Thursday, October 6, 2011

Autoimmune Disease and Borderline Personality Link

After the post about Overreactions to Illness and Hysteria with Borderline Personality, I have received many emails and comments about how their Borderline Personality Disorder (BPD) mothers have auto-immune diseases. Specifically, one reader wrote,  "I find it interesting that your mother was diagnosed with an autoimmune disorder, as my mother is also (she is diagnosed with rheumatoid arthritis and psoriasis). Although I know there is nothing that can be done to prevent an autoimmune disorder, I can't help but wonder why so many BPD individuals are diagnosed with them. A friend's BPD sister was recently diagnosed with an autoimmune disorder as well. Now, this could be pure coincidence, but I was wondering if you had any thoughts on this topic or knew of any related research."

After this email, I thought researching this correlation further (BPD correlating with autoimmune diseases) would be interesting and revealing. And it sure was!
  1. Individuals who have BPD or any of the other Axis II Cluster B's (BPD, NPD, ASPD, HPD) often suffer from autoimmune illness due to the stress and elevated cortisol levels which  induce a cascade of autoimmune issues. 
  2. Autoimmune-related inflammation may exacerbate BPD symptoms or vice versa.
  3. Present data demonstrate a clinically significant, longitudinal correlation between fluctuating antithyroid antibody titers and symptoms of BPD psychopathology.
Further, keep in mind that BPD is also associated with less healthy lifestyle choices (e.g., smoking, alcohol use, lack of regular exercise) which can cause a myriad of health challenges, problems, and diseases.  With this article, however, we are focused on the connection between BPD and autoimmune disease specifically.

First off,  BPD can have a major impact on physical health. BPD individuals often endure chronic medical conditions and pain disorders such as fibromyalgia, chronic fatigue syndrome, obesity, diabetes, hypertension, arthritis, and back pain (Psyche Solve). Additionally, individuals who have BPD or any of the other Axis II Cluster B's (BPD, NPD, ASPD, HPD) often suffer from autoimmune illness due to the stress and elevated cortisol levels which  induce a cascade of autoimmune issues. In normal circumstances, cortisol keeps the immune system in homeostasis, preventing inflammation from going out of control. In many patients with autoimmune diseases, this cortisol response and the cascade of brain hormones that stimulates its release are impaired, so there is no shutoff valve to end inflammation when it is no longer needed. In other patients, the cortisol response may be intact but immune cells are resistant to the anti-inflammatory effects of cortisol due to abnormalities in the cortisol receptor. In both circumstances, inflammation goes on unchecked without the dampening effect of the body own cortisol (American Autoimmune).

Next, in the book, "Sometimes I Act Crazy: Living with Borderline Personality Disorder" by Jerold J. Kreisman M.D. and Hal Stras, the authors draw a connection between autoimmune disorders and BPD. The following is an excerpt: Some researchers have investigated the connection of BPD to autoimmune disorders, in which the body has a kind of allergic reaction to itself and produces antibodies to its own organs. One example, rheumatoid arthritis, is associated with an unusually high prevalence of BPD. One study followed a woman with fluctuating BPD symptoms over a period of nine months while measuring her antithyroid antibodies. These investigators discovered significantly lower levels of the antibodies during periods when her depression and psychosis ratings were low, and higher levels when her symptoms increased. This finding suggests that autoimmune-related inflammation may exacerbate BPD symptoms or vice versa.

The following abstract is focused on the same issue, that BPD and autoimmune disease are correlated. And the conclusion is that a relationship between thyroid hormones / autoimmunity and BPD exists. Before reading, understand that antithyroid antibodies are antibodies directed against the thyroid gland (a gland which produces thyroid hormones). Antithyroid antibodies can be associated with inflammation of the thyroid gland and affect its function. Testing for antithyroid antibodies in the blood is useful in the diagnosis of some thyroid and other disorders including: Hashimoto thyroiditis (an autoimmune thyroid disease), Graves disease (overactivity of the thyroid), hypothyroidism (underactivity of the thyroid), thyroid cancer, Lupus, rheumatoid arthritis, autoimmune hemolytic anemia and Sjogren syndrome. Now to that abstract... deep breath and read on:

Circulating thyroid autoantibodies are more prevalent in patients with mood disorders than in the general population, but longitudinal clinical data that establish a relationship between thyroid antibody status and the course of any psychiatric syndrome have been lacking. In addition, scant attention has been paid to thyroid hormones and autoimmunity in borderline personality disorder (BPD). We report a case of a patient with classic BPD whose fluctuating mood and, especially, psychotic symptoms-rated using a double-blind method-were directly linked to antithyroglobulin antibody titers serially determined over an inpatient period of 275 d. Significantly lower psychosis and depression ratings were seen during a 4-wk period of relatively low antithyroid antibody titers, during blinded treatment with carbamazepine, than were observed during two high autoantibody epochs. The significant positive correlations between nurse- and patient-rated depression and thyroid autoantibodies over the entire period of inpatient study were similar to those also observed between urinary free cortisol levels and depression; the positive correlation between antithyroglubulin antibody titers and psychotic symptoms was stronger (r = +0.544; p < 0.002). Although this patient had biochemical indices of primary hypothyroidism, she showed only marginal improvement to triiodothyronine (T3) and no apparent clinical response to sustained levorotatory thyroxine (T4) administration; neither were antithyroid antibody titers significantly associated with changes in T3, free T4, or thyroid-stimulating hormone concentrations. She clinically deteriorated during a 50-d fluoxetine trial. The present data demonstrate a clinically significant, longitudinal correlation between fluctuating antithyroid antibody titers and symptoms of borderline psychopathology in our patient. It will be of interest to determine the prevalence, pathophysiologic mechanisms, and treatment implications of this putative autoimmune- BPD link.

Another interesting observation is that medical conditions which cause organic behavioral function may result in a clinical picture that mimics to some degree BPD. Hormonal dysfunction over a long period, or brain dysfunction (e.g. the encephalopathy caused by lyme disease) can result in identity disturbance and mood lability, as can many other chronic medical conditions such as Lupus. These conditions may isolate the patient socially and emotionally, and/or cause limbic damage to the brain. However, this is not BPD which results, but rather a reaction to the isolating circumstances caused by a medical condition and the possibly coincident struggles of the patient to control his or her mood given damage to the brain's limbic system (Wikipedia).

So, with the reports coming from Kreisman and Stras as well as scientific exploration into the correlation between autoimmune diseases and BPD, we may be closer to finding out if indeed a direct link exists. At this point, the assumption seems pretty strong that a link does exist-- and solid research has already been conducted and concluded in regard to bipolar and autoimmune diseases. With BPD gaining more attention, more studies will be conducted. I will be very interested to see the results. A link exists as high levels of stress have been proven to trigger autoimmune diseases; however, does the reverse apply? Does an autoimmune disease bring about BPD?


  1. Thank you so much for this article! And thank you for doing so much research on something that I've been wondering about for quite some time. From a very young age, I always knew there was something wrong with my mother. As I got older, I started to see the physical toll she was putting on her body through so much stress and hysteria. Her health continues to deteriorate as she is currently in 'conspiracy theory mode,' believing that visiting a doctor will cost her thousands of dollars in unnecessary tests and that those who visit doctors are 'hypochondriacs.' This topic brings up so many interesting points about the mind body connection. I guess it really is true that you can worry yourself sick. I often feel anger towards my mother for the way she treated me, but sometimes I truly for feel sorry for her. She lives in fear and has never had an honest, true connection to another human being.

    Reading this blog makes me wonder how we all made it through, but we did. It is so helpful to know that others have had similar experiences, and while we are unable to change our pasts, we can do something about our futures. :)

  2. The vast majority of people who have emotional illnesses and / or blaming, controlling, and "High Conflict Personalities" tend to have both thyroid and adrenal problems. Women are ten (10) times more likely to have thyroid problems than men.

    Since our glands are all connected, any issues associated with the thyroid and adrenals also tends to weaken the Amygdala (the "fear and stress center" of the Limbic System "Emotional Brain"). Many health experts who I follow and respect (i.e. Randi Kreger, Dr. Leland Heller, and Charles Linden) suggest that Asperger's, Austism, Epilepsy, and various personality and anxiety disorder traits are associated with a damaged Amygdala (or Amygdalae since there are 2 of them), which is typically due to benign tumors, high acidity and copper levels, and Heavy Metal toxicities (i.e. mercury, lead, aluminum, etc.).

    To heal the body and mind, once must first remove the toxins by way of chelation. Some of the best ways to remove toxins includes taking these supplements: Edible and external Bentonite Clays, Zeolite (a volcanic ash used by the Chernobly victims and quite popular in Tokyo right now too), Spirulina and Chlorella (rich in iodine and protein too - EXCELLENT for our thyroid), Vitamin C Ascorbate powder, cilantor, and raw garlic. Sauna treatments and exercise may be very helpful too.

    Then, one must switch to a more alkaline diet of organic fruits and vegetables in order to lower the high Copper levels. I am good friends with many of the people who run The Gerson Institute in San Diego ( They have been curing cancer, diabetes, heart disease, Lupus, MS, Migraines, chronic pain and / or Fibromyalgia (related to the Amygdala too, per Charles Linden), mood disorders, and schizophrenia for almost 80 years now. They do it by removing the toxins first, cleaning up the liver, and adding nutritional supplements by way of alkaline foods and drinks.

    Linked below is a 90 second animated video on the Amygdala's link to people's unconscious fears as well as how to improve anxiety and personality disorders from Charles Linden ($80 home study course at who says that he has cured over 125,000 worldwide. He also had TV shows in Great Britain in the past.

    I personally emailed Charles about ten times last year back and forth. He wanted to hire me as one of his U.S. representatives since I knew so much about health, but I work in finance although I prefer talking about health topics the most since I am a lifelong Health Fanatic.

    Since upwards of 97% of all of our perceptions of the world come from our unconscious or subconscious thoughts, this is typical behavior for all of us:

    Once the thyroid and adrenals weaken, then it causes Copper levels to elevate which may cause more depression, anxiety, dissociative behavior, and even Schizophrenia. To best offset elevated Copper levels (the most common form of a Heavy Metal toxicity) which are more common in women than men as well, I really like this article from Dr. Larry Wilson:

    Every health condition in life may be CURED. One just needs to take the the best approach so that the Immune System heals both the body and the mind!!! :))

    1. Hello Ms. Smith! I am working on my masters level thesis for my degree in clinical psychology. My topic is the connection between hashimotos and BPD. I was hoping you had some actual sites where you found your research. Please let me know! I think this is a very important area for the psychological community to study! Thank you for your time!

    2. Greetings,
      I agree with you about the importance of this topic
      I have been looking at the connection between Borderline Personality Disorder and Hashimoto by way of a literature search. I agree with the contributor (Thursday, October 6, 2011) who remarked how little data there appears to be. I have recently been studying the paper cited (Geracioti T et al) and find the data and the conclusions drawn to be somewhat disappointing and inconsistent.
      For example the abstract and the body of the report are contradictory.

  3. MANY mental illnesses are somehow linked to auto-immune diseases. Even mental giftedness and creativity is linked to auto-immune diseases AND some mental illnesses.

  4. Yikes!
    I am the daughter of an NM mother and ES ('enabling stepfather). My mother has always been very cold in so many ways as I grew older (she's great with very young children). I had my first child in 2009 and she didn't bother coming to the hospital, even though I'd begged her for months and she held me off with, "we'll see." When I confronted her about it, she blamed me and cited several incidents (not allowing her dog who bites to come, etc.) as the reasons behind her decision.

    Anyway, I have also suffered from seronegative arthritis since I was 11. At that age, I had my first knee flare and had it operated on. I just had my 6th operation 2 weeks ago.

    Does this make me a narcissist? Not at all. 11-year-olds with Juvenile RA and like diseases aren't narcissists. But my mother has psoriasis, which is linked, and her mother and her mother before her had autoimmune issues. My paternal grandmother also had RA.

    So for me, I like to think that my autoimmune disease is linked to mental giftedness and creativity. It most certainly is genetic on both sides.

  5. To the 1st Anon: thanks for the info! I've been on a plant based, whole foods diet for some time now and have totally turned over a new leaf health-wise! There was a time in my life when I thought I was severely clinically depressed with anxiety and the kitchen sink and my doctor didn't know what to do with me because nothing worked. This went on a few months until I was given a battery test of auto-immune diseases and viola! It indicated I had celiac disease, an auto-immune disease that is activated when you eat gluten (something in wheat). Another test confirmed it and luckily it's totally cured by just giving up gluten. After giving it up, I felt like a new woman!

    I honestly believe had I not been diagnosed and treated, I was on the path to crazytown. It was *changing* me.

    1. Thank goodness for places who let you post anonymously without filling out form. OK, this is very interesting to me as I think the obvious thing is not that auto-immune disease and mental disorders are feeding each other as much as they are being caused by something else. I wasn't always like this and it's so hard to go gluten free that I have almost given up!

  6. Hi! Another daughter of an NM and ES here. My NM uses health and religion as her weapons of choice so sometimes it is hard to know what is truth and what is fiction or catastrophized. But according to her, she's had CFS, back pain, Sjogrens syndrome and many other autoimmune diseases for a very long time...she has been diagnosed (when she was seen briefly by a psych once) with a cluster B PD (histrionic, but I feel is it more NPD or BPD) and somatization - the topic of somatization obviously ties in with all of this, it is very interestesting

  7. I take synthetic drugs for hypothyroidism and get terrible leg cramps in the middle of the night but when I change my meds to bovine capsules, my leg cramps stopped.

  8. The connection between autoimmune disease and BPD is interesting. My BPD mother has had arthritis since she was in her late 20s and she has a portfolio of other autoimmune diseases as well.

    I do wonder what came first. It's always been my intuition that the anger hormones were coursing through her body for so long that they had an effect on her body.

  9. "anger hormones were coursing through her body for so long that they had an effect on her body"... indeed, very very probable. All of the stress they put on themselves damages their immune system, bringing on all sorts of auto-immune diseases. I look forward to more research to come out in this area. Happy New Year!

  10. Really appreciate the information here - I am the child of a BPD mother and have strong BPD tendencies myself. (The one thing that keeps me from having severe resentment toward my mother is the fact that her example has helped me to reign in my own BPD to keep it from being as harmful to my daughters as my mother's was to me). My mother suffered from a host of automimmune disorders throughout her life - she died last March - and I seem to be following the same path, as I've been diagnosed with psoriatic arthritis and have other unexplained issues which seem very likely to be autoimmune-related. I have been convinced for years that my health issues were caused by my own stress and inability to properly regulate my emotions; I only recently realized how deeply I have been affected by my mother's personality disorder. I have a long road ahead of me but am so grateful (though saddened as well) that there are other people who can understand, and whose experiences can help validate - at long last! - some of the feelings that I have had. (It's not my fault! I do not need to feel this guilt!)


  12. my daughter has bpd and her father's family is loaded with autoimmune issues - lupus among others. the bpd is also rampant in his family. she does not seem to have autoimmune issues. interesting.

  13. I'm a bpd who used to have hyperthyroid and sjogrens

  14. My mother (with BPD) has all sorts of physical maladies, the worst of which seems to be thyroid issues.

    I myself was diagnosed with arthritis in my early 30s. Do I suffer from BPD? No. I have been through years of therapy in an effort to sort out the madhouse of my past and my therapist has reassured me that I am a normal functioning member of society; however, my rheumotogist tells me that my arthritis is the symptom of having an auto-immune disorder. I have had my thyroid levels checked yearly and they always come up within the normal range. My doctor has counseled me that the auto-immune disease (and subsequent arthritis) are due to having suffered raised cortisol levels most of my life because of the constant flight-or-flight mode that my parents kept me in.

    So my question is this: have you done any research into the children (of BPD parents) who suffer from auto-immune disorders? Children who are not themselves diagnosed with BPD or any other type of Cluster B disorder? According to my therapist and my rheumatologist, this (auto-immune disorders) is very common in adult children who were raised in abusive households.

  15. Spirulina and chlorella are rich in iodine, however iodine can exacerbate thyroid problems. It depends on a few things. People really should supplement with proper advice from someone qualified.

  16. My 24 year old, intensely intelligent daughter was diagnosed with BPD some years ago. The family naturopath has many times said to me that she needs to learn to control her emotions or it would negatively impact her physical health. She has recently been diagnosed with an autoimmune disease, Ankylosing Spondilitis. The two conditions together are dynamite. I'm exhausted from the drama and the worry. Trying to understand how she "got" this disease. "God" seems to have dealt her a cruel hand.

  17. My son is in his late thirties. He has ADHD and psoriasis. His sister living with him for two years is moving out because of his abusive behavior. All the women in my family has autoimmune issues. My daughter and I ave Hashimoto (thyroid), I also have Chronic Fatigue / Lyme Disease and heavy metal toxicity ( born and raised in a mining town and father smoking). I have hope for my son seeing the possibility of a link between BPD and autoimmune issues.
    I want to share with you a few things that are helping me. LDN Low Dose Naltrexone is helpful by telling the brain to restart the computing check it should do every morning between 4 and 6 am. Since I am taking it I was able to lower my Thyroid medication by half and start to feel better. Then I found out that I had a genetic mutation called MTHFR that affects the methylation cycle (detoxification) and the production of hormones and neurotransmitters. This is BIG, it affects so many biochemical reactions!
    You can have test done specifically for MTHFR through your medical insurance(check this before). Information can be found on Dr. Lynch website: article, video, etc where he explains a lot of things.
    Since I started to take supplements to help the methylation cycle, I am feeling much better: I have much more energy, I sleep better, no more brain fog, etc, with another supplement for thyroid, I am not taking any medication for that since two weeks.
    I am going to work with my son to help him detox, test for MTHFR, Take LDN, and take supplements for MTHFR. I am full of hope. I know that he is difficult with other people but he is also miserable and have to fight so many things.
    Hope this help in your search for answers.

  18. Anonymous, a year ago I met a wonderful 54 yo women who has lupus, after the first 3 months I notice a big change in personality ,In the 4 month she just broke it off for no reason.2 months later we go back together everything was going good until the lies didnt make sence and started to get distance . Blaming me for everything, lying cheating being a drama queen ,wouldnt talk to me or even breaking up over something as a misunderstood text message... and the rage unbelievable..Now she blocked me from everything. ..well needless to say thank goodness, but it still took a toll on me 2 months later.ok to be honest from what I have read and learned from therapy this is signs of narcissis personality disorder . she has lupus and bipolar disorder from what I was told.. .It's very confusing to understand unless you are around that person and deal with their actions. I do believe lupus is linked with bpd and npd along with bp..and the stress it causes the family can cause pts syndrom in partners as well.never hate the person just the disorder hope there's a cure someday for all these diseases. .God bless

  19. I Have Hashimoto's disease undiagnosed for 15 years. In me it was mild with the bug weight gains 15 here 15 there. Alsways active!! Worked out like crazy at 29 until I i was reduced to walking then couldn't even walk as exercise,you know my 5 miles fit in. Anyway,my sister's thyroid stopped working at 19 and she never was a constant ray of sunshine but after her thyroid stopped working and she went into treatment, she's been a flaming bitch (nice as she gets) to out right screaming at the top of her lungs spouting verbal abuse and making up lies about the person she's yelling at so she can say how bad that poor abusee is. I found an article about a woman who was misdiagnosed with bipolar disorder for 7-8 years and she really has Hashimoto's hypothyroidism. Once treated properly with conventional medication and autoimmune diet and getting the adrenal back in order with some process I didn't look into, this poor woman who suffered all those years is only on thyroid medication. Absolutely no bipolar medications (she was on a cocktail including lithium!!!). So my question is do SOME people really have mental disorders OR shouldn't the doctors check for thyroid gland problems, adrenal sluggishness, pituitary gland problems. YES YES YES! we already know doctors are way way too quick to throw someone on depression medication. Hello miss or mr doctor. I said I was having a bad day. That doesn't constitute clinical depression!!!! Think of all the $$$$ insurance companies can save by optimizing the thyroid, adrenal, pituitary, parathyroid etc. 1 medication is all that woman needs. I think the insurance companies sbe slapping themselves silly they've been throwing money at 4-7 medications a day for 8 years. All those years of wasted life, they could've gotten her thyroid hormones leveled and adrenal healthy then have the cost of 1 medication and have a person with a wonderful quality of life.
    Oh to accomplish this, throw out today's thyroid testing. It will not detect a problem until you're body is damaged and in bad shape!!! And patients have to go through more hardship to become normal again. I also want to say I truly understand there are personality disorders stealing people's lives and it makes me so sad bcuz those people deserve a good life. I'm just saying the medical community is broken when it comes to such important glands and all hormones and ut needs to change in order to catch and correct these horrid symptoms of "hey my body is slowly falling apart and dying". Yes hypothyroidism can cause coma and I'm sure a person is going to be mentally messed up before the body allows coma, you think?