BPD – Pathological personality traits in negative affectivity – Emotional liability –  Unstable emotional experiences and frequent mood changes.

What We Know

Intense and rapid changes in mood states is a major feature of borderline personality disorder (BPD). When looking at the neurology of this trait, a study done by Herperts and others (2001)[1]  reveals some interesting patterns. They administered fMRI’s to six female BPD patients and six age-matched female control subjects while viewing 12 standardized emotional and 12 neutral slides presented in random order. The found that BPD subjects, but not control subjects, were characterized by an elevated blood oxygenation level in the amygdala, the medial and inferolateral prefrontal cortex, and the fusiform gyrus. They concluded that enhanced amygdala activation in BPD subjects may reflect the intense and slowly subsiding emotions commonly observed in response to even low-level stressors. They also concluded that Borderline subjects’ perceptual cortex may be affected by the amygdala leading to increased attention to emotionally relevant environmental stimuli.

 A second study by Russel and others (2016)[2], examined the variability in mood and interpersonal behavior, over a 20-day event-contingent recording period. They  discovered that the BPD group were less dominant, more submissive, more quarrelsome, and more extreme in overall levels of behavior than controls.

So what does this mean in plain English when it comes to maladaptive personality traits associated with BPD. First we must remind ourselves that this a trait and not an impairment. In  other words it is a tendency, a thinking pattern, and not a behavior pattern. In other words we tend to have very shaky mind states that are linked to negative emotions.

 First let’s take a look at the neurology or what is happening in the brain. Because of our BPD, we tend to show over activation in the amygdala which is the overall emotional system involved in our fight, flight, or freeze mechanisms. We also have over activation in the medial prefrontal cortex  typically associated with self-processing and other-processing, and the inferolateral prefrontal cortex which is involved in balancing goal directed and habitual behavior. Add to that an over active fusiform gyrus in the temporal lobe which is involved in face recognition, and recognition of facial expressions. Taken together this indicates that we tend to over fixate on body and face language and integrating that information with the verbal messages we hear. Along with this we have difficulty processing this information thereby affecting our sense of self, leading to a feeling of helplessness and flight or freeze, or a sense of frustration and anger leading to a tendency to fight. According to Russel and others, these moods tend to shift over a twenty day period. We do not have any consistent strategies to deal with our feelings often leading to submissive behaviors fluctuating with outbursts of anger.

The good news is that this is just a trait. Once we recognize these traits we can take steps to process them before they become actions. In other words these traits do not have to lead to helplessness and hopelessness. They are merely thought patterns brought about by chemical interactions within our brain. They can be controlled through anti-anxiety medication that focuses on serotonin enhancement, along with developing simple control mechanisms such as self-talk and cues to reroute the automatic response so that it  includes a positive approach to dealing with potentially emotional situations.

 

[1] Herpertz, Sabine C.; Dietrich, Thomas, M.; Wenning, Britta; Krings, Timo; Erberich, Stephan, G.; Willmes, Klaus; Thron, Armin; and Sass, Henning. Evidence of abnormal amygdala functioning in borderline personality disorder: a functional MRI study. Biology Psychiatry. August, 2001.

[2] Russell, Jennifer J.; Moskowitz, D.S.; Zuroff, David C.; Sookman, Debbie; and Paris, Joel. Stability and variability of affective experience and interpersonal behavior in borderline personality disorder. Journal PsycINFO DataBase Record. 2016