800-671-4304Borderline Personality Disorder & Addiction [ + Recovery Toolkit ]
Borderline personality disorder (BPD) and addiction to drugs or alcohol are both serious and potentially debilitating mental health disorders affecting Americans.
They often co-occur, as both diagnoses share patterns of excessive risk taking and impulsive decision making.
This article will cover BPD and addiction symptoms and why these disorders co-occur. We will also share effective addiction treatment options and support resources that can change lives.
Need help with your BPD triggers? Call today to speak with someone.
SponsoredWhat is Borderline Personality Disorder?
While the name sounds vague, the borderline personality disorder definition is more clear. BPD is a chronic personality disorder characterized by an unstable sense of self that can lead to having distorted perceptions about the world, others, and the person’s own identity.
An individual with BPD has difficulties controlling moods, regulating behaviors, nurturing a positive self-image and maintaining healthy relationships.
These instability patterns frequently result in volatile emotional states, impulsive behaviors, strained relationships, chronic feelings of emptiness, and self-destructive behaviors such as drug abuse and even suicide.
BPD: A Misunderstood Mental Health Disorder
BPD typically develops in adolescence or early adulthood, a period of life characterized by change and growth. People with BPD can erroneously be seen as problematic, as the disorder may result in shocking behaviors and angry outbursts that can isolate individuals from even loved ones.
Nevertheless, BPD is a medical condition that has biological, genetic and social causes. Individuals with BPD need and deserve help. The good news is that effective treatment exists.
Download the BPD and Addiction Coping Toolkit
If you or someone you love is struggling with BPD or using substances to cope with emotional distress, our evidence-based resources are here to help.
Get practical worksheets for daily tracking, crisis planning, and family communication. Start using tools that make recovery more manageable and a new life possible.
Symptoms of Borderline Personality Disorder
BPD symptoms include:
- Identity disturbances
- Persistent feelings of emptiness
- Difficulties controlling anger
- Fear of abandonment
- Intense and unstable relationships
- Impulsive behavior
- Engaging in risky activities, including substance abuse, reckless sex, erratic driving and binge eating
- Self harm or suicidal behavior
- Intense mood swings
- Paranoid thoughts or dissociation
Keep in mind that many people without BPD have one or more of these symptoms. The only way to tell if you have BPD is after consulting a licensed professional who will evaluate your symptoms to establish a medical diagnosis according to the DSM-5.
Are You Born with BPD or Does It Develop Later?
A person is not born with BPD. While many causes for BPD include genetic or biological risk factors, these are only predispositions. BPD development is a gradual process.
It’s the result of the interaction between a person’s unique biological and psychological risk factors, family dynamics, adverse childhood experiences, socioeconomic conditions and everyday events.
Causes of Borderline Personality Disorder
Borderline personality disorder develops as a result of several causes coming together, but these causes will vary from person to person. Core causes of BPD include:
Genetic Predisposition
Traits that may lead to developing BPD, such as impulsivity and emotional reactivity, appear to be inheritable. Siblings of an individual diagnosed with BPD have almost five times the risk of developing BPD themselves.
Brain Chemistry
Certain variations in brain chemistry appear to play a role in borderline personality disorder:
- Dopamine: Individuals with BPD may present with dysfunction in dopamine that may lead to impulsivity and emotional dysregulation.
- Serotonin: Aggression, mood swings and impulsive patterns that appear in BPD are associated with unbalanced serotonin levels.
- Oxytocin: Low oxytocin levels may aggravate BPD symptoms, as it can influence interpersonal relationships.
- Glutamate: Impulsive decision-making and mood instability may be the result of imbalances in glutamate levels.
Environmental Trauma
Over 70% of individuals diagnosed with BPD experienced intense traumatic events in their childhood.
Neglect, physical, sexual and emotional abuse, and other forms of trauma can produce neurological changes affecting how an individual’s personality copes with stress, potentially making them more sensitive to it.
An individual’s personality is the result of the unique combination of psychological, biological, developmental and social factors. The interaction of these root causes contributes to the development of BPD, which can be aggravated by lifetime triggers such as everyday stressful events.
What Triggers Worsen BPD?
A person with BPD may have more pronounced symptoms at certain times as a reaction to triggers that worsen their symptoms. BPD triggers include:
- Criticism
- Perceived or real rejection
- Lack of treatment
- Insufficient social support
- Stress
- Losing a family member
- Being fired from a job
- Financial struggles
- Co-occurring mental health disorders
- Loneliness
One of the dangers of BPD is that other mental health disorders, such as substance abuse, can aggravate symptoms and multiply the risk of harmful consequences.
Need help with your BPD triggers? Call today to speak with someone.
SponsoredThe Connection Between BPD and Addiction
Individuals with BPD have almost 4 times the risk of developing a substance use disorder. What is the connection between a personality disorder and addiction?
Individuals with BPD or addictive disorders tend to struggle with controlling their emotions while showcasing a tendency to engage in impulsive behaviors like substance use.
It’s believed that the same developmental processes that can predispose a person to have trouble resisting urges and avoiding risky behaviors can lead to developing a substance use disorder, BPD, or as it often occurs, both disorders at the same time.
Additionally, one of BPD’s core characteristics is mood shifts. Substances are commonly used to cope with negative emotional states, which can lead to the gradual development of an addiction, and paradoxically, make BPD symptoms worse.
How Addiction Worsens BPD Symptoms
For individuals struggling with borderline personality disorder and addiction, each disorder can make the other one more severe.
Patients with BPD and a substance use disorder have:
- A more elevated suicide risk
- Higher hospitalization and mortality rates
- Lower treatment adherence
- Higher relapse rates
- Increased risk of paranoia
- Withdrawal symptoms and cravings exacerbate BPD’s emotional negative consequences
- Lower employment levels and profound functional impairments
Addiction is one of the worst prognostic factors for BPD recovery, meaning that it makes your BPD prognosis much worse. As addiction progresses, BPD symptoms accelerate while brain changes that can make negative behaviors become habitual are reinforced.
It’s a vicious cycle that can disrupt a person’s capacity to experience positive emotions, have meaningful relationships and accomplish goals.
BPD and Alcohol
Does alcohol make BPD worse? The short answer is yes, BDP and drinking alcohol are a potentially dangerous combination.
Alcohol addiction can predispose a person to worse episodes of BPD, while BPD can reinforce alcoholism because you might drink more to cope with the negative feelings that BPD causes.
BPD and alcohol abuse are associated with common risk factors that include a propensity to seek intense experiences, difficulties expressing affect and impulsivity.
BPD and Marijuana
Borderline personality disorder and weed are linked as well. It’s estimated that 31% of individuals with BPD also struggle with cannabis use disorder.
A person with BPD may try to cope with their symptoms by using marijuana, yet weed can increase the chance of experiencing psychotic episodes and worsen depressive and anxiety symptoms.
BPD and Other Substances
Prescription misuse is a common dual diagnosis with BPD. 8.4% of individuals with BPD also have a sedative use disorder.
Borderline personality disorder and stimulants use can also co-occur, increasing the risk of addiction and worsening BPD’s mental illness symptoms, such as anxiety and aggressiveness.
Psychedelics and BPD are another dangerous combination, as these drugs can elevate the risk of psychotic episodes and erratic behaviors.
Statistics on BPD and Addiction
To help you better understand the links between BPD and addiction, and how these conditions impact each other, let’s explore what data tells us.
Substance Abuse and Borderline Personality Disorder Statistics
- Almost 50% of individuals with BPD meet criteria for a substance use disorder.
- 25% of people with an addiction also have a BPD diagnosis.
- 72% of patients with BPD will develop a substance use disorder during their lifetime.
- Alcoholism is five times more likely in individuals with a BPD diagnosis.
BPD Statistics
- Between 0.7% to 2.7% of Americans are impacted by BPD.
- Up to 10% of individuals with BPD die by suicide.
- 75% of patients with BPD are at risk of self-harm.
- 9% of emergency room visits are associated with BPD.
- Women are diagnosed with BPD three times as often as men, but these disparities appear to be a consequence of men seeking treatment less frequently.
The Impact of BPD and Addiction on Daily Life
BPD and addiction together have profound negative impacts on functioning and health in a person’s day to day life.
Short-Term Effects
Co-occurrence of BPD and substance use may reinforce and aggravate symptoms of both disorders.
- More severe BPD symptoms and more severe addiction
- Low life satisfaction
- Persistent anger
- Emotional instability that can lead to relationship destruction
- Low academic and job performance
- Risky sexual behaviors
- Vehicular accidents
Long-Term Effects
In addition to impacting your day to day life in the short term, a co-occurring personality disorder and addiction can cause lifelong risks and issues as well, such as:
- Elevated suicide risk, one of the most devastating dangers of BPD
- Disruptions in accomplishing life milestones
- Financial, legal and housing issues
- Unemployment
- Elevated healthcare costs
- Other mental health disorders
- Loneliness, as only 16% of individuals with BPD are married or live with a partner
- Diseases caused by a lack of adequate diet and lifestyle, such as obesity, diabetes and heart problems
- Early death – patients with BPD die 14 to 32 years earlier on average
Impact on Families and Relationships
Living with someone with borderline personality disorder can be a challenge. Not everyone knows how to handle BPD.
Walking on eggshells, trying not to cause conflicts and dealing with the consequences of BPD can strain families and even break bonds. The compound devastating effects of addiction and BPD only aggravate things, and individuals can end up isolated.
Worried that you may have BPD? Call now for help.
SponsoredTreatment Options for BPD and Addiction
Treatment for borderline personality disorder and addiction is more successful when both conditions are addressed as part of a comprehensive dual diagnosis protocol. Otherwise, if you only treat one condition, the other condition will make that treatment less successful.
Detox and Stabilization
Treatment for borderline personality disorder and addiction generally starts with detox and stabilization. Recovery from BPD while actively consuming substances is rarely possible, if ever.
A detox rehab program is led by experts who will support a person in safely quitting by employing medications, if necessary, that can lessen withdrawal effects and manage cravings, while beginning to address emotional instability.
Inpatient Dual Diagnosis Treatment
Inpatient treatment for BPD is an ideal recovery option for individuals who may be in danger of self-harm, have severe addictive disorders or could use a fresh environment to focus 100% on healing.
Residential dual diagnosis centers provide therapies with evidence-based efficacy for both disorders, prescribe medications, and offer a safe community where empathy and understanding promote recovery. You have the accountability of having support around the clock to minimize your risk for relapse and crisis.
Outpatient and Long Term Care
Outpatient BPD treatment offers individuals the possibility to access dual diagnosis programs on a part-time basis. This flexibility is ideal for people with robust social support systems, less intense addictive disorders and low self-harm risk who don’t need 24 hour supervision.
Here, by attending regular therapy sessions, a person can develop structure and social skills and learn to manage uncomfortable emotions with better coping mechanisms while accessing medication, therapists and peers that can assist in the healing process.
As both BPD and addiction are chronic disorders that can recur, outpatient programs are ideally positioned for long-term support to prevent relapse and reroute treatment if necessary.
Medication Therapies
While there’s no unique BPD medicine that can put the disorder into remission, licensed professionals can offer medications to reduce symptoms.
Anxiety, depressive or psychotic symptoms can be treated with medications, but in every case, the decision to prescribe will be based on an individual’s needs and their physician’s criteria.
Meanwhile, licensed professionals may also employ prescription drugs for addiction. Depending on the substances you use, medications can manage the withdrawal effects and cravings that can emerge after quitting.
Download the BPD and Addiction Coping Toolkit
Get practical worksheets for daily tracking, crisis planning, and family communication. Start using tools that facilitate recovery.
How to Support Someone with BPD and Addiction
For families, partners, and friends needing help, there are certain things you can do to help with your loved one’s condition and to support a healthy relationship. Consider this guidance on how to handle BPD and addiction.
Communicating Effectively
How do you talk to someone with borderline personality disorder? These tips can help you communicate with them in a way that benefits you both.
- Be a good listener: Individuals with BPD and addiction can be sensitive to criticism and rejection. Offer an empathetic ear.
- Avoid passing judgment: There’s stigma surrounding BPD and addiction. People can be perceived as manipulative, deceptive, immoral, or attention-seeking.
- De-escalate confrontation, yet be firm: Establish boundaries around money, behaviors and what you will and not tolerate.
Safety and Danger Considerations
Are people with borderline personality disorder dangerous? While some may lash out, not all people with BPD have this risk. Pay attention to these warning signs:
- Self-harm behaviors: Suicide is one of the main dangers of BPD. If your loved one cuts themselves or makes remarks about harming themselves, it’s best to seek professional help. Don’t assume that they are “all talk” or are only seeking attention.
- Threats and criminal behavior: If a person with BPD and addiction threatens you or your family, invades your property or robs you, it’s best to contact authorities for guidance.
Downloadable Asset: Addiction and BPD Coping Toolkit (Exclusive)
Addiction and personality disorders such as BPD can affect entire families. Based on our expertise in helping hundreds of individuals recover from dual diagnoses, we have built an exclusive BPD and Addiction Coping Toolkit.
Here, you will find worksheets to develop communication and coping skills to grow as a person.
You will have access to exclusive scripts so you, as a loved one of a person struggling with BPD and addiction, know what to say and where to seek help.
Download it here.
When to Consider Getting Help
If you have BPD or suspect you may, seeking treatment for borderline personality disorder and addiction is a good idea if:
- You have suicidal thoughts
- Your drinking or drug use is escalating
- Family relationships are breaking down
- Your capacity to be productive is affected
- You can’t control your anger or impulses
Download the BPD and Addiction Coping Toolkit
Get practical worksheets for daily tracking, crisis planning, and family communication. Start using tools that make recovery from BPD and substance abuse more manageable.
FAQ: Borderline Personality Disorder and Addiction
Only a licensed professional can diagnose BPD. Symptoms such as relationship problems, uncontrollable anger, and impulsive behaviors may suggest BPD, but you need to seek medical guidance for an accurate diagnosis.
No, no one is born with BPD. The interaction of a person’s circumstances, environment, and biological characteristics contributes to developing BPD, which usually occurs in adolescence and early adulthood.
It depends, as each person’s case is unique. BPD often co-occurs with other mental health disorders such as addiction.
In these cases, a dual diagnosis treatment approach combining medication if necessary, behavioral health therapies and community support offers the best chances of recovery.
There are multiple causes of borderline personality disorder. Genetic inheritance that affects personality development, parenting, adverse childhood experiences and life events are all potential contributing factors for BPD development.
The word ‘’cure’’ is rarely used in mental health medicine as psychiatric disorders like BPD tend to have a chronic nature. Effective treatment for BPD exists, yet it works by reducing symptoms and helping people function better, not by offering a definitive “cure,” as relapse is possible.
The best borderline personality disorder medicine depends on each individual’s case.
For someone with a co-occurring opioid addiction, therapy and medication to treat this addiction can help them manage withdrawal symptoms and cravings. For another person, behavioral therapies alone may work better.
Yes, alcohol can aggravate BPD symptoms, while elevating the risk of addiction development, which also exacerbates the negative effects of mental health disorders such as BPD.
Not necessarily. While individuals with BPD can be aggressive, they aren’t inherently dangerous. However, if someone with BPD makes threats, it’s better to seek professional assistance.
While each person is unique, a calm, empathetic approach that avoids harsh criticisms yet establishes boundaries against aggression is usually the best way to talk to someone with BPD.
Yes, BPD and marijuana can be a harmful combination because weed may elevate the risk of addiction and psychotic episodes, while worsening symptoms such as anxiety and depression.
BPD and drug abuse are always a bad idea. Illegal drugs have no benefits for BPD, only aggravating symptoms in most cases, and leading to addiction in many others, which can create additional harmful consequences.
Borderline personality disorder statistics indicate that individuals with BPD can die 14 to 32 years earlier than the average person. However, life expectancy depends on many factors beyond BPD, such as chronic diseases, genetic risks and lifestyle choices.
One of the dangers of BPD is that it can disrupt a person’s capacity to lead a productive life, opening the doors to risky behaviors such as drug addiction and ultimately even isolation or suicide. Left untreated, BPD can impede a person from achieving their goals.
There’s Hope for People with BPD and Addiction
Accessing treatment for borderline personality disorder and addiction can be one of the best decisions you ever make.
Untreated BPD and addiction can distance you from the ones you love the most, truncate your dreams and affect your health.
The good news is that recovery is possible with dual diagnosis treatment. Don’t wait to get help; there are compassionate counselors waiting for you.
Need help taking the first step? Call now.
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