Hi, I'm Dr. Tracey Marks, a psychiatrist,
and I make mental health education videos.
Today I'm talking about a new study
using oxytocin to treat borderline personality disorder.
To date, we really don't have
a medication treatment for the disorder.
The main treatment is dialectical behavior therapy
and medication only to address other symptoms
like depression or anxiety.
I talk more about this in this video
that I did on borderpolar,
the combination of bipolar disorder
and borderline personality disorder.
But in a nutshell,
people with borderline personality disorder
struggle in relationships with mistrust.
They fear being abandoned by the other person,
and this can create a lot of anxiety and depressed mood,
impulsivity, and self-harming behaviors.
Some researchers believe that at the core of the disorder
is impaired empathy,
and that this is what causes the interpersonal problems.
So here's what the new research looks like.
Researchers out of Germany took a group of women
and looked at three aspects of empathy:
cognitive, emotional,
and what they call approach motivation.
They showed the women pictures of people
expressing different kinds of emotions.
Then they asked them to recognize the emotional state.
This would be the cognitive empathy.
Then they measured how much the women
could relate to the emotion that they saw,
and this is emotional empathy,
which is being able to put yourself
in someone else's situation.
And lastly they asked them
to rate how strongly they wanted to be
socially close to the person in the picture,
and this is the approach motivation.
The women with BPD scored low on all three measures
compared to the group of women without BPD,
however, the women with BPD were better able to recognize
negative emotions more than positive ones,
and this is probably because people with BPD
more commonly experience negative emotions.
It's a state they're more familiar with,
making it easier to relate to.
Then they gave a subset of both groups
a single dose of oxytocin through a nasal spray.
Oxytocin is a hormone produced primarily in your brain,
and it has a number of functions,
but the main ones are social bonding,
childbirth, and breast milk production.
Oxytocin plays a role in recognizing
and interpreting facial expressions
and feeling close to people.
Some people call it the love hormone.
Here's my oxytocin story.
It takes place at a time when I was breastfeeding.
I was out shopping at a retail store
and was checking out at the register,
and there were a few associates behind the counter.
One of them looked like he was developmentally
and socially impaired.
He didn't fit with the other people.
He was dressed in his shirt and tie,
but he was standing off to the side of everyone else
not making eye contact and looking down at the floor,
and I thought to myself, "That's great that he's got a job."
Because in my area there's a few large companies
that make a point of hiring people with impairments.
Then I thought, "I hope no one picks on him."
He was a big guy, tall, solid-looking,
but I pictured in my mind him being approached by bullies,
and I thought, "I wonder if he can fight,"
and the second I thought that I felt my milk come in,
and if you've never breastfed before,
there's a letdown reflex that you can feel
when your milk enters into the milk ducts.
It's like priming the pump.
And that reflex can be triggered by hearing your baby cry,
or by putting a baby's mouth to your breast,
but here my milk was being triggered
by my concern about whether or not
this mentally vulnerable man could defend himself.
Well, breasts filled with milk
and nowhere to go is a bad situation.
It can get very painful.
You need a baby, or a pump,
or something to get that milk out of there,
so I gathered up my bags and rushed out of the store,
and when I got to the parking lot where he was out of sight
I felt the sensation pass and the milk stopped,
but that was a close call
because I didn't have my pump with me.
But it fascinated me just how my thoughts
of wanting to protect him triggered oxytocin release,
and it was instant, within seconds of the thoughts,
and here my body was preparing me to nurse this man.
So that's a real, live example of how oxytocin works
in the context of emotional thoughts.
So here's how the study concluded.
The women with BPD who got one dose of oxytocin nasal spray
had rises in their empathy scores
that was equal to the women without BPD
who didn't get any treatment.
In other words, their reaction to the people's faces
changed such that they were better able to relate
to the negative and the positive emotions,
and they had the feeling of wanting to be close
to the people in the pictures,
kind of like my feeling of wanting
to protect the sales associate.
So this is definitely a positive finding.
It can set the stage for clinical trials
to use the drug as an add-on agent for therapy for BPD.
Learning how to manage your emotions,
tolerate distress, and improve your relationships
is still something that needs to be handled with therapy.
A drug can't teach you those things,
but this study adds weight to the idea
that biologically there's something missing
in people with BPD that makes it hard
for you to do these things on your own.
If you're lacking empathy,
it stands to reason that you're going to have problems
misinterpreting people's intentions
or meeting someone else's needs
because you have trouble relating to what the needs are.
So let's hope this goes somewhere.
This was studied in borderline personality disorder,
but problems with empathy is present in other disorders
like narcissistic personality disorder.
But with all of these interventions
we have to start somewhere,
so we pick a narrow area of focus and then expand later.
For more on borderline personality disorder,
watch these videos.
See you next time.