Is it Safe to Take Psychedelics if You Have BPD?

What is Borderline Personality Disorder?

Borderline Personality Disorder (BPD) is a complex and often misunderstood mental health condition, or more specifically, personality disorder. 

This means it involves deeply ingrained patterns of thinking, feeling, and behaving that significantly deviate from societal norms and cause distress to the individual or impair their functioning.

The exact causes of BPD remain unclear, but it is believed to result from a combination of genetic, environmental, and neurobiological factors. 

Individuals with BPD may have experienced early life trauma, neglect, or invalidation, leading to difficulties in emotional regulation and the development of a stable sense of self, and we already know how psychedelics have been shown to help heal trauma. 

There are, however, certain neurological variations that have been linked to BPD, and one of the hallmark features of BPD is emotional instability. 

“There is a genetic predisposition…studies show over 50% heritability (greater than that for major depression).  Environmental factors that have been identified as contributing to the development of borderline personality disorder include primarily childhood maltreatment (physical, sexual, or neglect), found in up to 70% of people with BPD, as well as maternal separation, poor maternal attachment, inappropriate family boundaries, parental substance abuse, and serious parental psychopathology” (Chapman et al., 2022).

For this disorder, the saying “it’s genes that load the gun, but lifestyle that pulls the trigger,” certainly seems to apply here, although it may be time for a new maxim.

Given that environmental factors play such a large role in its development, this could suggest that psychedelics have a high probability of helping to resolve whatever underlying issues are contributing to its manifestation.

Many people with this disorder experience intense and rapid mood swings, making it challenging for them to maintain stable relationships and cope with everyday stressors. 

There is also a higher risk for substance abuse and risky behaviors that could lead to morbidity, injury, imprisonment, or job loss. 

Interpersonal relationships can be highly challenging for those with BPD, and those suffering may oscillate between idealizing and devaluing others, known as “splitting.” 

This intense fear of rejection and abandonment can result in desperate efforts to prevent the loss of relationships, sometimes even pushing others away in the process.

Diagnostic criteria and symptoms associated with borderline personality disorder are: 

• • Abandonment Avoidance—abnormal behaviors which are intended to avoid abandonment, whether there is a real threat of it or not.

• • Unstable Relationships—intense or volatile relationships with others that pendulate between extreme idealization and hostility.

• • Identity Disturbance—unstable self-image or sense of self.

• • Impulsivity—behavior that is potentially dangerous or has negative consequences, participating in self-sabotage, self-harm or generally irresponsible behaviors.

• • Affective Instability—high levels of emotional reactivity, emotional overwhelm, such as feelings of emptiness, anxiety, depressive, or angered outbursts.

• • Dissociation—paranoia and lack of somatic awareness and feeling.

It is essential to note that BPD is a highly individualized condition, and not all individuals will display all symptoms equally. 

Diagnosis and treatment should be carried out by qualified mental health professionals who can provide a comprehensive assessment and develop tailored interventions.

The Current Treatments for BPD

Treatment for Borderline Personality Disorder (BPD) is multifaceted, aiming to address the various symptoms and challenges individuals face in managing their emotions, relationships, and overall well-being. 

The most common and effective treatment is psychotherapy, consisting of a variety of different approaches to help the person find a healthier relationship with their emotions, decisions, and behaviors. 

Therapies like Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, psychotherapy, and practices like meditation, art therapy, and group therapy may also be used to help shift maladaptive patterns in thought and behavior.

“No medications are FDA-approved for the treatment of borderline personality disorder. Medications such as SSRIs, mood stabilizers, and antipsychotics have shown limited effectiveness in trials aiming at the control of symptoms such as anxiety, sleep disturbance, depression, or psychotic symptoms” (Chapman et al., 2022).

And while anxiety is a common symptom of BPD, according to Chapman and colleagues, “Anxiety can be challenging to treat because patients may label their internal experiences with the word anxiety, even when they are not truly based on fear. Thus, “anxiety” may need to be accurately re-labeled, with treatment recommendations stemming from the patient’s specific internal experience.”

It’s for this reason that professionals often have trouble finding the right treatment plan for someone suffering with BPD because of the complexity of the inner experience and the ineffectiveness of medications.

What the Research Tells Us About Psychedelics & BPD 

The primary resource used during this portion of the article will be Zeifman and Wagner’s 2019 review, “Exploring the case for research on incorporating psychedelics within interventions for borderline personality disorder.”

In this review, they assess all past psychedelic research through the lens of relevancy regarding the symptomology and causes of BPD. All other sources and citations can be found within the extensive survey they provided. 

Firstly, Zeifman and Wagner defined psychedelic therapy benefits for BPD according to the symptomatic categories of behavioral regulation, emotional regulation, mindfulness, self-identity, and social functioning. 

When it comes to dysfunctional cognitive distortions in those with BPD,  “the core dysfunction of BPD is often identified as emotion dysregulation.” 

They found that “research on psychedelic-assisted psychotherapy has shown long-lasting decreases in affective symptoms, as well as decreases in neuroticism,” specifically in studies conducted with LSD and ketamine. 

“The impact of psychedelics on emotional dysregulation may be accounted for by the agonist action of psychedelics on 5-HT2A receptors in the prefrontal cortex, which lead to ‘top-down’ control of circuits related to emotional dysregulation.”

While the ways in which psychedelics work in the brain are mostly understood through the lens of acting upon the serotonergic system, there are also interesting effects on the default mode network which could have key implications for further research for those with BPD. 

Furthermore, “Among individuals with BPD and substance use, ketamine-assisted psychotherapy was found to lead to improvement in personality characteristics associated with self-criticism.”

When it comes to identity, those with BPD often struggle with an unstable sense of core identity, but “research suggests that psychedelics have an acute, and potentially long-lasting, impact on an individual’s sense of identity.”

“Qualitative research indicates that self-compassion and self-acceptance are important themes that emerge from interviews with individuals that received psilocybin, LSD, and MDMA-assisted psychotherapy, or used ayahuasca for therapeutic purposes. Cross-sectional and experimental research similarly suggests that psychedelics lead to increased self-compassion and positive views of the self.” 

And regarding social functioning, “healthy individuals receiving standard support for spiritual practice and two high doses of psilocybin…showed increases in closeness to others” and “decreases in aggression.”

“Psychedelics may also target deficits in social functioning that are associated with BPD, including social pain, rejection sensitivity, trust, empathy, and emotion recognition.”

Their effects on relationship dynamics and relational intimacy could have profound impacts on the outwardly manifesting lives of those struggling to maintain healthy relationships due to their BPD. 

But it does come with certain risks such as potential for abuse, specifically in the cases of ketamine and MDMA. It is important for those with severe mental, mood, and personality disorders to be extremely cautious of if and how you engage with these substances. 

Being in a therapeutic setting with professional guidance and support can help ensure that you come out with positive insights and changes, rather than with more trauma to process or feeling emotionally stirred up with no support. 

Overall, psychedelics have shown through a multitude of studies a strong potential for helping heal symptoms associated with behavioral and emotional dysregulation as well as identity and social dysfunctions. 

Get Matched with a Trusted Psychedelic Facilitator Near You

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Frequently Asked Questions (FAQS) on BPD & Psychedelic Medicine

Q: Is therapeutic psychedelic use effective in treating Borderline Personality Disorder (BPD)?

The use of psychedelics in treating Borderline Personality Disorder (BPD) is an area of ongoing research and exploration. 

While there is promising evidence for the potential therapeutic effects of psychedelics in other mental health conditions, such as depression and anxiety, their safety and efficacy for BPD require further investigation. 

Psychedelic-assisted therapy, conducted under controlled settings and with trained professionals, has shown promising results in addressing a range of psychological issues. 

However, due to the complexity of BPD and its emotional instability, caution is necessary before considering psychedelic treatment. 

Until more research is conducted, traditional therapies like Dialectical Behavior Therapy (DBT) and other evidence-based approaches remain the primary recommended treatments for BPD.

Q: Can individuals with BPD safely use psychedelics recreationally?

Recreational use of psychedelics by individuals with BPD can be risky and potentially harmful. BPD is characterized by emotional instability, impulsivity, and difficulty regulating emotions, which can be exacerbated by psychedelic substances. 

Psychedelics can induce intense and unpredictable experiences that may lead to overwhelming emotional responses and impulsive behaviors. 

Moreover, recreational use without proper guidance and therapeutic support may not address the underlying issues associated with BPD and could potentially worsen symptoms. 

It is essential for individuals with BPD to prioritize their safety and well-being and consult a qualified mental health professional before considering any substance use.

Q: How can traditional therapies help individuals with BPD?

Traditional therapies like Dialectical Behavior Therapy (DBT) have shown significant effectiveness in helping individuals with BPD cope with their emotions, improve interpersonal relationships, and develop healthy coping mechanisms. 

DBT, specifically designed for individuals with BPD, emphasizes skills training in areas such as emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness. 

By providing structured support and tools to navigate emotional challenges, traditional therapies help individuals with BPD build a foundation for positive change and personal growth.