The Cause of Borderline Personality Disorder
By Tim Pheil L.P.N.

I will start with the New Model, the one that the Sanctuary holds true. Followed by the Old Model and an Analogy.

New Model

The newest model is that the BPD is Biological, Neurological and Genetic. It is caused by a dysfunction of the Limbic area of the Brain, which controls emotion. The model suggests that emotions are mishandled. Such that a feeling of being slighted becomes RAGE versus anger, or feeling alone and unloved becomes severe anxiety thus the “I love you, don’t leave me” syndrome. This triggers depression. This malfunction can also trigger other areas of the brain leading to anxiety, disassociation and psychosis. Marsha Lineham refers to it as “Emotional Dysregulation”. The depression and uncontrolled emotional state is referred to as Dysphoria.
The reason that child abuse is so prevalent in the BPD history is that in many cases one or both parents are mentally ill. Dr Markovitz states that “Because people tend to congregate with the groups their most comfortable with. The mentally ill tend to congregate together, thus limiting the gene pool”. If you are a sufferer of a mental illness chances are you are friends with those who also have mental illnesses. 
In regard to child abuse; those who are diagnosed and treated for their illnesses tend not to abuse their children. But there are some that their illnesses are treatment resistant such as severe cases of Bipolar and Schizophrenia.
The Surgeon General estimates that 1 out of 5 Americans have a mental illness. But only half are diagnosed. Thus 1 out of 10 Americans has a mental illness and is undiagnosed and untreated. 

Genetics

Genetically mental illness is the trait, not a particular disorder. Dr Markovitz has estimated that the rate of transferring down the mental illness gene is around 7%. So one generation may have schizophrenia, the next may have bipolar, etc. 

Onset

Some feel the onset of BPD is at puberty, some feel earlier. Most will not diagnose until adulthood claiming the angst of puberty can mimic some BPD. Some are diagnosing the BPD in puberty now. Others use the Oppositional Defiance Disorder and Conduct Disorder diagnosis until adulthood. 

Old Model

The only thing that you can get the experts to agree on is that there must be Biological and Neurological predisposition for those to develop BPD. And if childhood abuse or childhood abandonment happed, then this person would develop BPD. This is of course is over simplified.

Treatment

Despite the cause, the illness must be treated. Medication is the first defense followed with some form of CBT (Cognitive Behavior Therapy). Even when properly medicated we still will react the same to the same stimuli. Thus CBT is important to learn the proper way to react to different emotions. We have made great strides in medication over the last 30 yrs. 
But still many find it hard to get proper treatment. We have compiled a list of Drs. who treat the disorder here. If you can’t find one near you, Dr. Markovitz suggest going to a nearest university. Almost all have an Bipolar expert on staff. And since you only treat the symptoms almost all the same medications are used to treat Bipolar. You can also try to find a Dr who is well versed in treating Borderline Personality Disorder. 
Also check your local Community Mental Health Department. At least a quarter of their caseload is treating those with Bipolar. Many even have DBT (Dialectical Behavior Therapy) groups. This has been found to be helpful with other mental illnesses other than BPD, which it was specifically designed for.
Because of the Human Genome Project, Dr Markovitz feels that in the next 10-20 yrs that we will be able to cure all mental illnesses with genetic therapy.

Analogy

Your standing on a chair changing a light bulb in your room. You fall off the chair on to your arm. Your arm hurts, you decide you need to go to the emergency room. On the way out the door you fall down a flight of stairs. Once at the hospital they discover you have a broken arm. Is it important if you broke your arm falling off the chair or falling down the stairs? Of course not. The only thing that is important is that you have a broken arm and it needs to be set and allowed to heal. 
I have received thousands of emails over the years of sufferers fixated on the cause of their mental illnesses. When in actuality best course would be to use all that energy should be used to get the best treatment for their illness.