Q. I was interested to read the doctor's letter to someone writing a book. The question was "what causes BPD". The answer: that it is genetic. I first had what was called a "nervous breakdown" when I was sixteen. Our family MD recommended I see a psychiatrist, but my father refused stating that we worked out our own problems. I guess we had plenty, but I remember little. I lived with all the symptoms listed in descriptions of BPD, mostly haunting medical MD's for answers. In an unhappy marriage, after the death of a brother, I decided to kill myself. I don't like that expression, prefer make myself gone; to escape it all. My illness changed over the years (I was fifty-six when I finally was hospitalized and got some help) until I was cutting myself in states of not knowing completely where or who I was. My question is, how can something like this be genetic? I realize the chemical component in the brain, but aren't neural pathways changed by learned coping mechanisms? I'm frightened that my daughters will develop a mental illness after reading that letter. I do have a mental illness and am not ashamed of it. But I don't want my children to go through what I have. It's hard enough on them to have to watch me. I experienced great relief when after all those years of inner struggle I learned that there was a reason and it could be treated. I've been in therapy and in the care of a good psychiatrist for ten years. I am on Effexor and Seroquel since my last hospitalization, and am doing better that I have for a long time.

A. . The genetics are assumed on my part for a number of reasons. Adopted apart at birth identical twins behave not only like each other, but have the traits of their biological parents, not the adopted ones in a larger amount than one could account for otherwise. Second, it dose not make sense that someone like yourself would keep doing something over and over that is painful. It is out of context with everything else you do, which is to feel good. In other aspects of your life you are burned (figuratively and literally) and you change to avoid pain. Not with BPD. Finally, there are a number of biological studies indicating neurochemical disturbances.

The fact that you are better makes it unlikely your kids will have to go through what you did. You are a living example of treatment working, and it will work for your kids, if they need it. Your having the illnesses does not guarantee the children will have it. Even if they do, they may get it a lot less. It is not an all or none response.

I am glad to hear you are doing well. Proof positive that everything this website stands for is true. Corrective therapy works.