How sexual abuse and borderline personality disorder are connected

Borderline personality disorder (BPD) is a mental health condition that can cause emotional instability, impulsivity, and a pattern of intense relationships. These symptoms may affect how a person feels about themselves and others and can make it difficult to function in daily life. 

Researchers are still working to understand all of the underlying causes of BPD. But there’s considerable evidence to suggest that adverse childhood experiences (ACEs), like abuse and neglect, are widespread among people with BPD. 

Childhood abuse can be physical, emotional, or psychological, and it can be chronic (long lasting) or acute (a one-time event). However, sexual abuse in particular has been shown to increase the risk of BPD and contribute to an earlier onset of the condition. 

In one recent study, researchers discovered that over 44% of people diagnosed with BPD reported a history of childhood sexual abuse. Understanding this connection can give us insight into how our early life experiences impact brain development and help us improve our mental health. 

Can sexual abuse cause BPD?

Trauma, including sexual abuse, is a key risk factor for developing BPD. But BPD can stem from a variety of causes, not just sexual abuse alone. It typically happens due to a combination of:

• Genetics: Having a first-degree relative, like a sibling or parent, who also has BPD may make you more likely to develop it.
• Brain chemistry: Neurotransmitters, like serotonin, act as messengers in the brain. Imbalances in these chemicals can impact behavior and emotions, potentially increasing your risk of BPD.  
• Brain structure: When studying the brains of people with BPD, researchers found increased activity in the areas of the brain that control mood, self control, and decision making. It’s believed that this may contribute to symptoms of BPD.
• Environment: This is where sexual abuse often plays a role. Research shows that experiencing childhood trauma in the form of abuse, neglect, instability, or unhealthy substance use in the home may increase your risk for BPD.

Unpacking CPTSD, BPD, and sexual abuse

Some people use the term complex post-traumatic stress disorder (CPTSD) to describe symptoms resulting from prolonged trauma, but it is not recognized as a distinct diagnosable disorder. Complex trauma can lead to mental health conditions, like post-traumatic stress disorder (PTSD) or other trauma-related disorders, resulting from prolonged or repeated exposure to traumatic or adverse life experiences.

PTSD is frequently diagnosed in people who have BPD, and the two conditions share some symptoms. These include emotional dysregulation, negative self-image, and relationship problems. 

This overlap in symptoms can make it difficult to tell the difference between BPD and PTSD, especially since both conditions can stem from sexual abuse. That’s why, if you’re struggling with your mental health, it’s so important to seek a professional evaluation. A therapist can ensure that you receive an accurate diagnosis and provide a treatment plan that reflects your unique needs and experiences with BPD, PTSD, or both.

Find hope and healing with treatment

If you’ve experienced sexual abuse or abuse of any kind, the pain you’ve likely experienced may be difficult to put into words. And if you have a BPD diagnosis as a result of your trauma, you may feel that no one can understand what you’ve been through. But you’re not alone, and with the right support, you can find hope and healing. 

Therapists who specialize in treating conditions like PTSD and BPD use a trauma-informed approach to providing care. This means they tailor their techniques to reflect the ways that sexual trauma and other adverse experiences have impacted your life and mental health. 

When seeking therapy for BPD, you might be wondering what to expect. Rest assured that your treatment experience will be tailored to your unique needs. But there are a few common elements of BPD treatment to be aware of. It may take time for symptoms to improve after treatment begins. Some people with BPD may require more intensive care, like inpatient care, while others may find success with outpatient care. 

And there are some specific treatment approaches that are known that work especially well, including:

• Dialectical behavioral therapy (DBT): This is the only form of therapy that was designed specifically to treat BPD. It incorporates elements of mindfulness to increase self-awareness. It can also help you learn skills to regulate your emotions, improve your relationships, and avoid harmful behaviors. 
• Cognitive-behavioral therapy (CBT): CBT helps people uncover and replace the thoughts and beliefs that may be driving unwanted behaviors. By replacing irrational thoughts with more functional ones, CBT can help reduce BPD symptoms like mood swings, anxiety, and self-harm.
• Eye movement desensitization and reprocessing (EMDR): Though not a primary treatment for BPD, EMDR can be effective for people who have experienced trauma. It can help people process distressing memories and reduce the intensity of traumatic experiences like sexual abuse, which may, in turn, alleviate some BPD symptoms.
• Family support: Along with individual therapy, family therapy can sometimes be helpful for the loved ones of someone with BPD. It can create a safe space for families to learn more about BPD and how it’s affected their loved one. Family therapy can also help improve communication and problem solving and strengthen the bonds among those impacted by BPD.
• Medication: Treatment for BPD sometimes includes medication. You can talk to your provider about whether medication is right for you.

If you’re living with the effects of sexual trauma and BPD, keep in mind that managing your symptoms could be an ongoing, long-term process. So try to have patience with yourself, and remember to practice self-compassion throughout your treatment journey. Remember that by staying committed to your recovery, you can reduce your symptoms and improve your quality of life.

Find care with Rula

Experiencing sexual abuse in childhood can affect your mental health in many ways. It can shape how you feel about yourself and impact your ability to sustain healthy relationships and regulate your emotions. Sometimes, this can lead to the onset of conditions like BPD or PTSD. These conditions can be challenging to live with and may require ongoing, long-term treatment. 

Thanks to Rula, you can receive affordable, accessible mental healthcare from the comfort of your home. With our digital platform and therapist-matching program, you can quickly find a provider who takes your insurance and schedule your first appointment as soon as tomorrow.

Find a therapist with Rula