IS THERE A RELATIONSHIP BETWEEN ASPERGERS AND THE BPD? Ask The Doctor Dr. Leland Heller Biological Unhappiness IS THERE A RELATIONSHIP BETWEEN ASPERGERS AND THE BPD? Question: Dear Dr. Heller, I am in the process of becoming a LMHC. I have had several clients and associations that have Borderline that seem to also display autistic/Aspergers as children and young adults which has led me to wonder, could there be a connection? I know and believe that Borderline is a biological condition and given that autism is also biological and those children are sensitive to sensory overload, and react to stimulus in many of the same ways that Borderlines do. What are the chances that an autistic/Aspergers child who does not get their needs met spirals into full blown borderline? I would love to have a conversation with you on this to find out what you know about this. My main consideration on this is my own child who is now 25 and we have gone through so much together. She had all the features of Aspergers and was diagnosed as AD/HD and dysthymia when she was 12 and bipolar when she was 15 and hospitalized for self-mutilation at that time. She was expelled from school in 10th grade because she had a knife and a minute amount of cannabis on her, but the real reason is because she has always refused to conform, dressing gothic and not paying attention to the rules. The other kids thought she looked mad all the time, when in reality, she was just shy and had a low affect. Substance abuse has been an issue since she was 15 and by the time she was 18 we put her in a reputable treatment center which she didn’t participate very well with. Everywhere she goes, people always act like they have never encountered anyone quite like my daughter. In the meantime, she is witty, smart, and intelligent and has a lot of insight into everybody elses issues but no clue for herself. Psyche evaluations indicate that she has significant issue with her executive functions and decision-making capacities. She had a bad car accident when she was 19 that complicated the problem with brain injuries in addition to crushed bones and a very long and painful recovery. On at least 2 occasions she has been admitted in the psychiatric ward for dysphoric episodes, self-mutilation and suicide ideation. It was there that she received the borderline diagnosis. She has also been through an enormous amount of psychotropic meds over the years. Currently, at 25, she has an 8 month-old baby boy who seems to have changed her life immensely. Although, just until her baby was born, she was still going through intense dysphoric episodes causing her to break windows, etc. She is now somehow better able to control herself than she has ever been in her entire life. Even though she still complains of feelings of emptiness and hopelessness, she does care about this baby above anything and wants to give him a life better than her own. In the meantime, I have a 15-year-old son that displays many of the same symptoms for Aspergers that my daughter did and many of my aspergers clients. He too seems to go into dysphoric episodes, as both have since they were very young. We never supported this and made them leave the room or left ourselves until they were able to get hold of themselves. My son has always been very apologetic for these episodes once they pass, but there seems to be little to keep them at bay once he falls into one. I know this is a lot of information, and I am not sure what, if anything, you could do to help me with that. I just want to know if you have seen similar issues with Aspergers and Borderline, or am I mistaken and all of these individuals were borderline from the start, or is it the other way around and they are all suffering from untreated autism.Please let me know your thoughts and any referrals you can give me for help. Thank you so much for your time Dr. Heller’s Answer: It sounds like youve had a very rough time.Substance abuse is frequently a mental illness symptom (self-medicating) or a primary problem. Theres no reason ADHD cant co-exist with multiple other diagnoses. Im a long way from being an expert on Aspergers or autism, but I do believe they are very different disorders from the BPD. Some interesting studies from 5-10 years ago implied that “oxytocin” may be low or deficient in these individuals and high oxytocin is found in very outgoing individuals. We need a revolutionary medication for this neurotransmitter like Prozac (fluoxetine) was for genetic depression and the BPD. The BPD appears to be a malfunction of the glial cells that support the nerve cells in the brains “trapped, cornered, wounded” instinctual areas of the limbic system. Prozac is far superior to other SSRIs primarily because of its effect on glial cells. Serotonin deficiency may be part of the problem, but low levels of serotonin metabolites in the spinal fluid are only seen in completed suicides (with or without the BPD) and impulsive murderers, not just the BPD. The BPD starts at puberty, when the limbic system goes into hyperdrive. There are many possible causes of the BPD including head trauma, genetic predisposition combined with emotional trauma, abuse, untreated or undertreated ADHD or childhood onset bipolar, and sometimes genetics alone is to blame. Any psychological or physical trauma can cause the release of pain oriented neurotransmitters (such as substance P) which likely damage the glial cells and possibly neurons and/or their connections. From this perspective its easy to see how both autism and Aspergers can result in the BPD at puberty since they are both painful conditions. Once someone with Aspergers and/or autism reaches puberty however, if BPD symptoms become present the BPD is now likely to be an additional diagnosis, especially when self-mutilation is present. Prior to puberty, childhood onset bipolar would be a more likely explanation for raging and out of control. http://pks.947.myftpupload.com/BiPlrKid.htm 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Ask the Doctor Home MENU: Screening Test “Ask the Doctor” (BPD)Borderline Personality Disorder Annual Updates Biological Unhappiness Disorders & Official Criteria Dr. Heller’s C.V. & Picture How Dr. Heller Got Involved If You Want to See Dr. Heller as a Patient Testimonials Table of Contents for the Book ‘Biological Unhappiness’ How to Order “Life at the Border” Why Read ‘Biological Unhappiness’? Goals AD(H)D and Relationships BPD, Bipolar or ADHD? Suicide What if BuSpar makes me anxious or ill? A Suicide Attempt Per Minute in the US Grandparents raising Grandchildren Information About Children What Signs are there that Someone May ‘SNAP’? TV & Cartoon Characters with Depression & Other Disorders Dr. Heller’s Office Website Dr. Heller’s Lectures Mentally Healthy People Retraining the Brain Today is a Gift Reviews Links Webrings Site Index Home Video DVDs now available! You can watch and listen to Dr. Heller in the comfort and convenience of your own home. Provides full explanations and treatment descriptions of Borderline Personality Disorder (BPD) – 90 minutes, other Biological Unhappiness disorders – 90 minutes. Click here to find out more about Dr. Heller’s educational videos. “Biological Unhappiness” “Open this book and it will open your mind. By combining proven medical procedure with hope and inspiration, Dr. Heller has made a significant difference in thousands of patients who had little hope for recovery. “Biological Unhappiness” contains critical information for those who have lost hope.”Zig Ziglar, motivational speaker, author, See You at the Top, Over the Top, Success for Dummies, Raising Positive kids in a Negative World. Dr. Leland Heller Dyslimbia Press, Inc. 1713 US Hwy 441 N, Suite E Okeechobee, FL 34972 863-467-8771 Email: Hours: M-Thu. 8:30AM-5PMFri. 8:30AM-12 Noon*(*During November through April, the office is open until 3PM on Fridays.) All material not explicitly credited otherwise is copyrighted © 1999-2011 Dr. Leland Heller. All Rights Reserved. May not be duplicated without the permission of Dr. Leland Heller or Dyslimbia Press. Biological Unhappiness, BiologicalUnhappiness.com, & Dyslimbia Press are trademarks of Dr. Leland HellerDesigned and/or hosted by the webmasters at: US-Webmasters.com (TM) Start here to find it FAST!(TM)