The Link between Borderline Personality Disorder and Stress

Among the many theories and assumptions made about Borderline Personality Disorder (BPD) and those who suffer from its symptoms is the idea that people with BPD have a lower tolerance to stress, have elevated reactions to stress, and have longer recovery times from stressful events.

A study by Lori N. Scott of the Department of Psychology at Pennsylvania State University uncovered some unanticipated results that fly in the face of this theory. Scott measured the cortisol levels of a group of women with Borderline Personality Disorder, a group with traits similar to BPD, and a group with no traits similar to BPD, then exposed them to stressors. Scott then measured the cortisol levels of each group post-exposure to the stressors.

Of all the groups, the cortisol spike was the lowest in the women with Borderline Personality Disorder. Additionally, the recovery time to return to the pre-stressor cortisol level was equal for all groups.

As surprising as these results may seem at first glance, Scott provides an explanation. The women with Borderline Personality Disorder had elevated cortisol levels to begin with, so were at a higher stress level originally when they were exposed to the stressors than the women without BPD.

“Our results provide some support for the high emotional intensity aspect, but not hyperreactivity and impaired recovery aspects, of current clinical theories of affective dysregulation in BPD,” Scott said.

Elevated Stress Levels

Why the elevated stress level to begin with? It may have something to do with the fact that those with Borderline Personality Disorder have difficulty regulating emotional reactions to seemingly everyday occurrences.

Psychology Professor Dr. Marsha Linehan, director of the Behavioral Research and Therapy Clinics at the University of Washington in Seattle and developer of Dialectical Behavior Therapy (DBT), describes those with Borderline Personality Disorder as being like patients with third-degree burns.

“People with BPD lack emotional skin,” Linehan has said. “They feel agony at the slightest touch or movement.”

Linehan should know. In 2011, Linehan revealed her personal struggle as an adolescent dealing with Borderline Personality Disorder. Linehan developed Dialectical Behavior Therapy, the leading treatment for Borderline Personality Disorder, to help patients identify thoughts, beliefs, and assumptions that make their lives challenging and that elevate their baseline stress levels, or “high emotional intensity.”

While Scott’s study did not take into consideration the effects of medication or co-occurring conditions that are often found with BPD (such as substance abuse or Post Traumatic Stress Disorder) which could potentially influence stress levels, future studies may take these into account when studying the full range of reaction in women with Borderline Personality Disorder.

1. Borderline Personality Disorder (BPD) Symptoms
2. The Role of Validation in BPD Treatment