Mental health treatment can benefit people with borderline personality disorder. However, using marijuana can mask BPD symptoms and make treatment less effective.

Article at a Glance:

  • BPD is a set of symptoms that make it hard to have long-lasting and meaningful relationships
  • People with BPD feel emotions more intensely than those without the disorder
  • A majority of people with BPD admitted to using or abusing drugs and alcohol
  • Marijuana can improve some symptoms of BPD but might make others worse
  • Treatment of BPD can be sabotaged by substance abuse

Borderline Personality Disorder & Marijuana

Borderline personality disorder and marijuana often intersect in behavioral health.

Personality disorders are a group of mental health disorders that make it hard to function in relationships. They can cause long-term problems with relationships and make integrating and functioning in society difficult. People with a personality disorder may not know they have one, mistakenly thinking they do not have a problem. Alternatively, they might know they have poor coping skills but not know how to change them.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V), borderline personality disorder (BPD) is, “A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts.”

To be diagnosed with this personality disorder, a person must have at least five of the following:

  • An unstable mood that lasts for days or hours and can change just as quickly
  • Difficulty controlling anger
  • Paranoia during periods of extreme stress
  • Avoidance of real or imagined abandonment
  • Alternating between extreme highs and extreme lows, which lead to unstable relationships
  • Unstable self-image or changing personal identity
  • Impulsive and dangerous behavior around binge eating, sex, spending money, substance abuse, reckless driving, and other behaviors
  • Suicidal thoughts, behaviors, and actions that happen over and over throughout a person’s life

People with BPD tend to see things and people as all good or all bad. One day a person might be their best friend and the next day they might be a rival. They can have rapidly changing friend groups with quickly changing interests, sometimes to blend in. The unstable nature of how they interact with people makes maintaining friendships and relationships difficult.

Can Marijuana Use Cause BPD?

People with BPD have a high rate of substance abuse, but cannabis does not cause BPD. About 6% of American adults have BPD, and of those, 85% have a co-occurring substance use disorder (SUD). These statistics show that there is a correlation between substance abuse and BPD, but no studies have identified cannabis as a cause.

People with BPD can feel stronger emotions than people without the disorder, which can drive chaotic and exaggerated reactions. To calm their emotions, many people will self-treat with drugs and alcohol, partly explaining the high correlation between BPD and SUD. Some genes that cause BPD overlap and contribute to SUD as well.

Related Topic: Marijuana and psychosis

Does Marijuana Affect BPD Symptoms?

Marijuana consumption is known to cause paranoia, which may be worse in someone with BPD. Otherwise, marijuana use and BPD symptoms do not intersect much.

Marijuana addiction can cause withdrawal symptoms, which may contribute to poorer mental health. The experience of having BPD is very stressful without substance abuse, and symptoms from marijuana withdrawal may make the condition harder to live with and treat.

Symptoms of marijuana withdrawal include:

  • Anxiety
  • Cravings
  • Decreased appetite
  • Irritability
  • Trouble sleeping

Related Topic: Do I have a personality disorder

Prevalence of Marijuana Use/Abuse in People with BPD

Substance use and abuse are alarmingly common in people with co-occurring BPD and marijuana abuse.

About 60% of men and 70% of women with BPD have used marijuana, which is lower than other substances like tobacco and alcohol. For comparison, over 80% of both genders used both alcohol and tobacco.

The high prevalence of substance abuse among people with BPD makes the condition harder to treat than many other co-occurring disorders.

Treatment Options for BPD and Co-Occurring Marijuana Addiction

Dialectical behavioral therapy (DBT) is the treatment option of choice for people with BPD. DBT helps people to overcome negative thinking patterns by focusing on mindfulness and rational coping skills. DBT encourages mindfulness, nonjudgmental thinking (of the self and others) and acceptance of reality.

Even the best treatment plans are not enough if co-occurring substance use disorders remain unaddressed. Substance use can make therapy less efficient by either creating or masking different symptoms, making it harder to recognize the underlying BPD.

For more severe cases of BPD co-occurring with SUD, inpatient rehab could be considered.

If you struggle with addiction that co-occurs with a mental health disorder like BPD, contact The Recovery Village today to speak with a representative about how addiction treatment can help. You deserve a healthier future, call today.

Thomas Christiansen
Editor – Thomas Christiansen
With over a decade of content experience, Tom produces and edits research articles, news and blog posts produced for Advanced Recovery Systems. Read more
Conor Sheehy
Medically Reviewed By – Dr. Conor Sheehy, PharmD, BCPS, CACP
Dr. Sheehy completed his BS in Molecular Biology at the University of Idaho and went on to complete his Doctor of Pharmacy (PharmD) at the University of Washington in Seattle. Read more

Distel, Marijn., et al. “Borderline Personality Traits and Sub[…]ohol Consumption.” Journal of Personality Disorders,  2012. Accessed June 15, 2019.

Lenzenweger, Mark, et al. “DSM-IV Personality Disorders in the N[…]rvey Replication.” Biological Psychiatry, 2007. Accessed June 15, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.