Does Childhood ADHD Increase the Severity of BPD Symptoms?
ADHD and BPD have a genetic component, although the hereditary aspect of ADHD is stronger. When parents have ADHD, home life is more likely to be inconsistent, unstructured, and emotionally volatile. Intense emotional responses may have been labeled as unacceptable over-reactions because the parents found them hard to tolerate. It seems that a history of childhood ADHD may increase the risk for developing BPD, and will increase the severity of BPD symptoms. In those with histories of early trauma, co-occurrence of the two disorders results in greater impulsivity and emotional dysregulation.
Does Trauma Contribute to BPD?
It is not surprising that childhood neglect and abuse increases the risk for developing a range of disorders as adults. In fact, studies have found that women with ADHD and BPD often have traumatic early histories. It is likely that early childhood trauma can exacerbate ADHD symptoms and contribute to the development of BPD. ADHD histories are more strongly associated with neglect and physical and emotional abuse, while BPD histories are more likely to involve emotional and sexual abuse. At least a quarter of those women with BPD will suffer from Post-Traumatic Stress Disorder (PTSD). There is also a high degree of overlap between ADHD and PTSD behaviors, including inattention, impulsivity, emotional dysregulation, and restlessness. Women with ADHD and BPD have been shown to have the highest levels of neglect in their histories.
The presentations of ADHD and PTSD can be remarkably similar. The state of hyper-arousal that typifies trauma survivors closely mimics the appearance of hyperactivity. Similarly, the dissociative state that can typify other trauma survivors closely mimics inattention.
Stress-related dissociation is often a response to trauma in Borderline women, but it is usually not seen in ADHD. Since many women with ADHD are predominantly inattentive, differentiating between inattentive symptoms of ADHD and dissociative symptoms of trauma is challenging. Some women diagnosed with ADHD may have BPD, and may be manifesting the symptoms of early chronic trauma.