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  • Borderline Personality Disorder (BPD) & Addiction | Dual Diagnosis Prevalence, Symptoms, Risk Factors, & Treatment

    Borderline Personality Disorder (BPD) & Addiction | Symptoms & Causes

    Borderline Personality Disorder (BPD) affects 1.4 percent of United States adults. People with BPD have trouble forming relationships and controlling their emotions. They act impulsively, often in self-destructive ways.

    Many people with BPD turn to drugs or alcohol abuse to relieve their symptoms, only to develop a substance addiction as well.

    Prevalence Of Borderline Personality Disorder (BPD) & Addiction

    A review of 70 studies on borderline personality disorder (BPD) and substance use disorder (SUD) found that the two often appear as co-occurring disorders. Half of the people with BPD have a current SUD. About 25 percent of people with a SUD also have BPD.

    A substance use disorder is characterized by substance abuse that interferes with daily life. The most severe type of SUD is alcohol or drug addiction.

    Other research shows that 78 percent of people with BPD will struggle with a SUD at some point in their lives. 

    Seventy-five percent of people diagnosed with BPD are women. This gender disparity may be because men are often misdiagnosed with post-traumatic stress disorder (PTSD) instead of BPD.

    Symptoms Of Borderline Personality Disorder (BPD) & Addiction

    Borderline personality disorder (BPD) and addiction share some symptoms, and each disorder can worsen the symptoms of the other.

    Symptoms Of BPD

    People with BPD have four types of symptoms: 

    • difficulty regulating emotions
    • acting impulsively
    • trouble with interpersonal relationships
    • self-harm or suicidal behavior

    The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) gives nine key characteristics of BPD and requires that a person have five of them before being diagnosed with the disorder. They are:

    1. desperate attempts to avoid abandonment, whether the threat is real or not
    2. unstable relationships characterized by intense shifts in feelings toward another person
    3. constant changes in how you view yourself (self-image)
    4. impulsive behavior in at least two areas (such as substance abuse and reckless driving)
    5. self-mutilation (cutting), suicide attempts, or threats to do these things
    6. intense mood swings in which a high or low can last a few hours or a few days
    7. a persistent feeling of emptiness
    8. out-of-control anger that occurs frequently and may result in physical fights
    9. temporary paranoid ideation or dissociation (disconnection from self or reality)

    Some BPD symptoms make it more likely that a person will abuse drugs and alcohol. Fear of abandonment can cause extreme anxiety that may be temporarily dulled by substance abuse. Many people try to fill feelings of emptiness with drugs or alcohol.

    Symptoms Of Addiction

    Addiction can lead to BPD-like symptoms, such as:

    • social isolation
    • unstable relationships
    • loss of behavioral control (over drug use)
    • drastic shifts in mood
    • paranoia, dissociation, or suicidal behavior (from some drugs)
    • difficulty controlling anger

    Other symptoms of addiction include:

    • physical and mental issues from drug use
    • money problems from buying drugs or alcohol
    • loss of interest in hobbies or work
    • poor performance at work or school, possibly leading to job loss or failed classes

    Risk Factors For Borderline Personality Disorder (BPD) & Addiction

    Scientists don’t completely understand why borderline personality disorder (BPD) occurs, but it’s likely caused by a combination of factors, such as:

    • Environment: If you went through trauma, abuse, or neglect, your BPD risk is higher.
    • Genetics: If a family member has BPD, you have a higher risk of developing it too.
    • Brain function: Some research indicates that parts of the brain responsible for decision-making and emotional control aren’t communicating properly in BPD.

    All of these risk factors also make a person more likely to develop an addiction. Further risk factors for addiction include:

    • Mental health disorders: Substance abuse can stem from mental illness as a way to cope with unpleasant symptoms or from poor mental health as a way to deal with stress.
    • Peer pressure: If you care what other people think of you and they pressure you to do drugs, it can be harder to resist. This is especially a problem with adolescents.
    • Lack of family involvement: Strained family relationships or lack of supervision from parents can increase the chance that you’ll abuse drugs or alcohol and become addicted.
    • Early use: Starting drug use in adolescence makes it more likely that you’ll develop an addiction.

    Dual Diagnosis Treatment For BPD & Addiction

    If addiction is treated but borderline personality disorder (BPD) is not, it’s likely the symptoms of BPD will cause a relapse of substance abuse. It can also be difficult to treat BPD without addressing addiction, which can take over a person’s life.

    Dual diagnosis treatment for co-occurring disorders like BPD and addiction is vital for a successful recovery. 

    A treatment program for BPD may include medication—such as antidepressants or mood stabilizers—and therapy. Therapies used to BPD are:

    • Cognitive-behavioral therapy (CBT): CBT pinpoints negative thought patterns that lead to destructive behaviors. It teaches coping mechanisms that help you think differently and act in a healthier way.
    • Dialectical behavior therapy (DBT): DBT is a form of CBT that includes recognizing triggers outside of yourself and choosing to respond differently to them.
    • Psychodynamic psychotherapy: This form of psychotherapy focuses on self-reflection and self-examination. The goal is to relieve unconscious thoughts that lead to mental illness.

    DBT and CBT are included in many substance abuse treatment plans, too. To heal any mental or physical disorder, it’s essential to address and resolve the root cause rather than focus on the symptoms. 

    Treatment plans for addiction and BPD should be tailored to each individual, as we all struggle with a different combination of issues that affects our mental health.

    Other treatment dual diagnosis treatment methods may include:

    • Mindfulness: Focusing on the present moment rather than obsessing over the past or worrying about the future. 
    • Exercise: Undoing the adverse effects of substance abuse and promoting mental stability through physical health.
    • Group therapy: Connecting with others who are going through the same struggles, feel their support, and gain insight from them.

    To learn more about dual diagnosis treatment for borderline personality disorder (BPD) and addiction, reach out to an Ark Behavioral Health specialist today. We’re always available to answer your questions with confidentiality and compassion.

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    American Psychological Association - Psychodynamic Psychotherapy Brings Lasting Benefits through Self-Knowledge
    Mayo Clinic - Drug addiction (substance use disorder)
    National Alliance on Mental Illness - Borderline Personality Disorder
    National Center for Biotechnology Information - Borderline personality disorder and substance use disorders: an updated review
    National Center for Biotechnology Information - Diagnosing borderline personality disorder

    Medically Reviewed by
    Davis Sugar, M.D.
    on June 26, 2022
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