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

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.


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





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



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