CAUSE: Injury-induced BPD?

[BPDFamily.com]

I'm a clinical supervisor for an Epilepsy Foundation affiliate.  The standard information we give persons with epilepsy in the frontal lobe area of the brain and their families is there's no equal signs between damage in that area of the brain and behavioral changes, BUT there's a lot of good research that shows that your chances of developing behavioral changes are very good if there's ongoing neurological changes in that part of the brain.  Remember that is the part of the brain that controls a lot of behavioral aspects of our actions.

Another concept we impart to everyone is that a brain injury causes damage not just at the site where the brain was impacted.  Think of the brain as sitting in a tub of fluid.  When a trauma is inflicted on the left side of the brain for example, the right side of the brain is slammed up against the inside of the skill and damage also occurs on the brain there.  And when damage occurs there may be blood clots, scaring or tearing of the brain tissue.  It can get very complicated as to the amount of damage done, and don't forget the tearing that can also occur to the brain stem.

Remember this is brain surgery stuff.  It is always best to leave the guessing to the neurologist, neurosurgery experts and the neuropsychologists.  We always recommend having a neuropsychologist do an evaluation after a person is stabilized to see what cognitive impairments may be present and to evaluate for clinical depression and behavioral changes.

This is my two cents worth.

[jreilly]

I'm a clinical supervisor for an Epilepsy Foundation affiliate.  The standard information we give persons with epilepsy in the frontal lobe area of the brain and their families is there's no equal signs between damage in that area of the brain and behavioral changes, BUT there's a lot of good research that shows that your chances of developing behavioral changes are very good if there's ongoing neurological changes in that part of the brain.  Remember that is the part of the brain that controls a lot of behavioral aspects of our actions.

Another concept we impart to everyone is that a brain injury causes damage not just at the site where the brain was impacted.  Think of the brain as sitting in a tub of fluid.  When a trauma is inflicted on the left side of the brain for example, the right side of the brain is slammed up against the inside of the skill and damage also occurs on the brain there.  And when damage occurs there may be blood clots, scaring or tearing of the brain tissue.  It can get very complicated as to the amount of damage done, and don't forget the tearing that can also occur to the brain stem.

Remember this is brain surgery stuff.  It is always best to leave the guessing to the neurologist, neurosurgery experts and the neuropsychologists.  We always recommend having a neuropsychologist do an evaluation after a person is stabilized to see what cognitive impairments may be present and to evaluate for clinical depression and behavioral changes.

This is my two cents worth.

[GENERAL ANNOUNCEMENT]

GENERAL ANNOUNCEMENT This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question. Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board. You will find indepth information provided by our senior members in our workshop board discussions (click here).

[jreilly]

Other informational resources I used are:

Institute's Brain Resources and Information Network for the National Institute of Neurological Disorders and Stroke (a component of the National Institute of Health) at www.ninds.nih.gov

Citizens United for Research in Epilepsy (CURE) at www.CUREpilepsy.org

Epilepsy Foundation www.epilepsyfoundation.org

National Organization for Rare disorders (NORD) www.rarediseases.org

[caggif]

I am an active volunteer for a group called "Headway" here in the UK.?  We offer support for both members and the families of people who have suffered brain trauma, either by accident, or by surgical process ie:?  removal of a brain tumor.

Many of our members have undergone complete personality changes after suffering trauma according to their families who knew them beforehand.?  Much of what they knew previously has to be re-learnt - ie: walking, talking, reading etc. Many initially have no "personality" of their own, and are like a blank page.?  They have no preferences for things like food, music, etc - the endless list that we each have that make us individuals.?  

In many cases its a matter of taking a brand new person, and teaching them how to live in the world again.?  How well they recover is very dependent on how much nerve damage they suffered, and what specific part of the brain was affected.

Those who have suffered frontal lobe injury are the ones who have the most difficulty in re learning acceptable behavior.?  According to our specialists, this is where our inhibitions are formed.?  Damage to this area can result in a patient having impaired or no sense of right and wrong.?  

For instance we have a lady member who has to be escorted where ever she goes for her own safety. This lady was very shy before her injury.?  Since recovering she has become very uninhibited and will offer sexual favours to any available male. She propositions bus drivers, taxi drivers, men in the street - and has no concept of the danger she puts herself in, or the possible consequences for the men involved - she cannot empathise with their embarrassment, and sees absolutely nothing wrong with what she does.

I could cite other examples all day.?  I have stories that would both horrify and amuse you, but then again maybe not, as many of them direct parallels with the behavior of our various BPD so's.

The very big difference between a person who has been brain injured and someone with BPD is IMHO that the brain injured person really does do not KNOW any different, whereas BPDs do know that their behavior is unacceptable and wrong.

With BPD it is a Personality Disorder, whereas a brain injured person it is a Personality Absense. 

Nothing to say that someone cant have both though .

We have one guy who had a really bad RTA, and is excused his dreadful behavior because of his head injury - I knew the guy for years before his accident, and believe me he was just as obnoxious before the crack to his head.

I hope I've explained that to ya all okay - sorry not very good with the technical jargon?  

Caggi xx

[Gonefromhell]

I think you might be interested in my experience. My ex wife was diagnosed with MS in 1998 with positive lesions on MRI scattered throughout her brain including the frontal lobe. She also has lesions on both optic nerves with episodes of iritis as well as optic neuritis. Her spinal tap was positive for all 3 markers of MS. She actually fit the secondary progressive MS description better than Relapse Remitting since she had nuro deficits that were permanent. She was put on Avonex as well as a boat load of other drugs. All 3 step children have some kind of emotional problems to include panic/anxiety in a daughter, crazy money spending & binge eating in a son & ADHD in the 3rd child. My granddaughter was dxd with Schizophrenia at age 15, non drug related. My ex has a history of depression, drug abuse, alcohol abuse & crazy behavior. Our marriage counsellor (RN, PhD Psy) felt she has BPD. Her MS did not cause her children's abusive behavior nor her grandaughter's schizophrenia. My ex's mother died of Lou Gerhig's disease and her alleged father committed suicide after numerous failed marriages. I believe my ex wife inherited BPD from her father combined with MS susceptibility from her mother. (ALS & MS being auto-immune diseases). My ex also abuses narcotics, tranqulizers, sleep aids & alcohol. I know she has MS & drug abuse while she likely has BPD too. All 3 things can screw up your cognition, memory, personality etc. Her children grew up in this BPD world & needless to say, are dysfunctional. I think there is a link between her MS & BPD or perhaps she is just unlucky enough to have both at the same time.

[Abigail]

Yes, I have read that certain brain injuries can cause BPD in some people.  It is not the only cause of BPD.  Genetic predisposition can be a factor as can abuse, early parental loss, untreated ADD, etc.

  I don't know about a connection with MS.

  Dr. Heller believes it is a type of epileptic seizure in the limbic system of the brain.  Check out www.biologicalunhappiness.com for more info.

  Abigail

[Abigail]

Pat,

  On Dr. Heller's website at www.biologicalunhappiness he refers to an article/study  Compr Psychiatry 2002 Sept.-Oct. (Milano, Italy) "History of childhood ADHD symptoms and borderline personality disorder:  a controlled study"

  Dr. Heller also strongly suspects that a large percentage of untreated ADHD patients go on to have the BPD.  He has also found in treating thousands of patients who have BPD that 50 % of them also have ADHD.

Abigail

[Almost_Nobody]

In this site

www.biologicalunhappiness.com/index.html

BPD is described as a form of epilepsy;

which i have not found much here or anywhere.

My dad have some hysteric anger driven fainting symptom - which i have only found in 2 more peoples here. Before even knowing about the BPD/NPD i thought his problem is a kind of epilepsy which i have understood is not true after studying BPD.


Now i find someone is describing it again as epilepsy.


Any idea?

[Abigail]

  There are many different opinions regarding the BPD--there is a lot that isn't known yet.  However, I do agree with Dr. Heller  that the rages are a type of epilepsy.  I may be mistaken but I don't think the disorder as a whole is epilepsy but some of the emotional outbursts, such as the raging.  My husband sees Dr. Heller and has greatly improved since being treated by him.  Dr. Heller has spent a lot of time researching and dealing with borderline patients, and successfully helping them, I might add.

   His books make very interesting reading.  From "Life at the Border", "The biological mechanism for panic likely exists within the limbic system.  Due to circuit damage and/or serotonin deficiency, a borderline's panic is uncontrolled--gaining momentum like a snowball rolling downhill.  Many neurochemicals are released excessively during stress/panic, stimulating feelings of anger, desperation, emptiness, and depression, resulting in dysphoria.  This massive "neuroelectrical" stimulation overflows into other brain areas, much like epilepsy.  When the stimulation reaches the temproal lobes, bizarre sensations occur--such as dejavu, depersonalization, etc.  The epilepsy medication Tegretol likely works by slowing down or stopping this neuroelectrical stimulation."

   Did you know that epilepsy was once thought to be a mental disorder and not biological in nature?

  Abigail

   

[goochiegirl]

I have recently read that epilepsy is also related to bipolar disorder.

I have bipolar, and I have been on Topamax for 4 years (the most successful medication I've experienced - after 2 years of trying other ones)... Topamax is an anti-epileptic, and is also prescribed off-label for bipolar.

[loki8447]

A woman who is student teaching brought up a similar idea, this weekend.?  She talked about a student that had seizures where they "went into some kind of a rage."?  I've heard this idea tossed around in a school setting but never heard it so clearly stated before.

?  ? She did mention that the staff was aware that all of the child's rages weren't seizure induced.?  Some of them were simply because the kid didn't get their way--but the rages were the same.?  The only way they could guess the difference was by watching to see if anything external triggered the rage.?  I'm not sure what to think about that one.

[Sara]

I don't know where else to post this.  I don't know where it should go, so if it needs to be moved, I will appreciate it going into the proper forum on this board.

I have a general question about BPD: Is there such a thing as injury-induced BPD?

I have a friend who has a family member who--until she was 13--was about as far from being a borderline as it is possible to be.  She was (and always had been) the all-around, balanced, healthy-in-every-way, outgoing, loved and loving, and truly caring child who was transforming into a very responsible, healthy, and balanced young woman.  One day she went out roller-blading and was hit by a car.  It was a horrible accident, with countless injuries, and during her hospitalization, she was in a coma-like state for over a week.  When she finally came to ordinary consciousness, her personality had completely changed.  Then as now, over a decade later, she is--according to everything I know about BPD--indistinguishable from a low-functioning, extremely difficult BPD.  Although she is being treated as bipolar, no one actually thinks she is.  None of the bipolar meds (and they've tried all of them) have worked to improve her in any way.  

Since, comparing the pre-accident with the post-accident "her," the differences between these two "people" were so stark, her family (and all of the medical professionals they have consulted) are at a total loss as to what happened back then or how to deal with it as it has devolved to this point in time.

Can the process through which someone becomes BPD happen "later" in life (i.e., at age thirteen), and due to nothing more than a very bad traffic accident?  (No prior mental illness; no indication or evidence of anything other than a totally healthy-in-every-way growing person.)  

I guess what I'm really asking is: is, or could be, BPD the result of some kind of "insult" to the brain that is physiological (even through the cause of that "insult" may not have necessarily been to the physical body)?

My post probably isn't very well phrased (or described) because I'm flailing.  I would appreciate any insights or information anyone might be able to offer, though.

The family is in great distress, and after all of these years, the problem they deal with on a moment-to-moment basis is worsening with every day and week.  I have suggested BPD (because the daughter now appears to meet every one of the BPD criteria), but since there was no indication of BPD up until the accident at age thirteen, it's difficult to discuss this as even a possible case of BPD.

Thank you.

       

[GENERAL ANNOUNCEMENT]

GENERAL ANNOUNCEMENT This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question. Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board. You will find indepth information provided by our senior members in our workshop board discussions (click here).

[LOAnnie]

Here's an excerpt from an article about TBI, traumatic brain injury, and the link to the whole article.  TBI can result in different complications depending on which parts of the brain are injured; personality changes are one of many possible results of TBI:

"Complications of TBI:

"TBI may cause emotional or behavioral problems and changes in personality.[65] These may include emotional instability, depression, anxiety, hypomania, mania, apathy, irritability, and anger.[101] TBI appears to predispose a person to psychiatric disorders including obsessive compulsive disorder, alcohol or substance abuse or dependence, dysthymia, clinical depression, bipolar disorder, phobias, panic disorder, and schizophrenia.[34] Behavioral symptoms that can follow TBI include disinhibition, inability to control anger, impulsiveness, lack of initiative, inappropriate sexual activity, and changes in personality.[101] Different behavioral problems are characteristic of the location of injury; for instance, frontal lobe injuries often result in disinhibition and inappropriate or childish behavior, and temporal lobe injuries often cause irritability and aggression.[105]"

www.en.wikipedia.org/wiki/Traumatic_brain_injury

Here's a link for you to read more about brain injury and help for those with TBI:

www.brainandspinalcord.org/recovery-traumatic-brain-injury/personality-changes-tbi/index.html

-LOAnnie

[Randi Kreger]

The answer is "no." By definition, a person can't develop a personality disorder due to an injury. The behavior must be "stable," of a "long duration," and "not due to a general medical condition (e.g., head trauma).This is pasted in from the net--see my highlights:Personality disorder definitions (DSM-IV-TR Axis II)According to DSM-IV-TR (see page 689)[4], the diagnosis of a personality disorder must satisfy the following general criteria, in addition to the specific criteria listed under the specific personality disorder under consideration.A. An enduring pattern of inner experience and behavior deviating markedly from the expectations of the individual's culture. This pattern is manifested in two (or more) of the following areas: cognition (perception and interpretation of self, others and events) affect (the range, intensity, lability and appropriateness of emotional response) interpersonal functioning impulse control B. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations. C. The enduring pattern leads to clinically significant distress or impairment in social, occupational or other important areas of functioning. D. The pattern is stable and of long duration and its onset can be traced back at least to adolescence or early adulthood.  E. The enduring pattern is not better accounted for as a manifestation or consequence of another mental disorder. F. The enduring pattern is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., head trauma).

[Secretsister]

I would think that brain injury could cause behavior that looks like BPD or any other disorder.  My son fractured his skull and was, afterwards, very different.  His trauma was not nearly as severe as what you describe, but he was depressed and just not himself.  I took him for Craniosacral Therapy, which is non-invasive.  It worked wonders for him.

My other thought is that perhaps she has PTSD from her trauma?

Secretsister

[Sara]

I would think that brain injury could cause behavior that looks like BPD or any other disorder.  My son fractured his skull and was, afterwards, very different.  His trauma was not nearly as severe as what you describe, but he was depressed and just not himself.  I took him for Craniosacral Therapy, which is non-invasive.  It worked wonders for him.

My other thought is that perhaps she has PTSD from her trauma?

Secretsister

Wow... .I had previously thought about suggesting CST (I am very familiar with it, and in my own family we have our own, regular CST therapist who is wonderful!), but it just seemed too much of a reach to suggest that this might help.  (The family, up to this point in time, has not had any previous experience with CST--even though in our family we've read most of the books by Upledger and several written by others.  For them, even considering this will have to begin with zero previous knowledge.)

If I could get across to them how powerful CST has been to us (and to several unrelated people we know personally)... .

It is definitely worth trying.

Thank you for suggesting CST, Secretsister!  

Thank you!

[Sara]

Seems like that would be a fascinating avenue of research, to discover if there is any correlation between BPD and the BPD-like traits and behaviors that can result as a complication of TBI.

Perhaps regular BPD is a naturally-occurring organic brain injury/malfunction (due to genetic causes, or malnourishment, stress hormones, birth trauma or a virus... .?) or perhaps BPD is TBI that is unreported by the parents (due to violence they perpetrated against the child) or an event unknown to the parents or the child (accidental TBI acquired during unsupervised play or sports, for example.)  Negligent, druggie parents wouldn't even care if their child suddenly started acting differently, wouldn't care about reporting a change in behavior or getting their child medical treatment.  I don't know how such research could be conducted, but I think it would be worth pursuing.

-LOAnnie

This has been rolling around in my head, too, LOAnnie.  Maybe what I am describing is just a situation where two totally unrelated things appear, from the outside, to be similar or identical, but maybe... .

This is absolutely, in my opinion, a direction that researchers should at least be considering.  If BPD turned out to be the result of a brain injury or malfunction, then there might at least potentially be a way to deal with it physically.  

And if so, this new knowledge could be of incalcuable value to so very many people.

What an incredible medical discovery that would be.

[Sara]

Thank you, everyone!

I am so grateful for all of your responses, and I know the family is going to be touched by your kindness and consideration, and extremely grateful for all your help.

I appreciate you all.  Thank you.

Sara

[neverenz]

This seems like a silly ? to me but atm my ds14 is having tests done and the Dr. suspects MS. I have an udBPD18 and an exhNPD. I have no idea what to think . Things are not looking great. Is there any info that i could read. Could this signal a pd for him also? i dont know what to think.My brain is all over the place and i cant seem to relax.

Please help

 neverenz

[innerspirit]

So sorry you're going thru all this  -- it must seem never-ending. 

First, please, especially here, there's no such thing as a silly question.

A friend has MS so I've learned it's a disease in which the immune system damages the myelin sheath around the nerve cells.  But I'm not aware of any connection between that illness and personality disorders.  There may be within a family, though, some genetic and/or environmental component to PD's. 

I found this on the 'net, maybe you have as well:

We Keep Moving is a site for people affected by multiple sclerosis. It contains unique stories about what it means to live with MS

www.nationalmssociety.org

[Randi Kreger]

No.Randi KregerAuthor, The Essential Family Guide to Borderline Personality Disorder: New Tools and Techniques to Stop Walking on Eggshells"

[neverenz]

Thanx innerspirit for your info, I will look it up.

Straight shooter hey Randi, thanx, I havnt read it yet but its obviously a great publication. Dont have it on me right now tho

xoxoneverenz

[GENERAL ANNOUNCEMENT]

GENERAL ANNOUNCEMENT This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question. Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board. You will find indepth information provided by our senior members in our workshop board discussions (click here).

[lbjnltx]

came across this hidden in a semi unrelated thread... .

think you might be interested in my experience. My ex wife was diagnosed with MS in 1998 with positive lesions on MRI scattered throughout her brain including the frontal lobe. She also has lesions on both optic nerves with episodes of iritis as well as optic neuritis. Her spinal tap was positive for all 3 markers of MS. She actually fit the secondary progressive MS description better than Relapse Remitting since she had nuro deficits that were permanent. She was put on Avonex as well as a boat load of other drugs. All 3 step children have some kind of emotional problems to include panic/anxiety in a daughter, crazy money spending & binge eating in a son & ADHD in the 3rd child. My granddaughter was dxd with Schizophrenia at age 15, non drug related. My ex has a history of depression, drug abuse, alcohol abuse & crazy behavior. Our marriage counsellor (RN, PhD Psy) felt she has BPD. Her MS did not cause her children's abusive behavior nor her grandaughter's schizophrenia. My ex's mother died of Lou Gerhig's disease and her alleged father committed suicide after numerous failed marriages. I believe my ex wife inherited BPD from her father combined with MS susceptibility from her mother. (ALS & MS being auto-immune diseases). My ex also abuses narcotics, tranqulizers, sleep aids & alcohol. I know she has MS & drug abuse while she likely has BPD too. All 3 things can screw up your cognition, memory, personality etc. Her children grew up in this BPD world & needless to say, are dysfunctional. I think there is a link between her MS & BPD or perhaps she is just unlucky enough to have both at the same time.

here is the link to the entire thread if you would like to get clarity on the direction of the discussion:

https://bpdfamily.com/message_board/index.php?topic=37561.0

lbjnltx

[neverenz]

Thankyou so much lbjnltx,

I will definately read this. Im at  loss as to what my son has. Do you know if a person develops scarring  of the brain quickly or over time? Sorry about your family situation. Thats a lot of mental illness to have to deal with  

 neverenz

[snowwhite]

It has come to my attention that my ex-husband (BPD) had a family history of brain cancer.  In fact, it is the illness that killed him (at the age of 50) and an uncle.  Since there is also a rather strong family history of mental illness, including a sister with BPD and an aunt treated for depression with electroshock treatments, I am wondering if anyone else here had seen this in the BPD's family? 

[connect]

Hi,

I may have asked this question before on another board.

Has anyone ever heard of BPD happening as a result of a traumatic brain injury?

Thanks,

[Abigail]

Yes, there is a connection.  Head injuries are one of the risk factors for developing BPD. 

[GreenMango]

From a brief search there looks to be two diagnoses for personality disorders Axis II and Organic Personality Disorder.  It looks like the Organic type used to be the typical diagnosis for a TBI, but the academic literature also presented a dual diagnosis option or just the going with an Axis II diagnosis.  With a TBI the psychiatric illness risk, in both Axis I and Axis II, is much higher than average.

A TBI is serious, the injury to the brain can cause major disruption and personality change.  From the literature, one of the key components after a TBI is the follow up psychiatric/psychological treatment and support.  For our members, the most helpful information is where the family, partners, or friends are able to find answers that point towards some constructive path. In this case, if your loved one is dealing with a TBI then review of the follow-up/long term treatment plan is prudent.

"In summary, our results suggest that traumatic brain injury can cause decades-long or even permanent vulnerability to psychiatric disorders in some individuals. Personality disturbances, which were common among our patients, can be difficult to detect and may impair compliance with rehabilitation. Therefore, psychiatric evaluation and follow-up should be included in the routine treatment of traumatic brain injury."~ Koponen in Axis I and II Psychiatric Disorders After Traumatic Brain Injury: A 30-year Follow-Up Study

This study is 11 years old, there may be better info out there; but it's also the most referenced on long term psychiatric disorders and TBI.

Axis I and II Psychiatric Disorders After Traumatic Brain Injury: A 30-Year Follow-Up Study

Salla Koponen, M.D.; Tero Taiminen, M.D., M.Sc.D.; Raija Portin, Ph.D.; Leena Himanen, M.A.; Heli Isoniemi, M.D.; Hanna Heinonen, M.D.; Susanna Hinkka, Ph.Lic., M.Sc.; Olli Tenovuo, M.D., M.Sc.D

Am J Psychiatry 2002;159:1315-1321. 10.1176/appi.ajp.159.8.1315

Abstract

OBJECTIVE: Patients who had suffered traumatic brain injury were evaluated to determine the occurrence of psychiatric disorders during a 30-year follow-up. METHOD: Sixty patients were assessed on average 30 years after traumatic brain injury. DSM-IV axis I disorders were diagnosed on a clinical basis with the aid of the Schedules for Clinical Assessment in Neuropsychiatry (version 2.1), and axis II disorders were diagnosed with the Structured Clinical Interview for DSM-III-R Personality Disorders. Cognitive impairment was measured with a neuropsychological test battery and the Mini-Mental State Examination. RESULTS: Of the 60 patients, 29 (48.3%) had had an axis I disorder that began after traumatic brain injury, and 37 (61.7%) had had an axis I disorder during their lifetimes. The most common novel disorders after traumatic brain injury were major depression (26.7%), alcohol abuse or dependence (11.7%), panic disorder (8.3%), specific phobia (8.3%), and psychotic disorders (6.7%). Fourteen patients (23.3%) had at least one personality disorder. The most prevalent individual disorders were avoidant (15.0%), paranoid (8.3%), and schizoid (6.7%) personality disorders. Nine patients (15.0%) had DSM-III-R organic personality syndrome. CONCLUSIONS: The results suggest that traumatic brain injury may cause decades-lasting vulnerability to psychiatric illness in some individuals. Traumatic brain injury seems to make patients particularly susceptible to depressive episodes, delusional disorder, and personality disturbances. The high rate of psychiatric disorders found in this study emphasizes the importance of psychiatric follow-up after traumatic brain injury.

Figures in this Article


Psychiatric disorders are a major cause of disability after traumatic brain injury (1). Before the introduction of DSM-III in 1980, the most extensive study on psychiatric disorders after traumatic brain injury was reported in 1969 by Achte et al. (2), who examined 3,552 veterans for psychoses with a follow-up of 22–26 years. Since the introduction of DSM-III, adult patients with traumatic brain injury have been evaluated by means of structured psychiatric interviews and diagnostic criteria (1, 3–11). In these studies, the longest follow-up we know of has been 8 years (9, 11).

Major depression has been the most studied psychiatric disorder after traumatic brain injury. The rates of axis I disorders in patients with traumatic brain injury are 14%–77% for major depression (1, 3–5, 8–10), 2%–14% for dysthymia (1, 4, 5, 9), 2%–17% for bipolar disorder (3, 7–9), 3%–28% for generalized anxiety disorder (1, 6, 8–10), 4%–17% for panic disorder (1, 8–10), 1%–10% for phobic disorders (8–10), 2%–15% for obsessive-compulsive disorder (8–10), 3%–27% for posttraumatic stress disorder (PTSD) (9, 10, 12), 5%–28% for substance abuse or dependence (1, 8–10), and 1% for schizophrenia (3, 10).

Since the famous case of Phineas Gage in 1848 (13), personality change has been reported in 49% to 80% of patients with traumatic brain injury (14–16). Franulic et al. (17) found ICD-10 organic personality disorder in 32% of patients after traumatic brain injury. To our knowledge, there have been only two studies that used structured interviews and diagnostic criteria to examine the occurrence of all personality disorders after traumatic brain injury. Van Reekum et al. (8) found DSM-III-R personality disorders in seven (39%) of 18 patients. Hibbard et al. (11) investigated 100 individuals for DSM-IV personality disorders an average of 8 years after traumatic brain injury. Sixty-six percent of the patients had at least one personality disorder, and the most common were borderline (34%), obsessive-compulsive (27%), paranoid (26%), avoidant (26%), and antisocial (21%).

The aim of this study was to evaluate the occurrence of axis I and II disorders after traumatic brain injury. The average follow-up of the patients was 30 years, which is, to our knowledge, the longest ever reported.

Here's another on the OPD and AxisII

Bull Menninger Clin. 2006 Winter;70(1):1-28.

Differential diagnosis between borderline personality disorder and organic personality disorder following traumatic brain injury.

Gagnon J, Bouchard MA, Rainville C.

Source

Départment de psychologie, Université de Sherbrooke, Québec, Canada. jean.gagnon@usherbrooke.ca.

Abstract

Organic personality disorder (OPD) is the traditional diagnostic category used to account for personality disturbances after traumatic brain injury (TBI). The recent use of Axis-II personality disorders, notably borderline personality disorder (BPD), has appeared in the TBI literature as an alternative to OPD. This would presumably offer a better description and understanding of the multiple clinical manifestations of these personality changes and disorders. This article offers a view that it is possible and fruitful to use both diagnoses in a complementary manner. An accurate recognition of the respective phenomenologies of both BPD and OPD is a key factor in achieving a differential diagnosis, including, if required, a dual diagnosis. The phenomenology of both conditions in reference to DSM-IV criteria is compared and illustrated through two clinical vignettes.

PMID: 16545030 [PubMed - indexed for MEDLINE]

[SeaCliff]

I personally believe that brain tumors and prescription pills may cause enough brain damage which may then worsen or mimic BPD type behaviors. Many health doctors state that various types of prescription pills may cause the equivalent of "chemical lobotomies" which may literally change the physical structure of the frontal lobe where empathy, social, and relationship functions or skills typically originate.

Our personality exists within our frontal lobes where emotions, problem solving, reasoning, and other functions are managed. Tumors may also cause similar damage to the frontal lobes, Pituitary Gland, Pineal Gland, Amygdala ("fear and stress center" of our brain), or other parts of our Limbic System ("Emotional Brain".

I believe that Dr. Leland Heller has also said that Autism, Asperger's, BPD traits, and Epilepsy were all potentially on the same "Emotional Spectrum" scale related to varying degrees of damage to one's Amygdala.

"The frontal lobes or, more specifically, the prefrontal cortex located within the frontal lobes, possess the ability to access information and memories we accumulate that remind us how to communicate and interact appropriately in social or public situations. The frontal lobes are responsible for empathetic behavior, allowing us to understand the thinking and experiences of others.

This understanding helps us take cues as to how to behave or respond in different types of social situations, such as the correct response to a job interview question, or understand the punch line of a joke. Damage to some areas of the frontal lobe can also affect sexual interest and activity." ("What are the functions of frontal lobe of brain" by Molly McAdams)

[muggins]

Mt question is directly about anyone who has or may have BPD/npd.

Has this person been involved in any type of accident or had any known head trauma/injury before diagnosis of BPD/npd? 

Yes / No / not known

[Turkish]

Mt question is directly about anyone who has or may have BPD/npd.

Has this person been involved in any type of accident or had any known head trauma/injury before diagnosis of BPD/npd? 

Yes / No / not known

Speaking about my mom (undiagnosed, but her therapist suggested she might be BPD), no. If you're speaking of those with strong undiagnosed traits, then for my Ex, no.