Tuesday, March 1, 2011

Inborn Biogenetic Temperaments: Origins of Borderline Personality Disorder


There is not one thing that leads to the development of BPD. Nature vs. Nurture, Psychological Factors, Social and Cultural Factors, Pathology… these things and more lead to the presentation of a Borderline Personality Disorder. I’m going to start looking into these things, take a more in depth look as some of the influencing considerations.  

In an article called A BPD Brief by John G. Gunderson, M.D. he talks about the Inborn Biogenetic Temperaments that lead to the development of BPD.

The degree to which Borderline Personality Disorder is caused by inborn factors called the “level of heritability” is estimated to be 68%. This is about the same as for bipolar disorder. What is believed to be inherited is not the disorder, per se, but the biogenetic dispositions, temperaments. Specifically, BPD can develop only in those children who are born with one or more of the three underlying temperaments or phynotypes: 

1.) Affect dysregulation
2.) Impulsivity
3.) Disturbed attachments 

Such temperaments represent an individual’s predisposition to emotionality, impulsivity, or relationship problems. For children with these temperaments, environmental factors can then significantly delimit or exacerbate these inborn traits.

Many studies have shown that disorders of emotional regulation or impulsivity are disproportionateloy higher in relatives of BPD patients. The affect/emotion temperament predisposes individuals to being easily upset, angry, depressed, and anxious. The impulsivity temperament predisposes individuals to act without thinking of the consequences, or even to purposefully seek dangerous activities. The disturbed attachment temperament probably starts with extreme sensitivity to separations or rejections. Another theory has proposed that patients with BPD are born with excessive aggression which is genetically based (as opposed to being environmental in origin). A child born with a placid or passive temperament would be unlikely to ever develop BPD.

Normal neurological function is needed for such complex tasts as impulse control, regulation of emotions, and perception of social cues. Studies of BPD patients have identified an increased incidence of neurological dysfunctions, often subtle, that are discernible on close examination. The largest portion of the brain is the cerebrum, the upper section, where information is interpreted coming in from the senses, and from hich conscious thoughts and voluntary movements are thought to emanate. Preliminary studies have found that individuals with BPD have a diminished serotonergic response to stimulation in these areas of the cerebrum and that the lower levels of brain activity may promote impulsive behavior. The limbic system, located at the center of the brain, is sometimes thought of as “the emotional brain”, and consists of the amygdale,  hippocampus, thalamus, hypothalamus, and parts of the brain stem. There is evidence that the volume of the amgydala and hippocampus portions of the brain, so critical for emotional functioning, are smaller in those with BPD. It is not clear whether such neurological irregularities have either genetic or environmental sources.

In summary, research indicates that individuals who have difficulty with impulse control and aggression have reduced levels of activity in t heir brains in a number of key locations. It is theorized that in personas with BPD, mild to moderate impairments in severl systems result in “errors” in the gathering, dissemination, and interpretations of data, and they are consequently more likely to respond with acts of impulsivity or aggression.

Can’t say as I have any arguments against this one. It seems pretty natural that someone with an emotional regulation problem would have the inborn genetics that predispose them to not regulate their emotions well.
I manage to fall into all 3 of the phenotype classes. Some more than others.

Affect dysregulation: Check.  My constant depression and anxiety aside, my temper flares, small things that any normal person would dismiss, bury themselves deep under my skin, set my fury on fire, I can’t let go of the thoughts and actions (intentional or not) that hurt me, and sink me into a murky mental grave. Every. Single. Thing… seems to affect me. Unless I go numb, shut myself off from the world, the people in my world, I can’t escape the barrage of sensations that affect my mood. I won’t say this is all the time,  I do manage to have short periods of times, sometimes a few days at a time, that are stable and okay, where my thoughts and moods don’t run away with me, but in the end, these don’t last.

Impulsivity temperament: Check.  I’m not so much with the not thinking about consequences. I can’t not think about consequences. I think about everything. I analyze things to death. Every path, every permutation, I think about it. Now ask me if that stops me. Not usually. I know the dangers, and I do it anyways. I’m too smart to ignore the consequences, but not smart enough to stop myself from pursuing the dangers, or maybe not smart enough to force myself to care about the consequences. I throw myself into things, the dangerous and the safe, the helpful and the harmful. I take it all in, until it all wears me out.

Disturbed attachment: Check.  Extreme sensitivity to separations and rejections. Some of my earliest childhood memories are of being afraid of rejection, not being able to please my father with my coloring, not being good enough, worrying that my mother wouldn’t come home from the hospital because no one told me she wouldn’t be gone forever.  These things are so small, so innocuous, I can’t imagine my reactions to these were normal. Who fears their father will stop loving them, or be gripped with anger, anxiety, and disappointment because a picture was ‘ruined’?  I had good parents that love me a lot, I don’t think they ever meant me any harm or intentional hurt, yet even in my earliest memories I read so much hurt and anxiety into the things that rocked my little world. I don’t believe it was anything they tried to do to me.

So , do I believe that my BPD is based, at least in part, to inborn traits? Yes, yes I do.

That’s not to say that the events and environments in my life didn’t contribute and exacerbate my problems. There’s no denying that. I can’t help but wonder though, if I wasn’t predisposed to feel, react, the way I do, would all these things ever have affected me the way they did? Still do?

Maybe I’m just hoping that there can be a genetic marker to pin point the brain dysfunction. If there’s a biological indicator, than there’s potential for a medical ‘cure’. Something that can be done to regulate those parts of the brain that don’t function to normal levels. I’m not sure you can actually cure a ‘personality’ {disorder}, but if there’s a genetic factor, than there’s possibly some scientific tinkering to help. I have a lot of faith in science (ß--- Irony).

5 comments:

  1. Lots of people grow up with trauma. Not too many get legitimate personality disorders because of it. I wouldn't be surprised if it was genetic-heavy in origin.

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  2. ::nods:: This was also a thought. Completely slipped my mind when I was writing this. My dad is actually a good example of this.

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  3. I am no scientist but I would agree that there is a genetic factor associated with some mental illness and I don't have to look very hard to see a pattern. Both of my sisters have been diagnosed with having OCD and anxiety disorders, same as I. My mom has not been clinically diagnosed but it is appearant that she has many of the same issues. She has chose to not seek medical treatment.

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  4. I'd like to believe you're right. I also suffer from Borderline Personality Disorder. My parents were good to me, still are. A pretty normal upbringing.

    It's always been a mystery to me that I've felt this way for AS LONG AS I CAN REMEMBER. Always felt not good enough, like I didn't fit in, like I was outcasted, unworthy, extremely sensitive to criticism and eager to please and afraid of failure. (Since my earliest childhood memories.) (Even though nobody blatantly MADE me feel that way on purpose.)

    It is a bitter amazement to me to remember being a small child, without obvious trauma, always feeling so very SAD and taking every little thing into the deepest area of my soul and allowing it to overwhelm me in a negative way.

    I feel as if I am made out of scars, wounds that never heal, tears, rejection, heartbreak, and failure. These are the building blocks of my entire being. It's a weak structure that is glued together with guilt.

    We as Borderlines are so fragile that we break at the slightest flick of an emotional switch and all of our internal negativities come pouring out in an episode of rage, or harsh severe depression...and normal people don't get us, which further adds to our sense of being alone with ourselves (who we hate to be with); and outside of the rest of the world, unable to cross into to bubble of normality and reality of social interactions and connections.

    That's another thing. It's like I'm broken. When 2 people make a connection their end of the bridge and your end of the bridge are supposed to meet in the middle so that an attatchment is made and emotions can cross back and forth between them.

    I can't reach out. I try. But my bridge will not make it past the gap. Almost as if it just doesn't work. I don't have the resources to build a successful bridge to another person, and I constantly feel alone no matter who I am with or where I am at.

    Well, you seem intelligent and reflective. It's been a while since you posted this, but I thank you. It's nice to read about familiar emotions and thoughts. It's comforting. Take care of yourself.

    --Amber 29, Ohio

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    Replies
    1. I understand absolutely the things you say here.

      I've always felt broken, which is probably why I'm so fixated on fixing myself. I don't know why I am this way, but I do know that I don't want to be this way. I want to be better for myself.

      Reaching out is so hard. I don't understand how to connect either. That figurative gap is always there, taunting me. It would almost be less tortuous if there wasn't a bridge at all, instead of hope just out of reach.

      Thank you for visiting me here.

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