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Ask About BPD: Self Medication

Ask About BPD:

I have a question… why is the only thing that seems to make my son seem half normal to self medicate. When he is stoned he seems to manage so well and seem so at peace and able to cope.. but as soon as his buzz wears off he is crazy angry again ;-(
It’s a lose lose situation it seems ….


I’m assuming that the drug in question is marijuana, so I will base my answer on that.

Self medicating is not uncommon amongst people suffering from any number of the many varieties of disorders that fall under the depression umbrella, especially those of us living with BPD. Nearly half of those diagnosed with BPD have histories of substance abuse disorder, a shockingly high number, though slightly less surprising when you consider that one of the most common characteristics of BPD is a lack of impulse control.


Why Cannabis:

One would seem to be hard-pressed to find a high-strung marijuana user–not to say that they don’t exist (I work with one)–but they seem to be few and far between. This is because THC, the chemical in marijuana that makes you high, is known to reduce activity in the amygdala, the part of the brain responsible for recognizing threat and fear.

It’s interesting to note that sufferers of BPD typically display hyperactivity in the left amygdala when shown photos of faces with neutral, happy, sad, and fearful facial expressions while mapping the activity in the brain using fMRI. I find this interesting because I myself often tend to misinterpret lack of emotional response in somebody as something to be angry about.

Anger is a response to perceptions of threat and fear. BPD has an infuriating proficiency for taking simple conversations and day to day activities and twisting them into a perceived indictment of our character, which in turn tends to elicit a fear response (i.e. angry outbursts). It won’t make sense to you, and that’s ok. It’s not your job to make sense of it. All that matters is that you understand that it happens, but please don’t take my words as meaning that you are required to take any emotional abuse of any kind.


Why Cannabis Works:

Our brains naturally produce chemical compounds known as endocannabinoids, which are similar to the chemicals in cannabis. Endocannabinoids affect our cognition, emotion and behavior, and have been linked to reduced feelings of pain and anxiety, increases in appetite and overall feelings of well-being. Research suggests that cannabis use can actually restore endocannabinoid levels in the body, which has the potential to help stabilize mood. It is important to note though, that some studies show that regular and heavy marijuana users may be at a higher risk of depression.

Some heavy marijuana users may also suffer from withdrawal symptoms. There are typically no physiological symptoms, however anxiety and irritability are very commonly reported among heavy pot smokers who quit cold turkey.

One thing I’ve learned through some of my own life experiences is that when using drugs, your problems don’t magically disappear and you don’t magically forget about them; when you’re high, your sense of anger surrounding what ails you just mercifully dims for awhile.

You are allowed to give your son space until he is able to calm down. A method once suggested to me for this was to go to the freezer, grab an ice cube, and recuse myself from the room and was only allowed to return once the ice cube had melted. Instead of focusing on my anger, I was somewhat forced to direct my attention to the discomfort of the cold in my hand, to the moisture dripping out of my fist. This allowed me the time to calm down and return to the issue with a more level head.

While I’m no doctor, and will not recommend that your son continue using marijuana without consulting a physician, I WILL say that on a personal level, other than issues of legality, I see nothing wrong with moderate short-term marijuana use in addition to talk therapy in order to get oneself back to ‘half normal’ (my therapist once called marijuana the ultimate mindfulness drug). The key here is getting your son to therapy on a consistent basis in order to learn viable coping mechanisms. The goal of therapy is to enable us to face triggers without ‘tanking out’ or reacting with anger, and ultimately be able to take on life’s stressors without the help of medication, prescribed or otherwise.

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