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Borderline Personality Disorder and Addiction: How Do They Occur?

what is borderline personality disorder

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The combined effects of borderline personality disorder and addiction are challenges for both the patient and their doctors. In essence, this coexistence can be lethal at times.

Table of Contents

Borderline Personality Disorder: An Overview

Borderline personality disorder (BPD) is a serious mental illness with severe mood swings, behavioral changes, and impulsiveness. Consequently, these unpredictable emotional responses and bursts of anger may also lead to relationship problems. In addition, they often misdiagnose it.
When one compares the coexistence to a single disorder, they pose a greater risk to the patient. Furthermore, it increases the incidence of drug addiction. A recent study shows individuals with BPD crave alcohol more than social drinkers.

Symptoms of Borderline Personality Disorder

Unfortunately, the symptoms of borderline personality disorder often overlap with those of other personality disorders. Consequently, this makes the diagnosis more complicated and in many cases, can cause mistakes in their diagnosis.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the symptoms include:

  • Distorted or unstable self-image
  • Abnormal response to perceived abandonment
  • Unable to set life or career goals
  • Lack of empathy
  • Ongoing thoughts of suicide or self-harm
  • Persistent feelings of emptiness
  • Irritability and anxiety
  • Overindulgence in sex, drug abuse, binge eating or other risky behaviors
  • Intense fear of rejection
  • Paranoid thoughts fueled by stress
  • Severe dissociation from reality

There is a clear link between BPD and addiction. However, it’s very difficult to determine whether BPD is a cause or effect of addiction. As a result, many hypotheses have been made to clarify the relation between BPD and addiction. The “self-medication hypothesis” is one of them.

The Self-medication hypothesis shows many symptoms of borderline personality disorder as major influences for drug addiction. In fact, people with those symptoms abuse substances such as opioids to feel good and achieve mental stability. Over time, drugs begin to take control of the brain, and addiction eventually sets in.

Findings show that alcohol and drugs are the most common addictions among people with BPD support this hypothesis.
Nevertheless, it is too early to jump into conclusions and say that BPD is the major cause of addiction. Consequently, we will need more further studies to confirm the role of BPD in addiction.

Is One at Risk of Co-existing BPD and Addiction?

Has one been abusing some drugs or alcohol and being scared about the risk of developing BPD? The following information will help to determine if a person is in the red zone. Remember, the risks are amplified by drug use.

Risk Factors for BPD

  • The genes could be the culprit: A risk increases five-folds if any of the first-degree relatives have had BPD.
  • Social and environmental factors: Many people with BPD have been found to have a history of abuse or some kind of traumatic experiences. Nevertheless, one cannot hold these factors responsible for BPD.
  • Biological factors: These include abnormal brain structures or functions that may lead to BPD.

What Treatment May Help?

There is no single treatment that can assure a cure. This condition is very complicated. Furthermore, doctors often make mistakes in diagnosis. As a result, treatment for BPD can be very tricky.
Borderline Personality Disorder
However, a careful assessment of the symptoms and their relevant addictions make up the core of the treatment. Ultimately, it will be a team effort. Active participation of the patient, family members, and many different healthcare professionals are crucial.
As with other illnesses, treatments that start early have higher chances of doing well. Doctors will design it to improve and stabilize the patient’s life. Furthermore, a combination of psychotherapy and drug therapy may help the patient.
Studies all around the world are happening to discover better treatments for borderline personality disorder and addiction. Some of the psychotherapies that have shown favorable results are as follows:

  • Dialectical Behavior Therapy for Substance Use Disorders (DBT-SUD): This therapy for BPD and addiction focuses on making their life better and keeping them off drugs longer. It does this by empowering the patients. It includes methods for motivation, adaptation, and creating new behaviors.
  • Dual focus schema therapy (DFST): The major aim is to prevent relapse of addiction. Through a continuous effort, it tries to change the patient’s negative picture of themselves, their environment. Furthermore, it tries to develop different coping techniques.

We still have much to find out, and the conditions are very complicated. As a result, it may take a while before the launch of definitive treatment. However, it does not mean one or their loved ones have to bear the pain forever.

The available treatments and addiction experts can help one enhance the quality of life. Also, they may minimize the severity of symptoms.

Does one have any questions about borderline personality disorder and addiction? Patients should talk to experts to get accurate information. Additionally, one can also learn more about specific drug addictions from them.
Connect with addiction experts nearby, Click here for details.

  1. Marina A. Bornovalova, Brad Verhulst, Troy Webber, Matt McGue, William G. Iacono, Brian M. Hicks. Genetic and Environmental Influences on the Co-development between Borderline Personality Disorder Traits, Major Depression Symptoms, and Substance Use Disorder Symptoms from Adolescence to Young Adulthood. Dev Psychopathol. 2018. 49-65.
  2. Bornovalova MA, Hicks BM, Iacono WG, McGue M. Longitudinal Twin Study of Borderline Personality Disorder Traits and Substance Use in Adolescence: Developmental Change, Reciprocal Effects, and Genetic and Environmental Influences. Personality Disorders-Theory Research and Treatment. 2013;4(1):23–32.
  3. Bornovalova MA, Lejuez CW, Daughters SB, Rosenthal MZ, Lynch TR. Impulsivity as a common process across borderline personality and substance use disorders. Clinical Psychology Review. 2005;25(6):790–812.


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