Borderline personality disorder (BPD) is a mental health condition that causes symptoms such as intense mood swings, feelings of guilt, and social anxiety. It can be genetic or develop due to childhood trauma or abuse.

BPD is a type of personality disorder that affects 1.4% of adults in the United States.

Although it has no single cause, having family members with the condition may make a person more susceptible. However, researchers still do not know how large a role genetics plays in developing BPD.

This article explains the genetics of BPD and other factors that may contribute to its symptoms.

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Research indicates that BPD may be genetic. Individuals who have a parent or sibling with this condition may have a high chance of developing it themselves.

According to a 2021 study, BPD has a heritability rate of 46%. The study also suggests the condition may be more likely to affect identical twins than fraternal twins.

Its authors state that BPD clusters in families occur due to genetic causes. This means that if two identical twins grow up in different environments, they still have the same likelihood of developing the condition.

However, environmental factors, including neglect and abuse, may also lead a person to experience BPD symptoms.

Individuals with a personality disorder also tend to have other mental health conditions, such as:

A 2017 study suggests the genes DPYD and PKP4 may contribute to BPD symptoms.

However, the authors also associate these genes with other conditions, such as schizophrenia and bipolar disorder.

BPD is a mental health condition that can cause a person to experience instability in their mood, self-image, and behavior from one day to the next.

The Office on Women’s Health associates it with intense moods and symptoms of depression and anxiety that may persist for hours.

Due to these symptoms, people with BPD may experience difficulty planning ahead or maintaining relationships with relatives or partners. Some may feel that others are not treating them with respect.

The NIMH states that signs of BPD include the following:

  • a distorted and unstable self-image
  • self-harming behaviors
  • thoughts or threats of suicide
  • persistent feelings of emptiness
  • behaviors that may be damaging, such as unsafe driving and substance misuse

Besides genetics, other factors that may lead to BPD include:

Environmental factors

A recent study estimates that 70% of people who receive a diagnosis of BPD have experienced physical or sexual abuse, neglect, or issues such as maternal separation, inappropriate family boundaries, or parental substance misuse.

Another study also associates long-term childhood sexual abuse with severe BPD symptoms in females. The authors recommend therapists ask people who present with these symptoms about their childhood history in order to provide the proper treatment.

The United Kingdom’s National Health Service (NHS) also states that living with a relative with bipolar disorder may increase a person’s chance of developing BPD.

Personality traits

Some research suggests certain personality traits may be possible risk factors for BPD.

For example, the authors of a 2016 longitudinal study suggest children who exhibit aggression and impulsivity may have an increased chance of experiencing BPD features at 23 years old.

Neurological issues

According to the NHS, problems with neurotransmitters, the chemical messengers that transmit messages between brain cells, may make a person more prone to experiencing depression and aggression.

It suggests this mostly happens when there is a change in serotonin levels.

The NIMH states that individuals with BPD may experience fewer and less severe symptoms, improved functioning, and better quality of life if they are able to consult a licensed mental health professional who can offer evidence-based treatments.

These may include psychotherapy sessions and prescription medications, such as antidepressants or low dose antipsychotic drugs.

Therapy techniques include dialectical behavior therapy, which aims to help individuals recognize and manage emotions, and cognitive behavioral therapy (CBT), which may help with addressing anxiety symptoms and how people think about themselves.

According to a longitudinal study from 2011, the cumulative remission rates for BPD over 10 years were 91%.

Some people may require a period of hospitalization during a BPD episode if they experience suicidal thoughts or impulsive behaviors that may be dangerous.

If possible, individuals who have a loved one with BPD may also wish to speak with a counselor, as this may help with understanding what their loved one is going through.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Click here for more links and local resources.

BPD is a mental health condition that can lead people to experience issues with self-image and suicidal thoughts. Without effective treatment, it may also make maintaining relationships more difficult.

Certain factors such as genetics and the experience of childhood trauma or neglect may increase a person’s chance of developing BPD. Treatment options that can help include psychotherapy and medications.