Borderline Personality Disorder and Co-Occurring Disorders
What the heck even prompts this disorder??
Borderline Personality Disorder develops as a result of an invalidating childhood experience and genetics.
Imagine this: you felt like you weren’t loved in childhood because your parents couldn’t give you attention, safety, or love in the way that you needed. Regardless of if they tried to make things better for you or not, that childhood experience can so easily result in us feeling unworthy of love. Really, what is the core experience in BPD?
It’s feeling unworthy, having an unsure sense of self, strong self-hate, self-harm, etc.
Do you see a correlation there? You should - there’s a direct cause and effect with childhood experience and development of BPD.
It’s also important I say that this doesn’t mean it’s okay for us to blame our family or our parents. Often our parents didn’t have any tools, resources, or skills to do any better.
Given the cause of BPD, you can probably imagine that there’s other common disorders that people with BPD may experience. This is especially true given the high amount of trauma people with BPD have experienced.
BPD and Major Depressive Disorder
The co-occurrence of borderline personality disorder (BPD) and major depressive disorder (MDD) is relatively common, with studies indicating a high rate of comorbidity between the two conditions. Research suggests that up to 50-70% of individuals diagnosed with BPD also meet criteria for MDD at some point in their lives. This significant overlap underscores the clinical complexity often associated with treating individuals presenting with both disorders concurrently.
Individuals grappling with both conditions often face heightened emotional dysregulation, intense mood swings, and pervasive feelings of emptiness characteristic of BPD, coupled with the debilitating symptoms of MDD, such as persistent sadness, hopelessness, and loss of interest in previously enjoyable activities. This comorbidity can exacerbate the severity of symptoms, leading to increased impulsivity, self-destructive behaviors, and suicidal ideation. Treatment typically involves a multifaceted approach, including psychotherapy focused on emotion regulation and interpersonal skills, alongside pharmacotherapy targeting depressive symptoms.
Here’s some resources:
A Workbook For Managing Anxiety and Depression
BPD and Post-Traumatic Stress Disorder
The co-occurrence of borderline personality disorder (BPD) and post-traumatic stress disorder (PTSD) is also notable, with studies indicating a substantial overlap between the two conditions. Research suggests that approximately 25-50% of individuals diagnosed with BPD also meet criteria for PTSD at some point in their lives. Similarly, individuals with PTSD are at an increased risk of developing BPD. This comorbidity highlights the significance of trauma in the development and manifestation of BPD symptoms.
PTSD symptoms, such as intrusive memories, hyperarousal, and avoidance behaviors, can exacerbate the emotional dysregulation, impulsivity, and identity disturbances characteristic of BPD. Conversely, BPD symptoms, including intense mood swings, interpersonal difficulties, and self-destructive behaviors, can impede recovery from trauma and exacerbate PTSD symptoms. The co-occurrence of BPD and PTSD can create a cycle of distress, with traumatic experiences triggering BPD symptoms and BPD-related behaviors perpetuating trauma-related distress.
Here’s some resources:
BPD and substance use
The co-occurrence of borderline personality disorder (BPD) and substance use disorders (SUDs) is relatively common, with research consistently indicating a high rate of comorbidity between the two conditions. Studies suggest that approximately 40-60% of individuals diagnosed with BPD also meet criteria for a substance use disorder at some point in their lives. This significant overlap underscores the complex relationship between BPD and substance use, with substance use often serving as a maladaptive coping mechanism to alleviate emotional distress and dysregulation associated with BPD symptoms. Conversely, substance use can exacerbate BPD symptoms and contribute to impulsivity, mood instability, and interpersonal difficulties.
Substance use puts individuals with BPD at risk for the following:
Increased Impulsivity
Heightened Emotional Dysregulation
Risk of Self-Harm and Suicide
Interference with Treatment
Increased Risk of Overdose and Accidents
Strained Relationships and Social Isolation
Here’s some resources:
The DBT Workbook For Addiction
BPD and eating disorders
The co-occurrence of borderline personality disorder (BPD) and eating disorders is significant, with research indicating a high rate of comorbidity between the two conditions. Studies suggest that approximately 20-25% of individuals diagnosed with BPD also meet criteria for an eating disorder at some point in their lives. This substantial overlap underscores the complex relationship between BPD and eating disorders, with shared risk factors such as emotion dysregulation, identity disturbance, impulsivity, and a history of trauma contributing to the development and maintenance of both conditions. Effective treatment typically involves addressing both BPD and eating disorders concurrently through integrated approaches that target emotion regulation, coping skills, and disordered eating behaviors.
Individuals with BPD often struggle with unstable and tumultuous relationships, which can contribute to feelings of loneliness and abandonment. Disordered eating behaviors may serve as a way to cope with these difficulties or as a means of seeking attention or validation from others. Additionally, traumatic experiences can contribute to the development of both conditions and may serve as triggers for disordered eating behaviors in individuals with BPD.
The Radically Open DBT Workbook for Eating Disorders
Resources
As you can see, BPD is a complex disorder to live with and it can impact many aspects of our lives but we do not have to be impacted by it so significantly that it completely derails us. In fact, I have ever disorder listed above and I’m a therapist who has a really good life - it’s a messy life and I take a lot of medication and go to a lot of therapy but it is a good life.
Here’s an overview of the resources above:
A Workbook For Managing Anxiety and Depression
The DBT Workbook For Addiction
