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Want to learn a more effective approach for treating borderline personality disorder? Attend our upcoming FREE webinar, Borderline Personality Disorder Redefined, led by Dr. James Greenblatt!

Borderline personality disorder (BPD) is a persistent mental health condition that significantly impairs an individual’s ability to manage and control their emotions. Due to these difficulties with emotional regulation, people with BPD often exhibit heightened impulsivity, low self-worth and unstable social connections and relationships. Self-harm is also a frequent symptom.

While medications are commonly used in the treatment of BPD, clinical responses are often varied and adjunctive therapies are frequently helpful. Similar to other mental health conditions, patients with BPD often have nutritional deficiencies, hormonal problems, inflammation, chronic infections and toxicities that can all contribute to their current symptoms. When these factors are identified and treated appropriately, psychotherapeutic interventions are significantly more effective. One of the core problems frequently encountered in BPD is a deficiency in omega-3 essential fatty acids.

Omega-3 Fatty Acids for Borderline Personality Disorder

In order to function properly, the brain needs omega-3 fatty acids. These fats are a component of cell membranes and are essential for neurotransmitter function (Liu 2016). When omega-3 fats are deficient, serotonin and other neurotransmitter signaling can be disrupted.

Increased inflammation is also commonly found in mental illness. Reducing this inflammation is another benefit that comes from supplementing omega-3 essential fatty acids (Layé 2018).

Clinical Trials

The impacts of omega-3 fatty acids on neurotransmission and inflammation appear to be directly relevant to the treatment of BPD. In fact, clinical studies examining the effects of omega-3 fatty acid supplementation on BPD have uncovered potential benefits. One of the first clinical trials compared eicosapentaenoic acid (EPA) to placebo (Zanarini 2003). EPA was shown to have greater benefits for aggression and depression scores, decreasing them by around two-thirds as compared to just over one-half with placebo.

A separate trial exploring the benefits of omega-3 fatty acids as compared to placebo in patients with a history of repeated self-harm also showed benefits (Hallahan 2007). After three months of supplementation, depression and stress scores were two to three times lower with omega-3 fatty acid supplementation.

In borderline adolescents at high risk of developing psychosis, omega-3 fatty acid levels at baseline correlated negatively with mental health symptoms and pathology (Amminger 2013). After three months of supplementation, depression and borderline personality disorder symptoms were decreased by 50% and 37% respectively as compared to very minimal benefits with placebo.

A recent meta-analysis found that fish oil supplements significantly reduced both impulsivity and irritability in individuals diagnosed with BPD (Karaszewska 2021). Given that no prescription medications have consistently demonstrated the ability to improve the core symptoms of this disorder, these results are remarkable. Omega-3 fatty acids are a valid and effective treatment option for this challenging condition.

Want to Learn More?

Join Dr. Greenblatt as he discusses the benefits of omega-3 fats and other functional and integrative treatments for Borderline Personality Disorder in a FREE webinar presented by Psychiatry Redefined on April 29th, at 8 PM ET.

Want to learn more functional approaches to help your patients with BPD and other conditions?

Enroll now in our Fellowship for mental health providers! Book a private call with Dr. Greenblatt to explore the program.

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Amminger GP, Chanen AM, Ohmann S, et al. Omega-3 fatty acid supplementation in adolescents with borderline personality disorder and ultra-high risk criteria for psychosis: a post hoc subgroup analysis of a double-blind, randomized controlled trial. Can J Psychiatry. 2013;58(7):402-408. doi:10.1177/070674371305800705

Gartlehner G, Crotty K, Kennedy S, et al. Pharmacological Treatments for Borderline Personality Disorder: A Systematic Review and Meta-Analysis. CNS Drugs. 2021;35(10):1053-1067. doi:10.1007/s40263-021-00855-4

Hallahan B, Hibbeln JR, Davis JM, Garland MR. Omega-3 fatty acid supplementation in patients with recurrent self-harm. Single-centre double-blind randomised controlled trial. Br J Psychiatry. 2007;190:118-122. doi:10.1192/bjp.bp.106.022707

Karaszewska DM, Ingenhoven T, Mocking RJT. Marine Omega-3 Fatty Acid Supplementation for Borderline Personality Disorder: A Meta-Analysis. J Clin Psychiatry. 2021;82(3):20r13613. Published 2021 May 4. doi:10.4088/JCP.20r13613

Layé S, Nadjar A, Joffre C, Bazinet RP. Anti-Inflammatory Effects of Omega-3 Fatty Acids in the Brain: Physiological Mechanisms and Relevance to Pharmacology. Pharmacol Rev. 2018;70(1):12-38. doi:10.1124/pr.117.014092

Liu JJ, Green P, John Mann J, Rapoport SI, Sublette ME. Pathways of polyunsaturated fatty acid utilization: implications for brain function in neuropsychiatric health and disease. Brain Res. 2015;1597:220-246. doi:10.1016/j.brainres.2014.11.059

Zanarini MC, Frankenburg FR. omega-3 Fatty acid treatment of women with borderline personality disorder: a double-blind, placebo-controlled pilot study. Am J Psychiatry. 2003;160(1):167-169. doi:10.1176/appi.ajp.160.1.167