Borderline Personality Disorder Treatment and Addiction

Borderline Personality Disorder Treatment and Addiction – Borderline personality disorder (BPD) is a debilitating condition that distorts a person’s self-perception and interferes with their ability to sustain stable relationships. Those who experience BPD are often perceived as manipulative and dramatic, a behavior that experts believe develops as a dysfunctional means to deal with emotional pain and instability and fear.

Addiction and BPD often occur concurrently, and the relationship between them can be explosive and unpredictable. People with BPD are more likely to use drugs or alcohol than others as a means of self-medication and to escape feelings of fear and abandonment.

In fact, research has shown that about two-thirds of those suffering from BPD have abused a substance at some point in their lives. Unfortunately, drug and alcohol use tend to exacerbate some of the more alarming symptoms of BPD – anger, anxiety, and depression, most prominently.

In an effort to overcome an intense sense of emotional emptiness, they may also frequently engage in self-injuring behaviors, such as cutting. They are also prone to attempting suicide, especially when substance abuse is present.

Recognizing BPD

Symptoms of BPD may include the following:

  • Intense mood swings
  • Emotional hypersensitivity
  • Extreme depression or anxiety
  • Suicidal tendencies
  • Impulsive behavior
  • Irrational perceptions of others
  • Paranoia and delusions
  • Extreme anger or aggression
  • Lack of or an unstable sense of self
  • Profound fear of abandonment
  • Feelings of emptiness
  • Manipulative impulses

The effects of BPD often leave individuals with an extremely poor sense of self-worth. Their impulsive behavior and mood swings can often push other people away, leaving them isolated and withdrawn. This isolation can lead to anxiety or profound depression, as individuals with BPD have an intense fear of being abandoned or alone.

Ironically, those with BPD often push others away and preclude themselves from enjoying intimate, meaningful relationships because they are afraid of being abandoned by that loved one later on. BPD is often misdiagnosed as bipolar disorder or some other mood or personality disorder.

What Causes Borderline Personality Disorder?

Although the precise origins of BPD are unknown, there are several theories about how this complex personality disorder may develop. Factors that are believed to contribute to the development of BPD include the following:

Family Dysfunction and Trauma

Children who are raised in families where they feel emotionally neglected, abandoned, or abused are more likely to develop BPD as adolescents or young adults. This environment may elicit any number of traumatic situations or events, including sexual or physical abuse, rampant drug or alcohol use, or serious mental health disorders.

More pointedly, BPD is thought to result from neglect and/or abuse during the stage of childhood development in which the child learns how to rely on and trust others. As a result, individuals with BPD lack this essential aspect of interpersonal relationships.


BPD and other personality disorders are often observed among close family members, such as parents and their children or siblings. This fact suggests that certain people may have a genetic predisposition to developing BPD. Researchers believe that certain inherited tendencies or personality traits, such as aggression, may increase the risk of BPD when combined with environmental factors.

Neurobiology and Brain Chemistry

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Abnormalities in the regions of the brain that regulate mood, behavior, and emotions may be at least partially responsible for the emotional instability and impulsive/unpredictable behavior exhibited by those with BPD. Research has found that some areas of the brain – namely the amygdala, hippocampus, and orbitofrontal cortex – may be smaller or more active in persons with BPD.

BPD may also be linked to imbalances in certain neurotransmitters, which are naturally-occurring chemicals in the brain that affect the way people feel and behave. These include serotonin, dopamine, and noradrenaline, which are neurotransmitters responsible for the regulation of certain emotions and urges.

How BPD and Addiction Overlap

Many of the neurological and environmental factors that contribute to BPD are also strongly associated with substance abuse. Many people who suffer from alcohol or drug addiction come from environments where heavy drinking or drug use was prevalent, and this in and of itself may cause trauma to children.

Complicating matters, a history of childhood sexual abuse or other trauma also increases the risk of substance abuse later in life, as the person seeks ways to escape feelings of anger, resentment, fear, and pain. Furthermore, some neurological imaging studies have found that addiction is related to brain structure and function.

When it comes to addressing borderline personality disorder and addiction simultaneously, the similarities between the symptoms of the two can make both conditions difficult to diagnose appropriately. Treatment can be especially challenging when the individual’s antisocial and manipulative tendencies make him or her exasperating to work with.

Overlapping Signs and Symptoms of BPD and Addiction

As mentioned, symptoms of BPD are often confused with those of substance abuse, which can make BPD challenging to identify. Both BPD and substance abuse/addiction may be characterized by the following:

  • Impulsive, self-destructive behaviors
  • Manipulative and deceitful actions
  • Unstable and strained relationships
  • Legal, financial, or employment problems
  • Mood swings from profound depression to mania
  • Recklessness and neglect of one’s own health and safety

Borderline Personality Disorder Treatment

Addiction and BPD can be addressed concurrently in addiction treatment centers that offer dual diagnosis programs. These treatment programs generally provide therapy, counseling, support, and pharmacological intervention for both mental health and substance use disorder.

Perhaps the most common and effective approach to treating both these conditions is cognitive-behavioral therapy (CBT). CBT is used in rehab facilities to help patients identify the thought patterns that cause their impulsive and addictive behavior. Likewise, CBT teaches patients how to regulate their moods and emotions better, so they are less likely to resort to the use of drugs or alcohol as a means to cope.

Treating borderline personality disorder is particularly challenging because clients with BPD often make unrealistic demands of their therapists and insist on constant contact with their treatment team. They may come across as dependent and needy due to a propensity to seek out caregivers who can meet or enable their unreasonable emotional needs.

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Surreal portrait of a young girl covering her face and eyes with her hands face shines through hands face is divided into many parts by cards double exposure

Making treatment even more difficult, individuals with BPD may turn against their providers, and become antagonistic and paranoid without any apparent reason. Understanding the emotional landscape of borderline personality disorder is critical for professionals who treat this severe psychiatric condition.

In addition to individual psychotherapy, clients who receive integrated treatment can attend classes and counseling sessions that focus on relapse prevention. Relapse prevention training is vitally important for those with co-occurring conditions such as these, as relapse rates tend to be high. Relapse prevention often involves peer group support meetings, where clients who have been diagnosed with both BPD and substance abuse problems can share coping strategies and address the challenges of living with this dual diagnosis.

Psychiatric drugs and anti-addiction medication can also be powerful tools when used as part of a comprehensive treatment plan. Many BPD patients find that medications that restore balance to levels of neurotransmitters (e.g., antidepressants in the selective serotonin reuptake inhibitor family) are beneficial. Moreover, anti-addiction medications such as Suboxone and naltrexone can also help by reducing withdrawal symptoms and mitigating cravings for alcohol or opioid drugs.

How We Can Help

If you or a loved one has borderline personality disorder and is also suffering from drug or alcohol addiction, contact us as soon as possible to learn about our treatment options and how we can help you recover from both conditions and reclaim your life.

We employ certified addiction professionals who are dedicated to helping every client we serve by providing them with the tools and support they so direly need to achieve abstinence and sustain long-term wellness and sobriety.

You can experience the fulfilling life you deserve! Contact us today!

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