Can CBD oil be used as a treatment for Borderline Personality Disorder? CBD is being extensively researched as a way to tackle BPD, as existing methods of treatment such as SSRI prescription and psychotherapy have proven to be largely unsuccessful. This article explores the latest research and explains how CBD interacts with the brain in those living with BPD, offering promising results that indicate CBD oil may in future be prescribed as an effective, long-lasting treatment for BPD.
What is Borderline Personality Disorder?
Borderline Personality Disorder (more commonly referred to as BPD) is a psychiatric disorder that has a significant negative impact on the lives of those who suffer from it, and the lives of their loved ones. It is characterised by difficulty in regulating emotions and adapting to new situations, fear of abandonment, impulsivity, aggression towards themselves and tendency to self-harm, and struggles with addiction. In many cases, sufferers of BPD have either attempted or committed suicide.
Ineffective treatment to date
The common treatment for BPD in the UK is psychotherapy, a talking therapy that attempts to help patients cope with their emotional instability. However, those suffering from BPD often have difficulty maintaining consistency with therapy and, on the whole, results from this type of treatment are lacking. Researchers have conducted numerous studies to attempt to find a treatment with higher efficacy levels, but various medications such as antidepressants and anti-anxiety medication have been insufficient to really tackle the symptoms of borderline personality disorder on a long-term basis.
Brain differences in those with BPD
A recent study1, published in 2021, found that two of the most compromised areas of the brain in those suffering from BPD (the hypothalamus and corticolimbic system) have high amounts of CB1 and CB2 receptors, which are the main receptors that form the endocannabinoid system (ECS). The ECS plays a key part in regulation of our emotions and mood, and CBD oil indirectly affects the CB1 and CB2 receptors to change our body’s response to certain situations. This means that cannabinoids are going to have a greater effect on these people, as there are more places in the brain for CBD to interact with.
With this revelation, researchers started to look at ways in which CBD might be able to be used as a treatment for the symptoms of BPD, stating that “no other pharmacological treatment has shown long-lasting improvement in the BPD population to date”.
How can CBD be used to treat BPD?
The endocannabinoid system (ECS) is highly involved in regulation of our responses to stressful situations. In people with BPD, a panic-like response is common due to their inability to process emotions in a normal way. This is often expressed through anxiety, depression, impulsivity, or aggression, due to the body being in a heightened state. We call these ‘defensive reactions’, as the body is doing its best to protect itself in the face of such situations when the brain is struggling to cope.
CBD for impulsivity control
As part of the study mentioned earlier, researchers found that injections of CBD directly to the hypothalamus of rats produced lowered defensive behaviours, showing promising results. The way this works is that the activation of CB1 in the hypothalamus reduces glutamate release. Glutamate is the main chemical that excites our central nervous system, and causes a panic feeling. When glutamate release is inhibited, we see greater capability in managing emotions in response to stressful situations, reducing instability and impulsivity in those suffering with BPD.
CBD for anxiety and depression
Endocannabinoids in the corticolimbic system are seen to regulate our levels of anxiety, and the connectivity of the CB1 receptors in the corticolimbic system are strongly related to expressions of depression.
There are two sides of the functioning of the endocannabinoid system (ECS) when it comes to stress. The ECS’ functioning is affected by stress, but it also has some control over how much stress our body is exposed to (as relates to the amount of cortisol we transport around our body in stressful situations – also known as the ‘fight or flight’ response).
One of the aspects of BPD, thought widely to be a causing factor of the psychiatric disorder, is the experience of repeated stress early in life. Chronic stress increases the level of CB1 receptor connectivity (which, as mentioned above, has been related to depression) in the prefrontal cortex (PFC). The PFC is the part of the brain that determines our social behaviour, and as such determines our expression of depression and social anxiety.
Another study using rats showed that, after a 40-day break from highly stressful situations, levels of CB1 receptor connectivity in the PFC had returned to normal levels. Where people suffering with BPD have higher levels of CB1 receptors in these parts of their brain, they feel the effects of heightened CB1 receptor connectivity stronger than people without a psychiatric disorder would. This means they are more prone to experiencing severe feelings of depression and anxiety. The research is therefore promising, as it implies that a break from stress can help return the endocannabinoid system to healthy functioning in those with BPD. Essentially, this suggests a successful long-term treatment option for borderline personality disorder.
The ability of CBD oil in reducing stress is widely known, and its use may assist those with BPD in managing stress over a period of time long enough for the endocannabinoid system in their brains to return to a healthy, normal level of functioning. This means that BPD sufferers will be less likely to experience anxiety or depression as a result of chronic stress, and they will be better able to process and cope with their emotional instability.
Further research required
Whilst the results of the studies thus far have been promising, there is still further research that needs to be done in order to determine whether CBD oil can be used as a successful treatment for those suffering with borderline personality disorder. Most of the studies thus far have been conducted on rats, and the studies involving human sample groups are minimal, which means they can not yet be used as conclusive evidence that the use of cannabinoids can be a long-term treatment for BPD. We are also as of yet unaware of which dosage of CBD oil would be required for BPD treatment.
Due to the relative safety of using CBD oil, it is being studied extensively for the purpose of BPD treatment. Whilst many people with BPD have been known to self-medicate with cannabis, this is detrimental due to the active component, THC, which has psychomimetic properties and often makes symptoms of the condition worse. CBD oil offers the benefits of cannabinoids without the harmful element of THC, which means that further studies can be conducted ethically. It’s definitely something to keep an eye out for, and we’re expecting exciting results.
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