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What are the Underlying Causes of BPD (Borderline Personality Disorder)?

Reviewed by: Melody Stone

Borderline Personality Disorder (BPD) is a mental health condition characterized by unstable moods, difficulties in interpersonal relationships, and impulsive behavior. Typically diagnosed in early adulthood, the exact causes of BPD remain uncertain. However, current evidence suggests a combination of genetic and environmental factors.

Surveys have estimated that approximately 1.6% of the general population have BPD. This emphasizes the importance of identifying and addressing risk factors associated with the disorder, including childhood abuse, brain abnormalities, and more. By recognizing and taking steps to mitigate these risk factors, individuals with BPD can experience an improvement in symptom management and overall well-being.

If you suspect you or a loved one has BPD, take our BPD self-test to help determine whether to meet with a mental health professional for an official diagnosis.

Woman screaming in public, having a BPD episode - causes of bpd

Genetic and Biological Causes of BPD

Neurochemical Imbalances

BPD is associated with neurochemical imbalances in the brain, particularly with serotonin, dopamine, and norepinephrine levels. These imbalances can contribute to emotional volatility and impulsive behaviors, which are characteristic symptoms of BPD. While impulsive behaviors are common in those with BPD, they’re even higher in individuals with impulsive BPD. If you or a loved one tend to have behaviors characterized by impulsivity, learn more about impulsive BPD.

The Role of Genetics in BPD

There is evidence to suggest that heredity plays a crucial role in the emergence of BPD. Studies involving twins and families have demonstrated that individuals with a family history of BPD are at a higher risk of developing the disorder. However, it is important to remember that having a genetic predisposition does not guarantee that BPD will develop, as other factors can also contribute to its onset.

Brain Abnormalities in BPD

Neuroimaging studies have discovered irregularities in the brain structure and function of individuals with BPD. These irregularities primarily occur in regions responsible for emotion regulation, impulse control, and social cognition, which could explain the emotional instability and relationship difficulties experienced by those with BPD.


Environmental Causes

Childhood Events and Surroundings

Early experiences and one’s environment shape personality and can contribute to personality disorders like BPD. Factors such as unstable family relationships, neglect, childhood trauma, and exposure to ongoing stress and fear can increase the risk of developing BPD. These formative relationships influence self-perception and what is considered normal. Unresolved issues from early life can intensify BPD symptoms like impulsivity, emotional intensity, and fear of abandonment.

Individuals with petulant BPD, a subtype of BPD, tend to be highly sensitive to criticism and have a fear of abandonment. They may exhibit outbursts through tantrums, pouting, or acting out to seek attention. Neglect during childhood is a possible factor in developing petulant BPD. To learn more about this subtype and its differences from BPD, read about petulant BPD here.

Childhood Trauma and BPD

Childhood trauma, such as sexual, emotional, or physical abuse, may also contribute to the onset of BPD. Unstable relationships are a primary symptom of BPD, and children with traumatic backgrounds or unhealthy family relationships might be more prone to developing BPD later in life. They may not recognize that their relationships are abnormal.

Research has found that about 30.2% of individuals diagnosed with BPD also have a comorbid diagnosis of PTSD. This suggests that there may be a link between the two disorders, possibly stemming from childhood trauma. For instance, a child growing up with a caregiver who has a mental health disorder or substance abuse problem and models risky behavior and poor lifestyle choices may develop a distorted self-image and worldview, which could contribute to the development of BPD.

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Risk Factors

Experts agree that specific risk factors increase the likelihood of developing BPD, though the exact causes and why some individuals develop the disorder while others do not remain unclear. These risk factors include:

  • Neglect: Children who experience neglect in childhood, such as a lack of emotional support or physical care
  • Trauma: Traumatic experiences, such as physical or sexual abuse, witnessing violence or death, or experiencing a natural disaster
  • Brain abnormalities: Abnormalities in certain areas of the brain, including the prefrontal cortex, amygdala, and hippocampus, may contribute to the emotional dysregulation and impulsivity seen in BPD
  • A close relative with a mental health disorder: Having a close relative with a mental health disorder, including BPD, increases the likelihood of developing the disorder, suggesting a hereditary component and shared environmental factors
  • Substance abuse: Substance abuse or addiction, particularly to drugs or alcohol, may increase the risk of BPD
  • Genetic predisposition: Studies have suggested certain genetic variations may increase the likelihood of developing BPD
  • Co-occurring mental health disorders: BPD often occurs alongside other mental health disorders, such as depression, anxiety, or substance use disorders

If any of these risk factors apply to you, it is important to know that BPD is not a hopeless condition and there is help available. Despite the complex causes of BPD, effective treatments are available, and trained professionals can offer support and guidance to help manage and control the disorder’s symptoms. For individuals experiencing borderline personality disorder dissociation, specialized therapies can address both the dissociative symptoms and the broader emotional and behavioral challenges associated with BPD.

Treatment options such as Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), and medication can significantly improve the quality of life for those with BPD. Additionally, understanding and managing dissociative symptoms is crucial for comprehensive care. With the right support and resources, individuals with BPD can lead fulfilling and stable lives. Seeking help from mental health professionals who are experienced in treating BPD and its associated symptoms is a vital step towards recovery and well-being.

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Find BPD Treatment at Acera Mental Health

Understanding the complex interplay of genetic and environmental factors contributing to BPD is crucial for developing more effective treatments and preventative measures. As research continues to shed light on this challenging mental health condition, it is essential to remember that support is available to help manage and control the symptoms of BPD, enabling individuals to lead fulfilling and successful lives.


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