Addiction and Borderline Personality Disorder (BPD): What’s the Connection?

Addiction and Borderline Personality Disorder
Dominic Nicosia

Written By

Dominic Nicosia
Dr. Po-Chang Hsu -

Medically Reviewed By:

Dr. Po-Chang Hsu

Last Medically Reviewed on January 29, 2024

As Recovery Unplugged observes 2020 National Mental Health Month, we’re taking a look at some of the primary mental health issues that impact active alcohol and drug users, as well as those within the recovery community. This includes the relationship between addiction and borderline personality disorder (BPD).

Addiction and BPD are closely linked. One study from 2014 found that around 78 percent of BPD sufferers also developed substance use disorder at some point in their lifetime.

What Is BPD?

BPD is defined as a behavioral health condition that impacts the way you think and feel about yourself and others, which leads to problems functioning in everyday life and relating to other people. It is often manifested through self-image issues, difficulty managing emotions and behavior, and a pattern of unstable relationships. It can be hard to diagnose BPD, and signifying behaviors often come off as simply “erratic”, “angry”, “rude” or “clingy” because sufferers are acting out from a fear of rejection or being alone.

Some of the more common behavioral indicators of BPD include, but are not limited to:

  • Intense fear of abandonment and going to extremes to avoid separation or rejection
  • Idealizing someone in a relationship then suddenly being cruel or pushing them away because you don’t feel like they care enough
  • Rapid changes in self-identity and self-image
  • Periods of stress-related paranoia and loss of contact with reality, lasting anywhere from a few minutes to a few hours
  • Impulsive and high-risk behavior, such as gambling, reckless driving, unsafe sex, irresponsible spending, binge eating, or drug abuse
  • Sabotaging success by suddenly quitting a good job or ending a positive relationship
  • Suicidal threats or behavior or self-injury, often in response to fear of separation or rejection
  • Shifts in mood lasting from a few hours to a few days, which can include intense happiness, irritability, shame or anxiety, and an ongoing feeling of emptiness
  • Frequent loss of temper, sarcasm, bitterness, and frequent physical confrontations

BPD often emerges in early adulthood, and symptoms can change over time, with some individuals experiencing improvement as they age; however, each case is different. The causes of BPD are multifactorial, involving a combination of genetic, environmental, and neurological factors. Estimates of the prevalence of BPD in the general population vary, with some studies suggesting figures around 1.6%.

The Relationship between Addiction and Borderline Personality Disorder

When you think about the behavioral patterns, causes, and effects of BPD, it’s easy to see how the condition can become such a prime incubator for alcohol and drug use disorder. There are multiple ways in which these two conditions can become linked, including but not limited to:

  • Coping with Dysfunctional Relationships and Toxic Thought Patterns through Substance Use
  • Engaging in Codependent Drug or Alcohol Use to Please A Partner and Keep from Losing Them
  • Impulsively Abusing Substances during Erratic Changes in Mood

The link between addiction and borderline personality disorder is generally situational; however, it can often be attributed to the user’s relationships with either their friends, family, or romantic partners. Behavioral indicators often overlap, so it can be hard to spot co-occurring issues. The cruel irony is, however, that the longer substance abuse persists, the more of a threat it becomes to a person’s relationships, exacerbating the real and imagined abandonment fears of many BPD sufferers.

Treating Co-Occurring BPD and Addiction

Like other types of co-occurring disorders, treatment for BPD and addiction should include comprehensive interventions to address the physical and behavioral aspects of both conditions. Dialectical behavioral therapy (DBT) is a widely recognized treatment for BPD, addressing various aspects of the disorder, though it may not address all root causes. If you’re suffering from addiction and BPD, you need to address the “why” as well as the “how” of the condition. This can be done through group and individual therapy, as well as supplemental therapies, depending on your care needs and lifestyle. The process must also include learning to cultivate healthy relationships and interact better with others.

Don’t Let Addiction and Borderline Personality Disorder Ruin Your Health and Relationships

You know what addiction and BPD have cost you. At the very least, they’ve threatened your meaningful relationships. They can also easily derail your career, your quality of life, your sanity, and your overall health. Stop alienating yourself and the people who are most important to you. Recovery Unplugged is ready to offer compassionate and effective treatment for BPD and addiction. Contact us today to learn more about what we can do for you and your loved one.

We take our music-focused treatment for addiction very seriously, so we are going to hold our content to the same precision standards. Recovery Unplugged’s editorial process involves our editing safeguard and our ideals. Read our Editorial Process.

Dominic Nicosia

Dominic, a seasoned content writer at Recovery Unplugged, brings a wealth of knowledge and expertise to the realm of healthcare writing, particularly in the addiction and recovery field.

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