Borderline personality disorder genetic

What You Need to Know About the Genetics Behind Borderline Personality Disorder

How to Find Help for a Loved One Who’s Been Diagnosed With Borderline Personality Disorder

While BPD symptoms are often present during adolescence, the disorder frequently remains undiagnosed until adulthood, notes the Personality Disorder Awareness Network (PDAN). That’s because personality traits fluctuate during these years. (7)

Still, the group recommends not ignoring possible symptoms, and not waiting to seek help until your child is older. Having a child evaluated early can be invaluable in getting them on the path toward wellness, they note, citing Australian research that found that symptoms in childhood predict a personality disorder diagnosis. (8) This early intervention can help kids learn to manage their emotions in effective, healthy ways rather than self-destructive ones.

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

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

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

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

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

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

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

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

What Causes Personality Disorders?

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