Note: Abrupt discontinuation of medications may lead to serious symptoms that require emergency care. Do not stop taking psychiatric medications without the supervision of a doctor or nurse practitioner.
Can you treat borderline personality disorder naturally and without medication?
Borderline personality disorder (BPD) is a cluster of symptoms that may include any combination of depression, anxiety, disturbed sleep, impulsive behaviors, obsessive thoughts, intense anger, emptiness, self-hatred, and a compulsive need to act on self-destructive urges.
Currently there is no FDA-approved medication to treat borderline personality disorder or self-injurious behaviors. While medications can target certain symptoms related to BPD, there is no one drug that helps to treat every intense mood swing or disruptive thought that someone with BPD might have in any given day.
Drugs can not only be costly for individuals diagnosed with borderline personality disorder but side effects can often introduce even more problems leaving everyone feeling discouraged and hopeless.
Although there is no "cure" for BPD, below I've listed some ideas for nutritional supplementation that may help to reduce the intensity or duration of many of the symptoms associated with borderline personality disorder.
• Omega 3 Fatty Acids: For many years it's been known that deficiencies in Omega 3 Fatty Acids are correlated with a number of mental health diagnoses such as depression, bipolar disorder, ADHD, and schizophrenia.
The good news is that supplementation with Omega 3 Fatty Acids appear to be an effective treatment for adolescents and adults with a diagnosis of borderline personality disorder. In research conducted by Drs. Mary Zanarini and Frances Frankenburg, supplementing with 1000 mg of Omega 3 Fatty Acids daily over the course of 8 weeks resulted in a significant decrease in both depression and aggression.
A scientific article published in 2021 also noted that there may be a link between a deficiency in Omega 3 Fatty Acids and impulsive or aggressive behaviors. Supplementing with foods higher in Omega 3 may help reduce some of the behaviors that can be a part of borderline personality disorder.
Sources of Omega 3 Fatty Acids: Salmon and other cold water fish, cod liver oil, walnuts, grass-fed beef, brussels sprouts, cauliflower, flax seed, hemp seed, and hemp oil.
• Magnesium: Supplementing with magnesium—a natural muscle relaxer—may benefit individuals who are diagnosed with borderline personality disorder and are experiencing migraines, depression, high anxiety, or have a co-occuring diagnosis of generalized anxiety disorder.
In 2015, the authors of one study noticed a correlation between very low magnesium levels and the symptoms of BPD. Other research looked at the potential benefits of higher levels of magnesium, folate, and zinc in women with depression and anxiety. A study published in 2017 also recommended supplementing with magnesium for the treatment of depression.
Some interesting research published in 2021 looked at low magnesium levels in children with “callous-unemotional” (CU) traits. The article suggests that nutritional supplementation or diets higher in magnesium “…could improve CU traits in children.”
Sources of magnesium: Epsom salt baths, leafy greens, dark chocolate or cacao, avocados, and salmon. Magnesium-supplemented products such as Natural Vitality Calm (and magnesium gummies) may also reduce insomnia when taken before bedtime.
• Vitamin C: Vitamin C may also be beneficial in treating individuals with BPD whose symptoms are manifested through anxiety, restlessness, or nervous energy. One research study showed that supplementation of 500 mg of Vitamin C significantly reduced anxiety among college students.
Research published in 2017 revealed that "High-dose sustained-release vitamin C was effective in reducing anxiety and blood pressure in response to stress." Another study noted that Vitamin C may be beneficial in reducing anxiety among individuals with type 2 diabetes.
Sources of Vitamin C: dark leafy greens, tomatoes, strawberries, and citrus fruits.
• Vitamin D: Upwards of 40% of adults in the United States may be Vitamin D deficient and individuals with darker skin tones are particularly at risk for low Vitamin D. Deficiencies in Vitamin D are also well-documented among those diagnosed with mood and anxiety disorders such as dysthymia, schizophrenia, and depression.
In 2018, a study concluded that adults who supplemented with Vitamin D showed improvement in both anxiety and depression. Another recent study showed that supplementation with Vitamin D for a period of three months helped to reduce the severity of depression.
Another recent article looked at how correcting a vitamin D deficiency (2023) could be a potential way to reduce suicide risk and self-harming behaviors.
Persons who believe that they may have a Vitamin D deficiency and are getting little sunlight most days can ask their doctors for a blood test to determine their current levels.
Sources of Vitamin D: Adequate amounts of sunshine (you can calculate your Vitamin D exposure through sunlight with this smart phone and Apple watch app), wild-caught salmon, mushrooms exposed to ultraviolet light, cod liver oil, and fortified foods such as milk.
• Cacao/Chocolate: For people with borderline personality disorder who have trouble with their memory or are frequently distracted or overwhelmed by new information, supplementation with chocolate may be something to consider. One study published in 2019 looked at the benefits of dark chocolate in reducing depressive symptoms.
Adding dark chocolate to your diet may help reduce symptoms related to depression.
Another study looked at the use of cocoa flavanols to potentially improve symptoms related to mental fatigue. A promising study from 2013 suggested that increased chocolate consumption may "ameliorate the symptoms associated with clinical anxiety or depression."
A more recent study published in 2022, looked at the benefits of mood improvement with 85% dark chocolate. The researchers concluded that dietary intake of dark chocolate may also improve gut health—a potential link to better emotional and physical health.
Sources of cacao and chocolate: Dark chocolate (as opposed to milk or white chocolate with higher sugar content) and cacao (which is different than cocoa) are rich sources of important antioxidants that are key to emotional and physical health. A teaspoon or two of powered cacao can be successfully added to your favorite smoothie and cacao nibs can be added to unsweetened yogurt for a nice boost of flavanols and magnesium.
Can nutritional changes help treat borderline personality disorder?
Decades of research suggest that better nutrition can help improve our emotional and physical health.
You can start by asking your general practitioner or family doctor to run a comprehensive vitamin and mineral panel to screen for nutritional deficiencies. A psychiatrist, psychiatric nurse practitioner, or registered dietician will also be able to order these important lab tests. This information is vital for both your emotional and physical health. The next steps are up to you.
How long will it take before I see benefits in my mood after eating healthier or supplementing with vitamins and minerals?
Most individuals with a diagnosis of borderline personality disorder or have traits of borderline personality disorder will not always see benefits in a matter of days or after a few weeks of dietary changes. Additionally, individuals with a history or a current diagnosis of eating disorders, alcohol abuse, or illegal drug use may also be at risk for severe vitamin and mineral deficiencies. For people who are correcting long-standing or significant nutritional deficiencies, patience and self-compassion will be a necessity.
Years ago when I learned that I had a vitamin D deficiency, it took six months for me to raise my levels from 18 to 36. After lots of experimentation, I now know that I’m at my healthiest when my vitamin D levels are around 75 but I still need to monitor those levels at least twice a year.
I encourage my clients to be kind to themselves while their bodies heal and recover from the nutritional deficiencies that may have caused (or exasperated) many of their symptoms. During this period, it’s important to remain hopeful. Please count any small reduction in symptoms as a success to celebrate.
What’s next?
Healthier lifestyles—paying greater attention to diet, exercise, and sleep—combined with an evidence-based treatment for BPD (such as dialectical behavior therapy) can make a profound difference.
If you are interested in reading more about treating the symptoms of BPD without psychiatric medications, I can highly recommend the following books:
Nutrition Essentials for Mental Health: A Complete Guide to the Food-Mood Connection by Leslie Korn
Depression Free, Naturally by Joan Mathews Larson
The Anti-Anxiety Food Solution by Trudy Scott
Depression and Other Mental Illnesses Caused by Medical Diseases: It’s Not All in Your Head by David Skaer
Other articles that may be beneficial to read
Evolution of Well-Being and Happiness After Increases in Consumption of Fruits and Vegetables (2016)
Food and Mood: How Do Diet and Nutrition Affect Mental Wellbeing? (2020)
Is Exercise a Treatment for BPD? (2020)
Should People with BPD Drink Alcohol? (2021)
Looking for evidence-based treatment for borderline personality disorder, self-harming behaviors, or emotional dysregulation? I'd love to help. Email me today at amanda@hopeforbpd.com.