Because borderline personality disorder (BPD) is a mental illness that affects emotional regulation, people tend to focus on the mental and emotional symptoms people experience.

But people with BPD can also experience physical symptoms we need to talk about.

Dr. April Foreman, a psychologist who specializes in BPD, told The Mighty most people with BPD also live with co-occurring mental illnesses like depression and anxiety (which may come with their own physical symptoms as well). Some studies estimate that 96 percent of people with BPD have a co-occurring mood disorder, and about 88 percent have an anxiety disorder specifically.

When you live with BPD, heightened emotional extremes can take a toll on the body. That’s why we asked our Mighty BPD community to share some surprising physical symptoms they experience. Read what they shared below.

Here are the surprising physical symptoms our community shared with us:

1. Sensory Block During Dissociation

Dissociation is one of the nine classic symptoms of BPD, but what we don’t always talk about is how detachment from reality can affect your senses. According to WebMD, in periods of dissociation, perception may be distorted and memory loss can occur.

“Staring into space and temporarily having hearing blockage during severe dissociation. It’s like I’ve left the room in spirit but my body is just left [frozen] and staring at the wall. It’s quite freaky and takes a long time to snap out of it. Especially if I’m on my own.” — Pheobe A.

“When I dissociate, I get tunnel vision, my ears start ringing, I start sweating profusely, my pulse rises and my face burns.” — Kayla F.

2. Developing Rashes or Worsening of Skin Conditions Like Eczema

In times of intense stress, the body increases production of stress hormones like adrenaline and cortisol. According to The National Eczema Organization, when the body over-produces cortisol, it can suppress the immune system and cause an inflammatory skin response like eczema or other kind of rash.

“I developed mild dyshidrotic eczema on my palms and fingers from being so stressed all of the time, mainly from dealing with my BPD symptoms. When I’m more stressed than usual, my hands itch and sting even more. And they sweat like there’s no tomorrow. “ — Holly B.

“I get random hives. More prominent is when I’m having an episode or getting stressed.” — Kady L.

3. Sensory Overload

Sensory overload is a symptom many folks with PTSD can experience. Though PTSD and BPD are different conditions, one study found that 53 percent of people who met the criteria for BPD also met the criteria for lifetime PTSD. Because of this, it makes sense that many folks with BPD experience this physical symptom.

4. Constant Fatigue

Fatigue is a common symptom of depression, a mood disorder 71 to 83 percent of people with BPD have. Though folks with BPD will have emotional extremes lasting anywhere from a few hours to a few days, the periods of depression can be emotionally and physically taxing.

“Constant tiredness and fatigue — even if you do nothing or very little all day because your mind is busy processing racing thoughts and constant emotions throughout the entire day. It’s exhausting!” — Rayleena N.

5. Hypervigilance

Hypervigilance is a heightened state of arousal that puts someone (usually someone who has lived through trauma) on high alert, even in times of safety. Studies have shown most patients with BPD have lived through trauma, especially in childhood.

“My BPD forces me to be in fight-or-flight mode for things other people find unimportant. This includes someone walking away from me while we are in public, loud noises, kids screaming, people staring at me, someone mentioning the way I eat, someone bringing up things I’m insecure about, etc… These things bring me into a panicked, fight-or-flight mode and it comes out as rage.” — Kayla F.

6. Digestive or Stomach Issues

Stress can affect digestive functioning. According to Harvard, “the gastrointestinal tract is sensitive to emotion. Anger, anxiety, sadness, elation — all of these feelings (and others) can trigger symptoms in the gut.” When you live with a disorder like BPD that is characterized by constantly fluctuating emotions, your gut may respond.

“Definitely a lot of digestive issues related to the stress I feel at agonizing over what people around me are doing and what it means for my relationship with them.” — Kayla B.

“A physical symptom I have is now I have really bad stomach problems. With BPD, your body over-stresses and the acid in your stomach can grow. So I have ulcers.” — Destiny W.

7. Muscle Aches and Pain

Another common physical symptom of stress and anxiety is muscle pain/aches. Many folks with BPD experience high emotional stress due to rapid cycling moods, so this kind of physical symptom may be common.

“For me it’s the physical toll the anxiety takes on your entire body. Aches from muscles being tensed 24/7, fatigue all day every day no matter how much you sleep the night before, heart palpitations, nausea, shaking so hard I can’t even type on my phone. And then even more exhaustion from dealing with meltdowns caused by already being exhausted. It’s an endless loop.” — Kierstyn D.

8. Body Temperature Changes

Emotional stress may also contribute to temperature changes in the body. One study examined how stress may even induce “psychogenic fever,” a high body temperature response to emotional events or chronic stress.

“When the anxiety runs too deep, my body temperature changes to too cold in both feet and hands. The depression episode can last around three days with consequences such as insomnia, exhaustion and excessive eating.” — Ana H.

9. Chest Pain

Chest pain has been linked to common psychiatric conditions like anxiety and depression — diagnoses many people with BPD also have. One study found that chest pain is a psychiatric symptom in up to 25 percent of patients. Chest pain can also be a symptom of panic attacks.

“Constant heaviness in my chest.” — Lisa R.

Though we often think of mental illnesses as only “mental,” your mind is intimately connected to your body. If you live with borderline personality disorder and experience common “mental” BPD symptoms like “splitting,” uncontrollable rage or chronic emptiness, it might be worth talking to your doctor about if any physical symptoms you experience are related to your mental illness. Whatever your experience is, you’re not alone BPD warriors.