Actually, I hear discussion often in the professional arena. Amongst the mental health diagnosis, typically the Dx borderline personality is referred to as "created, not born or injured in this way". What that usually refers back to is one's early childhood/early development stages. The theory is that somewhere during early developmental stages in a child's life, there is a deficit, or lack of very important bonding during these stages. This does not mean that a person diagnosed with borderline personality had horrible parents who abandoned them, however, there are many links to abandonment, sexual, physical and/or emotional abuse with borderline personality disorders. However, on the organic question, there is a lot of talk right now about how there seems to be a strong commonality between Bipolar Disorder sharing a diagnosis of Borderline Personality Disorder.
(On the flip side, there are many people who have been abused or neglected-who don't have a diagnosis of bpd).
The intriguing thing about borderline personality disorder is this person is typically a survivor. They are often gifted with the ability to read people in the blink of an eye, and can be very resourceful. The part about having bpd that I see over and over is that whatever has happened to create such a survivor,such a powerful, unique human being, can also work against them in social and relationship areas. Someone who learned at a very young age to "protect" themselves often seems to have a difficult time trusting others. For example, I spoke to someone recently who said "others aren't important", but almost in the same sentence, said "I really wish that I could have a relationship with xxxx". She was torn between her instincts to protect herself emotionally, and her desire to not be alone anymore. She was torn between her thought processes of "hurt him before he hurts me" and just wanting to have a simple relationship without all of the oldthought patterns she was used to. Medications can help with some depression or anger that comes along with the circumstances of this particular diagnosis.Medications not being very effective for symptoms of this particular diagnosis could also be further evidence of borderline Dx not being organic. However, Dialectical Behavior Therapy (DBT) is what the mental health community is strongly encouraging as far more successful than medications. (Cognitive Behavioral Therapy as well). These types of therapies can help a person take a look at the actual thought processes and patterns that might otherwise lead them to harmful behaviors. This remains the largest approach for mental health professionals for helping someone diagnosed with borderline.
Organic issues would most likely be a different primary diagnosis, with symptoms and behaviors that mimic borderline personality disorder. Does this make sense? For example, someone with a recent organic diagnosis might receive schizoaffective disorder, and present with symptoms like isolation-then clinginess, anger-then manipulate with making others sympathize with them. These could be symptoms similar to borderline personality disorder, however, they will probably be viewed as symptoms of the diagnosis-schizoaffective disorder.
Remember also, that a person can have more than one primary mental illness diagnosis, and also have a primary personality disorder diagnosis also.So it is possible for someone who has a borderline personality diagnosis to have an organic brain issue going on, but organic issues alone most likely will not generate a borderline personality diagnosis. I hope this helps. If you're interested there is a book titled I hate you, don't leave me". It's an older book, so some theories have changed,but the general idea remains true today. You may find the book's concepts of the early developmental stages interesting. Take it with a grain of salt though, just like my reply-it's what others have seen. Use what works for you! I hope this helps.Take Care