QUESTION:

Doctor,

In your FAQ you say that 'Borderlines are "allergic" to alcohol and should never use it'. I've not been able to find much more detail regarding this anywhere and was wondering if you could elaborate on this in order to explain how alcohol consumption would be attributed to changes in the behaviour of someone with BPD.

Regards...

DR. HELLER'S ANSWER:

There isn't any good science to back it up because the studies haven't been done. I cannot ignore my experiences and what patients (and their loved ones) have told me. A high percentage, if not the majority, of individuals admitted to a psychiatric facility have alcohol as a primary cause or trigger of that hospitalization.

These are my reasons for advising those with BPD to avoid alcohol...

1) When someone with BPD experiences a stressor that triggers the "trapped, cornered, wounded animal" part of the brain, that individual has trouble thinking their way through the event. Their priority is to do anything they can to stop that pain. Alcohol first inhibits the prefrontal and frontal part of the brain - which means the ability to think before acting is impaired. This can be dangerous and result in incarceration or death.

2) When the right dose for that individual is found, Prozac (fluoxetine) completely eliminates unprovoked mood swings and chronic anger and irritability. When the individual with BPD drinks alcohol, these Prozac (fluoxetine) benefits seem to be overwhelmed by the alcohol, and the mood swings and anger return until the alcohol leaves the system. When alcohol is in the system, an individual with BPD can get very angry and inappropriately moody, which frequently results in divorce, legal problems including incarceration, profound self destruction and death.

3) I strongly believe BPD dysphoria (anxiety, rage, depression and despair) is an epileptic phenomenon (nerve cells firing inappropriately and out of control). Epileptics can get an "alcohol withdrawal seizure". When an individual with BPD drinks alcohol, they commonly experience dysphoria (anxiety, rage, depression and despair) 6-72 hours after the alcohol was consumed. They don't relate the two glasses of wine on Friday night as the cause of their severe depression and self destructive behaviors on Sunday, but it's commonly the cause.

next: What Are the Effects of Alcohol on Depression and BPD? ~ back to: Borderline Personality Disorder FAQs Table of Contents