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  • What Is BPDWhat Is BPD
  • GeneticsGenetics
  • ResearchResearch
  • Risk FactorsRisk Factors
  • TreatmentTreatment
  • Passing BPD Down to ChildrenPassing BPD Down to Children
  • ConclusionConclusion
  • InfographicsInfographics
  • Additional ResourcesAdditional Resources
BPD Articles BPD Treatment for BPD Types of BPD Best Online Therapy

Is BPD Genetic? Causes & Risk Factors

Headshot of Lydia Antonatos, LMHC

Author: Lydia Antonatos, LMHC

Headshot of Lydia Antonatos, LMHC

Lydia Angelica Antonatos LMHC

Lydia has over 16 years of experience and specializes in mood disorders, anxiety, and more. She offers personalized, solution-focused therapy to empower clients on their journey to well-being.

See My Bio Editorial Policy
Headshot of Trishanna Sookdeo, MD, MPH, FAAFP

Medical Reviewer: Trishanna Sookdeo, MD, MPH, FAAFP Licensed medical reviewer

Published: May 9, 2023
  • What Is BPDWhat Is BPD
  • GeneticsGenetics
  • ResearchResearch
  • Risk FactorsRisk Factors
  • TreatmentTreatment
  • Passing BPD Down to ChildrenPassing BPD Down to Children
  • ConclusionConclusion
  • InfographicsInfographics
  • Additional ResourcesAdditional Resources
Headshot of Lydia Angelica Antonatos, LMHC
Written by:

Lydia Antonatos

LMHC
Headshot of Trishanna Sookdeo, MD, MPH, FAAFP
Reviewed by:

Trishanna Sookdeo

MD, MPH, FAAFP

Borderline personality disorder (BPD) is a psychiatric condition marked by persistent patterns of intense emotions and severe mood swings often resulting in impulsive behaviors and difficulty with interpersonal relationships. Precise causes for BPD are unclear; however, many experts agree that BPD emerges from a combination of genetics, biological factors, and early life adverse environmental influences.

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What Is Borderline Personality Disorder?

Borderline personality disorder (BPD) is a pervasive condition involving unhealthy thinking and behavioral patterns. BPD is primarily characterized by emotional instability, impulsivity, identity confusion, and unstable relationships. People living with BPD can struggle greatly with these signs and symptoms and experience significant distress affecting their quality of life and overall functioning.1

Other signs and symptoms of BPD include:1

  • Desperate attempts to avoid real or imagined abandonment
  • A pattern of chaotic interactions in relationships that alternate between extremes of idealization and devaluation
  • Persistent feelings of emptiness
  • Unclear and inconsistent self-image or sense of identity
  • Impulsivity in potentially self-destructive behaviors like drug abuse, binge eating, spending, reckless sex, dangerous driving, etc.
  • Severe mood swings and extreme reactions to situational stress
  • Recurrent self-harming behaviors and suicidal ideation, threats, or attempts
  • Frequent inappropriate and unpredictable anger outbursts
  • Transient, stress-related feelings of unreality, paranoia, or disconnection from the self

Is BPD Genetic?

While existing research suggests that borderline personality disorder does run in families, there is a scientific consensus that BPD is likely a byproduct of the interaction of underlying vulnerabilities that include genetics, brain anomalies, and environmental triggers.1,2,3

Family history is a compelling predictor for BPD. This personality disorder is about five times more common among first-generation biological relatives with BPD as compared to the general population. That means that people with a close family member like a sibling or parent with BPD have a higher probability of developing this mental illness. Additionally, BPD is generally more often diagnosed in females than males.

What Does it Mean For BPD to Hereditary?

The hereditary nature of borderline personality disorder refers to the transmission of certain qualities from one generation to the next. Parents pass on a combination of genes that influence how children look, behave, or whether they develop a type of illness. The closer you are in the family tree to the person with the condition, the more likely you are to get it.6

What Does Research Say About BPD & Genetics?

Although studies are scarce and outcomes vary, there is moderate evidence linking genetics with BPD. Most of these studies cannot conclusively determine if a genetic vulnerability is a cause, but a strong predictor of borderline personality disorder is due to genetics. The majority of scientific research is typically inclined toward the theory of “nature” vs. “nurture,” meaning BPD evolves from a combination of genetics and environmental influences.

Here are several examples of research on BPD and genetics:

  • Early 2000’s twin studies: Two twin studies had moderate evidence for the genetic transmission and heritability of BPD. The findings revealed a higher rate of BPD between identical twins in comparison to fraternal twins. However, a third twin study indicated that environmental factors outweigh genetics in the development of BPD.2
  • A 2014 scientific review: This review found genetic predisposition to be a strong underlying influence in the development of BPD. Nevertheless, it suggested that the onset of BPD was likely caused by a gene and environment interaction.4
  • A 2019 twin study: Perhaps a more compelling comprehensive study in 2019 examined identical twins and concluded that BPD would have likely developed even if the identical twins were raised in different environments.5
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Other Risk Factors for BPD

Note that while having one contributing element or a mixture of risk factors (genetics, environmental triggers, and brain anomalies) can increase the chances of developing BPD, it doesn’t necessarily mean you’re going to have it. Similarly, there are incidences where individuals who lack these predispositions still develop BPD in their lifespan.

Here are key components that factor into the development of BPD:

Problems With Brain Development

BPD can impact brain development, specifically the amygdala, hippocampus, and orbitofrontal cortex.

  • The amygdala is central to emotional regulation and those with BPD have a compromised or underactive amygdala: This could be related to poor neurotransmitter communication in the brain, specifically serotonin which can result in poor emotional regulation.
  • The hippocampus is central to behavioral regulation and impulse control: Those with BPD may have a smaller hippocampus and thus struggle more with these behaviors.
  • The orbitofrontal cortex is central to decision making: Those with BPD may have a smaller cortex, and hence why these individuals struggle with decision making skills.

Environmental Factors

Genetic factors and a family history of BPD are relevant predisposition factors for a BPD diagnosis, but it doesn’t mean that you will absolutely develop BPD if someone in your family did. It is important to be aware of the environmental factors that can be just as critical for some.

Environmental factors that may trigger the onset of BPD symptoms include:

  • Childhood abuse: Child abuse leaves the brain damaged in many ways as well as changes the natural trajectory of how the brain develops.
  • Childhood trauma: Childhood trauma and trauma in general changes the brain as well, and changes how one may react to stressful situations. 
  • Parental rejection: This can be considered a type of abuse and/or neglect and rejection from caregivers can lead to personality issues later in life.
  • Growing up in a toxic environment: An unstable and unsafe home environment leaves children more susceptible to mental health issues later in life.

Brain Chemical Imbalances

Alterations in certain neurotransmitters like serotonin have also been identified and linked with BPD. However, these findings are inconclusive in showing whether brain anomalies lead to BPD or if these occur because of the condition itself.

Borderline Personality Disorder Treatment

Seeking borderline personality disorder treatment is of utmost importance. It can help you develop the necessary skills for building a validating and stable family environment.7

Begin your recovery process by searching an online directory to find the right therapist who is experienced with personality disorders, uses evidenced-based techniques, and you can bond with. Evidence shows that psychotherapy is the most effective treatment path for those with BPD.

Treatment options for borderline personality disorder may include:

  • Dialectical behavioral therapy (DBT): This therapy approach helps people understand and regulate their emotions.
  • Cognitive behavioral therapy (CBT): This therapy approach helps people understand how their thoughts become behaviors and can help them change those thoughts for the better.
  • Schema-focused therapy: This therapy approach focuses on modifying automatic thoughts and behaviors through role-playing.
  • Mentalization-based therapy: This therapy approach unites thoughts and feelings and the impact on one’s actions.
  • Medications: Medication for BPD can make a big difference in the lows and highs that come with BPD splitting as well as managing and regulating emotions.
Borderline Personality Disorder Workbook

BPD Workbook

Our workbook includes our best BPD worksheets to help you better understand and manage challenges of Borderline Personality Disorder (BPD), including triggers, emotions, and self-care.

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Can BPD Be Passed Down to Children?

Although being raised by borderline parents may put children at a greater genetic risk for developing this condition, only a small percentage will. However, inserting your genetically predisposed child into a dysfunctional, traumatic environment will likely result in the development of BPD. Many studies conclude that early life chronic exposure to trauma and maltreatment are the most influential risk factors for BPD.1,2

Can Parents Prevent BPD?

As a parent with BPD, you may worry about how it could affect your parenting or passing on the disorder. Since the environment plays a significant role in your child’s development, you can put your worries to rest. There are many things you can do to create a nurturing, stable, safe, and validating atmosphere and reduce your child’s risk of developing BPD.

Take the following actions to create a healthy environment for your child:

  • Reach out to an individual therapist: Individual therapy for children can make a big difference for the child and help them learn about their emotions, feel validated, and work through any barriers they have in functioning appropriately.
  • Seek family therapy: Family therapy can help the whole family understand the diagnosis and learn how to work with it instead of against it.
  • Join a parenting-focused support group: Parents who are going through similar things can find comfort in each other from a support group and can learn tips and tricks from other parents or just have a listening ear.
  • Take a course on effective parenting skills: Learning how you can be a better parent is never a bad thing and will only help your child.
  • Create a safe environment: Making all types of safety a priority in the home is key to ensuring that your child is feeling at ease and comfortable.

Final Thoughts

Borderline personality disorder has often been misunderstood and stigmatized. Luckily, decades of diligent research have advanced our understanding about this multifaceted disorder. As the research on BPD continues, more specific causes will likely be uncovered. This can pave the way for a more comprehensive level of care.

Is BPD Genetic Infographics

What Is BPD? Is Borderline Personality Disorder Caused by Genetics? Will Children of Borderline Parent Inherit BPD?

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, ChoosingTherapy.com has partnered with leaders in mental health and wellness. ChoosingTherapy.com may be compensated for marketing by the companies mentioned below.

Talk Therapy 

BetterHelp – BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $65 per week and is FSA/HSA eligible by most providers. Take a free online assessment and get matched with the right therapist for you. Free Assessment

Brightside Health – develops personalized plans that are unique to you and offers 1 on 1 support from start to finish. Brightside Health accepts United Healthcare, Anthem, Cigna, and Aetna. Appointments in as little as 24 hours. Start Free Assessment

DBT Skills Course

Jones Mindful Living Dialectical Behavior Therapy (DBT) is a popular treatment for BPD. Learn DBT skills with live weekly classes and online video courses for only $19 per month. Free One Week Trial

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For Further Reading

  • Borderline Personality Disorder Resource Center
  • National Education Alliance for Borderline Personality Disorders
  • National Institute of Mental Health (NIMH)
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Sources Update History

ChoosingTherapy.com strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Chapman, J., Jamil, R. T., & Fleisher, C. (2021, August). Borderline Personality Disorder. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430883/

  • Kulacaoglu, F., & Kose, S. (2018). Borderline Personality Disorder (BPD): In the Midst of Vulnerability, Chaos, and Awe. Brain Sciences, 8(11), 201. https://doi.org/10.3390/brainsci8110201

  • NIMH» Borderline Personality Disorder. (2017). Nih.gov. https://www.nimh.nih.gov/health/topics/borderline-personality-disorder

  • Amad, A., Ramoz, N., Thomas, P., Jardri, R., & Gorwood, P. (2014). Genetics of borderline personality disorder: Systematic review and proposal of an integrative model. Neuroscience & Biobehavioral Reviews, 40, 6–19. https://doi.org/10.1016/j.neubiorev.2014.01.003

  • Skoglund, C., Tiger, A., Rück, C., Petrovic, P., Asherson, P., Hellner, C., Mataix-Cols, D., & Kuja-Halkola, R. (2019). Familial risk and heritability of diagnosed borderline personality disorder: a register study of the Swedish population. Molecular Psychiatry, 26(3), 999–1008. https://doi.org/10.1038/s41380-019-0442-0

  • NIMH» Looking at My Genes: What Can They Tell Me About My Mental Health? (2020). Nih.gov. https://www.nimh.nih.gov/health/publications/looking-at-my-genes

  • Choi-Kain, L. W., Finch, E. F., Masland, S. R., Jenkins, J. A., & Unruh, B. T. (2017). What Works in the Treatment of Borderline Personality Disorder. Current Behavioral Neuroscience Reports, 4(1), 21–30. https://doi.org/10.1007/s40473-017-0103-z

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We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

May 22, 2025
Author: No Change
Reviewer: No Change
Primary Changes: Added BPD Workbook with four worksheets.
May 9, 2023
Author: No Change
Reviewer: No Change
Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources. Added “Other Risk Factors for BPD”, revised “Borderline Personality Disorder Treatment” and “Can Parents Prevent BPD?”. New material written by Silvi Saxena, MBA, MSW, LSW, CCTP, OSW-C and reviewed by Kristen Fuller, MD.
December 20, 2022
Author: No Change
Reviewer: No Change
Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources. Added “What Is BPD?”. New material written by Lydia Antonatos, LMHC, and reviewed by Dena Westphalen, PharmD.
December 3, 2021
Author: Lydia Antonatos, LMHC
Reviewer: Trishanna Sookdeo, MD, MPH, FAAFP
Show more Click here to open the article update history container.

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