Borderline Personality Disorder and Addiction

Borderline Personality Disorder (BPD) and addiction often happen simultaneously and have similar signs and symptoms. A dual diagnosis treatment program can help those struggling with BPD and addiction.

What is Borderline Personality Disorder?

Borderline Personality Disorder (BPD) is a mental illness characterized by a distorted self-image, impulsiveness, extreme emotions and intense, unstable relationships. Individuals with BPD generally suffer from other psychological disorders, such as anxiety, depression and eating disorders.

People with borderline personality disorder have higher rates of suicidal behaviors and substance abuse.

Researchers believe several factors contribute to a person’s development of borderline personality disorder, including:

  • Genetics – BPD tends to runs in families which lead scientists to believe genetics play a role in the disorder. Certain inherited temperaments or personality traits, such as aggression, may increase BPD risk when combined with environmental factors.
  • Neurotransmitters – Altered functioning of neurotransmitters in the brain, specifically serotonin, dopamine and noradrenalin, may make a person more likely to develop BPD. These neurotransmitters are responsible for the regulation of certain emotions and urges.
  • Neurobiology – Studies have shown that certain regions of the brain tend to be smaller or more active in those with BPD. The three areas in particular are the amygdala, hippocampus, and the orbitofrontal cortex.
  • Environmental factors – There are several environmental factors that seem to be common among those with BPD. These factors include childhood trauma, growing up in an unstable family situation or around people with mental disorders or substance use problems.

Borderline Personality Disorder and Addiction

Addiction and BPD often occur concurrently. Two-thirds of all individuals suffering from BPD have abused a substance at some point in their lives.

Some BPD sufferers use drugs to mask their symptoms or to feel better about themselves, making substance abuse common among those with this disorder. For others, it can be a form of self-medication that brings feelings of calm.

The symptoms and signs of BPD and addiction are very similar.

BPD and addiction are both characterized by extreme mood swings, self-destructive behaviors, deceitful actions, and unstable relationships and careers. These similarities make it difficult to diagnose the conditions separately. Often, a single condition is diagnosed first and the other is discovered later.

Treating co-occurring addiction and BPD is quite challenging. Given that those with BPD are already prone to emotional instability, using drugs or alcohol can make their behaviors and choices even more erratic. One of the biggest struggles in treating these co-occurring disorders is getting the patient to complete the treatment program.

“Addicts with BPD have been described as both treatment demanding and treatment resistant. Research shows more positive outcomes the longer an addict with BPD stays in treatment, yet keeping them in treatment is no easy task. In a study of patients in a detox program, those with BPD were significantly more likely to have an unplanned discharge than those without BPD.” – Dr. David Sack, Psych Central, 2012

Even though diagnosing and treating these disorders can be difficult, there is an increasing number of facilities that offer dual diagnosis programs for BPD and addiction.

Questions about treatment?

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BPD Symptoms and Effects

Symptoms of BPD are often confused with symptoms of substance abuse. However, therapists have made great strides over the past 20 years in understanding and diagnosing BPD and addiction.

Some people with BPD may also lapse into brief psychotic episodes when under stress.

The effects of BPD leave individuals with an extremely low feeling of self-worth. Many people with BPD have a fear of being alone or abandoned. However, their impulsive behaviors and bouts of anger can push others away, leaving them isolated. This isolation usually leads to extreme anxiety or depression. People suffering from BPD are often unsure of their sense of self and are constantly trying to change who they are in an effort to build relationships.

Common borderline personality disorder symptoms include:

  • Intense emotional swings
  • Extreme episodes of depression or anxiety
  • Suicidal tendencies
  • Impulsive behavior
  • Extreme changes in perceptions of others
  • Paranoia
  • Episodes of extreme anger or aggression
  • Lack of or unstable sense of self
  • Intense fear of being alone
  • Eating disorders, such as anorexia or bulimia
  • Feelings of emptiness
  • Manipulative behavior

Addiction and Borderline Personality Disorder Treatment

Addiction and BPD can be treated simultaneously in rehabs that offer dual diagnosis programs. These programs provide both psychotherapy and substance abuse treatment services.

Various modes of therapy, such as cognitive behavioral therapy, are used in rehabilitation facilities to help patients identify the thought patterns that cause their impulsive behavior. Cognitive behavioral therapy also helps patients to better manage their emotions so they don’t have to turn to drugs or alcohol to cope.

Co-occurring substance abuse is treated with the help of a physician that oversees the patient’s withdrawal from drugs or alcohol.

Addiction and BPD can be treated on an inpatient or outpatient basis, depending on the severity of the disorders.

If you or your loved one is struggling with co-occurring BPD and addiction, please call us now for help finding a dual diagnosis program.