Ptsd And Borderline Personality Disorder

Nadia Bokody Reveals Borderline Personality Disorder Diagnosis

When Nadia Bokodys partner left her text messages unanswered, it sparked an emotional meltdown she now knows was a telling sign.

Everything has gone pitch black.

I dont have any depth perception.

Theres not even a snatch of colour or a faint outline to guide me. Its just terrifying, suffocating nothingness.

With every second that passes, I can feel myself slipping further into the darkness.

Im starting to forget what is real

This isnt a nightmare or a bad drug trip, though it feels like both.

Its a well-worn pathway in my brain firing up for the umpteenth time this week in reaction to what would be a pretty inconsequential event for most people being apart from a partner.

The ability to hold onto other peoples feelings when I cant see them has always been elusive to me.

Any warmth, love, or connection I share with those closest to me evaporates into a kind of metaphorical black void when Im unable to physically verify it like a magician snapping his fingers and disappearing into a plume of smoke.

A part of my brain knows, of course, what Im witnessing is visual trickery that the magician is still somewhere on stage, carefully concealed from the audience.

But while Im in the moment, riveted to the show, whats happening feels completely real: if I cant witness an emotion, my brain believes it no longer exists.

It bought clarity to why things which always appeared trivial to friends were fraught with pain and difficulty for me.

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Can Bpd Be Distinguished Psychobiologically From Ptsd And Cptsd

As noted above, numerous diagnostic studies have identified a comorbid BPD-PTSD sub-group that differs from BPD alone, both clinically and neurobiologically. BPD has been shown to be associated with smaller hippocampi , but a more consistent finding is that reduced hippocampal volume in BPD tends be specific to persons with BPD and comorbid PTSD or childhood maltreatment rather than BPD alone . BPD also is related to reduced amygdala volumeexcept with comorbid depression and ACC volume .

Physical pain has been found to be problematic in both BPD and PTSD , and to potentially be neurobiologically associated with suicide risk, self-injury, and SUD . However, BPD and PTSD appear to have distinct pain profiles . BPD often involves pain analgesia consistent with dissociation and self-medication with analgesic medications , potentially mediated by a neurobiological substrate specific to BPD has been identified . In BPD, physical pain is associated with a complex pattern of heightened co-activation of sensory , affective , self-referential , and executive/inhibitory brain areas , as well as a less integration and connectivity of the PfC with the DMN and an attenuated DMN response associated with dissociation .

Physical And Verbal Abuse

Physical abuse consists of the non-accidental infliction of physical injury on the other person , while verbal abuse involves some sort of verbal interaction that causes a person’s emotional harm . Several studies found a relationship between physical or verbal abuse and BPD development .

Children who were physically maltreated developed more BPD symptoms at age 12 compared to non-maltreated peers and were especially vulnerable if they had relatives with psychiatric disorders . Harsh treatment and inherited vulnerability seem to play a synergistic role to foster borderline personality features. Not only family history, but also children temperamental characteristics can facilitate manifestation of BPD symptoms if physical abuse is suffered: children with a low level of the temperamental trait of affiliation who were physically abused showed an earlier onset and a higher severity of BPD symptoms . The relationship between perpetrated maltreatments and temperament is complex and debated: maltreatment could promote the onset of BPD in patients who had a biological vulnerability . Nevertheless, it is also possible that precocious and repeated familial maltreatments influence at least some of the temperamental features related to BPD. Timing of measurement of temperamental features constitutes a limitation as it is hard to distinguish temperamental traits in personality of adult patients.

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Making A Correct Diagnosis For Bpd Or Ptsd

BPD can sometimes be mistaken for PTSD or C-PTSD, and vice-versa. C-PTSD is a subset of PTSD which is associated with long-term or chronic exposure to trauma much like BPD. Both can cause emotional distress, mood swings, flashbacks, anxiety and anger.

Its thought there are some generalised key differences to look out for, but of course, everybody is different:

• Although both conditions can lead to problems maintaining personal relationships, people with BPD tend to fear abandonment, whereas people with C-PTSD may avoid intimacy or relationships altogether because of feeling somehow unlovable or undeserving because of the abuse they endured.
• People with BPD are more likely to self-harm, than people with PTSD or C-PTSD.
• While both those with BPD and C-PTSD struggle with emotional regulation and often experience outbursts of anger or crying, those with C-PTSD may experience emotional numbing, emptiness, or a detachment from emotions.
• Someone with PTSD may be calmed by going to a familiar environment and being reassured that they are safe. This might irritate someone with BPD, who may respond more positively to being told their feelings are valid.
• People with PTSD are more likely to be triggered by a specific external trigger and think and behave rationally outside those triggers. For people with BPD, the triggers tend to be internal thoughts and feelings, which can be less predictable.

How To Treat Bpd And Cptsd

Regardless of which disorder is evident, the treatment process will largely be the same. With adults, treatment usually includes a combination of medication and evidence-based therapies like Cognitive Behavioral Therapy and Dialectical Behavioral Therapy . These types of therapies are effective because they require the patient to gain an understanding of their negative thoughts or feelings. By doing so, patients should be able to develop better coping skills that target their negative thoughts or feelings.

With children, thepsychiatric treatment community likes to avoid using medications whenever possible. Instead, they put more emphasis on therapy, often using the same kinds of evidence-based therapies.

Mission Harbor not overly concerned about which diagnosis you might have. What we would like to see is you coming in and letting us help formulate the proper diagnosis on your behalf. From there, we should be able to create a treatment plan that could help you lead a happier life. If youre ready to get help or know someone who is, contact us today.

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The Role Of Trauma And Victimization In Bpd And Cptsd

Adults diagnosed with BPD have been shown to be three times more likely than adults with other psychiatric or personality disorders to have experienced childhood maltreatment, and 13 times more likely than adults with no psychopathology . Emotional abuse and neglect were particularly prevalent, with BPD associated with more than 30 times increased likelihood of the former and more than 20 times increased risk of the latter, as compared to non-clinical adult samples . Physical abuse and neglect, and sexual abuse also were more prevalent for BPD cohorts than non-clinical controls, with an approximately seven times increased likelihood among BPD-diagnosed persons . Childhood adversity was more than twice as likely to be reported by persons diagnosed with BPD than those with mood, psychotic, or any other personality disorders . Extreme interpersonal trauma in adulthood also has been shown to be associated with severe personality disorders including BPD .

Summary

Therapy For Caregivers And Family Members

Having a relative or loved one with the disorder can be stressful, and family members or caregivers may unintentionally act in ways that can worsen their loved ones symptoms.

Although more research is needed to determine how well family therapy helps with borderline personality disorder, studies on other mental disorders show that including family members can help support a persons treatment. Families and caregivers also can benefit from therapy.

Family therapy helps by:

• Allowing the relative or loved one to develop skills to understand and support a person with borderline personality disorder.
• Focusing on the needs of family members to help them understand the obstacles and strategies for caring for someone with the disorder.

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Can Bpd Be Distinguished On A Neuropsychological Basis From Ptsd And Cptsd

With the many unanswered questions about the role and type of trauma exposure in the etiology of BPD, cPTSD, and PTSD, psychobiological studies exploring commonalities and distinguishing features of the disorders are particularly important. Although several recent relevant studies have been reported, it is important to note that cPTSD as defined by the ICD-11 has not been included in any published neuroimaging studies to our knowledge. Distinctions in neural patterns that have reported between BPD and cPTSD thus are based mainly on a DESNOS formulation of cPTSD, or using severe child-abuse-related DSM-5 PTSD as a proxy for cPTSD . Neuroimaging and psychobiological research comparing the ICD-11 version of cPTSD to BPD clearly is needed.

A case-control study with 45 adult outpatients diagnosed with BPD and 56 matched non-psychiatric controls found that BPD was associated with deficits in verbal comprehension, sustained visual attention, working memory and processing speed. Comorbid BPD/PTSD was associated with additional deficits in high-order neurocognitive functions . Although the BPD patients reported more severe childhood maltreatment than controls , childhood trauma was associated only with one neurocognitive deficitâand only with trauma in the form of physical abuse.

Whether cPTSD has a profile analgesia or hyperalgesia, with corresponding brain structures and activation or connectivity patterns, has not been investigated.

Summary

Bpd And Ptsd: How Common Is The Overlap

Image courtesy of HealingfromBPD.org

How common is it to have a diagnosis of both Borderline Personality Disorder and Post Traumatic Stress Disorder ? This is a key question currently being considered in the mental health community. Studies show anywhere from 26% 57% of comorbidity of these two disorders. These findings further suggest that this particular personality disorder may be a variant of PTSD however, it is not known how prevalent PTSD is in the other personality disorders . A rationale behind the comorbidity rate is that PTSD can develop after experiencing a traumatic event that leaves one feeling unsafe or threatened. BPD develops partly from genetic predisposition along with an invalidating environment. Often, trauma occurs in this invalidating environment, which thereby causes the connection between the two disorders.

When we hear about someone experiencing trauma, we dont always judge how intense or for how long the trauma was endured yet this is very helpful to know so that we can gauge the severity in light of the duration. Was this a onetime event or an ongoing experience? According to Out of the Fog , an online resource, C-PTSD results more from chronic repetitive stress from which there is little chance of escape. This will most likely impact the type of treatment thats most fitting and the approach to take.

Here are a couple of examples to assist with the differences between PTSD and C-PTSD:

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The Role Of Trauma In Early Onset Borderline Personality Disorder: A Biopsychosocial Perspective

• Department of Neuroscience, School of Medicine, University of Turin, Turin, Italy

The role of childhood trauma in the development of borderline personality disorder in young age has long been studied. The most accurate theoretical models are multifactorial, taking into account a range of factors, including early trauma, to explain evolutionary pathways of BPD. We reviewed studies published on PubMed in the last 20 years to evaluate whether different types of childhood trauma, like sexual and physical abuse and neglect, increase the risk and shape the clinical picture of BPD. BPD as a sequela of childhood traumas often occurs with multiple comorbidities . In such cases it tends to have a prolonged course, to be severe, and treatment-refractory. In comparison with subjects who suffer from other personality disorders, patients with BPD experience childhood abuse more frequently. Adverse childhood experiences affect different biological systems , with changes persisting into adulthood. A growing body of evidence is emerging about interaction between genes and environment .

Apparatus And Physiologic Recordings

We controlled stimulus delivery using Presentation software . We recorded physiologic data at a rate of 256 Hz in continuous mode using the Vitaport II system and vitagraph software, version 4.61 . We measured skin conductance using Ag/AgCl-electrodes filled with an isotonic electrodermal response jelly TDE-246 and placed on the thenar and hypothenar eminences of the nondominant hand . We assessed arm movement as a control measure using a 2-dimensional accelerometer.

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Other Terms For Complex Ptsd

Complex PTSD is a fairly new term. Professionals have recognised for a while that some types of trauma can have additional effects to PTSD, but have disagreed about whether this is a form of PTSD or an entirely separate condition, and what it should be called.

For example, you may find some doctors or therapists still use one of the following terms:

• enduring personality change after catastrophic experience
• disorders of extreme stress not otherwise specified this term is more common in America than the UK.

At times I felt nothing was going to end the distress, experiencing more than 10 flashbacks a day… It was a long process of recovery, with lots of bumps along the road, but the right medication and long-term therapy with someone I came to trust, has changed my life.

Symptoms Of Ptsd Vs Bpd

Because several symptoms are common in both PTSD and BPD, diagnosis can be challenging. For this reason, its important to address all aspects of someones condition before making any sort of diagnosis and to go to a licensed healthcare provider for diagnosis.

Symptoms that can occur in both PTSD and BPD include:

• Difficulty with emotion regulation

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When Bpd And Ptsd Co

BPD and PTSD occur at the same time in a large number of people. One reason for this is that experiencing traumatic events in childhood is a risk factor for both disorders. PTSD can intensify the symptoms of BPD.

If both disorders do occur at the same time, treatment for both disorders is needed. While psychotherapy is an effective treatment method for both disorders, each may require a different approach. For example, in BPD, dialectical behavioral therapy is often recommended, while a person with PTSD may get better results from exposure therapy to help them face and control their fears.

The similar symptoms that occur between BPD and PTSD can make it hard to distinguish between them. Each individual with mental illness is unique and, while some symptoms may overlap, each may require a different approach to treatment.

If you or a loved one are struggling with a BPD or PTSD, please contact us at or submit the form below and a treatment specialist will contact you.

Mental Wellness Treatment At The Wave

The Wave offers a transformative treatment experience for young people looking for mental wellness support. We are specialists in trauma treatment, eating disorders, mental health, and addiction treatment for young adults, drawing on decades of experience and unequalled expertise.

The Wave offers a holistic approach to treatment that focuses on full recovery and positive growth. We understand that every young person is different, and we provide individualised and flexible programmes that suit their unique needs. Our treatment plans combine psychotherapy with experiential activities and body-mind approaches to promote deep and meaningful healing.

At The Wave, recovery means more than just managing symptoms. We want young people to leave our centre ready to follow their dreams. We help adolescents rediscover their purpose in life and equip them with the skills they need to reach their goals.

We understand that being apart from your child can be hard, so we ensure that families are included from the beginning to the end of the treatment process. We offer regular updates, information, and comprehensive explanations for your peace of mind.

If youre looking for a transformative recovery experience that combines mental wellness treatment with a GAP year journey, contact us today. Were here to help.

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What Are The Treatment Options For Cptsd Vs Bpd

cPTSD and BPD both require different types of treatment. cPTSD is often treated with psychotherapy, which can include:

• Cognitive-Behavioral Therapy is a form of talk therapy that helps you understand the thoughts and feelings that underlie your behavior. It aims to help people reduce negative thought patterns and behaviors by encouraging positive thinking habits.
• Eye Movement Desensitization and Reprocessing is a therapy that helps you deal with traumatic memories. It involves making repeated eye movements while thinking about the traumatic event. EMDR has been shown to be effective in treating cPTSD.

BPD is often treated with a combination of medication and psychotherapy, which may include:

• Dialectical Behavior Therapy is a form of cognitive-behavioral therapy originally developed to treat borderline personality disorder . It combines cognitive-behavioral techniques with concepts from Zen Buddhism.
• Mentalization-based therapy is a type of psychotherapy that helps you understand how you think and feel about yourself and others.
• Transference-Focused Psychotherapy focuses on the relationship between the therapist and patient to help them get better. Its a type of psychoanalysis that concentrates on the unconscious mind and how it affects behavior.

Causes Of Cptsd Vs Bpd

Causes of CPTSD

CPTSD can develop when a person is exposed to long-term trauma. While CPTSD is a type of PTSD, it has additional unique symptoms.

There does not need to be a single traumatic event associated with trauma people develop CPTSD from long-term traumatic situations. Generally, PTSD in adulthood can stem from short- or long-term abuse or neglect in childhood. Shame from childhood abuse can persist for a persons lifetime and affect their self-perception and perception of others.

A person may be more likely to develop CPTSD if they:

• Experienced trauma at an early age

• Were hurt by someone they trusted

• Couldnt escape the harm they endured

• Theres substantial evidence³ that some families are genetically predisposed to PTSD, indicating that the presence of one or more genes may make a person susceptible to developing the condition.

Causes of BPD

A variety of factors contribute to the development of BPD. While theres no known BPD gene, its worth noting that there does seem to be some genetic basis for the disorder.

A review of relevant scientific literature reported that 11.5% of people diagnosed with BPD have a first-degree relative who also has the condition. That said, the majority of people with family histories of BPD dont go on to develop it themselves. BPD typically results from a combination of factors, including:

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