10-second takeaway: Patients with BPD may have certain nutritional requirements including vitamin D, omega-3, magnesium and nutrients associated with bone health. More research is needed in this area.

What is Borderline personality disorder?

Borderline personality disorder (BPD), also known as Emotionally Unstable Personality Disorder (EUPD), is a complex psychiatric disorder characterised by dichotomous thinking, extreme emotional instability and mood swings, intense persistent fear of abandonment and interpersonal relationship difficulties. Women and men are equally affected by BPD, but women are more frequently diagnosed (Grant et al., 2008). 

There is much debate regarding BPD, and diagnosis can depend greatly upon the physician who is seen. Sometimes BPD can be misdiagnosed in place of post-traumatic stress disorder (PTSD) as both conditions share some common symptomatology. Autism can also sometimes be misdiagnosed as BPD due to the way autism manifests differently in women and some of the social and emotional overlaps between the two conditions. 

Diagnosis of BPD is more prevalent in individuals who have experienced domestic abuse as children or adults. Emotional abuse in childhood has also been strongly associated with BPD development, and it’s been suggested that childhood abuse of all kinds is present in the personal histories of around 90% of all individuals who are diagnosed with BPD. Presently, the treatment offered may involve CBT (cognitive behavioural therapy), mentalisation therapy group therapy and art therapy. There are no medications currently licensed to treat BPD specifically.

What nutritional support may be needed for patients living with borderline personality disorder? 

Current research has identified that gut-brain axis disruption, neurotransmitter imbalances and fluctuations in oestrogen levels appear to play a role in the development of BPD. An interesting observation made by one paper suggested that women with BPD have been indicated to be at higher risk of developing bone disorders, such as osteoporosis.

Omega-3

Very little research to date has been conducted on how nutrition may support individuals with BPD. Some evidence has indicated that omega-3 may help to reduce the severity of symptoms in women with BPD, particularly with relation to impulsivity. Omega-3 has also been suggested to be beneficial in conjunction with valproic acid, with beneficial effects continuing to be observed following cessation of supplementation in a follow-up study, particularly for outbursts of anger. Moreover, another study indicated that omega-3 supplementation, in the form of EPA, was beneficial for reducing symptoms of aggression in women with BPD.

Vitamin D

Although Vitamin D has not been studied in relation to BPD, lower levels have been commonly observed in individuals experiencing suicidality, which is a key feature of the condition. 

Magnesium

Interestingly, magnesium deficiency has also been observed in samples of women with BPD, although this area remains under-researched.

Brain and bone health for borderline personality disorder

Notably, all these nutrients play a key role in brain function and mood stability, as well as bone health and structure, which could account for the observed link between BPD and osteoporosis. It is also interesting to consider the shared mechanism of changes in oestrogen levels in both BPD and osteoporosis. 

Moreover, other nutrients associated with bone health that have been studied with regards to osteoporosis, such as calcium and vitamin D, magnesium, B vitamins, vitamin K, manganese, iron, selenium and copper, as well as omega-3 could be key targets for further research in this area.

Key takeaways

• Borderline personality disorder (BPD), otherwise known as emotionally unstable personality disorder (EUPD), is a complex psychiatric condition. Research suggests it may include features of gut-brain axis disruption, neurochemical imbalance and fluctuations in oestrogen level
• Patients with BPD may have specific nutritional needs including vitamin D, omega-3 and magnesium, although there is not much research to-date
• The neurochemical and hormonal interplay suggest a possible link between brain and bone health in BPD, and therefore nutrients associated with bone health may need to be considered.

 

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About the author

Alice Benskin BSc MSc RNutr is senior nutritionist at Nutritank. She has a BSc in Nutrition Science and MSc in Personalised Nutrition and has worked over the past 10 years in the food industry, agriculture, nutrition education and research. 

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