Genetics and Borderline Personality Disorder - Any Insights?

[antiqueplatecollector]

Hi everyone, I have a question for those familiar with borderline personality disorder. My sister's husband's sister has been diagnosed with BPD, and their daughter, my niece, has been showing signs of it (possibly) since she was 12. We are considering talking to the GP about it, but we are hesitant because we have read that BPD is often linked to trauma rather than genetics. My niece has not experienced any trauma, so we're wondering if BPD can run in families. Can anyone share their experiences or insights on this? Thank you.

Additionally, my sister's husband has a history of criminal behaviour when he was a youth before my niece entered the world (did time in YOI several times for things like street fighting, selling weed) but has since turned his life around.

Hi OP, I’m wondering that you say that your niece hasn’t experienced any trauma. Wouldn’t the BPD behaviour of her mother exposed her to trauma?

Something to consider is that BPD ( now more commonly named Emotionally Unstable Personality Disorder) is often misdiagnosed in females- with the correct diagnosis being Autism spectrum disorder.
ASD can be caused by genetics ( combinations of genes increasing likelihood more commonly than specific ones) . In my experience true BPD/ EUPD almost always is rooted in early neglect or trauma.
However a pp has a point- if your young family member has been exposed to her Mum dysregulating/ self harming/ complex emotional needs presentation or if her Mums MH interfered with her ability to meet her Daughters emotional needs then yes this could in turn have predisposed her- in the team I work in we can see multiple family members coming or assessments all presenting similarly however when you learn about each person’s life story it becomes clear how trauma has been passed down through generations.

Excellent post. I was misdiagnosed with BPD, I’m actually autistic and have ADHD. ADHD meds have transformed my MH.

Hello! Thank you for your replies.

My sister's SIL, let's call her Diane, is the one who is diagnosed BPD.
Not my sister.
Which is why I query the genetic aspect.

Diane is not involved in my niece's life due to very destructive behaviour and a mutual decision to avoid each other. My niece was raised in a stable, loving household and is very close to our family. The only trauma we can think of is my sister had a difficult birth with her.

I bring up my BILs past criminal record (when he was a teen - he's now almost 40) because I'm considering if he may have a genetic predisposition for that behaviour, even though he is no longer involved in criminal activities and has always been supportive and even indulgent to the children.

To clarify my sister does not have BPD.
My niece's aunt on her father's side does.

I've been diagnosed with EUPD and no one in my family has it. Also diagnosed with ADHD and suspect DF has it.

A sensitive temperament (which is genetic) combined with an invalidating environment can lead to EUPD. Even loving parents can unwittingly invalidate their children. I wouldn't rush to label this girl though, you haven't said how old she is but she sounds young, and difficulties with emotional regulation, self- harming etc is something many teens go through and come out of. Definitely wouldn't hurt to talk to the GP about an assessment though if she is struggling

How old is your niece op? I have a family member recently diagnosed at the age of 21 but they had a diagnosis of adhd when younger.

Psychologists now generally won't diagnose bpd until people are well into their twenties, and any diagnoses of teenagers etc are highly questionable as so much is still developing at that age.

You really can’t diagnose a teenager with BPD - arguably not even a young adult although obvs it happens. So much crossover with usual teenage / hormonal behaviour surely 🤷🏻‍♀️ If you’re concerned maybe get her a decent child therapist that can see her consistently so she has this for the next few years, or refer to CAMHS but you won’t always get long-term support. It’ll be so unhelpful for her to be labelled with an EUPD diagnosis if would do all I could to get her therapeutic support.

sorry I misread and thought she was 12 now! ----

I was googling the symptoms of EUPD earlier today and it was my family member to a T from when they were a child. As soon as they reached 18, the doctors and psychologists started discussing personality disorders and now they have a diagnosis.

Thanks again everyone.

She's turning 14 this year so still very young.

• Started cutting at 12, but has been clean since December
• Struggling with explosive anger, causing her to push away friends followed by a desperate desire for companionship
• Regularly changing best friends who she talks about a lot and makes stuff for and then has an explosive fall out with cycle repeats
• Sister found texts about wanting to die to her one longstanding friend who she also falls out with a lot
• Negative self image despite being very pretty
• Doesn't like being left alone, often yells downstairs to check if my sister is home
• Tiktok and Snap taken off her phone after putting up suggestive pictures of herself and reposting videos about death and drugs. Some really dark pages on tiktok btw.

Sister took her to the GP for help with self harming at the time. They discussed anxiety and depression but not much came of it. Sister asked if niece would like to talk to a therapist - she would pay. Niece was reluctant to try therapy, saying it would make her feel worse. Instead, she choose a specific leisure activity, which has helped her feel happier. However, there is still a lot of underlying concern.

Sister hadn't considered BPD until BIL mentioned that she reminded him of his sister (Diane) when they were growing up. So my sister had been quietly panicking about it.

Very true that there can be overlap between lots of different mental health conditions, hell adolescence itself can be very overwhelming with an the hormonal changes. I'll remind my sister of this because its easy to get one track minded and worry. Thanks all.

Hi OP.

To answer your question heritability may play a role but I wouldn't rush to diagnose or label her.

Unfortunately, EUPD / BPD is often stigmatised in our society and in the media.

Some of the things you describe could be part of hormonal fluctuations. Teenage years are notoriously hard! I went through a self harm phase in my own teen years, it's really not that uncommon especially with girls.

If she does have EUPD the symptoms can be challenging, but things like Dialectical Behavior Therapy (DBT) can be very helpful along with a loving support system.
Good luck.

If you are seeing similar traits in your niece as you are SIL I would push for both to have an autism assesment. Autistic women are often misdiagnosed as having borderline personality disorder. Autism is genetic unlike BPD.

If autism is then ruled out I would query what child is being exposed to and whether she is learning the behaviour from her mother unfortunately. Edit: just realised you say niece hasnt grown up with her mother. Seems very likely this is autism

My niece has grown up with her mother (my sister) in a loving, protective, supportive, normal home.

My niece's aunt (my sister's husbands sister) has a diagnosis of BPD.

My sister's husband mentioned that some of their daughters behaviour reminded him of his sister's behaviour (the one with the diagnoses) growing up. This sparked concern about the potential for it to be passed down genetically. We looked online to see studies linking it both to trauma and genetics. Two studies quoting around 40% genetics. So we thought maybe others who have personal experience with it may have more insight.

If you scroll down here, the description by 'JR Williams' is on point with my sister's sister-in-laws behaviour. She is diagnosed BPD, and definitely not autism.

Quora

It is commonly for males with ADHD to have a criminal record for impulsive activities such as street fighting and dealing drugs.

Being ND, whether ADHD, autistic, or both, can be traumatic if this little girl isnt in the right environment.

You perception and/or your dsis perception of a loving, protective, supportive, normal home may not be the same as the little girls. For example, if mum and dad are overly strict to try and avoid the issues they have faced in their own childhood.

Being unable to regulate your emotions is a key symptom of ADHD. Challenges with controlling their impulses put girls with ADHD at greater risk of self harm and suicidal thoughts https://www.sciencedaily.com/releases/2012/08/120814100158.htm

Rejection sensitivity dysphoria causes significant social problems for girls with ADHD.

Sounds like this little girl needs support from CHAMS to help her get to the bottom of her issues and develop the relevant coping strategies.

Sounds like it may be an insecure/disorganised attachment pattern, and it’s definitely possible that the traumatic birth could contribute to that.
there’s a really good attachment style video by Lewis psychology on YouTube, I’ll try and find a link.

This
it describes that extreme trauma creates a disorganised pattern but it can be any trauma.
or she may be a bit anxiously attached. These things are exacerbated in adolescence.

How do you know she has had no trauma?

This

I am sure she was diagnosed as BPD. She could indeed be BPD but it is VERY common for autistic women to be misdiagnosed as having BPD. I read all those comments on the link you shared and all of those could be reframed as autism when someone understands the two. I was misdiagnosed BPD as a teen, but I am autistic (NHS re diagnosed me)

Now that's not to say your sisters sister in law doesn't have BPD, but considering that BPD isn't genetic but autism is, all I am saying is if this child is showing signs that she is like her mother it would be a very good idea to have her undergo an autism assessment to rule it out before considering BPD or other personality disorder diagnosises. There is no harm in having her tested for autism to rule it out.

Hi

(Posted too soon)
Yes. Contemporary research shows a genetic connection with EUPD (formerly BPD), but seeking reassurance online will lead to guesswork and confusion. Lots of girls with autism are misdiagnosed as EUPD. The last thing you need is an incorrect diagnosis.

The things you describe may just be typical teenage angst or signs of various other conditions — we don't know. Maybe you're here seeking reassurance that it's unlikely she has EUPD which no one here can give you.

My strong advice would be keep tabs on symptoms and jot them down in a diary to have evidence if you decide to consult a professional. If you decide to consult a pro, definitely use the opportunity to mention the cycle of antisocial behaviour and criminality present in her father's family history.

I can attest that early intervention, DBT therapy, love and a strong support system can make a significant difference if its what she has. Don't pay attention to the negative stories online - approach this with love and resilience.
GL