What does borderline personality disorder look like in the brain?
MRI studies have demonstrated that people with BPD have reduced volume in the frontal lobe, bilateral hippocampus, bilateral amygdala (a reduced volume that has not always been replicated in MRI studies), left orbitofrontal cortex, right anterior cingulate cortex, and right parietal cortex and increased putamen volume.
Personality disorders, including borderline personality disorder, are diagnosed based on a: Detailed interview with your doctor or mental health provider. Psychological evaluation that may include completing questionnaires. Medical history and exam.
That's not true! Although it is not caused by a chemical imbalance in the brain, such as what happens during a depressive episode, BPD does have biological foundations. BPD develops partly from having a highly sensitive nervous system.
Brain scans alone cannot be used to diagnose a mental disorder, such as autism, anxiety, depression, schizophrenia, or bipolar disorder. In some cases, a brain scan might be used to rule out other medical illnesses, such as a tumor, that could cause symptoms similar to a mental disorder, such as depression.
Stressful or traumatic life events
Often having felt afraid, upset, unsupported or invalidated. Family difficulties or instability, such as living with a parent or carer who experienced an addiction. Sexual, physical or emotional abuse or neglect.
BPD Looks Like So Many Other Mental Health Conditions
In particular, there is evidence that BPD is commonly misdiagnosed as Bipolar Disorder, Type 2. One study showed that 40% of people who met criteria for BPD but not for bipolar disorder were nevertheless misdiagnosed with Bipolar Type 2.
Researchers have used MRI to study the brains of people with BPD. MRI scans use strong magnetic fields and radio waves to produce a detailed image of the inside of the body. The scans revealed that in many people with BPD, 3 parts of the brain were either smaller than expected or had unusual levels of activity.
Screenings for BPD should be done face-to-face in person or virtually rather than via an online test. A complete assessment for BPD includes: A thorough interview including a discussion of your symptoms and past and present life. A review of your personal and family medical history.
- Bipolar disorder.
- Complex post-traumatic stress disorder (C-PTSD)
- Depression.
- Anxiety.
- Psychosis.
- Antisocial personality disorder (ASPD)
Childhood trauma such as sexual, emotional, or physical abuse also may lead to the onset of borderline personality disorder. Unstable relationships are a main symptom of BPD , and children with traumatic backgrounds or unhealthy family relationships may be more prone to developing BPD later in life.
Is BPD mental or neurological?
Objective: Borderline personality disorder is a disabling and dramatic psychiatric condition. To date, its pathophysiology remains unclear. Scientific evidence seems to have found underlying, nonfocal, central nervous system dysfunction in borderline personality disorder.
BPD primarily affects the fronto-limbic network, in particular, the amygdala, hippocampus, and orbitofrontal cortex, whereas BP affects both cortical and subcortical areas.

Some of the benefits brain scans can provide include: Identifying lesions in the frontal or temporal lobes and the thalamus and hypothalamus. Brain lesions can cause a number of psychiatric disorders like anxiety, depression, schizophrenia, and anorexia as well as cognitive dysfunction.
Imaging scans can tell us a lot about the brain. But, right now, brain scans are not used to diagnose bipolar disorder. To diagnose this condition, a psychologist or other mental health professional may do a physical exam or order lab tests. These can help rule out any other medical condition causing your symptoms.
And, just like anyone else, people with BPD may also lie when they are trying to defend themselves or are emotionally hurt.
This is where the term “favorite person” comes from in the borderline community. There is usually one of two people that we absolutely idolize and want to spend all our time with, and if they are busy and can't spend time with us we tend to get angry and feel abandoned.
Physical and Verbal Abuse
Children who were physically maltreated developed more BPD symptoms at age 12 compared to non-maltreated peers and were especially vulnerable if they had relatives with psychiatric disorders (23).
Clinicians can be reluctant to make a diagnosis of borderline personality disorder (BPD). One reason is that BPD is a complex syndrome with symptoms that overlap many Axis I disorders.
- Wide mood swings lasting from a few hours to a few days, which can include intense happiness, irritability, shame or anxiety.
- Ongoing feelings of emptiness.
- Inappropriate, intense anger, such as frequently losing your temper, being sarcastic or bitter, or having physical fights.
If left untreated, the person suffering from BPD may find themselves involved with extravagant spending, substance abuse, binge eating, reckless driving, and indiscriminate sex, Hooper says. The reckless behavior is usually linked to the poor self-image many BPD patients struggle with.
How does a psychiatrist test for BPD?
There is no borderline personality disorder test, but your doctor may ask you to answer mental health questionnaires or take psychological tests and assessments to learn more about you. To diagnose the condition, mental health professionals gather information about your symptoms, life experience, and family history.
Antipsychotics are widely used in BPD, as they are believed to be effective in improving impulsivity, aggression, anxiety and psychotic symptoms [Nose et al. 2006; American Psychiatric Association, 2001].
Those of us who've been diagnosed with BPD have different views on whether the label is helpful. Some of us find it useful to have a diagnosis because we feel it explains and helps us to understand our difficulties, or gives us a sense of relief and validation. It may also be helpful for accessing treatment or support.
During the manic phase of bi-polar, some are able to stay up for days. While during the depression phase, they sleep for 10-15 hours per day. A person with BPD may have poor sleep habits but they are not consistent with the mood swings.
“BPD is one of the most commonly misdiagnosed mental health conditions,” according to the National Alliance on Mental Illness.
BPD in particular is one of the lesser-known mental illnesses, but all the same it is one of the hardest to reckon with. (Some people dislike the term so much they prefer to refer to emotionally unstable personality disorder.)
But borderline personality disorder does not develop as a result of those traumas. Instead, it is a combination of genetic factors and childhood experiences (early environmental influences) that cause a person to develop borderline personality disorder.
Genetics A person's genetics are a big factor in whether he or she experiences BPD. “Studies show anywhere from 49 to 65 percent of the development of BPD is genetic in nature,” says Dr. Riggenbach.
Overview. Borderline personality disorder (BPD) is a serious, long-lasting and complex mental health problem. People with BPD have difficulty regulating or handling their emotions or controlling their impulses.
When stressed, people with borderline personality disorder may develop psychotic-like symptoms. They experience a distortion of their perceptions or beliefs rather than a distinct break with reality. Especially in close relationships, they tend to misinterpret or amplify what other people feel about them.
What do people with BPD struggle with?
A person with BPD is highly sensitive to abandonment and being alone, which brings about intense feelings of anger, fear, suicidal thoughts and self-harm, and very impulsive decisions. When something happens in a relationship that makes them feel abandoned, criticized, or rejected, their symptoms are expressed.
BPD primarily affects the fronto-limbic network, in particular, the amygdala, hippocampus, and orbitofrontal cortex, whereas BP affects both cortical and subcortical areas.
Borderline personality disorder (BPD) is a severe psychiatric disorder with multiple psychopathological domains; so studying the correlation of clinical or behavioral data with underlying structural and functional neurological findings in BPD is the focus of interest in recent years.
Many people who live with BPD will also experience other mental health problems. Such as depression, anxiety, eating disorders, PTSD and alcohol or drug misuse. People who live with BPD can also be diagnosed with bipolar disorder. The symptoms of bipolar disorder can often be confused with those of BPD.
Borderline personality disorder (BPD) is one of the most damaging mental illnesses. By itself, this severe mental illness accounts for up to 10 percent of patients in psychiatric care and 20 percent of those who have to be hospitalized.
Researchers have used MRI to study the brains of people with BPD. MRI scans use strong magnetic fields and radio waves to produce a detailed image of the inside of the body. The scans revealed that in many people with BPD, 3 parts of the brain were either smaller than expected or had unusual levels of activity.
- misusing alcohol.
- generalised anxiety disorder.
- bipolar disorder.
- depression.
- misusing drugs.
- an eating disorder, such as anorexia or bulimia.
- another personality disorder, such as antisocial personality disorder.
High-functioning BPD tends to leave a person feeling chronic emptiness, uncertainty about their identity, insecurity, and dissatisfaction with self. Someone experiencing the disorder may ruminate, fear rejection, or perseverate on things they wish they never said (or should have said).
Results: People with Borderline Personality Disorder have a reduced life expectancy of some 20 years, attributable largely to physical health maladies, notably cardiovascular. Risk factors include obesity, sedentary lifestyle, poor diet and smoking.
Borderline personality disorder (BPD) is a mental health condition. People with BPD have extreme mood swings, unstable relationships and trouble controlling their emotions. They have a higher risk of suicide and self-destructive behavior.
Can neurologists diagnose BPD?
Only a qualified mental health professional like a psychiatrist, psychologist, or clinical social worker can diagnose BPD.