Borderline Personality Disorder (BPD) and Post
Traumatic Stress Disorder (PTSD) can and often do
overlap. There is a high incidence of those diagnosed
with BPD also having PTSD.
Post Traumatic Stress Disorder is an enduring consequence of
a traumatic experience or a series of traumatic experiences.
Many associate PTSD with war vetrans and accident victims
or the victims of very violent crimes (all of which can also
be causes). PTSD, in a high number of instances is often
the result of abuse and neglect.
A National Center for PTSD Fact Sheet explains:
Post-Traumatic Stress Disorder, or PTSD, is a psychiatric
disorder that can occur following the experience or witnessing
of life-threatening events such as military combat, natural
disasters, terrorist incidents, serious accidents, or violent
personal assaults like rape [childhood sexual abuse]. People
who suffer from PTSD often re-live the experience through
nightmares and flashbacks, have difficulty sleeping, and feel
detached or estranged, and these symptoms can be severe enough
and last long enough to significantly impair the personís
PTSD is marked by clear biological changes as well as
psychological symptoms. PTSD is complicated by the fact that
it frequently occurs in conjunction with related disorders such
as depression, substance abuse, problems of memory and cognition,
and other problems of physical and mental health. The disorder
is also associated with impairment of the personís ability to
function in social or family life, including occupational
instability, marital problems and divorces, family discord,
and difficulties in parenting.
"Who is Most Likely to Develop PTSD?"
1. "Those who experience greater stressor
magnitude and intensity, unpredictability,
uncontrollability , sexual (as opposed
to nonsexual) victimization, real or
perceived responsibility, and betrayal.
2. Those with prior vulnerability factors such
as genetics, early age of onset and longer-
lasting childhood trauma, lack of functional
social support, and concurrent stressful
3. Those who report greater perceived threat
or danger, suffering or being upset, terror,
and horror or fear.
4. Those with a social environment which produces
shame, guilt, stigmatization, or self-hatred."
Source Quoted for PTSD facts
The National Center For Post Traumatic Stress Disorder.
"Symptoms of PTSD include, but are not limited to:"
"Recurrent, intrusive, and distressing thoughts
about the event
Recurrent dreams, nightmares (sometimes called
"night-terrors") about the event
Flashbacks (a sense of reliving the event)
Distress caused by reminders of the event
(sights, sounds, smells)
Alienation, isolation, and avoidance of people
No sense of future
Survivor guilt (for having survived when others
did not, or for behavior required for survival)
Difficulty falling or staying asleep
Anger and rage
Difficulty concentrating or remembering
Hyper-vigilant, or survivalist behavior
Exaggerated startled response (usually to loud
*These symptoms may lead to substance abuse
or other self-destructive addictive behavior.*"
Source for the Symptoms of PTSD
The American Legion Guide To: Post Traumatic Stress Disorder
Borderline Personality disorder in many ways can be compared
to having a cognitive-emotional (often fear/panic) button stuck
in the "ON" position. Many borderlines are very much
stuck in hyper-vigilant, "survivalist behavior" and often not
without knowing why. In this state of hyper-awareness (which is
a narcissistic - defense) a borderline (with PTSD) is always on
guard. He/she is always on the lookout for that person, thing,
comment, or word that will hurt them. Often when something does
hurt, or frighten them they do not know why.
Much of the borderline experience carries with it differing
levels of dissociation. This means that borderlines often experience
things in the present as if they were things in the past. A
sudden loud noise outside, for example, which likely has no
consequence in the borderline's life, in the present, will be
perceived as a threat. The borderline (with PTSD) will have
to investigate it and then often will ruminate on what could
have happened or may still happen, the what-if's of the noise
and it's potential ramifications. This can be "crazy-making".
The excessive focus on that loud noise, for example, causes
even more distress (sometimes could trigger anger/rage) than
the noise itself did in the first place. This focus and or
concern is generally not well received or well understood by
those around the borderline with PTSD.
Although I was diagnosed with BPD at the age of 19 and
recovered from it in my mid 30's I was not aware that I also
had PTSD until well after that. I am now 43 and it has just
been in the last 4 years that I have come to know that some
of what I still experience is in fact PTSD. Not to say that
this will be everyone's experience, but, in my case, I had to
heal the BPD before I could even begin to address the PTSD.
PTSD can mimic BPD in that it can leave you feeling "similar
things", focusing excessively on perceived threats and or
experiencing things in fragmented ways.
I would recommend that anyone with BPD follow up with their
therapist as to whether or not they may also have PTSD. There
are many causative factors associated with both that overlap.
The further we move away from our pasts the more we may tend
to trivialize our pasts. As we get older, heal more and recover
functionality in our lives perhaps things don't seem "that bad"
anymore. However, it is important to remember that we suffered
as children, was experienced very differently by us then than it
is by us in later years as we re-live it (flashbacks) and or go
back over it in therapy.
In fact if you look at the list of symptoms above it would
be quite easy to just change the wording a little bit and you
would end up with the very way that the criteria for BPD is
explained. BPD Defined
There are no easy answers. Recovery takes time. You may, as
I had to have to recover from the BPD in order to gain enough
awareness, insight and understanding into yourself (establish
your true identity) in order to be able to then begin to deal
effectively with the PTSD.
Things that helped me were:
re-living the feelings and thoughts and
catching myself in the thought loops that
would just continue to produce, emphasize
and or make worse my thoughts and feelings
based on my past and not my here and now
learning to differentiate between then and
realizing that the most uncomfortable and
or terrorizing thoughts/feelings you may
experience are the BPD/PTSD working it's
way into your consciuosness so that you
by being willing to face my pain and my
sitting with the pain and the thoughts that
can be triggered and being gentle with
myself until they pass
learning not to degrade myself or think of
myself negatively or as crazy when facing
that pain or those triggers
learning to re-focus and do implement other
(healthy) activities where I would dwell on
the past before
learning that I did not have to ruminate
on the thoughts/worries which I had
excessively focused on for years and
finding their source in therapy and then
learning to cope with and manage symptoms
until I have been or am ready to let them go
I learned that I did not have to be
hypervigilant in order to be safe.
As with many other mental disorders, PTSD often overlaps or
is co-morbid with BPD. Getting to the bottom of the puzzle that
BPD presents you in your life may well mean being tested,
diagnosed and treated for other presenting disorders. Do not
try to categorize yourself. Let a professional assess you.
As word of encouragement here I have found PTSD very formidable
but nowhere near as formidalbe as I found BPD. Once you establish
your identity and understand BPD you will find renewed energy
and desire to deal with any other diagnosis that may also exist
in your case, along with the BPD.
Validate yourself. Believe in yourself. Seek and be consistent
in your seeking treatment. Want to get well. Know that you can
get well. You are the writer of the book that is your life.
© Ms. A.J. Mahari - January 21, 2001
as of January 5, 2002