The Surprising Effects of TMS for BPD (Borderline Personality Disorder)

As transcranial magnetic stimulation (TMS) becomes an increasingly common treatment for Depression, healthcare professionals have found a positive link between TMS for borderline personality disorder (BPD) for effectively treating people with BPD symptoms.

Using TMS for BPD represents a promising treatment approach because many individuals with this condition also experience Depression that has not responded well to medication alone. For those wondering can TMS help with BPD, the answer lies in how TMS focuses on specific areas of the brain associated with mood regulation. By targeting these key areas, TMS may help reduce depressive symptoms in patients with BPD while complementing other aspects of their treatment plan.

Using TMS for BPD: What Is Borderline Personality Disorder?

The research linking TMS and borderline personality disorder is well documented—more so each year. But understanding this condition thoroughly before choosing a treatment modality is an integral part of approaching this multifaceted condition.

Borderline personality disorder (BPD) is a serious mental illness that affects the way an individual thinks or feels about themselves and others and negatively impacts daily life functions. Borderline personality disorder affects around 5.9% of adults (14 million Americans). Symptoms of BPD usually begin to occur by early adulthood and include:

• Unstable personal relationships
• Intense or uncontrollable feelings of anger
• Distorted self-image
• Periods of intense depressed mood, irritability, or anxiety
• Fear of real or imagined abandonment
• Ongoing feelings of emptiness
• Impulsive acts or reckless behavior
• Fear of and/or intolerance of being alone

People with borderline personality disorder experience extreme mood swings and difficulty managing their emotions and behaviors. Indicating the severity of the condition, individuals that suffer from BPD are at high risk of self-harming themselves or experiencing thoughts of suicide.  Over 75% of BPD sufferers engage in self-harming behavior such as cutting.  Almost 80% attempt suicide and 8-10 % die by suicide.

Who is Most at Risk for BPD?

While the causes of borderline personality disorder aren’t fully understood, research shows that environmental factors such as child abuse or neglect are linked to the condition. Additionally, genetics and brain abnormalities can also contribute to the development of BPD. BPD is commonly misdiagnosed or underdiagnosed because it often occurs alongside other mental health conditions such as Depression, anxiety, and substance abuse. Therefore, treatment options such as beginning a course of TMS and BPD therapy are often delayed or prevented.

Treatment for BPD varies depending on the patient and the severity of their condition.  Psychotherapeutic approaches, especially DBT (dialectical behavior therapy) and CBT (cognitive behavior therapy), are commonly used to help a patient establish and maintain healthier relationships, enhance coping strategies, process past traumas, and attain greater self-understanding. Medications such as antidepressants and mood stabilizers may also be helpful.

The Research on TMS for Borderline Personality Disorder

TMS (Transcranial Magnetic Stimulation) is an outpatient medical procedure that uses magnetic energy to stimulate nerve cells in the brain to alleviate depressive symptoms. For patients asking “can TMS help with BPD,” research has found that TMS can effectively treat the symptoms of borderline personality disorder. The connection between TMS and BPD is especially relevant since people with BPD also often suffer from Depression. TMS can substantially reduce their symptoms of Depression, including their ability to effectively cope with stressors and manage their negative emotions. 

Can TMS Help With BPD Symptoms?

Many patients and individuals who are looking to find new pathways to meaningful relief are often left wondering: can TMS help with BPD symptoms beyond Depression? The research on TMS and BPD looks promising. 

In addition to treating depressive symptoms, TMS has in fact also been shown to successfully treat other symptoms of BPD. The first TMS study in BPD was a case report published in 2013 in which a 22-year-old woman had a reduction in her depressive symptoms and impulsivity after a course of TMS. TMS BPD patients also experienced increased emotional control and stability, behavioral self-awareness, increased motivation for change, sociability, and attention to the behavior of others and planning ability according to this patient’s reports over a three-month period. 

A 2014 study demonstrated that just 10 TMS sessions improved anger, emotional instability and ability to plan in a small group of patients with BPD.  A meta-analysis published in 2017 concluded that TMS and BPD treatment is for reducing impulsivity and improving self-control in patients with BPD.  Probably the most comprehensive study on TMS for BPD was published in 2018; it demonstrated that TMS reduced symptoms in every domain of BPD, particularly in reducing impulsivity, anger, and mood swings.

TMS BPD Patients Show a Reduction in Depressive Symptoms

Recent research also indicates that TMS and BPD treatments may be more helpful than electroconvulsive therapy (ECT) in the treatment of the depressive symptoms of patients with comorbid BPD and Depression. A retrospective analysis published by the Journal of Affective Disorders in late 2020 found that TMS therapy led to a gradual and continuous drop in the self-reported depressive symptoms of patients with BPD.

Analyzing data from over 1,400 TMS BPD patients between the years 2011 and 2018, the analysis reported that TMS more effectively reduced the depressive symptoms of people with comorbid BPD than ECT did. On average, the Quick Inventory of Depressive Symptomatology Self Report (QIDS-SR) scores of patients with BPD who received TMS treatment dropped by an average of 10 points over time. Patients with BPD who received ECT dropped by 8 points in their first 5 sessions, on average, then plateaued in following sessions.

Stephen Seiner, M.D., one of the co-authors of the analysis, noted that the positive results of TMS in this analysis will help expand the treatment options available for people with Depression and BPD. Using this evidence to create a hopeful link between TMS and borderline personality disorder, clinicians are well on their way to helping patients recover from this challenging condition. 

How It Works: TMS and Borderline Personality Disorder

TMS for BPD works on a number of neurological levels. The brains of people with BPD include an underdeveloped amygdala and an underactive prefrontal cortex. The amygdala plays a key role in regulating emotions, especially negative emotions such as fear, anxiety, and aggression. The prefrontal cortex allows you to reason, plan for the future, and make appropriate decisions. Abnormalities in these areas of the brain contribute to borderline personality disorder and can be treated with TMS.

For TMS BPD patients, TMS is administered at the dorsolateral prefrontal cortex. Subsequently, the regions of the brain associated with causing BPD show increased activity and enhanced functioning and thereby allows patients to find relief from their BPD symptoms. Patients taking medications for borderline personality disorder should generally continue to take their medications while undergoing TMS.

Find Relief with TMS and Borderline Personality Disorder at Mid City TMS

Research continues to explore the full potential of TMS for BPD, and early findings are encouraging. While TMS is not a standalone cure for borderline personality disorder, it can be a valuable component of a comprehensive treatment approach. 

Patients who have struggled to find relief through medication or other therapies may benefit from the targeted brain stimulation that TMS provides. Combining TMS and borderline personality disorder can offer a promising new alternative. As with any treatment, results vary from person to person, and Mid City TMS works closely with each patient to determine whether TMS is an appropriate option for their specific needs.

When patients lack adequate results from traditional BPD treatments, TMS may be warranted. If you’re ready to experience the potentially remarkable effects of TMS on treating borderline personality disorder, contact us today to speak with a healthcare expert and find the relief you deserve.

Sources:

1. National Education Alliance for Borderline Personality Disorder. (n.d.). BPD overview. Borderline Personality Disorder Resource Center. https://www.borderlinepersonalitydisorder.org/what-is-bpd/bpd-overview/
2. WebMD. (n.d.). Dialectical behavior therapy (DBT). WebMD. https://www.webmd.com/mental-health/dialectical-behavioral-therapy#1
3. Mayo Clinic. (n.d.). Cognitive behavioral therapy (CBT). Mayo Clinic. https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610
4. Psych Congress. (n.d.). Repetitive TMS shows promise in treating depression, BPD. Psych Congress Network. https://www.psychcongress.com/article/repetitive-tms-shows-promise-treating-depression-bpd
5. Feffer, K., Berlim, M. T., & Fettes, P. (2014). Repetitive transcranial magnetic stimulation for borderline personality disorder: A review of the literature. Journal of Psychiatric Research, 52, 50-55. https://pubmed.ncbi.nlm.nih.gov/24309885/
6. Mehta, S., & Sahakian, B. J. (2014). Repetitive transcranial magnetic stimulation for impulsivity in borderline personality disorder. Neuroscience & Biobehavioral Reviews, 47, 537-545. https://pubmed.ncbi.nlm.nih.gov/24503285/