Self-harm May Stop Painful Emotions for People with BPD

People diagnosed with Borderline Personality Disorder (BPD) often hurt themselves physically because it makes them feel better emotionally, according to a study published in a recent issue of the journal Biological Psychiatry.

People with BPD typically experience intense emotions and have a hard time controlling those emotions. Physical pain seems to help them release emotional tension and is likely why they engage in self-harm, a common symptom of Borderline Personality Disorder.

Researchers at the University of Heidelberg in Germany used magnetic resonance imaging to examine the brain activity of people with Borderline Personality Disorder. Both people diagnosed with BPD and those who weren’t were shown pictures meant to stimulate positive, negative, or neutral emotions. The researchers found that areas associated with emotions (including the amygdala, insula, and anterior cingulate cortex) in the brains of people with BPD were more active when they were shown negative and neutral pictures than the same areas on the healthy subjects.

Action near the amygdala also corresponded with the patients reporting difficulty in regulating their emotions.

When people with BPD were subjected to a painful heat stimulus, the activity in their amygdala and anterior cingulate cortex decreased. Pain seemed to reduce neural activity in those areas of the brain, which may be interpreted as feelings of relaxation in people with BPD. That response may be the reason why many people with BPD engage in self-harmful behaviors, such as cutting.

Researchers previously believed that people with BPD experience hyper-emotional states. These new findings indicate that pain actually stops, rather than simply distracts, the brain of BPD patients from experiencing painful emotions.

BPD Individual’s Brain Activity May Also Impact Trust

This isn’t the first time researchers have found differences in brain activity in people with Borderline Personality Disorder. A study published in the journal Science in August 2008 found that the brains of BPD patients differed from healthy subjects when participating in an experiment design to establish trust and cooperation.

Scientists at Baylor College of Medicine in Houston discovered through neuroimaging scans that an area of the brain called the anterior insula lights up when processing sensations such as pain and uncomfortable social situations. In healthy subjects, situations involving lack of trust or cooperation triggered the insula. The brains of people with BPD lacked this activity in the same situations.

Researchers suspect the anterior insula tracks people’s behavior and puts out a sensation of discomfort. It seems that people with BPD may not get a “gut feeling” that someone may not be good for them, which makes them more unlikely to trust anyone.