Imagine a person who is really happy one moment, but the next moment he is crying profusely or taking a dig at others for no reason. In another scenario, a person is feeling extremely worried about people abandoning him/her, but at the same time finds it difficult to make and keep stable relationships. A person might have intense emotions, but can act impulsively and even do things that could harm him or her. Some might think that people in such situations were undergoing extreme mood swings, but little are they aware that this is a problem of borderline personality disorder (BPD).
BPD is a serious psychiatric condition which is marked by chronic feeling of emptiness, unstable moods, unstable and stormy relationships, confusing sense of identity, and poor impulsive control in areas such as spending, eating, sex, and substance use. Such emotional instability leaves individuals vulnerable to emotional upheaval that manifests into destructive behavior such as self-harm (for e.g. cutting) or suicide attempts.
According to the National Alliance on Mental Illness (NAMI), around 1.6 percent adults in the United States have BPD but it may be as high as 5.9 percent. Nearly 75 percent of people diagnosed with BPD are women, but recent research suggests that men may be almost as frequently affected by BPD.
Emotional dysregulation in BPD
A recent study, published in the Biological Psychiatry in January 2016, provides a quantitative summary of the brain abnormalities that may be filtering the emotional upheaval in BPD patients. The study stated that some dysfunctional brain regions underlie the ‘emotional turmoil’ in patients.
Dr. Lars Schulze at Freie Universität Berlin and his colleagues at Heidelberg University focused on understanding the emotional processing pertaining to BPD in this meta-analysis. They investigated the related functional and structural abnormalities in the brain of patients with this disorder.
They reviewed 19 published studies, and surveyed a total of 281 patients with BPD and 293 healthy control subjects. However, structural data was available for 10 studies, with a total of 263 patients with BPD and 278 healthy subjects that formed the basis of the results. The researchers found that BPD patients showed enhanced activations of the left amygdala along with blunted responses of the dorsolateral prefrontal cortex during the processing of negative emotions as compared to healthy controls. These brain regions were also found to overlap with abnormalities in gray matter volume.
Dr. Schulze highlighted that the amygdala is known to process an emotional arousal and is hyperactive in BPD. The dorsolateral prefrontal cortex, on the other hand, has a key role in the regulation of emotions; it is, however, less active during the processing of negative emotional stimuli in BPD. Both amygdala and dorsolateral prefrontal cortex highlights abnormalities in the brain.
These findings categorize BPD as a disorder of emotional dysregulation. The treatment options that can help these irregularities in the brain may help alleviate some of the distressing clinical symptoms of BPD. However, more neuroimaging studies will be needed to evaluate different treatment options pertaining to cure BPD in suffering individuals.
If you or your loved one is suffering from BPD, the first and most important thing is to get the right diagnosis and treatment. The California Mental Health Helpline can help you get the best treatment options for an effective recovery. Chat online or call at 855-559-3923 for more information.