The Midlife BPD Crisis Nobody Talks About | BPD, Perimenopause and Menopause

Have you spent years stabilizing your BPD, only to feel like you're unraveling again in your 40s or 50s? What if it's not your therapy failing, it's your hormones? In a medical blind spot affecting so many, perimenopause and menopause can dramatically amplify BPD symptoms, yet almost no one is talking about it.

In this episode, we look into one of the most critical and overlooked intersections in women's mental health: Borderline Personality Disorder through perimenopause and menopause. This isn't about hot flashes, this is about your brain chemistry undergoing its most significant shift since adolescence, colliding with the emotional dysregulation at the heart of BPD.

🌱 Have questions, stories, or something you’d like us to cover? We’d love to hear from you. Email us at ⁠⁠⁠⁠⁠bpddiariespodcast@gmail.com ⁠⁠⁠⁠⁠ and let’s keep the conversation going.

🎧 Looking for meditations made for emotional regulation, BPD, and more? Check out Empowered Heroes Meditations on ⁠⁠⁠⁠Spotify.

If you’d like more support in your journey toward BPD recovery, Steff offers 1:1 sessions using evidence-based tools from DBT and Mindfulness to help you heal. Email for a free 30-Minute Consultation:

📩 steff@bpdsupport.org or check out the website: www.bpdsupport.org

📚 Referenced Research Includes:

Barth, C., Villringer, A., & Sacher, J. (2015). Sex hormones affect neurotransmitters and shape the adult female brain during hormonal transition periods. Frontiers in neuroscience, 9, 37. https://doi.org/10.3389/fnins.2015.00037

Behrman, S., & Crockett, C. (2024). Severe mental illness and the perimenopause. BJPsych Bulletin, 48(6), 364–370. doi:10.1192/bjb.2023.89

Cohen, L. S., Soares, C. N., Vitonis, A. F., Otto, M. W., & Harlow, B. L. (2006). Risk for new onset of depression during the menopausal transition: the Harvard study of moods and cycles. Archives of general psychiatry, 63(4), 385-390. doi:10.1001/archpsyc.63.4.385

Crowell, S. E., Beauchaine, T. P., & Linehan, M. M. (2009). A biosocial developmental model of borderline personality: Elaborating and extending Linehan’s theory. Psychological bulletin, 135(3), 495. https://doi.org/10.1037/a0015616

Gordon, J. L., Rubinow, D. R., Eisenlohr-Moul, T. A., Xia, K., Schmidt, P. J., & Girdler, S. S. (2018). Efficacy of transdermal estradiol and micronized progesterone in the prevention of depressive symptoms in the menopause transition: a randomized clinical trial. JAMA psychiatry, 75(2), 149-157.

Gunter, J. (2021). The menopause manifesto: own your health with facts and feminism.

Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford press.

Maki, P. M., Kornstein, S. G., Joffe, H., Bromberger, J. T., Freeman, E. W., Athappilly, G., ... & Soares, C. N. (2018). Guidelines for the evaluation and treatment of perimenopausal depression: summary and recommendations. Menopause, 25(10), 1069-1085.DOI: 10.1097/GME.0000000000001174

Toffoletto, S., Lanzenberger, R., Gingnell, M., Sundström-Poromaa, I., & Comasco, E. (2014). Emotional and cognitive functional imaging of estrogen and progesterone effects in the female human brain: a systematic review. Psychoneuroendocrinology, 50, 28-52. https://doi.org/10.1016/j.psyneuen.2014.07.025

Resources:

The North American Menopause Society (NAMS): www.menopause.org
The International Menopause Society: www.imsociety.org
Menopause Mastery: https://mlrb.net/menopause-bpd/