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.
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