Inextricably Linked: The Relationship Between BPD and PTSD
PTSD (Post-Traumatic Stress Disorder) and BPD (Borderline Personality Disorder) often show up together, but it is important to note that these are two separate disorders. Although a great deal of research is being done on this topic, those studying the issue acknowledge — even in the scientific literature — that the exact nature of the relationship between PTSD and BPD is unknown. However, many researchers have noted that PTSD often seems to function as a kind of precursor to BPD. Some researchers into the relationship between these disorders include complex post-traumatic personality disorder (CPTSD) as a closely related disorder that can result from experiencing long-term trauma.
What Kinds of Experiences May Lead to PTSD?
To get to the root of what causes BPD, it may be helpful to backtrack and attempt to isolate events that have triggered PTSD. Common experiences that seem to set off this disorder include:
- Accidents of all kinds, including traffic accidents
- Situations in which personal safety is threatened, such as being held at gunpoint
- Being the victim of an assault
- Any kind of sexual violence
- Being abused as a child
Experiences that can trigger CPTSD include:
- Long-term child physical or sexual abuse
- Long-term domestic violence
- Being a victim of human or sex trafficking
- War
- Frequent community violence
Why Do Some People Develop PTSD While Others Do Not?
Unfortunately, many of the experiences that are linked to PTSD are very common. With around one in four children being abused or neglected, it is easy to see how so many people in our society have developed PTSD.
However, not every abused child will eventually be diagnosed with PTSD. It is estimated that 1%–6% of abused boys and 3%–15% of abused girls will develop PTSD. This type of disparity can also be seen in combat veterans. While some go on to be diagnosed with PTSD after their military service, many do not. Experts estimate that the more recently diagnosed disorder, CPSTD, may affect 1%–8% of the world population.
The Risk Factors That May Influence Whether Someone Develops PTSD
A history of substance abuse seems to lead to an increased likelihood of PTSD. Abuse that takes place over a long period of time can be more debilitating than one isolated incident. Other mental conditions, such as anxiety and depression, also seem to amp up the likelihood of PTSD.
Additional factors that can play a role include:
- Having experienced an earlier traumatic event
- Not having a solid support network of family and friends
- Having family members who suffer from anxiety and/or depression
What Are the Symptoms of PTSD?
PTSD Symptom: Flashbacks
One of the most frightening symptoms of PTSD is experiencing flashbacks. Suddenly, individuals with PTSD will find themselves back at the scene of their trauma. There will often be a trigger, and then they will see the trauma as if it is unfolding in front of them — even if it happened half a century ago. The sights and sounds will be as clear as they were during the event itself, tricking the brain into thinking that this traumatic event is happening all over again.
For example, someone who’s been involved in a horrific car accident could be triggered by the sound of squealing tires or a minor fender bender. Soldiers who have served in combat may be triggered by fireworks or find themselves experiencing night terrors.
Do BPD Clients Experience Flashbacks?
People with BPD may also experience flashbacks. It’s important to note that someone suffering from BPD will often have a much more difficult time recovering from a flashback than a person who has PTSD without the comorbidity of borderline personality disorder.
PTSD Symptom: Frequently Experiencing a State of Hyperarousal
Most people can identify with the feeling of being “keyed up” on a temporary basis. After all, daily life stressors — being cut off in traffic or getting a parking ticket — are very common and can get under almost anyone’s skin. However, with a neurotypical person, the feeling of being keyed up may pass very quickly. For someone suffering from PTSD, however, anger may erupt without even having an identifiable trigger. Instead of paying their parking ticket and forgetting about it, they may assign greater meaning to the event and literally lose sleep over it. Those with PTSD may seem “jumpy,” as though they are always on the lookout for some tragedy to unfold right in front of their eyes.
Do People With BPD Experience Hyperarousal?
Depending on the way their disorder presents, people with BPD may also become hyperaroused. With BPD, emotions can be intense but fleeting. This is one of the factors that can differentiate BPD from many other mental disorders. Someone with BPD can be sobbing and inconsolable for several minutes and then recover almost immediately, laughing with friends and experiencing a good mood just an hour later. People often confuse this kind of behavior with manic-depressive incidents — and BPD is sometimes misdiagnosed as bipolar disorder. However, wildly shifting emotions are specifically a symptom of BPD, which is thought to affect 2%–6% of the population.
PTSD Symptom: A Feeling of Numbness
Those with PTSD often describe a numbness that seems to settle over them, preventing them from experiencing the full range of human emotions. This was a PTSD symptom that manifested very often for World War II veterans. Because they lived during a more emotionally restrained time, many of these combat veterans did not feel comfortable sharing their pain with others or talking directly about their experiences during the war. Many of these people developed coping mechanisms that included avoidant behavior. For example, many combat veterans would come home from the war and then find themselves unable to communicate with a romantic partner about their feelings; this is common for those with PTSD, regardless of the triggering factor.
Another common issue related to numbness would be not enjoying activities that the person loved previously. If someone has always been a golf fanatic and suddenly doesn’t want to play anymore, for example, this could be a symptom of PTSD.
Do People With BPD Experience Numbness?
A type of numbness can be associated with BPD, but clients tend to describe this mental state a bit differently. With BPD, a chronic feeling of emptiness may be one of the most distinguishing characteristics from other mental disorders. With BPD, there is a distinct feeling of “nothingness” that can sometimes lead BPD clients to question whether they are actually alive. It is this nothingness that often seems to be associated with the self-harm behaviors that BPD clients may demonstrate. BPD clients with self-harming tendencies will often report that their reason for self-harming was that they wanted to feel something. Their desperation to feel anything can consume them to the point of engaging in cutting or other self-harm activities.
PTSD Symptom: Avoiding Scenarios That May Be Triggers
For people who are suffering from PTSD, anything that reminds them of the traumatic event can be a trigger — and they may choose to avoid it entirely. An example of this might be someone who has survived a plane crash. After this traumatic event, they may want to avoid going on planes. They may also avoid talking about planes or watching films and TV shows featuring aircraft. Blink-182 drummer Travis Barker suffered from PTSD after being a passenger in a private jet crash that killed four other people onboard. Not only did he not fly for over a decade, but he also reported feeling anxious whenever he saw a plane in the sky. In order to recover from PTSD like this, clients will often have to undergo a great deal of therapy. It’s important to note that even a multimillionaire like Barker, who has access to world-class medical care, still struggled with PTSD after his accident and was not instantly cured upon seeking treatment. PTSD affects those from all walks of life.
Although BPD sufferers can be avoidant, this is a symptom that is more closely associated with the aftereffects of a trauma that later produces PTSD. Also, a person who suffers from BPD and PTSD is just as likely as anyone else to demonstrate avoidant behavior.
Not Everyone With PTSD Develops BPD
It is imperative to note that not everyone with PTSD goes on to develop BPD. One emerging field of research right now is the link between CPSTD and BPD, with some claiming that the two disorders are even more linked than standard PTSD and BPD.
What Are the Main Symptoms of BPD?
One of the symptoms that sets BPD apart from many other mental illnesses is that suicidal ideation is frequently a feature. Self-harm may occur as a result of a real or perceived abandonment, which is one of the main symptoms of BPD in general; people suffering from this disorder are often terrified by the thought of being abandoned. However, they are not always accurate in their perception of someone abandoning them.
BPD mood swings are also a common symptom, as are displays of bad temper. Becoming paranoid, even to the point of losing a grasp on reality, is another symptom. Those with BPD may also struggle with substance abuse issues and an unstable work or relationship history. Yet another classic BPD symptom is “splitting” — seeing the world and people in black and white and not being able to comprehend many nuances. This quality, unfortunately, can lead to a lot of instability.
The Good News
Although PTSD and BPD are serious conditions, they are both treatable. These days, therapists are more qualified than ever to deal with both of these disorders — and they have become better educated in differentiating between them. Counselors working with BPD patients have experienced great success by using dialectical behavior therapy DBT). Recovery is possible, and working with an experienced counselor or seeking out any kind of assistance if currently dealing with a mental health crisis is the way to go. With persistence and care, both these disorders can be managed to allow the client to live a full and happy life.
Resources for Mental Health
Sometimes, those who are suffering from mental disorders, as well as their loved ones, feel the need to speak to another person about what they’ve been experiencing. Fortunately, the National Depression Hotline offers help around the clock. If you have a burning question in the middle of the night, on a weekend, or at any other time, you can simply call (866) 629-4564 and speak to someone for free. The team at the National Depression Hotline is skilled at listening and providing advice or pointing people toward additional resources that may help them throughout their journey. While navigating this complex world, it is always good to know that an organization cares about your well-being.
