Comorbid Depression and Borderline Neutralizes Effects of Cortisol Reactivity

Borderline personality (BPD) can have significant, life-altering symptoms. People who develop BPD often have a history of extreme and chronic abuse, trauma, or maltreatment, including physical abuse, sexual abuse, or emotional abuse. Borderline manifests differently for each individual, but many people with BPD experience violent mood swings, fear of abandonment, relationship and self-image problems, self-injury, and impulsivity. Additionally, it is common for people with BPD to also have other mental health problems, most often mood problems such as anxiety, depression (MDD), or posttraumatic stress (PTSD). Stress reactivity and its association and influence on psychological well being have been studied at length. However, until now, no study has looked at how stress reactivity affects people with BPD alone or as a comorbid illness.

Katja Wingenfeld of the Department of Psychiatry and Psychotherapy at Charité University Berlin in Germany led a study to find out if elevated levels of cortisol would affect the memory of people with BPD. She used a participant sample that included 71 females with BPD and 40 females with no history of mental issues. The participants were given hydrocortisone or a placebo prior to completing working memory, autobiographical memory tests (AMT), and memory retrieval tasks. The results revealed that elevated cortisol affected the women differently depending on whether or not they had a comorbid illness.

Specifically, the control participants performed worse on retrieval tasks compared with the BPD participants. In fact, cortisol increases improved the ability of the BPD participants to perform all the memory tasks. Those who also had PTSD performed the best at AMT. But the women with BPD and MDD experienced neither enhanced nor diminished performance. Elevated cortisol in these women resulted in no change in memory performance at all. Wingenfeld believes that these results reveal that two specific subgroups of BPD clients may exist, one group with a history of trauma-based symptoms who respond positively to stress, and another group with mood-related symptoms whose memory abilities are unaffected by elevated stress levels. Wingenfeld added, “Future studies should investigate whether there are subgroups of borderline patients with different endocrine and psychopathological patterns, in addition to potentially related therapeutic options.”

Wingenfeld, K., et al. Effects of cortisol on memory in women with borderline personality disorder: Role of co-morbid post-traumatic stress disorder and major depression. Psychological Medicine 43.3 (2013): 495-505. ProQuest Research Library. Web. 3 Feb. 2013.

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  • Sally


    February 13th, 2013 at 3:48 AM

    Funny how one little element in your body has so much influence over so many things! I mean, until recently I didn’t even know what cortisol was, and the I started hearing about how those levels could affect your weight, belly fat, and now could evencontr ibute to depression. That’s pretty amazing when you think about this one hormone having so much power over you. And who knows what else!

  • desmond


    February 13th, 2013 at 2:38 PM

    interesting to see even the cause of bpd plays a role in how they react to may even point to the fact that reasons for a disorder may determine how a specific drug helps .Or even if it does.and that is quite a finding.hope they check for reactivity to medication differing due to the cause.

  • sue


    February 14th, 2013 at 4:41 PM

    it makes me feel so bad that people with one illness often have another.they suffer doubly as a result.just wish they had it a little easier.also the coexistence of multiple illness could lead to ineffective treatment.its good to see they are conducting studies such as these to determine the variables and possible fall outs of the coexistence but I hope the results convert into some good news for those suffering.



    February 15th, 2013 at 11:36 PM

    The results are a bit surprising.because having BDP would be detrimental for memory tasks I wouldve thought.but the results are exactly the opposite.what exactly are the reasons for this result?

  • Lne


    February 17th, 2013 at 1:21 AM

    I don’t think it’s surprising; in fact I think it should be rather obvious. I mean, really: cortisol is produced by what? Stress. Cortisol causes us, in times of extreme stress/terror to what or to what? Fight or flight. Okay – so – how is it a surprise that, when exposed to a traumatic experience which would induce a healthy person to fight or flee thus causing elevated levels of cortisol to be released by the adrenal gland into the blood stream (and even a person already marked by trauma to experience an elevated level of cortisol based on fear of that vent repeating) this individual will require higher levels of cortisol for “normal” functioning? An additional point of note is that cortisol is a hormone which individuals only make so much of. In essence, like hair, it depletes. So after prolonged exposure to trauma or a repeated traumatic experience, an individuals cortisol level depletes (hello – self injury?) and if pharmaceutically increased it, they neutralize. Thus can live in the moment. This can respond in the moment. This can remember.

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