Substance misuse is known to have complex relationships with a range of mental health conditions, illnesses and disorders. And although it might be slightly less well-known, there is a link between borderline personality disorder (BPD) and addiction.

When it comes to BPD and addiction, the interplay between these conditions can be every bit as complex, with each one influencing the other in different ways.

In this blog, we’ll be exploring what you need to know about BPD and addiction.

What is Borderline Personality Disorder (BPD)?

Borderline personality disorder (BPD) is the second most common personality disorder, and it affects 1 in every 100 people in the UK. It’s a condition that impacts mood and how the person perceives and interacts with others.

BPD can manifest in different ways but will generally involve four main areas:

  • Emotional instability.
  • Disturbed patterns of thinking or perception.
  • Impulsive behaviour.
  • Intense but unstable relationships with others

People with BPD will often struggle with their own self-image as well as their relationships with others. It is not fully understood what causes BPD, but in most cases, it is likely to be a combination of factors. These could include genetics, environmental factors, issues with neurotransmitters in the brain (particularly those involved with the ‘happy hormone’ serotonin) and problems with brain development.

The Connection Between BPD and Addiction

There are long-established links between substance misuse, addiction and various mental health conditions, and BPD is undoubtedly no exception. Nearly four-fifths (78%) of adults with BPD also develop a substance-related disorder or addiction at some time in their lives.

It is quite common for people dealing with the consequences of BPD to turn to alcohol or drugs.  This can be an attempt to achieve temporary relief from emotional stress. But, it is only ever short-lived and can often make the feelings and situations they are attempting to deal with worse.

There is also some research suggesting that substance abuse may, in some cases, lead to BPD or make an existing condition much worse. Chronic drinking or drug use may reduce serotonin, for example, leading to uninhibited, self-destructive and impulsive behaviours.

People who already have a genetic or neurobiological predisposition to BPD may sometimes find their condition triggered by the consequences of their substance misuse – such as losing their jobs or damaging relationships through their drinking or drug use.

Whichever came first, substance misuse, addiction and BPD can all continue to influence each other in a negative cycle of thinking and behaviours once they are present at the same time.

Why Do People with BPD Often Turn to Substances?

One of the main links between borderline personality disorder and substance misuse occurs when people turn to substances in an attempt to deal with BPD and its effects.

As with other mental health conditions and illnesses, people with BPD may try to self-medicate or use drugs and alcohol. These substances may provide temporary relief from emotional distress, feelings of emptiness, or overwhelming thoughts. They will generally be counter-productive, though, as they can lead to a worsening of symptoms.

Substance misuse can also worsen situations such as physical health, relationships, finances and work – all of which can feed into aspects of the BPD.

The Impact of BPD and Addiction on Mental and Physical Health

Borderline personality disorder can have a massive impact on mental health but is also associated with many negative physical health outcomes. These can include an increased risk for serious chronic diseases such as diabetes, heart disease, and arthritis.

BPD is also linked with obesity – with compulsive overeating often playing a similar role to drugs and alcohol in an attempt to temporarily feel better.

Substance abuse and addiction can also have a huge negative effect on both mental and physical health, although the risks and harms involved can vary depending on the substance. Excessive or long-term cannabis use, for example, has been linked with schizophrenia and other psychoses, as well as an increased risk of developing social anxiety disorder.

Alcohol misuse, meanwhile, is the single most significant risk factor for death, ill health and disability among 15-49-year-olds in the UK. It is linked with a wide range of mental and physical health conditions, including depression, anxiety, liver disease, high blood pressure and several types of cancer. Depending on the substance involved, there may also be additional risks, such as overdosing.

When BPD and addiction are combined, the symptoms and risks of each element can also mix and worsen. Co-occurring disorders often exacerbate symptoms of each condition, which can also make treatment more difficult.

Challenges in Treating Co-occurring BPD and Addiction

Borderline personality disorder can be challenging to treat in its own right. People with BPD may find it difficult to adhere to treatment plans due to issues such as emotional instability and frequent mood changes. Similarly, people with an addiction may be living what is sometimes termed a chaotic lifestyle and may find it incredibly difficult to attend treatment sessions.

It is also essential to treat co-occurring conditions such as BPD and addiction at the same time. Within a residential rehab setting, this would be known as following a dual-diagnosis treatment plan. If one condition is left untreated, it will be more challenging to make a full recovery on the other side, and it will also make relapse more likely.

Treatment Options for BPD and Addiction

Some of the issues involving sticking to treatment plans can be addressed by attending inpatient rehab, where you will stay at the rehab centre and can entirely focus on recovery in a safe and secure environment. This is not the only option, however, and outpatient programmes can also be valuable for some people.

If you have co-occurring BPD-substance abuse issues, dual diagnosis can be used to treat both conditions simultaneously for the best outcomes. Evidence-based therapies (e.g. dialectical behaviour therapy) can be especially effective for treating BPD. Cognitive behavioural therapy can also be used to treat addiction. A holistic approach incorporating therapy, medication, and support networks is generally the best way to ensure long-term recovery.

Seeking Help for BPD and Addiction

If you are struggling with borderline personality disorder, addiction or a combination of the two, it is crucial to seek professional help as quickly as possible.

Whether you need dedicated addiction treatment or dual diagnosis support, get in touch today by calling us on 0800 880 7596 for more detailed information on how we can help.

John Gillen - Director at Ocean Recovery

John Gillen - Author - Last updated: October 25, 2024

John is one UK’s leading professionals in the addiction recovery industry. Pioneering new treatment techniques such as NAD+ and ongoing research into new therapy techniques such as systematic laser therapy, John is committed to providing the very best treatment for people throughout the UK and Europe. During his extremely busy schedule, John likes to regularly update our blog section with the latest news and trends in the industry to keep visitors to our site as well informed as possible on everything related to addiction treatment.