Borderline personality disorder (BPD) is a serious mental health disorder that affects the way a young person sees themselves and interacts with the world around them. Young people with BPD often have an unstable or incoherent sense of self, patterns of unstable relationships, and intense emotional reactions. They may experience chronic feelings of emptiness and a fear of abandonment by others.
While it’s still not clear exactly what causes BPD, research shows that genetic, neurobiological, and environmental factors all play a role. In particular, experiences of childhood trauma are common among young people with BPD. These experiences affect the way a young person develops, leading to the traits and symptoms that characterise the disorder.
In recent years, scientific studies have pinpointed several environmental factors that make the development of BPD more likely. Among these is the presence of mental health disorders in the family, including anxiety disorders among mothers of children with BPD.
Some studies even suggest that mothers’ mental health during pregnancy could also increase the risk of developing BPD. One study found that maternal anxiety before birth was linked to borderline personality disorder symptoms in children by the age of 11-12.
Understanding the causes of BPD is hugely important in preventing the disorder and identifying young people who are most at risk. It facilitates early intervention programs that aim to prevent BPD symptoms from fully developing, avoiding the mental and social harm that BPD can cause.
This blog offers information about the causes and development of borderline personality disorder. Specifically, it looks at the link between maternal anxiety – both before and after birth – and a later diagnosis of BPD.
How and When Does Borderline Personality Disorder Develop?
Borderline personality disorder is usually diagnosed in early adulthood, but research suggests that it’s also common among adolescents. Around 3% of adolescents may meet the criteria for a diagnosis of BPD, around the same percentage as among adults.
However, BPD doesn’t just suddenly appear. Instead, BPD diagnoses are a continuation of symptoms that develop during childhood or early adolescence. These symptoms, in turn, develop from the interaction of genetic vulnerabilities with life events, sometimes including experiences from the first years of a person’s life.
BPD, Parenting Styles, and Attachment
Parents have a huge influence on a child’s life. Their parenting style (the way they interact with and respond to a young person) and their dynamics with partners can shape the way a young person develops emotionally, cognitively, and socially.
When parents are sensitive to a child’s needs, responding with care and comfort, children learn to trust other people and understand themselves as worthy of love. They are more likely to form stable, close relationships with other people. This is known as secure attachment.
Secure early relationships also allow young children to learn and develop emotionally and socially. Through interactions with caregivers, they learn to understand the mental states of others and themselves.
However, when parents are unable to or choose not to meet their children’s needs, these processes are disrupted. Children may instead mistrust others and believe themselves to be unworthy of love. This can cause a fear of abandonment or avoidance of intimacy.
These insecure attachments also affect a young person’s development. When a young child both relies upon and is harmed by a caregiver, they may be unable to develop integrated and cohesive ideas about other people and themselves or understand their thoughts and emotions. They may be unable to learn healthy methods for coping with their emotions or to self-soothe in times of distress.
Many of the consequences of insecure attachment – such as a fear of abandonment and emotional dysregulation – are also core features of BPD. Indeed, research has established that parenting style and early life attachment style are both related to the later development of the disorder.
There are many reasons why parents or caregivers may not be able to meet their children’s needs. These can include abuse or neglect, but there can also be reasons that are out of parents’ hands. For example, difficult financial or living conditions can cause stress and prevent parents from giving children the time and attention they need, especially if they are working long hours. Mental and physical illness can also cause parents to be absent from a child’s life or unable to properly care for them.
On this basis, it’s not surprising that children with family members with mental health disorders are more likely to develop BPD. In one study, anxiety disorders, depression, and suicidality in the family had the biggest associations with the disorder.
Maternal Anxiety Before Birth and BPD
Environmental factors such as insecure attachment, peer bullying, and harsh parenting may all contribute to the later diagnosis of BPD. However, environmental factors only partially explain the development of the disorder.
This gap has led some researchers to explore how genetics and environmental factors before birth may be linked to BPD symptoms, including maternal adversity, such as maternal anxiety or depression. A 2015 study found that both pre-natal (before birth) and post-natal (after birth) maternal anxiety were linked to BPD symptoms by age 11-12.
There are several different reasons why maternal anxiety before birth could be linked to the later development of BPD. One explanation is that mothers who have anxiety before birth are also more likely to have anxiety after a child is born, subsequently affecting a young person’s development through their parenting style and behaviours.
Another theory is that maternal anxiety could impact a child’s development while it is still in its mother’s womb. For example, maternal stress during pregnancy may affect the development of a child’s HPA axis, a system of nerves and hormones that controls reactions to stress and regulates many other body processes.
When the HPA axis is altered, individuals can become especially sensitive to stress. This can cause emotional sensitivity, impulsivity, and intense emotional reactions – traits that are common in borderline personality disorder.
Maternal anxiety during pregnancy may also affect the development of the amygdala, a brain region involved in processing emotions and forming responses to emotional stimuli. Research has found that the amygdala is smaller and more active among people with BPD.
The 2015 study found that, while pre-natal anxiety made post-natal anxiety more likely, it didn’t fully explain the link with BPD. This suggests that prenatal effects on a foetus could play a role – although more research is needed to explore this theory.
The Wave Clinic: Specialist Recovery Programs for Young People
The Wave Clinic provides transformative recovery programs for young people who have experienced complex trauma, eating disorders, borderline personality disorder and other mental health concerns. We offer a diverse selection of treatment modalities delivered with exceptional expertise. We’re experts in child and adolescent psychiatry, providing the best quality evidence-based treatment with fairness and inclusivity.
We understand that lasting recovery requires resilience, a support system, and a sense of self and purpose. Through education, enriching experiences, and community projects, we support young people to grow in self-confidence, discover new life paths, and develop the skills they need to follow them.
Our programs are about building life advantage and making a difference in young people’s futures from all around the world.
If you’re interested in finding out more about our programs, get in touch today. We’re here.
