“One of the fascinating new areas of research into mental health is the link between Autism Spectrum Disorder and Borderline.”
For those who have both, it is a new way of seeing their illness through a neurological perspective and allowing them to find tools to help manage the symptoms. Major areas of crossover include:
1. Sensitivity to other people’s emotions
Hypersensitivity to facial expressions and nonverbal communication of other people can trigger strong emotional and physical responses that feel overwhelming and can be difficult to control. Some people in the mental health community describe it as having “too much empathy.”
2. Difficulty expressing emotions
Not only being sensitive to others’ emotions but having trouble communicating one’s own emotional experience can build frustration and frantic efforts to communicate in ways that may be difficult to understand for friends, loved ones, and strangers.
3. Problems with interpersonal functioning
As a result of the difficulties with emotion and communication, people with Autism Spectrum Disorder and/or Borderline Personality Disorder can struggle to build and maintain relationships. Since communication is key in most social settings, this can leave many with these comorbid diagnoses feeling isolated and hopeless.
4. High on systemising
Both autistics and those with BPD are known to be high systemisers – that means a drive to analyse and build a system based upon patterns of information.
One largescale 2017 study found that people with autism and BPD had equally high systemising traits, but those with autism or those with comorbid autism and BPD were lower on empathy traits. It’s worth pointing out here that many in the autism community now believe autistic people are only lower on cognitive empathy traits, with some actually experiencing higher than normal emotional empathy.
Another study found that people with BPD were more neurotic, more emotionally dysregulated, had higher extraversion, were more open for new experiences, and were less conscientious than those with autism. Those with autism were found to be more inhibited, and more compulsive than those with BPD.
5. Comorbidities
“It’s common for people with BPD or autism to also have anxiety disorders, depression, OCD, ADHD, and eating disorders.”
It’s common for people with BPD or autism to also have anxiety disorders, depression, OCD, ADHD, and eating disorders.
This 2019 review found that the limbic system (the brain’s emotional processing centre) is structurally different in similar ways in patients with anorexia, autism, and BPD. The limbic system is also impaired in eating disorders, depression, ADHD, OCD, and anxiety disorders.
These overlaps in symptoms between the two conditions can lead to problems with differential diagnosis, especially in females who are diagnosed with BPD at a much higher rate than males, yet diagnosed with autism much less often than males because they are known to ‘fly under the radar’ with social imitation.
Additionally, people with comorbid autism and borderline have a much higher suicide rate than those with only one condition. It’s for this reason that correct diagnosis is essential.
There is still much more to learn about these two diagnoses. And as awareness grows, the understanding and acceptance of people who respond in unique ways will allow our society to become a more welcoming place.
