The Surprising Effects of TMS on Borderline Personality Disorder

The Surprising Effects of TMS on Borderline Personality Disorder

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

What Is Borderline Personality Disorder?

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.

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 is 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 and 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. TMS has been found to effectively treat the symptoms of borderline personality disorder. 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. 

In addition to treating depressive symptoms, TMS has 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 also led to 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 is an effective treatment 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.

Recent research also indicates that TMS therapies 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 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.


How Does It Work: TMS and Borderline Personality Disorder

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.

When TMS is administered at the dorsolateral prefrontal cortex, 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

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.

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