How Targeting the Endocannabinoid System Can Help Treat Borderline Personality Disorder

Cannabis is known to help patients with a wide variety of health concerns and conditions, including different mental health issues. According to recent studies, cannabis can offer symptom relief and management solutions for one such mental illness: borderline personality disorder (BPD).

In this article, you’ll discover how BPD affects the body and how cannabis targets the endocannabinoid system (ECS) to offer those affected by this condition numerous symptomatic benefits.

What is Borderline Personality Disorder (BPD)? 

Borderline personality disorder (BPD) is a mental condition that results in people who have it struggling with difficulty managing emotions, relationships, and how they perceive themselves overall.

Millions of American adults suffering from BPD struggle with fluctuations in their mood, along with unstable thoughts, feelings, and behaviors.

Common challenges for people with BPD include:

• Maintaining healthy relationships
• Fear of abandonment 
• Intense, unstable emotions
• Impulsive behavior
• Difficulty controlling anger, irritability, worry, or sadness (neuroticism)
• Frequent self-image issues
• Stress-related paranoia
• Cognitive distortions and dissociation
• Severe functional impairments, like decision-making and long-term planning
• Self-harming behavior, including suicidal thoughts and attempts

While treatment options for BPD are limited, it can be managed in several ways. Some of the treatment options include therapy, help from healthcare providers, medications (e.g., antipsychotics, mood stabilizers, dietary supplements, antidepressants), and utilizing family and friends as a support system.

More recently, patients have also found relief from BPD symptoms as a result of cannabis and the way it affects the brain.  

Brain Areas Affected by Borderline Personality Disorder

The brain areas that BPD typically impacts include the limbic system and prefrontal cortex, showing dysfunction between their connections. This contributes to the emotional dysregulation in BPD. These brain regions are primarily involved with, and regulate, impulse control, emotions, and decision-making.

Research suggests certain hormonal, neurotransmitter, and endocannabinoid imbalances in the brain are observed in BPD patients. These imbalances, such as anandamide, may also play a role in BPD symptoms.

Because these various brain regions and endocrinology are disrupted, treating these areas of the brain can help people significantly with BPD.

Understanding the Endocannabinoid System (ECS) 

The endocannabinoid system (ECS) regulates bodily processes such as appetite, fat storage, and balance. It also affects mental processes like motivation, mood, memory, and cognition.

The ECS works by controlling the communication between cells. They release molecules called endocannabinoids, which interact with two receptors: cannabinoid type-1 (CB1) and cannabinoid type-2 (CB2).

CB1 receptors are primarily found throughout the brain and nervous system, while CB2 receptors are found throughout the immune system. CB1 receptors involve mood regulation, memory, and cognitive function.

Once bound to their respective receptors, cannabinoids regulate biochemical reactions such as pain sensation and regulation, inflammation, neuroplasticity, and more.

How Cannabis Can Help With BPD 

Because recent research shows that high levels of CB1 receptors exist in the same major brain areas associated with BPD, cannabinoids offer a promising treatment for this condition.

No other pharmacological treatment for BPD has yet to achieve long-term success for those seeking relief from symptoms associated with BPD. However, cannabis might be the answer for those struggling with BPD symptoms.

Mood regulation is crucial for people with BPD, and the endocannabinoid system uses cannabinoids and CB1 receptors to help balance out these mood imbalances and improve mood overall.  

Preliminary studies also suggest cannabis can help alleviate symptoms like anger, irritability, depression, anger, anxiety, sleep disturbances, and suicidal thoughts.

Cannabidiol (CBD) specifically lowers FAAH (an ECS enzyme) and increases anandamide (AEA), which activates endocannabinoid receptor CB1. CBD works directly on 5-HT1A serotonin receptors.

Anandamide and serotonin are known as “happy chemicals” in the body, which is why CBD can be so helpful with mood imbalance and depression.  

What Type of Cannabis is Best for BPD?  

A treatment ratio of high levels of cannabinoids like cannabidiol (CBD) and a lower level of THC is suggested to have the most effective results for BPD so far.

• Tetrahydrocannabinol (THC) is the psychoactive cannabinoid responsible for inducing the “high”, but also anxiety and paranoia, associated with marijuana use. Common THC therapeutic properties include appetite stimulation, anxiety relief, pain relief, and nausea reduction.
• Cannabidiol (CBD) is a non-impairing cannabinoid known for its anti-inflammatory, anti-anxiety, and antipsychotic properties. By decreasing FAAH activity and increasing endocannabinoids like AEA, CBD is more helpful for BPD.

Overall, it’s recommended to find a strain or hemp products higher in CBD and lower in THC since THC has a higher chance of causing an anxiogenic reaction, meaning something that causes fear or anxiety, in these BPD patients.

The low-THC to high-CBD ratio typically balances out cannabis features in the best way for those with BPD.

What Strains of Weed and Terpenes Are Best For BPD? 

Some specific strains of weed are optimal for those with BPD because of their THC and CBD ratios, along with the other terpenes and cannabinoids they possess.

That doesn’t mean those suffering from BPD haven’t found strains higher in THC and lower in CBD that have helped them. There isn’t any evidence specifically on cultivars (strains) for BPD, but sativa strains may be best fit for those with BPD during daytime use, as they boost your mood and help ease anxiety.

However, some people with BPD use an Indica-dominant strain at night specifically to help calm the mind and help them sleep. 

Many strains these days are hybrids, though, so it’s best to journal your experiences with different strains – or better yet, try hemp products rich in CBD, CBDA, or CBG.

Considering the terpenes within the cannabis strain that might help alleviate symptoms associated with BPD is also important.

Terpenes are aromatic compounds that naturally occur in cannabis plants. When consumed, they create a signature scent, flavor, and compound that has therapeutic benefits. Many studies have indicated that terpenes have the potential to help relieve stress, anxiety, and inflammation, as well as other properties like anxiolytic and sedative effects.

These terpene aroma profiles may also be used as aromatherapy to further help induce relaxation, uplift mood, or improve focus.

Some of the terpenes that can help alleviate common BPD symptoms are:

• Myrcene: Relieves inflammation, pain, and insomnia. Strains that are high in myrcene include OG Kush, ACDC, Purple Urkle, Critical Mass, and Granddaddy Purple. You can also look for strains like Chemdog, Sour Diesel, Girl Scout Cookies, Cookies and Cream, and Death Star.
• Caryophyllene: Relieves anxiety, depression, stress, inflammation, and pain. Popular strains that are high in this terpene include Chemdog, Sour Diesel, Girl Scout Cookies, Cookies and Cream, and Death Star.
• Limonene: Stress reducer, anti-depressant, and anxiety reducer. Popular strains that are high in limonene include Lemon OG, Trainwreck, Durban Poison, Bruce Banner, Sour Diesel, and OG Kush.
• Linalool: Relieves anxiety, stress, inflammation, insomnia, and pain. Popular strains that are high in this terpene include Amnesia Haze, Lavender Kush, Granddaddy Purple, and Purple Urkle.
• Pinene: Pinene can help boost energy levels, improve mental focus, reduce inflammation, and counter short-term memory loss, as well as being antiseptic and antiviral among other benefits. Popular strains high in this terpene include Bubba Kush, Dutch Treat, Blue Dream, Jack Herer, and Harlequin. 

Strains with a combination of the terpenes listed above that complement BPD symptom relief in high levels can be helpful.

Does CBD Without THC Help BPD?

CBD products made from, or with, hemp oil without THC might also benefit those struggling with BPD.

Hemp oil is high in cannabinoids, terpenes, essential minerals, and omega-3 fatty acids. These compounds could have additional anti-inflammatory effects on the brain and help with cognitive function. 

As previously mentioned, CBD increases endocannabinoids and helps with overactive neural health, mood, and communication.  It also helps improve serotonin levels, which further helps improve mood, in addition to increasing AEA.

This helps with symptoms such as anger, anxiety, paranoia, and impulse control.

Final Thoughts  

Thanks to recent research and cannabis becoming better known for its medicinal properties, those suffering from borderline personality disorder might find relief from this incredible plant. The way cannabis, particularly CBD, boosts the endocannabinoid system is a game-changer for those with BPD because of how it affects the mind and relieves their symptoms.

Some strains, terpenes, and ratios of THC and CBD need to be explored and tested for individuals with BPD to see what works best for them.

Conventional psychiatric treatments typically fail to show long-lasting improvements for BPD patients. However, many people have already found relief using weed to help them with their symptoms.

Cannabis has offered hope to those fighting BPD who have yet to find relief through these conventional treatment methods. 

Note: The content on this page is for informational purposes only and is not intended to be professional medical advice. Do not attempt to self-diagnose or prescribe treatment based on the information provided. Always consult a physician before making any decision on the treatment of a medical condition.

This article was originally written by Lemetria Whitehurst in 2023 and updated in January 2025.