That's not easy to answer. Although changes were found in the brain, as is the case with many other mental and psychiatric illnesses. However, there is always the question of the hen and the egg: what came first?
Altered brain areas
What is certain is that the disease is associated with certain brain changes that can be measured and displayed. For example, there are abnormalities in the regulatory circuits of emotional regulation.
Imaging studies in pulse control tests tend to show subfunction in the so-called prefrontal cortex. This is part of the frontal area of the brain, which is responsible for higher mental, but also mental and social achievements of the human being.
Downsized brain volumes could also be detected in areas of the brain that are important for the memory functions (hippocampus) and emotional reactions (amygdala). Nerve messengers such as serotonin or Dopamine are also likely to be important in personality disorder. Here scientists assume an imbalance.
Much still unclear
But back to chicken and egg: Does the brain change trigger the disorder, or is the organic neurobiological change the result of the disease?
Since it is known that traumatic experiences in childhood and adolescence can cause brain changes, one could at least assume that this is also true in the case of borderline disorder, which is usually associated with trauma in the course of development. Of course, it is also questionable whether anyone with a borderline personality disorder has organic changes in the brain.
It is well conceivable that brain structures and also the brain metabolism normalize with an improvement of the disease. For this, many more examinations and studies would have to be carried out.
Interplay of body and psyche
Basically, with all due caution and the still considerable need for research, it can be said that a borderline disease has organic components. In addition, however, other factors still play a role. Often traumatic experiences such as abuse and violence in childhood and youth are in the background.
And finally, the individual disposition and personality structure is crucial to how these experiences and imprints are processed. Because not everyone who has suffered such mental injuries, develops a personality disorder.
Authors: Dr. med. Julia Hofmann, Eva Bauer (doctor)