, Daniel Goleman, explains that EI falls into five domains: 1.   Knowing one’s emotions2.   Managing emotions3.   Motivating oneself4.   Recognizing emotions in others5.   Handling relationships[3]BPD seems to diminish a person’s skills in all five domains.[/i]You also mentioned the child-like developmental level, another thing I touch on in the new book and also SWOE.Primitive defense mechanisms include splitting, dissociation, denial, and acting out. As we grow older and become more sophisticated about social situations, most of us move from these “primitive” defense mechanisms to more mature and complex ones, like rationalization. People with BPD, however, keep using primitive defense mechanisms even in adulthood. That’s why interacting with a BP can be reminiscent of dealing with a child.

This article from Columbia University explains environmental transmission pretty well. https://bpdfamily.com/bpdresources/nk_a108.htm

Children of mothers with BPD show a significantly higher prevalence of ‘disorganized’ attachment than children of mothers without BPD.

Skip, thanks for the link.

When I started fully understanding BPD and I was able to unprofessionally diagnose my wife with confidence, I realized that all the horrible stories of neglect and abuse by her mother pointed to BPD in her as well. In fact, her mother is the more "classic" case of BPD whereas I believe my W has some mix of disorders.

Then, turning to her sister, the stories of explosive anger outbursts, her rude and inconsiderate mannerisms, her isolating her husband and family, all started making sense.

The odds are very high that MIL, W, and SIL are all borderlines of varying severity, but I have been very careful in the past of posting it because I did not want to appear as somebody who wants to find a BP under every rock! But when the evidence is there... .

Randi Kreger- A caution on using that reference to Phineas Gage. Some new research has been conducted that deconstructs the Myth of Phineas Gage. The wikipedia article has some information and references that are quite enlightening on the subject.

Agree. That it is a combination of genetic vulnerability and childhood trauma/environment.

I just want to add that among siblings who have BPD ,they present symptoms differently .e.g.

one sister is quick to break and go to new relationship every few months whereas other sister changes partner only 2 or 3 times in entire life. Both have fear of abandonment though. First one has chaotic work life ,second one has stable job life and so on. Degree of symptoms can vary among siblings.

I absolutely learned from my BPD mom. I have a very good early childhood memory, and most of my behavior was a slow spiral in direct relationship to her level of craziness. I was a smart, quiet, helpful, normal kid that got dragged into the middle of a load of relentless chaos.

I see the behavior as a kind of "grasping at straws" in lieu of proper emotional vocabulary. We witness people resolving conflicts with tantrums, threats and abuse, and when conflict arises in our own lives that's the only tool we have.

I think this is why DBT is so useful. It's a tool box of life skills I didn't learn as a child.

Oh boy, this is a big topic for me and my pwBPD. He did have a TBI, which he has historically blamed on me. He also has OCD, and for the first 2-3 years after he obsessed INTENSELY about his intelligence (the only thing he valued about himself at the time, which he felt he lost because of me. He is brilliant, and I never noticed a change in his intelligence, only his self-confidence). This has been a huge source of contention between us. He was attacked by a group of about 7 guys after we had gotten in an argument and were walking down the street late at night. His yelling due to our argument (I had walked away at this point, and when I returned there they were harassing him) was misinterpreted by these sad excuses for human beings who attacked him from behind and proceeded to kick him in the head until I jumped on him to prevent them from kicking him anymore. He blames the entire preceding argument on me (not to shirk my role in it. It takes two to argue, but I didn't make those guys attack him), and has said very hurtful things such as "I wish you had just let me die". And at other times I've been called his angel, but it's been a long time since I've heard that sentiment. I've been painted black for a long time now. (Lesson I learned here... .  NEVER argue in public. EVER.)

Anyway, regarding your actual question, it definitely didn't bring on his BPD, but I think it may have made it worse. Whether or not that is due to purely psychological or physiological reasons, or a combination of the two, I don't know. I have too heard of TBI's causing drastic changes in people's personalities, however, often making them depressed, moody and volatile.

Yes, my uBPDh was in a coma for a month due to a four wheeler accident when he was 13.  He also witnessed and experienced domestic violence as a very young child.  And he was also sexually abused by a female babysitter as a young child.

My ex apparently slept-walked and fell out of her bedroom window when she was about 13/14 and ended up in hospital... .  broken bones, head injury, etc.

Don't know how much of her story I believe; I sometimes wonder if she didn't really sleep walk, and if it was all just a cry for attention from her parents.

I would also recommend you to track down some general information about the cause of BPD outside of this site. You will find a less psychodynamically colored take on things, where consensus is that not so much is known about the cause of BPD at all.

What types of resources are you recommending?

From what ive read im inclined to favour nature over nurture as the main cause. I believe nurture is only a factor in an abusive upbringing.

Where nuture plays a role with BPD in most cases is due to how the pwBPD is treated due to their behaviour. A child with BPD may play up more, may lie more, may have more caue to be told off. This I believe is why they grow up feeling they were victimised.

I believe my exgf daughter is highly likely to have BPD. Ive witnessed how her and her brother are treated and it is normally the same. Where the difference lies is that she likes to make trouble and therefore gets told off more. Her mum also panders to her to try and prevent her blowing up.

This is a support site as opposed to a research site but that said there is a wealth of knowledge here.

I think the problem with BPD is that no one has a 100% answer to the cause. Everything is opinion. Be it that of psychiatrists or that of doctors.

All you can do is research findings on BPD and come to your own conclusion until a definitive answer is found.

You can research behaviours and this can be a useful way of finding a cause but you will be met with a myriad of opinions.

Interesting discussion

Skip just referenced this research The National Institute of Mental Health's on the cause of BPD, which suggests that the causes are 42% genetic and 58% environmental.

www.ncbi.nlm.nih.gov/pubmed/17988414

Livednlearned from what you're saying Blaise Aguirre pretty much inverts this ratio between nature and nurture. Is he basing his conclusions on more recent research?

Reforming

I think the answer to "nature or nurture" is "some times nature, sometimes nurture".

Judith Herman at Harvard would like to see the "nurture" induced BPD characterized as Complex PTSD.


I'm going to guess it the same data and one of us here quoted it wrong.

Thanks Skip,

I followed your link which confirmed that the statistic you quoted , 42% genetics / heritability 58% environment.

I've just come across some videos of Gunderson and Scott Wilson talking at a conference in 2008 and they appear to support Livednlearned ratio - Wilson says genetics  50%-60% responsible.

Quite a big difference between these two

Reforming

I checked Blaise Aguirre's book -- the second edition, which came out in Sept 2014. He writes,

"Most researchers consider BPD to be 60 percent genetic and 40% environmental." He also refers to what he says is "the largest studies on BPD and genetics" and writes, "... . genes accounted for 69 percent of the symptoms of BPD and that environmental factors accounted for 31%."

If it is 50/50 nature/nurture, or 60/40, or 40/60, I'm wondering what difference that makes to people?

Thanks for the quote, livednlearned, we can add this to our data sources.

What is the practical benefit of this information to a parent or relationship partner? I think it is helpful for parents from a guilt perspective.  I think it is helpful for a relationship partner who is see's traits but knows that the family was not neglectful or abusive.  For these applications, 60%:40% or 40%:60% aren't significantly different.

Here is the work:

The general BPD factor was substantially influenced by genetic factors, with a heritability of 55%. This finding is similar to the heritability estimates in the above-mentioned twin studies, which were 60% and 51%, and in the family study by Gunderson et al3 (43.9% or 58.6%, depending on method of assessment). The heritability estimates in all of these studies are higher than what has been reported from studies using dimensional representations of DSM-IV personality disorders5 or sum scores of questionnaire items.4 This difference is probably due to the fact that the effects of measurement error are largely eliminated by examination of a common factor.

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JAMA Psychiatry. 2013 Nov; 70(11): 1206–1214.

doi:  10.1001/jamapsychiatry.2013.1944

Structure of Genetic and Environmental Risk Factors for Symptoms of DSM-IV Borderline Personality Disorder

Ted Reichborn-Kjennerud, MD, PhD, Eivind Ystrom, PhD, Michael C. Neale, PhD, Steven H. Aggen, PhD, Suzanne E. Mazzeo, PhD, Gun Peggy Knudsen, PhD, Kristian Tambs, PhD, Nikolai O. Czajkowski, PhD, and Kenneth S. Kendler, MD, JAMA Psychiatry. 2013 Nov; 70(11): 1206–1214. , PMCID: PMC3927987, NIHMSID: NIHMS526980

www.ncbi.nlm.nih.gov/pmc/articles/PMC3927987/

Thanks Livednlearned,

I think there's a lot of people out there, parents, partners, ex partners, siblings and offspring who are all very interested in knowing the extent to which nature and nurture cause BPD for understandable reasons.

It's clear that you've researched this yourself and you mentioned the breakdown in your previous post so I assume you felt that it was relevant too.

For my part I spent a big chunk of my life in a relationship with someone who I think is very likely BPD.

That relationship had a big impact on me and understanding the factors that shaped her and our relationship helps me to process it in a healthier way.

Understanding better helps me to be more compassionate to myself and her

Reforming

It does help me make sense of things to know whether there is a genetic component, although the degree or percentage to which heredity affects BPD or anything my son might have would probably not change how I think about the nurture piece. That is the only part I control. If BPD was 90 percent genetic and 10 percent environmental, I would continue to do what I'm doing, establishing a validating environment and making therapy a priority.

When I read the article about genetics and depression, it did relieve some guilt for me, although certainly not all. When I read about the chances of a child with a BPD parent developing BPD, that seems to fan my fears.

Thanks for sharing Livednlearned,

I'm not a parent, but I thought your post on the other thread impressive and inspiring.

"With my son, my approach is to focus on creating the most validating environment I can. This change has been the most critically important part of treatment for S13. I cannot change his genetic predisposition, and I cannot give him a nuclear family with a mentally stable father. I had to examine validation with a microscope, right down to the choice of words, right down to the level of authenticity and intention I use in my voice when using validation. Doing this required deep change. My T and my son's psychiatrist both talked about how uncomfortable change is, and how many roadblocks and obstacles exist psychologically when it comes to changing family dynamics and interaction patterns. "

I've found deep change very hard and at times I get very frustrated at my stop start progress. Reading your words really helped to remind me why it's so worthwhile and that it's possible

Thanks

Reforming