From Childhood’s Hour: 10 risk factors for BPD
And how to minimise their long term impact
If you have been diagnosed with Borderline Personality Disorder, you first question might be why me? Stuck in an unrelenting crisis of emotional instability, you may feel like you’re in a nightmare you can’t wake up from. But this illness does in fact have a cause. While the condition begins in adolescence, the roots stretch back into childhood. Just knowing them, means you can begin a process of disentanglement. Here are ten risk factors for acquiring BPD.
- Genetics — Contrary to popular belief it’s in the genes; perhaps even the serotonin transporter gene 5HTT, thought to have a role in regulating emotions and impulsivity. While the true culprit is yet to be determined, it’s beyond doubt, BPD, or at least its symptoms, can be inherited. In fact, twin studies suggest the risk of acquiring the condition is around 30 to 50%. Take a look at your own family, notice anything peculiar? Even if you don’t see personality disorder, it’s likely there’s someone with a condition which shares similar traits: ADHD, PTSD or Bipolar. Sometimes it’s just bad luck. Don’t forget though, as well as inheriting ‘bad’ qualities, you also inherited plenty of good ones as well.
- Stressed-out Mothers — Researchers have long suspected stressed-out mothers can cause BPD in their children. It begins in the womb. New research has revealed mother’s who experience severe stress during gestation are ten times more likely to have children who later acquire Borderline Personality Disorder. These intra-uterine factors are still being unravelled; but it stands to reason, in this antenatal ecosystem whatever affects the mother will affect the infant. Psychiatry’s ignominious history of mother-bashing, has meant research once overlooked, is now being reexamined. No blame, just honest enquiry: With good maternal mental healthcare, both mother and child can avoid this risk factor all together.
- Clingy Children—Secure attachment is a requisite for success, insecure attachment is a recipe for disaster. A failure in mother and infant bonding leads to clingy children; clingy children are at risk of a developing BPD. Communication errors abound, and “object constancy” is lost. The result is an anxious-ambivalent attachment style, where children will be inhibited, fearful and preoccupied with the proximity they have to their caregiver, and their perceived safety. When this pattern carries over into adult life it can lead to interpersonal chaos, and attachment system which is hyperactive or completely shutdown. Individuals with BPD veer between being too involved to being completely alone: Personality traits, which can have psychiatrists reaching for the textbook.
- Pushy Caregivers — It goes without saying bad parenting can cause all sorts of mental health problems for children and adolescents. But what constitutes a bad parent? Besides abuse and neglect there are more subtle forms of mistreatment. A pushy, self-orientated parent, who is over-involved in their son or daughters life, makes the latter vulnerable to BPD. Why? Because, when a child’s individuality is crushed and under the heavy-hand of forced-compliance, it will not only lead to a false self created out other people’s needs and wishes, but extreme acts of self-destruction, such as self-harm and suicide attempts. These are often desperate attempts to communicate needs which have not been addressed.
- Trauma — 70% of BPD sufferers will have experienced some form of childhood trauma; a fact so startling, it means many therapists consider it a disguised form of PTSD. Whether it’s abuse, neglect, poverty, or bereavement, trauma leaves a mark, quite literally a biological signature. Beyond the psychological effects, severe and chronic stress is particularly dangerous leaving children and adolescents with elevated levels of cortisol pumping through their bloodstream. This stress hormone is thought to impact everything from the amygdala, the part of brain controlling fear and aggression, to the hypothalamic–pituitary–adrenal axis which maintains the body’s homeostasis. With the body and brain out of control, life too becomes unsteady. It’s important to find ways to calm down.
- No Self-Control — A person with borderline personality disorder, is likely to have had a problem with impulsivity as a child. In fact, they may even acquire the label of ADHD or Oppositional Defiant Disorder. This isn’t simply a misdiagnosis; symptoms overlap. Whatever the case, uncontrolled behaviour, poor executive-functioning, inability to tolerate delayed gratification, all are risk factors of later life mental health problems. However when combined with a biological predisposition towards intense, and often negative emotions, Borderline Personality Disorder is one possible result. It’s a question of temperament; however it usually takes an adverse formative enviroment to warp a character out of shape.
- Identity Disturbance — The ‘Storied self’ as it sometimes called, is the narrative we spin about our lives in order to construct our identity. The tales we tell, leave a lasting impression on our psyche and create a sense of who we are as individuals in our community. Individuals with BPD are often empathetic, creative, and idealistic; nevertheless they tend to have complicated and convoluted autobiographies. The gap between the idea and reality is the borderland for mental illness. In a story that’s all too familiar, if the book of life, is tarnished in the first chapter, the latter pages may consist of a single acronym made up of three letters BPD.
- Social Exclusion — We’ve heard it many times before: What you think is what you will become. However this well worn cliche, may in fact be inaccurate. Research suggests, it’s actually what others think of us that determines how we turn out. From the earliest days of infancy, we are socialised by the reactions of those around us. Without a network of reliable trustworthy friends or family, we soon find our personality broken into fragments. Unable to see the permutations of our own mind or the minds of others we become lost in the fog of loneliness. Chameleon-like characters who blend into the enviroment, but never truly belong to it. To reach recovery, it’s important to be yourself. However this is only possible, when you grow up in an enviroment which you can trust.
- Hapless Healthcare — Iatrogenesis is a Greek word, meaning “brought forth by the healer.” It refers to healthcare which harms us. Back in the old days BPD was considered a ‘dustbin diagnosis’ precisely for this reason. Seen through the prurient eyes of fusty old psychoanalysts, it was a condition once viewed as untreatable. As a result there’s still a lingering prejudice amongst doctors that we are in fact basket-cases. Clinicians tend not to like us; and this inevitably leads to misdiagnosis, and mistreatment both of which create and reinforce symptoms. Know the enemy within and without: Find a therapist who understands and can help you.
- Self-harm — 60% of adolescents who repeatedly self-harm will go on to develop Borderline Personality Disorder. Whats the difference between a chance encounter with a blade, and a cut that goes deeper? The answer may simply be the reason for doing it. Individuals with BPD who self-harm, often do so on a chronic basis, and report feeling very agitated, or conversely completely numb, prior to doing it. Attacking the body is, either the desire to escape pain, or affirm it. It really is blood sweat and tears from here on out, but in truth there’s better ways to solve problems. With time even deep wounds heal over.
A checklist of bad luck and missed opportunities, these are just some of childhood risk factors that can lead to a diagnosis of Borderline Personality Disorder. While you can’t change the past, you can change the future. BPD recovery rates stand at 80 to 90%. Timr is what created this condition, and time will also end it. That, and a little bit of skills training and self-compassion.
Sometimes it’s just a case of facing-up to what’s happened to you. With patience, forbearance, acceptance, and courage, you too can begin walking the long bumpy road to recovery.
