BPD And The Hypothalamic-Pituitary-Adrenal Axis

The hypothalamic-pituitary-adrenal (HPA) axis is a complex network of nerves that interconnect :

  • the hypothalamus
  • the pituitary gland
  • the adrenal glands

See diagram below for the location of the above in the body :

From top to bottom : 1) The hypothalamus ; 2) The pituitary gland ; 3) The adrenal glands

What are the functions of the hypothalamus, pituitary gland and adrenal glands?

Their functions are as follows :

  1. The hypothalamus : controls body rhythms, temperature, thirst, hunger.
  2. The pituitary gland : secretes the hormone known as oxytocin which is believed to play an important role in the mother-child bonding / attachment process.
  3. The adrenal glands : these are responsible for regulating our response to stress via the functioning of two main hormones – cortisol and adrenaline.

Interaction Of These Three Organs :

As already stated, these three organs interact , communicating with one another by the means of neurotransmitters and hormones, and in so doing :

  • determines how we respond to stress.
  • controls the quality of the mother-infant attachment process in early life.
  • regulates mood.
  • regulates sexuality.

The Relevance Of The Hypothalamic-Pituitary-Adrenal (HPA) Axis To Individuals Who Have Been Diagnosed With Borderline Personality Disorder (BPD) :

One of the major theories relating to BPD is that, in those suffering from the condition, the HPA Axis as a whole and its complex interconnected nerve system does not function properly.

And, according to a meta-analysis of research into this phenomenon, an important adverse effect of this dysfunction of the HPA Axis is the elevation of ‘continuous cortisol output’ (resulting in higher than normal levels of cortisol circulating in the blood system) but also the ‘blunting’ of cortisol’s response to psychosocial stressors (meaning that BPD suffers are less able to deal with stress than the ‘average’ person).

High levels of cortisol in the blood system, when prolonged, can have a number of harmful effects, including increases in blood pressure and blood sugar levels (thus raising the chances of developing diabetes).

Furthermore, elevated cortisol levels can increase the risk of suicide (Lester and Bean, 1992), negatively impact the immune system, accelerate the ageing process and damage the brain’s hippocampus.

REDUCING STRESS CAUSED BY A DYSFUNCTIONAL HPA AXIS :

Methods for reducing stress in those affected include yoga, neurofeeback, mindfulness meditation and trauma release exercises. There also exists some evidence that antioxidants may be of benefit.

RESOURCE :

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eBook :

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David Hosier BSc Hons; MSc; PGDE(FAHE).

Childhood Trauma : Its Link To Depression And Anxiety (Free PDF).

depression-anxiety

Below you can view the free PDF of my eBook (previously published on Amazon) Childhood Trauma And Its Link To Depression And Anxiety.

To view my other eBooks that are currently for sale on Amazon, click here.

ChildhoodTraumaandItsLinktoDepressionandAnxiety.zip

Oprah Winfrey Talks About Childhood Trauma Treatment.

The video which I provide a link to below features Oprah Winfrey talking about the vital importance of understanding, and treating, the adverse effects of childhood trauma on individuals’ mental health, physical health and life chances in general.

It opens with Oprah talking to one of the world’s leading experts on developmental trauma, Bruce Perry PhD, who explains how young children are particularly sensitive to the ill-effects of dysfunctional environments due to the brain’s extreme plasticity / neuroplasticity in early life.

He explains that just as a baby’s / infant’s brain is super-sensitive to linguistic input (nearly all learn language easily and naturally even though they are not making a conscious effort to do so due to the early brain’s sponge-like absorption of the words, grammar etc. they are exposed to) so, too, are they super-sensitive to any dysfunction that is going on around them (e.g. domestic violence, maternal stress / anger / rage, neglect etc.).

Similarly to how the young brain absorbs language, it absorbs these dysfunctional elements of its environment which, in turn, potentially adversely affect the development of their malleable and highly ‘plastic’ brains which, in its turn, sets the stage for the potential later development of behavioral, emotional and social problems.

In relation to this, Oprah Winfrey talks about the importance of understanding the roots of dysfunctional behavior in children, adolescents and adults (i.e. the adverse effects of their early environments on brain development) that might make themselves apparent in a whole host of ways (e.g. problems controlling anger, alcoholism, proneness to violence, inability to hold down a job etc.) and of treating such individuals using trauma-informed therapy.

During the interview, Oprah Winfrey also discusses why some children appear to be more resilient to trauma than others and the fact that one key to such resilience is to have at least one relationship which is emotionally supportive (the example given is that of a supportive school teacher though it could be a counsellor, god-parent or other caring and responsible person).

To read about the seminal study on the effects of childhood adverse experiences (ACEs) on mental and physical health in later life, click here to be taken to my article entitled : Childhood Trauma : The Adverse Childhood Experiences (ACE) Study.

Anyway, here’s the link to the video : https://www.cbsnews.com/news/oprah-winfrey-childhood-trauma-ptsd-60-minutes-report/

David Hosier BSc Hons; MSc; PGDE(FAHE).

Link Between Childhood Trauma And Mental Illness Is ‘Public Health Crisis.’

I have written extensively about the link between childhood trauma and the development of psychiatric problems extensively on this site already.

In this article, I will outline the findings of a study conducted in 2018 which serves to confirm this association.

The study I refer to was published in the Journal of the American Medical Association.

The authors of the study considered the association between childhood trauma and mental illness to be so severe as to justify declaring the adverse effects of childhood trauma to be a public health crisis.

The researchers summarized the findings of their study as demonstrating that ‘cumulative childhood trauma was associated with higher rates of adult psychiatric disorders and poorer functional outcomes.’

RESULTS OF THE STUDY :

THe study found that those participants who had been exposed to significantly traumatic events in childhood were, on average, 1.5 times more likely to suffer from psychiatric illness than those who had suffered no exposure to significant childhood trauma. A more detailed breakdown of the findings of the study is presented below :

When compared with those who had experienced no significant childhood trauma, those who had experienced exposure to childhood trauma were, on average :

1.4 times more likely to suffer an anxiety disorder.

1.7 times more likely to suffer from a depressive disorder.

1.2 times more likely to suffer from ADHD.

1.5 times more likely to suffer from oppositional defiant disorder.

1.8 times more likely to suffer from conduct disorder.

1.3 times more likely to suffer from substance abuse disorder.

Furthermore, they were :

1.3 times more likely to live in a household of low socioeconomic status.

1.5 times more likely to live within an unstable household.

1.5 times more likely to live within a dysfunctional family.

1.4 times more likely to be bullied by peers.

There was also an association between the experiencing of childhood trauma and the later development of adult psychiatric problems ; these results were as follows :

Those who had experienced childhood trauma were, on average, when compared with those who had not experienced significant childhood trauma :

1.3 times more likely to suffer from an anxiety disorder.

1.2 times more likely to suffer from a depressive disorder

1.2 times more likely to suffer from a substance disorder.

Whilst the researchers concluded that their study had many strong points, they also drew attention to a few caveats, including using a sample of individuals who were not wholly representative of the U.S.A. (American Indians and individuals from rural areas were over-represented) and also the study’s reliance upon some self-reporting of traumatic experience which was difficult to verify in terms of complete accuracy.

For more information relevant to the content of the above article, you may also wish to read about the Adverse Childhood Experiences (ACE) Study, the seminal study showing the association between childhood trauma and damaged physical and mental health in later life.

beginners-guide-childhood=trauma

Above eBook now available for immediate download from Amazon. Click here for further details.

David Hosier BSc Hons; MSc; PGDE(FAHE).

Traumatic Victimization In Childhood And The ‘Cascade Of Impairment.’

We have already seen from numerous other articles that I have published on this site that if, as children, we experienced traumatic victimization, particularly chronic victimization (e.g. physical abuse or being exposed to domestic violence) by a parent or significant other responsible for our care and prorection we may develop long-lasting problems that (without effective therapy) may extend well into adulthood (e.g. in the form of complex PTSD, addictions, relationship problems, anxiety, depression, suicidality and inability to control emotions – this last example is sometimes referred to as ‘emotional dysregulation‘).

It may also lead to the development of conditions that may manifest themselves in childhood such as oppositional defiant disorder, difficulties controlling aggressive impulses and severe emotional disturbance.

Some children suffering in this way may sometimes appear callous and unconcerned about the feelings of others though this can often be explained by the necessary defense mechanisms they have unconsciously developed, such as emotional numbing and detachment, to protect themselves from being completely psychologically crushed.

THE CASCADE OF IMPAIRMENT :

According to Patterson (1993) children who develop oppositional defiant disorder (which can be marked by symptoms such as open hostility, overt aggression, extreme negativity, defiance, suspicious resentment and chronic indifference) and other problems controlling intense aggressive impulses can inadvertently trigger a CASCADE OF IMPAIRMENT for themselves that can potentially ruin their lives (one worst case scenario being getting in serious trouble with the law in late adolesence or adulthood).

The ‘cascade of impairment’ refers to a vicious circle whereby the child’s defiance and aggressive behavior has the effect of alienating others and increasing the likelihood that they will avoid the child or act negatively towards him in other ways. This, in turn, is likely to increase the child’s view of himself as being unlovable / disliked / rejected / ostracized / ‘intrinsically bad.’

This negative self-view may well then cause the child to feel yet more emotional hurt and distress, and, not understanding or being able to articulate the true source of his problems, he is liable to express this mental anguish through even more intense outbursts of anger and aggression. (Indeed, it is theorized that one function of anger is to ease emotional pain).

Furthermore, feeling rejected by society, he may well start to identify with peers who also perceive themselves to have become ‘social pariahs’ and, together, they may form what effectively come to be seen as a ‘gang of social outcasts’ who reinforce one another’s negative views, start rebelling against ‘mainstream society’ and begin indulging in delinquent behavior which can quickly escalate to serious levels ; such behavior then becomes ‘normalized’ within their group, thus lowering further their remaining inhibitions about behaving in such a way and leading to further trouble for both themselves and for others.

Furthermore, once the child is firmly ensconced within such a group of rebels his problems may be further increased by a lack of appropriate supervision and also of positive social role-models.

Patterson’s (1993) research identified boys who, by the time that they reached grade 4, had developed serious problems in relation to their school studies and their interpersonal relationships with peers.

These same boys were followed up over a 5 year period and were found to develop a cascade of problems (as referred to above) relating to social, emotional and behavioral aspects of their lives, including the following :

  • lack of adult supervision
  • failure to abide by ‘curfews
  • severe depression
  • problems with the law
  • becoming part of ‘delinquent gangs’
  • truancy

Whilst the above research focused on boys, girls who develop oppositional defiant disorder have been found to be more likely to internalize (as opposed to externalize, as boys are more likely to do) their accompanying psychological problems leading to conditions such as anxiety, depression, irritability, somatization, eating disorders, self-devaluation, suicidal ideation, truancy and avoidance of parents and teachers.

THERAPIES :

Therapies for young people suffering from serious problems such as those referred to above include :

  1. EMDR
  2. Trauma Focused Treatment Groups
  3. Cognitive Processing Therapy
  4. Motivation-Adaptive-Skills-Trauma-Resolution (MASTR).

RESOURCE :

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eBook :

ANGER MANAGEMENT PROBLEMS : THEIR ROOTS IN CHILDHOOD TRAUMA.

Above eBook now available for instant download from Amazon. Click here to view further details.

David Hosier BSc Hons; MSc; PGDE(FAHE).

BPD And Resolving Conflict With Others

If we suffered severe and chronic childhood trauma, particularly if, as a result, we have gone on to develop borderline personality disorder, it is likely that, without appropriate therapy, we frequently find ourselves in heated conflict with others, especially those others to whom we are emotionally attached such as partners or family members.

Indeed, one of the hallmarks symptoms of BPD is the experiencing of difficulties with interpersonal relationships.

We may have relationship problems for a variety of reasons that include :

And, when a relationship ends, sufferers of BPD are liable to take it particularly hard, especially if rejected in such a way as to trigger reminders of childhood rejection (on either a conscious or unconscious level). Indeed, the emotional pain of such rejection can be as excruciating as severe physical pain.

Because of the frequent ‘love-hate’ relationships BPD sufferers are prone to creating, the nature of the conflict between the sufferer and his / her partner tends to be cyclical and the first step is to become aware of the cycle and recognize its futility and destructiveness.

We also need to recognize the damage it is doing to our relationship ; conflict leaves both us and the person with whom we are in conflict feeling bad. Indeed, following outbursts of anger and rage, BPD sufferers tend to experience overwhelming feelings of profound shame. So, in essence, everyone loses and the relationship is undermined (and is likely to collapse altogether in the absence of effective, remedial action being taken).

Once we have become aware of this destructive cycle, we next need to make a definite commitment to trying our best to break it.

Obviously, though, if one has had a long history of getting into high conflict situations with others, the process of change is likely to take time and cannot, of course, be expected to work instantaneously ; one needs to learn and practice new social skills until they, in an ideal situation, become ‘second-nature’ and there will inevitably be setbacks along the way, paricularly when one is under intense stress, is deliberately provoked or is facing rejection.

Of course, each individual will have their own set of personal triggers which put them at high risk of entering into conflict with another so the next step is to try to IDENTIFY SUCH TRIGGERS.

Not letting potential triggers set off undesirable behaviors also entails controlling impulsivity ; you can read my previously published article entitled : Control Impulsive Behavior by clicking here. Also, you may wish to read my articles : Impulse Control : Study Showing Its Vital Importance and Childhood Trauma And The Development Of Impulse Control Disorders.

Once triggers have been identified, the next step is to rehearse in the mind how one will respond in such a way as not to create conflict or in a way that de-escalates any conflict that already exists. Using visualization techniques to aid mental rehearsal of one’s new, positive ways of dealing with situations that would have previously led to conflict can be particularly effective.

In his excellent book : The High Conflict Couple : A Dialectical Behavior Therapy Guide To Finding Peace, Intimacy And Validation (see image below to view on Amazon), Fruzzetti PhD endorses the above techniques and suggests using the acronym SET to help us to remember more constructive ways of dealing with conflict than we may used in the past ; SET stands for utilizing sympathy, empathy and truthfulness.

Assertiveness training can also help to ensure that a gentler approach to dealing with potential conflict does not lead to being taken advantage of.

RESOURCE :

Fruzzetti PhD’s Book :

David Hosier BSc Hons; MSc; PGDE(FAHE).

Symptoms Of Trauma And Their Link To ‘Energy Trapped In The Body.’

According to Dr Peter Levine, symptoms of trauma may be explained by ‘energy trapped in the body,’ and, as a direct result of his theory, he has developed a therapy known as SOMATIC EXPERIENCING THERAPY.

WHAT IS MEANT BY ‘ENERGY TRAPPED IN THE BODY?’

If we have experienced chronic trauma and have felt frequently under threat of physical and/or psychological harm during childhood we can become ‘stuck in the fight / flight response’ which, in turn, can lead to a build up of trapped energy in the nervous system that fails to be discharged. It is theorized that this ‘trapped energy’ in the nervous system is a fundamental cause of the symptoms of PTSD and Complex PTSD and, in order to heal from such conditions, it is necessary discharge and release it (ideally. as I have already stated, using Somatic Experiencing Therapy.

10 TECHNIQUES AND STRATEGIES THAT CAN HELP TO RELEASE ENERGY THAT HAS BECOME TRAPPED IN THE BODY AND, THUS, REDUCE ASSOCIATED FEELINGS OF STRESS :

Ideally, seek Somatic Experiencing Therapy. However, if this is not feasible, the following suggested techniques should prove helpful in healing the trauma trapped in the body.

  1. If you are very nervous and shaking, allow your body to shake rather than trying to resist it (for more on this, you may wish to read my previously published article which discusses why this is important).
  2. Likewise, if you find yourself crying, allow yourself to cry rather than trying to fight it ; in relation to this, you may wish to read my article entitled : ‘Crying May Help Us To Re-engage With Authentic Feelings.’
  3. ‘Zoning Out’ : technically, this is known as ‘dissociating‘ and you can read about it in my previously publised article entitled : ‘Always Zoning Out? Dissociation Explained. Whilst mild dissociation is normal and acts as a ‘defense mechanism’ against psychological distress, if it starts to significantly impair daily fumctioning ‘grounding techniques’ can be effective for remedying this (grounding techniques involve using the five senses – sight, hearing, taste, smell and touch to help the person ‘reconnect with reality’ , return to the ‘here and now’ and return his/her body to a state of homeostasis). Also, going for a walk / jog / swim etc. or doing yoga can help the individual to break free from his/her dissociative state.
  4. Remember the importance of good nutrition.
  5. Spend time where you feel safest with people you can talk to and trust. Affectionate physical contact such as hugging also has a calming physiological effect. If all else fails, Dr Peter Levine (see above) even suggests ‘hugging oneself’ to feel safe and comforted by putting the left hand under the right armpit and the right hand on the bicep of the left arm.
  6. Unreleased energy trapped in the nervous system may manifest itself as tension in various parts of the body, including the arms / shoulders and legs. Swimming is a good way to release tension throughout the body as the act of swimming involves so many of the body’s muscle gtoups. To release tension in the legs, walking, jogging cycling etc. can be beneficial whereas tension in the arms may be alleviated by sports such as boxing.
  7. Learning to breathe in a way that helps to keep one calm is also important, especially if the individual suffers from hyperventilation.
  8. Getting as much sleep as you need is important as it is believed that it is during REM (rapid eyemovement) sleep when we are dreaming that the brain processes stressful events that we have experienced. (if you have sleep problems you may wish to read my previously published articles, Night Terrors : Sleep Paralysis ; Childhood Trauma : Link To Excessive Dreaming During Sleep ; Overcoming Nightmares And Hallucinations With ‘Paradoxical Intentions.’ ; PTSD Nightmares : Typical Content And Symbols.’
  9. Mindfulness is useful for learning to ‘live in the present.’ In relation to this you may wish to read my previously published artivle Mindfulness Meditation : An Escape Route From Obsessive Ruminations.’
  10. Yoga

RELATED ARTICLE ‘FIGHT, FLIGHT, FAWN OR FREEZE ‘ : TRAUMA RESPONSES.

RESOURCES :

Body Scan Relaxation Technique

Learn Deep Breathing Relaxation Techniques Rapidly

Experience Yoga Nidra by the Pro’s

David Hosier BSc Hons; MSc; PGDE(FAHE).