BPD and the Sympathetic Nervous System

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Ever wonder what gets your heart pumping while you’re watching a scary movie? Or what’s responsible for your quick reaction when someone cuts you off in traffic? Or why your brain goes blank and your palms get sweaty when you have to give a presentation to a room full of people?

Understanding the Autonomic Nervous System

The sympathetic nervous system is one branch of the autonomic nervous system (the other branch is theparasympathetic nervous system). The autonomic nervous system regulates the functions of organs like your heart, stomach, bladder, and intestines that take place without conscious effort. It also controls the muscles in your body. You usually don’t notice this system at work because it acts reflexively in response to stimuli like a wild animal.

In acutely stressful situations, a number of things happen in your brain. First, theamygdala, which is responsible for detecting fear and preparing for emergency events, sends the message to your hypothalamus that you’re in danger. In turn, the hypothalamus releases CRH (corticotropin releasing hormone), which stimulates the pituitary to release ACTH (adrenocorticotropic hormone), which then tells the adrenal glands to releaseadrenaline(epinephrine) and noradrenaline (norepinephrine). This sets off a number of physiological and hormonal changes, such as dilated pupils, increased heart rate and blood pressure, increased alertness, and heightened senses. In addition, blood sugar and fats are released into your bloodstream for energy, so you can “fight” or “flee” from the danger.

In borderline personality disorder, the very well-orchestrated automatic nervous system is more easily triggered, which can cause serious emotional conflict, both inside and out.

The Sympathetic Nervous System With Borderline Personality Disorder

Borderline personality disorder(BPD) is a common and disruptive mental illness that affects about 1.4% of the population and 4 million Americans.Despite its prevalence, little research has been performed to study the neurological or physiological mechanisms behind BPD. Some scientists have suggested that better understanding the mechanics behind BPD, such as issues with the sympathetic nervous system, may lead to the creation of more effective treatment options. To date, though some drugs can help manage specific symptoms of BPD, there’s no medication specifically approved to treat BPD.

According to the “Diagnostic and Statistical Manual of Mental Illnesses, 5th edition,” a reference healthcare professionals review when making a diagnosis, people with BPD typically have trouble regulating their emotions. Researchers have hypothesized that this means the sympathetic nervous system in people with BPD may be overly stimulated, causing intense or irrational reactions.People with BPD tend to display signs of stress longer than others.

The Importance of Learning to Manage Stress

Whatever the cause, because people with BPD tend to be more readily sent into the fight-or-flight state, and to remain in that state even when the source of stress has ended. Learning to manage the stress that can trigger that spiral is vital to preventing relapses and improving overall health. Over time, maintaining a state of constant alert can cause your body to work overtime. This wear and tear, known as allostatic load, can cause serious health problems.

Press Play for Advice On Regulating Your Emotions

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5 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bourvis N, Aouidad A, Cabelguen C, Cohen D, Xavier J.How Do Stress Exposure and Stress Regulation Relate to Borderline Personality Disorder?.Front Psychol. 2017;8:2054. oi:10.3389%2Ffpsyg.2017.02054National Institute of Mental Health.Personality Disorders.Mcfetridge M, Milner R, Gavin V, Levita L.Borderline personality disorder: patterns of self-harm, reported childhood trauma and clinical outcome.BJPsych Open. 2015;1(1):18-20. doi:10.1192%2Fbjpo.bp.115.000117Eddie D, Bates M, Vaschillo E, Lehrer P, Retkwa M, Miuccio M.Rest, Reactivity, and Recovery: A Psychophysiological Assessment of Borderline Personality Disorder.Front Psychiatry. 2018;9:505. doi:10.3389%2Ffpsyt.2018.00505National Alliance on Mental Health.Managing Stress.Additional ReadingAustin, M., Riniolo, T., Porges, S. “Borderline Personality Disorder and Emotional Regulation: Insights From the Polyvagal Theory”.Brain and Cognition, 2007, 69-76.Harvard Health Publications.Understanding the Stress Response.National Alliance on Mental Health.Understanding Borderline Personality Disorder.Science Daily.Sympathetic Nervous System.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Illnesses, 5th edition, 2013.

5 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bourvis N, Aouidad A, Cabelguen C, Cohen D, Xavier J.How Do Stress Exposure and Stress Regulation Relate to Borderline Personality Disorder?.Front Psychol. 2017;8:2054. oi:10.3389%2Ffpsyg.2017.02054National Institute of Mental Health.Personality Disorders.Mcfetridge M, Milner R, Gavin V, Levita L.Borderline personality disorder: patterns of self-harm, reported childhood trauma and clinical outcome.BJPsych Open. 2015;1(1):18-20. doi:10.1192%2Fbjpo.bp.115.000117Eddie D, Bates M, Vaschillo E, Lehrer P, Retkwa M, Miuccio M.Rest, Reactivity, and Recovery: A Psychophysiological Assessment of Borderline Personality Disorder.Front Psychiatry. 2018;9:505. doi:10.3389%2Ffpsyt.2018.00505National Alliance on Mental Health.Managing Stress.Additional ReadingAustin, M., Riniolo, T., Porges, S. “Borderline Personality Disorder and Emotional Regulation: Insights From the Polyvagal Theory”.Brain and Cognition, 2007, 69-76.Harvard Health Publications.Understanding the Stress Response.National Alliance on Mental Health.Understanding Borderline Personality Disorder.Science Daily.Sympathetic Nervous System.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Illnesses, 5th edition, 2013.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Bourvis N, Aouidad A, Cabelguen C, Cohen D, Xavier J.How Do Stress Exposure and Stress Regulation Relate to Borderline Personality Disorder?.Front Psychol. 2017;8:2054. oi:10.3389%2Ffpsyg.2017.02054National Institute of Mental Health.Personality Disorders.Mcfetridge M, Milner R, Gavin V, Levita L.Borderline personality disorder: patterns of self-harm, reported childhood trauma and clinical outcome.BJPsych Open. 2015;1(1):18-20. doi:10.1192%2Fbjpo.bp.115.000117Eddie D, Bates M, Vaschillo E, Lehrer P, Retkwa M, Miuccio M.Rest, Reactivity, and Recovery: A Psychophysiological Assessment of Borderline Personality Disorder.Front Psychiatry. 2018;9:505. doi:10.3389%2Ffpsyt.2018.00505National Alliance on Mental Health.Managing Stress.

Bourvis N, Aouidad A, Cabelguen C, Cohen D, Xavier J.How Do Stress Exposure and Stress Regulation Relate to Borderline Personality Disorder?.Front Psychol. 2017;8:2054. oi:10.3389%2Ffpsyg.2017.02054

National Institute of Mental Health.Personality Disorders.

Mcfetridge M, Milner R, Gavin V, Levita L.Borderline personality disorder: patterns of self-harm, reported childhood trauma and clinical outcome.BJPsych Open. 2015;1(1):18-20. doi:10.1192%2Fbjpo.bp.115.000117

Eddie D, Bates M, Vaschillo E, Lehrer P, Retkwa M, Miuccio M.Rest, Reactivity, and Recovery: A Psychophysiological Assessment of Borderline Personality Disorder.Front Psychiatry. 2018;9:505. doi:10.3389%2Ffpsyt.2018.00505

National Alliance on Mental Health.Managing Stress.

Austin, M., Riniolo, T., Porges, S. “Borderline Personality Disorder and Emotional Regulation: Insights From the Polyvagal Theory”.Brain and Cognition, 2007, 69-76.Harvard Health Publications.Understanding the Stress Response.National Alliance on Mental Health.Understanding Borderline Personality Disorder.Science Daily.Sympathetic Nervous System.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Illnesses, 5th edition, 2013.

Austin, M., Riniolo, T., Porges, S. “Borderline Personality Disorder and Emotional Regulation: Insights From the Polyvagal Theory”.Brain and Cognition, 2007, 69-76.

Harvard Health Publications.Understanding the Stress Response.

National Alliance on Mental Health.Understanding Borderline Personality Disorder.

Science Daily.Sympathetic Nervous System.

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