Borderline Personality Disorder (BPD) is a less known mental health condition, and yet those affected by it have a high risk of developing addictions. Understanding how BPD and substance use disorder are related can help people get the treatment they need.
Unlike physical conditions, mental illnesses can be easy to dismiss. People may stereotype as “dramatic” or “emotional” could actually be a diagnosable personality disorder that can affect all areas of a person’s life. Such a condition is called Borderline Personality Disorder (BPD), which affects 4 million people, or 1.4% of the population in the United States alone.
What Is Borderline Personality Disorder?
Borderline Personality Disorder (BPD) is a mental health condition that affects people’s way of thinking about themselves and others. The thought patterns of a person with BPD can affect their relationships, daily responsibilities, and overall outcome of their lives.
To be specific, the traits of someone with Borderline Personality Disorder include the following:
Intense fear of abandonment
In relationships, people with BPD are described as extremely ‘clingy’ and will do anything within their means to keep their partners. They can be irrationally suspicious, or can sometimes be overbearing or controlling to the point that it harms the relationship they are trying to restore.
Another characteristic of someone with this disorder is having an unstable personality or shifting moods. Quite different from bipolar disorder, people with BPD feel negative emotions intensely, which makes them react to seemingly simple situations exaggeratedly. For example, a partner forgetting to call or send a message once may result in an extreme emotional outburst.
This trait is related to BPD’s unstable personality characteristics. Since they feel emotions intensely, they also tend to do risky behaviors that they may regret later on. Risky behaviors include actions that can harm the relationship and put others’ lives or their own lives in danger as well.
Another hallmark characteristic of someone with a Borderline personality is their frequent shift in perception regarding their identity. One moment they may feel secure and happy about themselves, and in the next instance, they may feel empty, angry, or unsure about themselves.
If these personality traits are present in you or a loved one, they may have Borderline Personality Disorder (BPD). It is best to seek professional help to get the appropriate diagnosis and management of this condition.
Borderline Personality Disorder And Addiction
Now, how does BPD relate to having substance use disorder problems? There are many reasons why many mental health conditions are associated with having an addiction. To be precise, below are possible links as to why those suffering from Borderline personality may also have a co-occurring substance use disorder (SUD):
- People with BPD are likely to exhibit risky behaviors: A study published in 2014 quoted that 78% of individuals diagnosed with BPD have developed a substance use-related disorder at some point in their lives. One of the reasons to explain this is their tendency to commit behaviors that are risky. They are prone to using illicit drugs, drinking large amounts of alcohol, or abusing prescribed medications.
- A coping mechanism for unstable moods and chronic stress: Just like other mental health illnesses, people with Borderline personality tend to experience more emotional stress than normal. Since the unstable moods and stressful relationships are difficult to manage, people with BPD may end up using drugs or alcohol to experience some form of stability or to “numb out” the intense feelings coming through.
- Exposure to medications: Those with a formal diagnosis of BPD may be prescribed mood stabilizers and antidepressants to help with their instances of depression. The exposure to medications may increase the risk of using beyond the intended dosage. Some individuals end up having prescribed medication addictions.
The factors described above depict the strongest associations as to why people with Borderline personality tend to abuse drugs and alcohol as well. People who suffer from a dual diagnosis condition (BPD and substance use disorder) tend to have at least one of these factors in their history.
BPD Symptoms And Effects
Aside from the traits that describe Borderline personality, there are also specific symptoms and effects that you may want to observe in yourself or a loved one. Additionally, there are also potential effects of developing this condition without treatment.
Common borderline personality disorder symptoms:
- Fear of being abandoned, often seen by initiating volatile relationships or cutting off intimacy in anticipation of the other person leaving
- Unstable relationships with others, ranging from warmth and closeness while going towards hate and anger rapidly.
- Distorted sense of self, low self-esteem, or unrealistic perception of one’s identity
- Incidences of self-harm or suicidal attempts
- Lack of trust with others
People with BPD often experience these symptoms with triggers that appear “normal” to others. Events such as a loved one traveling, or missing a phone call when driving can be triggers for someone with borderline personality to experience heightened mood swings and may even negatively threaten their family, friends, or partners.
As a result, there are various effects in an individual’s life due to this condition.
Typical effects of borderline personality disorder:
- Strained relationships with family, friends, and partners
- Inability to perform daily tasks and responsibilities
- Substance use disorder problems
- Health issues related to chronic stress (nausea, vertigo, insomnia, weight changes, hair loss, etc.)
- Bipolar behavior
- Legal and financial troubles related to impulsive behavior and substance use disorder.
- Accident-prone behaviors
Someone suffering from both Borderline personality disorder along with substance use disorder needs a special kind of treatment. Since the dual diagnosis comprises two serious mental health conditions, professional help is necessary to achieve recovery from these disorders.
What Causes Borderline Personality Disorder?
Scientists believe that the exact cause of BPD is unknown. However, there are several risk factors that make people prone to having this certain personality disorder. Genetics, neurotransmitters, neurobiology, environmental factors are just some of the reasons why people develop BPD.
- Genetics: Some personality disorders run in families. People who have a family history of depression, anxiety, and other mood disorders tend to pass it on to their children.
- Neurotransmitters and neurobiology: Brain chemicals also affect people who are susceptible to BPD. For example, women who have hormonal changes during their menstruation and borderline personality tendencies may have intense outbursts due to brain chemical imbalances. Some brain development problems may have occurred due to seizures, trauma, or issues during fetal growth.
- Environmental factors: People who have experienced abuse or unstable relationships growing up may also develop negative patterns of thinking that lead to BPD.
Combining “nature” and “nurture” factors equally influences people who develop this pervasive personality disorder. As addiction and mental health specialists assess people with addiction and personality disorders, it is important to note the client’s risk factors. This is necessary to provide the best treatment possible.
Addiction And Borderline Personality Disorder Treatment
High-quality rehab centers such as Sunshine Behavioral Health offer a myriad of treatment options to those who have substance use disorder and BPD. When looking for a facility that presents various rehab approaches, it is important to find addiction and mental health specialists who rely on evidence-based principles.
Below are some of the treatment options for BPD and addiction which are supported by research:
Dialectical behavioral therapy
According to a study done in 2003, dialectical behavior therapy (DBT) is one of the most effective approaches for treating people with borderline personality and addictions. The study showed that patients had better retention rates and lesser instances of impulsive and self-harming behaviors.
Dialectical behavioral therapy is based on the following goals:
- The therapist should facilitate means for patients who enhance their capabilities
- These capabilities should be generalized into their natural environment
- Finding sources of motivation and decreasing dysfunctional thinking and behaviors
- Structuring the environment to avoid triggers and help increase motivation
In general, the goal of DBT is to help patients improve their capability to regulate emotions and improve their sense of self.
Another form of psychotherapy is called cognitive-behavioral therapy or CBT. Although it is commonly used to treat mental health disorders such as schizophrenia, anxiety, autism, and depression, it is also beneficial in conditions that accompany unstable moods such as BPD.
The following principles summarize Cognitive-behavioral:
- Understanding that thoughts influence emotions, and emotions influence behavior
- The way patient perceives a situation can greatly affect their response
- Faulty ways of thinking or thought patterns can be avoided, which helps improve responses and behaviors
In essence, CBT works by helping patients process how they perceive events in their lives, and finding ways to eliminate unhelpful thought patterns. This results in better ways to respond and cope with situations.
Treatment of BPD is complicated in patients with ongoing substance use. Psychoeducation and motivational interviewing are useful approaches. In patients with a co-occurring substance use disorder, treatment of the substance use disorder takes precedence over BPD. Physiologically dependent patients, if willing, undergo medically supervised withdrawal followed by maintenance treatment.
Aside from these major treatment options, patients also choose other approaches that they feel might be a great fit for them. These include holistic therapies, faith-based treatment, 12-Step, and Non-12-Step options.
Personality Disorders And Addiction? Don’t Let It Control You
If you’re someone who has a personality disorder such as BPD along with an addiction, it is easy to feel like you’re out of control. However, with the right resources and people to help you, it is possible to achieve a better quality of life.
- Nimh.nih.gov – “Personality Disorders”.
- Mayoclinic.org – “Borderline Personality Disorder”.
- Ncbi.nlm.nih.gov – “Borderline Personality Disorder and Comorbid Addiction”.
- Ncbi.nlm.nih.gov – “Efficacy and Tolerability of Pharmacotherapies for Borderline Personality Disorder”.
- Nimh.nih.gov – “Borderline Personality Disorder”.
- Semanticscholar.org – “Dialectical behaviour therapy for women with borderline personality disorder”
- Ncbi.nlm.nih.gov – “Dialectical Behavior Therapy”.
Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.
Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.