Cognitive Enhancement Without Drugs

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Cognitive Enhancement Without Drugs

Elizabeth Ricker stands before the tranquil ocean, contemplating the vast expanse before her.

This is Elizabeth Ricker. She’s a Harvard-and-MIT-trained neuroscientist and researcher, who now runs the “Citizen Science” DIY-neurohacking organization, NeuroEducate.

Sounds fun! What’s it about?

The philosophy that spurs on her research and practice can be summed up as follows:

❝I’m not going to leave my brain up to my doctor or [anyone else]… My brain is my own responsibility, and I’m going to do the best that I can to optimize it❞

Her goal is not just to optimize her own brain though; she wants to make the science accessible to everyone.

What’s this about Citizen Science?

Citizen Science” is the idea that while there’s definitely an important role in society for career academics, science itself should be accessible to all. And, not just the conclusions, but the process too.

This can take the form of huge experiments, often facilitated these days by apps where we opt-in to allow our health metrics (for example) to be collated with many thousands of others, for science. It can also involve such things as we talked about recently, getting our own raw genetic data and “running the numbers” at home to get far more comprehensive and direct information than the genetic testing company would ever provide us.

For Ricker, her focus is on the neuroscience side of biohacking, thus, neurohacking.

I’m ready to hack my brain! Do I need a drill?

Happily not! Although… Bone drills for the skull are very convenient instruments that make it quite hard to go wrong even with minimal training. The drill bit has a little step/ledge partway down, which means you can only drill through the thickness of the skull itself, before the bone meeting the wider part of the bit stops you from accidentally drilling into the brain. Still, please don’t do this at home.

What you can do at home is a different kind of self-experimentation…

If you want to consider which things are genuinely resulting in cognitive enhancement and which things are not, you need to approach the matter like a scientist. That means going about it in an organized fashion, and recording results.

There are several ways cognitive enhancement can be measured, including:

  • Learning and memory
  • Executive function
  • Emotional regulation
  • Creative intelligence

Let’s look at each of them, and what can be done. We don’t have a lot of room here; we’re a newsletter not a book, but we’ll cover one of Ricker’s approaches for each:

Learning and memory

This one’s easy. We’re going to leverage neuroplasticity (neurons that fire together, wire together!) by simple practice, and introduce an extra element to go alongside your recall. Perhaps a scent, or a certain item of clothing. Tell yourself that clinical studies have shown that this will boost your recall. It’s true, but that’s not what’s important; what’s important is that you believe it, and bring the placebo effect to bear on your endeavors.

You can test your memory with word lists, generated randomly by AI, such as this one:

Random Word List Generator

You’ll soon find your memory improving—but don’t take our word for it!

Executive function

Executive function is the aspect of your brain that tells the other parts how to work, when to work, and when to stop working. If you’ve ever spent 30 minutes thinking “I need to get up” but you were stuck in scrolling social media, that was executive dysfunction.

This can be trained using the Stroop Color and Word Test, which shows you words, specifically the names of colors, which will themselves be colored, but not necessarily in the color the word pertains to. So for example, you might be shown the word “red”, colored green. Your task is to declare either the color of the word only, ignoring the word itself, or the meaning of the word only, ignoring its appearance. It can be quite challenging, but you’ll get better quite quickly:

The Stroop Test: Online Version

Emotional Regulation

This is the ability to not blow up angrily at the person with whom you need to be diplomatic, or to refrain from laughing when you thought of something funny in a sombre situation.

It’s an important part of cognitive function, and success or failure can have quite far-reaching consequences in life. And, it can be trained too.

There’s no online widget for this one, but: when and if you’re in a position to safely* do so, think about something that normally triggers a strong unwanted emotional reaction. It doesn’t have to be something life-shattering, but just something that you feel in some way bad about. Hold this in your mind, sit with it, and practice mindfulness. The idea is to be able to hold the unpleasant idea in your mind, without becoming reactive to it, or escaping to more pleasant distractions. Build this up.

*if you perchance have PTSD, C-PTSD, or an emotional regulation disorder, you might want to talk this one through with a qualified professional first.

Creative Intelligence

Another important cognitive skill, and again, one that can be cultivated and grown.

The trick here is volume. A good, repeatable test is to think of a common object (e.g. a rock, a towel, a banana) and, within a time constraint (such as 15 minutes) list how many uses you can think of for that item.

Writer’s storytime: once upon a time, I was sorting through an inventory of medical equipment with a colleague, and suggested throwing out our old arterial clamps, as we had newer, better ones—in abundance. My colleague didn’t want to part with them, so I challenged him “Give me one use for these, something we could in some possible world use them for that the new clamps don’t do better, and we’ll keep them”. He said “Thumbscrews”, and I threw my hands up in defeat, saying “Fine!”, as he had technically fulfilled my condition.

What’s the hack to improve this one? Just more volume. Creativity, as it turns out, isn’t something we can expend—like a muscle, it grows the more we use it. And because the above test is repeatable (with different objects), you can track your progress.

And if you feel like using your grown creative muscle to write/paint/compose/etc your magnum opus, great! Or if you just want to apply it to the problem-solving of everyday life, also great!

In summary…

Our brain is a wonderful organ with many functions. Society expects us to lose these as we get older, but the simple, scientific truth is that we can not only maintain our cognitive function, but also enhance and grow it as we go.

Want to know more from today’s featured expert?

You might enjoy her book, “Smarter Tomorrow”, which we reviewed back in March

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  • How To Reduce The Harm Of Festive Drinking (Without Abstaining)

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    How To Reduce The Harm Of Festive Drinking

    Not drinking alcohol is—of course—the best way to avoid the harmful effects of alcohol. However, not everyone wants to abstain, especially at this time of year, so today we’re going to be focusing on harm reduction without abstinence.

    If you do want to quit (or even reduce) drinking, you might like our previous article about that:

    How To Reduce Or Quit Alcohol

    For everyone else, let’s press on with harm reduction:

    Before You Drink

    A common (reasonable, but often unhelpful) advice is “set yourself a limit”. The problem with this is that when we’re sober, “I will drink no more than n drinks” is easy. After the first drink, we start to feel differently about it.

    So: delay your first drink of the day for as long as possible

    That’s it, that’s the tip. The later you start drinking, not only will you likely drink less, but also, your liver will have had longer to finish processing whatever you drank last night, so it’s coming at the new drink(s) fresh.

    On that note…

    Watch your meds! Often, especially if we are taking medications that also tax our liver (acetaminophen / paracetamol / Tylenol is a fine example of this), we are at risk of having a bit of a build-up, like an office printer that still chewing on the last job while you’re trying to print the next.

    Additionally: do indeed eat before you drink.

    While You Drink

    Do your best to drink slowly. While this can hit the same kind of problem as the “set yourself a limit” idea, in that once you start drinking you forget to drink slowly, it’s something to try for.

    If your main reason for drinking is the social aspect, then merely having a drink in your hand is generally sufficient. You don’t need to be keeping pace with anyone.

    It is further good to alternate your drinks with water. As in, between each alcoholic drink, have a glass of water. This helps in several ways:

    • Hydrates you, which is good for your body’s recovery abilities
    • Halves the amount of time you spend drinking
    • Makes you less thirsty; it’s easy to think “I’m thirsty” and reach for an alcoholic drink that won’t actually help. So, it may slow down your drinking for that reason, too.

    At the dinner table especially, it’s very reasonable to have two glasses, one filled with water. Nobody will be paying attention to which glass you drink from more often.

    After You Drink

    Even if you are not drunk, assume that you are.

    Anything you wouldn’t let a drunk person in your care do, don’t do. Now is not the time to drive, have a shower, or do anything you wouldn’t let a child do in the kitchen.

    Hospital Emergency Rooms, every year around this time, get filled up with people who thought they were fine and then had some accident.

    The biggest risks from alcohol are:

    1. Accidents
    2. Heart attacks
    3. Things actually popularly associated with alcohol, e.g. alcohol poisoning etc

    So, avoiding accidents is as important as, if not more important than, avoiding damage to your liver.

    Drink some water, and eat something.

    Fruit is great, as it restocks you on vitamins, minerals, and water, while being very easy to digest.

    Go to bed.

    There is a limit to how much trouble you can get into there. Sleep it off.

    In the morning, do not do “hair of the dog”; drinking alcohol will temporarily alleviate a hangover, but only because it kicks your liver back into an earlier stage of processing the alcohol—it just prolongs the inevitable.

    Have a good breakfast, instead. Remember, fruit is your friend (as explained above).

    Want to know more?

    Here’s a great service with a lot of further links to a lot more resources:

    With You | How to safely detox from alcohol at home

    Take care!

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  • Eating on the Wild Side: – by Jo Robinson

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The author is an investigative journalist, and it shows here, as she leaves no stone unturned in her quest for the truth in the face of many food myths.

    She covers a lot of “popular wisdom” things that are varyingly true or false, or sometimes even both—in the case of food lore that’s a good rule of thumb, but has notable exceptions (e.g. “more colorful and/or darker-colored fruits/vegetables contain more nutrients”, which is a very good rule of thumb until one meets a cauliflower, for example).

    She also covers food preparation myths, and how, to give one example, in spite of the popularity of “less cooked is better”, in some cases certain cooking methods will indeed destroy nutrients; in others, certain cooking methods will improve nutritional availability. Either by destroying an adjacent antinutrient (e.g. phytates), or by breaking something down into a more manageable form that our body can absorb. Knowing which is which, is important.

    The book is organized by kinds of food, and does exclusively cover plants, but there’s more than enough material for any omnivore to enjoy.

    The style is… Journalistic, it would be fair to say. Which is not surprising, given the author. But it means that it is written in a fairly narrative way, to draw the reader in and make it an enjoyable read while still being informative in all parts (there is no padding). In terms of science, the in-the-prose science is as minimal as possible to still convey what needs to be conveyed, while 25 pages of bibliography stack up at the end to show that indeed, this journalist cites sources.

    Bottom line: this is a really enjoyable book, packed with a wealth of knowledge, and is perfect to uplift your cooking by knowing your ingredients a little more intimately!

    Click here to check out Eating On The Wild Side, and, enjoy!

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  • Vitamin C (Drinkable) vs Vitamin C (Chewable) – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing vitamin C (drinkable) to vitamin C (chewable), we picked the drinkable.

    Why?

    First let’s look at what’s more or less the same in each:

    • The usable vitamin C content is comparable
    • The bioavailability is comparable
    • The additives to hold it together are comparable

    So what’s the difference?

    With the drinkable, you also drink a glass of water

    If you’d like to read more about how to get the most out of the vitamins you take, you can do so here:

    Are You Wasting Your Vitamins? Maybe, But You Don’t Have To

    If you’d like to get some of the drinkable vitamin C, here’s an example product on Amazon

    Enjoy!

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  • What’s Keeping the US From Allowing Better Sunscreens?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    When dermatologist Adewole “Ade” Adamson sees people spritzing sunscreen as if it’s cologne at the pool where he lives in Austin, Texas, he wants to intervene. “My wife says I shouldn’t,” he said, “even though most people rarely use enough sunscreen.”

    At issue is not just whether people are using enough sunscreen, but what ingredients are in it.

    The Food and Drug Administration’s ability to approve the chemical filters in sunscreens that are sold in countries such as Japan, South Korea, and France is hamstrung by a 1938 U.S. law that has required sunscreens to be tested on animals and classified as drugs, rather than as cosmetics as they are in much of the world. So Americans are not likely to get those better sunscreens — which block the ultraviolet rays that can cause skin cancer and lead to wrinkles — in time for this summer, or even the next.

    Sunscreen makers say that requirement is unfair because companies including BASF Corp. and L’Oréal, which make the newer sunscreen chemicals, submitted safety data on sunscreen chemicals to the European Union authorities some 20 years ago.

    Steven Goldberg, a retired vice president of BASF, said companies are wary of the FDA process because of the cost and their fear that additional animal testing could ignite a consumer backlash in the European Union, which bans animal testing of cosmetics, including sunscreen. The companies are asking Congress to change the testing requirements before they take steps to enter the U.S. marketplace.

    In a rare example of bipartisanship last summer, Sen. Mike Lee (R-Utah) thanked Rep. Alexandria Ocasio-Cortez (D-N.Y.) for urging the FDA to speed up approvals of new, more effective sunscreen ingredients. Now a bipartisan bill is pending in the House that would require the FDA to allow non-animal testing.

    “It goes back to sunscreens being classified as over-the-counter drugs,” said Carl D’Ruiz, a senior manager at DSM-Firmenich, a Switzerland-based maker of sunscreen chemicals. “It’s really about giving the U.S. consumer something that the rest of the world has. People aren’t dying from using sunscreen. They’re dying from melanoma.”

    Every hour, at least two people die of skin cancer in the United States. Skin cancer is the most common cancer in America, and 6.1 million adults are treated each year for basal cell and squamous cell carcinomas, according to the Centers for Disease Control and Prevention. The nation’s second-most-common cancer, breast cancer, is diagnosed about 300,000 times annually, though it is far more deadly.

    Dermatologists Offer Tips on Keeping Skin Safe and Healthy

    – Stay in the shade during peak sunlight hours, 10 a.m. to 4 p.m. daylight time.– Wear hats and sunglasses.– Use UV-blocking sun umbrellas and clothing.– Reapply sunscreen every two hours.You can order overseas versions of sunscreens from online pharmacies such as Cocooncenter in France. Keep in mind that the same brands may have different ingredients if sold in U.S. stores. But importing your sunscreen may not be affordable or practical. “The best sunscreen is the one that you will use over and over again,” said Jane Yoo, a New York City dermatologist.

    Though skin cancer treatment success rates are excellent, 1 in 5 Americans will develop skin cancer by age 70. The disease costs the health care system $8.9 billion a year, according to CDC researchers. One study found that the annual cost of treating skin cancer in the United States more than doubled from 2002 to 2011, while the average annual cost for all other cancers increased by just 25%. And unlike many other cancers, most forms of skin cancer can largely be prevented — by using sunscreens and taking other precautions.

    But a heavy dose of misinformation has permeated the sunscreen debate, and some people question the safety of sunscreens sold in the United States, which they deride as “chemical” sunscreens. These sunscreen opponents prefer “physical” or “mineral” sunscreens, such as zinc oxide, even though all sunscreen ingredients are chemicals.

    “It’s an artificial categorization,” said E. Dennis Bashaw, a retired FDA official who ran the agency’s clinical pharmacology division that studies sunscreens.

    Still, such concerns were partly fed by the FDA itself after it published a study that said some sunscreen ingredients had been found in trace amounts in human bloodstreams. When the FDA said in 2019, and then again two years later, that older sunscreen ingredients needed to be studied more to see if they were safe, sunscreen opponents saw an opening, said Nadim Shaath, president of Alpha Research & Development, which imports chemicals used in cosmetics.

    “That’s why we have extreme groups and people who aren’t well informed thinking that something penetrating the skin is the end of the world,” Shaath said. “Anything you put on your skin or eat is absorbed.”

    Adamson, the Austin dermatologist, said some sunscreen ingredients have been used for 30 years without any population-level evidence that they have harmed anyone. “The issue for me isn’t the safety of the sunscreens we have,” he said. “It’s that some of the chemical sunscreens aren’t as broad spectrum as they could be, meaning they do not block UVA as well. This could be alleviated by the FDA allowing new ingredients.”

    Ultraviolet radiation falls between X-rays and visible light on the electromagnetic spectrum. Most of the UV rays that people come in contact with are UVA rays that can penetrate the middle layer of the skin and that cause up to 90% of skin aging, along with a smaller amount of UVB rays that are responsible for sunburns.

    The sun protection factor, or SPF, rating on American sunscreen bottles denotes only a sunscreen’s ability to block UVB rays. Although American sunscreens labeled “broad spectrum” should, in theory, block UVA light, some studies have shown they fail to meet the European Union’s higher UVA-blocking standards.

    “It looks like a number of these newer chemicals have a better safety profile in addition to better UVA protection,” said David Andrews, deputy director of Environmental Working Group, a nonprofit that researches the ingredients in consumer products. “We have asked the FDA to consider allowing market access.”

    The FDA defends its review process and its call for tests of the sunscreens sold in American stores as a way to ensure the safety of products that many people use daily, rather than just a few times a year at the beach.

    “Many Americans today rely on sunscreens as a key part of their skin cancer prevention strategy, which makes satisfactory evidence of both safety and effectiveness of these products critical for public health,” Cherie Duvall-Jones, an FDA spokesperson, wrote in an email.

    D’Ruiz’s company, DSM-Firmenich, is the only one currently seeking to have a new over-the-counter sunscreen ingredient approved in the United States. The company has spent the past 20 years trying to gain approval for bemotrizinol, a process D’Ruiz said has cost $18 million and has advanced fitfully, despite attempts by Congress in 2014 and 2020 to speed along applications for new UV filters.

    Bemotrizinol is the bedrock ingredient in nearly all European and Asian sunscreens, including those by the South Korean brand Beauty of Joseon and Bioré, a Japanese brand.

    D’Ruiz said bemotrizinol could secure FDA approval by the end of 2025. If it does, he said, bemotrizinol would be the most vetted and safest sunscreen ingredient on the market, outperforming even the safety profiles of zinc oxide and titanium dioxide.

    As Congress and the FDA debate, many Americans have taken to importing their own sunscreens from Asia or Europe, despite the risk of fake products.

    “The sunscreen issue has gotten people to see that you can be unsafe if you’re too slow,” said Alex Tabarrok, a professor of economics at George Mason University. “The FDA is just incredibly slow. They’ve been looking at this now literally for 40 years. Congress has ordered them to do it, and they still haven’t done it.”

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

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  • Beating Sleep Apnea

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    Healthier, Natural Sleep Without Obstruction!

    Obstructive Sleep Apnea, the sleep disorder in which one periodically stops breathing (and thus wakes up) repeatedly through the night, affects about 25% of men and 10% of women:

    Prevalence of Obstructive Sleep Apnea Syndrome: A Single-Center Retrospective Study

    Why the gender split?

    There are clues that suggest it is at least partially hormonal: once women have passed menopause, the gender split becomes equal.

    Are there other risk factors?

    There are few risk other factors; some we can’t control, and some we can:

    • Being older is riskier than being younger
    • Being overweight is riskier than not being overweight
    • Smoking is (what a shock) riskier than not smoking
    • Chronic respiratory diseases increase risk, for example:
      • Asthma
      • COPD
      • Long COVID*—probably. The science is young for this one so far, so we can’t say for sure until more research has been done.
    • Some hormonal conditions increase risk, for example:

    *However, patients already undergoing Continuous Positive Airway Pressure (CPAP) treatment for obstructive sleep apnea may have an advantage when fighting a COVID infection:

    Prolonged Effects of the COVID-19 Pandemic on Sleep Medicine Services—Longitudinal Data from the Swedish Sleep Apnea Registry

    What can we do about it?

    Avoiding the above risk factors, where possible, is great!

    If you are already suffering from obstructive sleep apnea, then you probably already know about the possibility of a CPAP device; it’s a mask that one wears to sleep, and it does what its name says (i.e. it applies continuous positive airway pressure), which keeps the airway open.

    We haven’t tested these, but other people have, so here are some that the Sleep Foundation found to be worthy of note:

    Sleep Foundation | Best CPAP Machines of 2024

    What can we do about it that’s not CPAP?

    Wearing a mask to sleep is not everyone’s preferred way to do things. There are also a plethora of surgeries available, but we’ll not review those, as those are best discussed with your doctor if necessary.

    However, some lifestyle changes can help, including:

    • Lose weight, if overweight. In particular, having a collar size under 16” for women or under 17” for men, is sufficient to significantly reduce the risk of obstructive sleep apnea.
    • Stop smoking, if you smoke. This one, we hope, is self-explanatory.
    • Stop drinking alcohol, or at least reduce intake, if you drink. People who consume alcohol tend to have more frequent, and longer, incidents of obstructive sleep apnea. See also: How To Reduce Or Quit Drinking
    • Avoid sedatives and muscle relaxants, if it is safe for you to do so. Obviously, if you need them to treat some other condition you have, talk this through with your doctor. But basically, they can contribute to the “airway collapses on itself” by reducing the muscular tension that keeps your airway the shape it’s supposed to be.
    • Sleep on your side, not your back. This is just plain physics, and a matter of wear the obstruction falls.
    • Breathe through your nose, not through your mouth. Initially tricky to do while sleeping, but the more you practice it while awake, the more it becomes possible while asleep.
    • Consider a nasal decongestant before sleep, if congestion is a problem for you, as that can help too.

    For more of the science of these, see:

    Cultivating Lifestyle Transformations in Obstructive Sleep Apnea

    There are more medical options available not discussed here, too:

    American Sleep Apnea Association | Sleep Apnea Treatment Options

    Take care!

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  • For tennis star Destanee Aiava, borderline personality disorder felt like ‘a death sentence’ – and a relief. What is it?

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    Last week, Australian Open player Destanee Aiava revealed she had struggled with borderline personality disorder.

    The tennis player said a formal diagnosis, after suicidal behaviour and severe panic attacks, “was a relief”. But “it also felt like a death sentence because it’s something that I have to live with my whole life”.

    A diagnosis is often associated with therapeutic nihilism. This means it’s viewed as impossible to treat, and can leave clinicians and people with the condition in despair.

    In fact, people with this disorder can and do recover with adequate support. Understanding it is caused by trauma is fundamental to effectively treat this complex and poorly understood mental illness.

    A stigmatising diagnosis

    The name “borderline personality disorder” is confusing and adds greatly to the stigma around it.

    Doctors first used “borderline” to describe a condition they believed was in-between two others: neurosis and psychosis.

    But this implies the condition is not real in itself, and can invalidate the suffering and distress the person and their loved ones experience.

    “Personality disorder” is a judgemental term that describes the very essence of a person – their personality – as flawed.

    What is borderline personality disorder?

    People with the disorder can express a range of symptoms, but high levels of anxiety – including panic attacks – are usually constant.

    Symptoms cluster around four main areas:

    • high impulsivity (leading to suicidal thoughts and behaviour, self-harm and other risky behaviours)
    • unstable or poor sense of self (including low self-esteem)
    • mood disturbances (including intense, inappropriate anger, episodic depression or mania)
    • problems in relationships.

    People with the disorder greatly fear being abandoned and as a result, commonly have distressing difficulties in interpersonal relationships.

    This creates a “push-pull” dynamic with loved ones, as people with borderline personality disorder seek closeness, but push away those they love to test the strength of the relationship.

    For example, they may escalate a small issue into a major disagreement to see if the loved one will “stick with them” and reinforce their love.

    Conversely, if a loved one appears distant or fed up – for example, is thinking about ending the relationship – the person with borderline personality disorder will make major efforts to “pull” them back. This might look like a flurry of messages, expressions of despair, or even suicidal behaviours.

    An annoyed woman looks at her sad girlfriend sitting next to her.
    People with borderline personality disorder greatly fear being abandoned, making relationship issues common. Drazen Zigic/Shutterstock

    Who does it affect?

    The disorder affects one in 100 Australians, although this is likely a conservative estimate, as diagnosis is based on the most severe symptoms.

    Women are much more likely to be diagnosed with it than men – but why this is so remains a major debate, with political and sociological factors playing a role in making psychiatric diagnoses. Symptoms usually begin in the mid to late teens.

    While an initial response to receiving a diagnosis can be comforting for some, it is commonly seen as a chronic, relapsing condition, meaning symptoms can return after a period of improvement.

    Borderline personality disorder can fluctuate in intensity and mimic other conditions such as major depression, bipolar disorder, anxiety disorders and psychosis.

    Estimates suggest 26% of presentations at emergency departments for mental health issues are by people diagnosed with personality disorders, particularly borderline personality disorder.

    What causes it?

    The main cause for borderline personality disorder appears to be trauma in early life, compounded by repeated traumas later.

    Early life trauma can lead to biological changes in the brain that cause behavioural, emotional or cognitive shifts, leading to social and relationship issues. This is known as complex post-traumatic stress disorder.

    Aiava has acknowledged the disorder is “mainly from childhood trauma”, although she has not given details about her specific experiences.

    People with borderline personality disorder usually have complex post-traumatic stress disorder. But complex post-traumatic stress disorder doesn’t always result in a borderline personality disorder diagnosis.

    Although the two disorders are not identical, they share many similarities, in particular that they are both caused by complex and repeated trauma.

    However those with borderline personality disorder tend to experience more rage, emotional disturbances and have a greater fear of abandonment.

    They also face greater stigma, whereas the term “complex post-traumatic stress disorder” doesn’t carry the same negative connotations and focuses on the cause of the condition – trauma – rather than “personality”, leading to better treatment options.

    The recognition of the major role of trauma in borderline personality disorder is an important step forward in treating the disorder. But because of the stigma associated with it, using the diagnosis of complex post-traumatic stress disorder maybe a better step forward in the future.

    Can it be treated?

    There are many effective psychological therapies and other treatments for people with borderline personality disorder or complex post-traumatic stress disorder.

    For example, dialectical behavioural therapy is a type of cognitive therapy that helps people learn skills such as tolerating distress, managing relationships, regulating emotions and practising mindfulness.

    The treatment of people with post-traumatic stress disorder, including victims of war and rape, has taught us a lot about how to treat complex, underlying trauma. For example, with trauma-focused psychological therapies.

    Other new treatments, such as eye movement desensitisation and reprogramming, have also shown to be effective.

    Many people with borderline personality disorder who receive treatment and have supportive relationships are able to “outgrow” the condition. Others may need to continue to manage symptoms while pursuing a good quality of life.

    Treating trauma, not personality

    Rethinking borderline personality disorder as a trauma disorder enables a more effective and understanding approach for those with it.

    Understanding what trauma does to the brain means newer, targeted medications can also be used.

    For example, our research has shown how the brain’s glutamate system – the chemicals responsible for learning and making sense of one’s environment – is overactive in people with complex post-traumtic stress disorder. Medications that work on the glutumate system may therefore help alleviate borderline personality disorder symptoms.

    Educating partners and families about borderline personality disorder, providing them support and co-designing crisis strategies are also important parts of total care. Preventing early life trauma is also critical.

    If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

    Jayashri Kulkarni, Professor of Psychiatry, Monash University and Eveline Mu, Research Fellow in Women’s Mental Health, Monash University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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