People with BPD have a higher risk (susceptibility) of developing PTSD and therefore there is an statistical overlap with many patients having both disorders (my wife included). However:
Co-occurrence (two things happening together) does not automatically mean causation, interaction, or a direct relationship;
Roughly 15-20% of Vietnam veterans experienced PTSD, with a lifetime prevalence around 18% according to major studies like NVVRS. Overall, that wasn't because of BPD at it did it make them develop BPD. Because BPD is a more complex disorder with origins in childhood and is also harder to treat.
Well, to be fair, among the veterans with PTSD, a fraction of them (8,7%) actually developed BPD. But, there are studies indicating that they already had BPD features (traits) previously. It is understandable that 18% x 8,7 = 1,5% of the veterans would already have subclinical BPD and then progress to develop clinical BPD after suffering from war traumas.
Yet complex-PTSD (CPTSD, as described by Pete Walker), on the other hand, relates better with BPD, since it also comes from childhood reoccurring traumatic memories.
Having that said, studies with Psychedelics on BPD patients must be designed and carried out very carefully. As by today, December 2025, the most clearly “in-progress / registered” work I can point to are:
1)
NCT05399498, an interventional study testing psilocybin in people with co-occurring major depressive disorder and borderline personality disorder, explicitly looking at symptom change in both conditions.
2)
NCT06683014, an interventional study testing MDMA’s effects on social cognition in adults with borderline personality disorder.
3)
ACTRN12624000871549 (ANZCTR), a registered trial combining BPD-specific psychotherapy with MDMA in a public mental health setting.
Major psychedelic centers (for example the Parsons Center at Mount Sinai) now list MDMA-assisted therapy for BPD among their research lines, although details are still emerging and these are small, early-phase investigations (
link).
There are also peer-reviewed discussions and case literature arguing for, and exploring, BPD-targeted psychedelic approaches (including LSD and MDMA frameworks), but those do not serve as a demonstration of efficacy. See more
here.
Perhaps a safer approach is Ketamine. One interesting case is about a BPD patient who was at the most extreme situation but finally begun to respond to treatment after Ketamine infusions:
Treatment of Borderline Personality Disorder with Ketamine - Dr Helena RoggRead more here:
Intravenous ketamine for suicide ideation in borderline personality and depressionKetamine is not actually a psychedelic, but the patient does loose contact with reality during the infusion. Ketamine is classified as a "dissociative anesthetic that has psychedelic properties". This is an already approved drug to treat persistent depression, not yet BPD. It works through the promotion of neuroplasticity, very similarly to Ayahuasca from Amazon forest, but without the associated risk of permanent psychosis. It helps by creating new pathways in the brain that enable the patient to break through the persistent recurring negative thoughts that sustained a depressive mood.
By the way, Ayahuasca is not recommended for BPD patients. My wife actually developed mild visual and auditory hallucinations after experimenting it in low dosage (around 20 ml). She only recovered from it one year later, after taking high dosage of B1 vitamin, which has neuroprotective effects (it was Benfotiamine, a high absorption form). Overall, it is too risky to experiment with Psychodelics with BPD patients, especially in a unsupervised way, because they can cause persistent hallucinations and psychosis due to brain damage.
My personal opinion is that the abnormal functionality seen in BPD, as well as the brain damage that is frequently seen in image exams, is related to low levels of essential nutrients during the first years of brain formation (e.g.: inside the womb and the first two years of life). That's why nutrients such as high quality Omega-3 TG are so helpful for BPD patients. And therefore, igniting the brain with a drug that has psychedelic features is a recipe for more brain damage. Perhaps replenishing with those nutrients for a few years would allow the brain to get stronger. But the challenge is to know the exact nutrients that are lacking. There are advanced intracellular exams for that purpose, but they are not designed to test brain cells.
