Medical cannabis treatment for personality disorders in the UK

While the NHS and other private healthcare providers routinely recommend talking therapies, often combined with antidepressants, antipsychotic or antianxiety medications - hundreds of thousands of people in the UK still struggle with personality disorder symptom management. 

From intense bouts of anxiety or worried thoughts, to feeling detached from things - or people - they once loved, to struggling to maintain a stable, daily routine with intensely varying emotions: a one-size fits all approach simply doesn’t work - and the same treatments don’t work for everyone. 

This is why many have started to look into a new alternative: cannabis-based treatments for personality disorders. Perhaps you’re the same, which is why you’ve landed here, or maybe you’re simply curious to learn more about whether medical cannabis could be helpful for those living with a personality disorder - but don’t worry, you’ve come to the right place. 

But first: how are personality disorders diagnosed?

In the UK, how personality disorders are described, and therefore diagnosed, has changed significantly in just the last three years - which can make researching them tricky. 

Prior to 2022, there were ten recognised ‘types’ of personality disorder - each with their own distinction, but in more recent years the overlap and complexity of these symptoms has become more apparent. Now, a new approach is taken: healthcare professionals categorise the severity - as opposed to the type - of symptoms, and therefore, personality disorder. 

So, what were the ten ‘types’ of personality disorder?

Up until 2022, individuals with specific traits and symptoms were diagnosed as having either one, or a number, of the following:

• Antisocial personality disorder
• Avoidant personality disorder
• Borderline personality disorder (formerly known as emotionally unstable personality disorder)
• Dependent personality disorder
• Histrionic personality disorder
• Narcissistic personality disorder
• Obsessive-compulsive personality disorder
• Paranoid personality disorder
• Schizoid personality disorder
• Schizotypal personality disorder

Because these distinctions only changed in the last three years, many individuals in the UK still use these terms, whether it's in professional healthcare settings or in their private lives, to describe their personal experiences, so it's unsurprising many still attempt research using these terms. 

But it’s important to stay up to date. 

Now, the International Classification of Diseases (ICD-11) categorises personality disorders in those over the age of 18 by severity - as opposed to specificity - using the following terms:

• Personality difficulty
• Mild personality disorder
• Moderate personality disorder
• Severe personality disorder

Understanding personality disorders: traits and terminology

Now we’ve established that personality disorders are no longer categorised as separate mental health conditions, and instead as a varying scale of one complex disorder, let’s take a deeper dive into some of the traits that characterise personality disorders. 

Arguably the most apparent symptom of personality disorders is experiencing difficult emotions, or feeling emotions very intensely. This can range from getting easily frustrated or upset, reacting negatively to criticisms, or problems, or experiencing anankastia: a need to be in control of situations while setting extremely high standards, which when aren’t met, can cause anxiety and despair. 

People with personality disorders often have low self-confidence or self-esteem and struggle to trust others, and feeling detached from others is another typical trait. Much like struggling to trust, people with personality disorders frequently find it difficult to express how they feel, and therefore avoid social interactions and opportunities that involve connecting with others, as they also tend to struggle when others are emotional. And feeling detached doesn’t just relate to other people either, it can involve activities, hobbies, and finding things enjoyable.

In turn, this can easily lead to impulsive behaviours to chase ‘good feelings’, or, to lessen the ‘bad’ ones. From ‘dopamine shopping’ and gambling, to destructive behaviours like using recreational drugs or binge-drinking, disinhibition is a typical trait and can often lead to individuals missing deadlines at work, failing to meet their personal goals, or pay bills on time. 

‘Borderline patterns’ of behaviours, thoughts, and feelings

The main last personality trait worth mentioning here is what they call a ‘borderline pattern’ and this was (until very recently) the main criteria for diagnosing borderline personality disorder. 

This pattern of behaviours involves having intense emotions that can change quickly, from feeling worried about abandonment to pushing people away, from having a different sense of who you are depending on the people you’re around, to finding it hard to keep stable relationships and friendships. 

People with borderline patterns typically feel empty or lonely, they act impulsively, and self-harm and suicidal thoughts are common. Dissociation, paranoia, and psychotic experiences may also occur when someone with these traits is extremely stressed or particularly anxious. 

So, can these personality disorder symptoms be helped by medical cannabis?

An emerging treatment: medical cannabis for personality disorders

As we previously mentioned, at the moment in the UK first-line treatments for personality disorders follow the same premise as many other mental health conditions: primarily using talking therapies - however, the waiting lists for these are notoriously long. 

Therefore, NHS personality disorder treatment plans also routinely incorporate pharmaceutical medications that are designed to target specific symptoms such as anxiety, low mood, emotional instability, and poor sleep for day-to-day support. And while this approach works for many, unfortunately, it doesn’t meet the mark for everyone - hence the need for alternatives. 

Medical cannabis emerged as a potential treatment for personality disorders in the UK in 2018, when it was legalised for conditions known to respond to cannabis-based options. Those who have found conventional treatments to be ineffective, or have caused unpleasant or uncomfortable side effects, are likely to be considered suitable for prescribed cannabis providing they do not have a history of psychosis or schizophrenic tendencies. 

While these traits can occur in individuals with personality disorders - they do not, by any means, affect everyone with a personality disorder. Therefore, on a case-by-case basis cannabis-based treatments can be prescribed to treat personality disorders to relieve anxiety and stress, or improve mood or sleep routines - but much like the traditional approaches: this solution won’t work for everyone, which is why clinical supervision and support is paramount.

How do prescribed cannabis treatments work for personality disorders?

We’ve previously explored the role of the endocannabinoid system on the Releaf blog in great detail, but for the sake of clarity, here’s a quick recap: 

• The endocannabinoid system is in charge of regulating homeostasis within the body, impacting mood, sleep, pain, inflammation and so much more.
• Our bodies produce endocannabinoids to interact with this system to restore balance where needed. 
• Cannabis contains a class of chemicals called cannabinoids (or phytocannabinoids) that can mimic, or impact the effects of, endocannabinoids. 
• Therefore, when applied appropriately, cannabinoids like THC and CBD can interact with the endocannabinoid system, and its regulation of mood, sleep, pain, and inflammation. 
• When cannabinoids are used together, the entourage effect can occur - enhancing their effects within the body and the overall effects felt by the individual using cannabis-based treatments. 

We already know from wider research that medical cannabis can be promising for those with anxiety, depression, and issues with concentration - all of which are traits or signs of personality disorders. 

Similarly, depending on the severity of personality disorder, sleep can be impacted, whether it’s difficulty falling asleep, waking up frequently throughout the night, or getting poor quality sleep. And because sleep regulation is closely linked to the endocannabinoid system, medical cannabis treatments may help to restore a healthier sleep-wake cycle, in turn, supporting better mood stability throughout the day. 

Is there any evidence to support medical cannabis for personality disorders?

When it comes to specific findings relating to medical cannabis and personality disorders, published findings from project T21 in 2023 are particularly relevant. 

While T21 is the largest observational study of medical cannabis patients in the UK - it must be noted these results only relate to seven individuals who had been diagnosed with borderline personality disorder (BPD) and so, this is an extremely small sample. 

Nonetheless, five out of these seven individuals indicated that their cannabis-based treatment had made a definite improvement on their symptoms and made a real, worthwhile difference, with only one saying they didn’t feel any reported benefits with an oral cannabis extract after just one month.

Researchers theorise this is due to the slow-acting nature of cannabis oils, while inhaled cannabis treatments like medical cannabis flower and THC vapes achieve much more rapid symptom relief, which can be particularly helpful for conditions with fast-acting symptom onset, like the intensity that’s typical with personality disorders. 

While this sample size is far too small to draw universal conclusions, it mirrors what’s being seen in research into overlapping conditions. For example, studies on medical cannabis for post-traumatic stress disorder (PTSD), generalised anxiety disorder, and major depressive disorder have supported significant improvements in mood, better emotional regulation, and a reduction in intrusive thoughts, which could be relevant for many living with personality disorders. 

What this means in practice: How Releaf might be able to help

For people living with a personality disorder, no two days are exactly the same, and that’s just as true when it comes to treating symptoms. 

One of the reasons medical cannabis appeals to some patients is its flexibility. Unlike many medications that have to be taken at a certain time, in a fixed dose, with a long onset time, medical cannabis can be used as it's needed, providing rapid relief - allowing you to respond to your symptoms in real time. 

Whether it's anxiety creeping in in the early hours, impulsive busy thoughts that come mid-afternoon, to evenings that make unwinding feel impossible that seem to be impacting your wellbeing, at Releaf you and your doctor decide on the right treatment plan for you together. 

This includes selecting the right product formulations (cannabis oil, THC vapes, and medical cannabis flower) for your personality disorder needs, to the advised concentrations and dosages depending on how severe your symptoms typically feel - this truly is patient-centred care. 

Medical cannabis isn’t a one-size fits all magic fix, in fact for some it won’t work at all - but for others, it can help take the edge off disruptive days, potentially easing anxiety, benefitting focus, smoothing out intense emotions, and improving overall sleep.

If you think medical cannabis might be worth exploring, our expert team of clinicians and patient support staff are here to guide you through the process every step of the way. It starts with our free online eligibility check, followed by an initial consultation that’s protected by our money-back guarantee, and then our doctors will work with you to design your own, bespoke treatment plan. 

At Releaf, we believe treatment should work around you - not the other way round. 

Together, let’s rethink healthcare.