Borderline Personality Disorder and Addiction

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What is Borderline Personality Disorder?

Borderline personality disorder is a serious mental disorder marked by a pattern of ongoing instability surrounding moods, behavior, self-image, and functioning. Those who suffer from BPD tend to be emotionally unstable, highly impulsive, and harbor intense fears of abandonment. Estimated to affect between 1.6% and 5.9% of the general population, BPD can be safely and effectively treated using long-term psychotherapy.

BPD is more common in females than in men, with roughly 75% of those diagnosed being female. The impairment and risk of suicide with this mental disorder is more prevalent among those in early adulthood, and become less frequent among older age groups. Having BPD is also linked to an increased risk for substance use disorders, depressive and bipolar disorders, eating disorders, PTSD, and ADHD. Those who suffer from both BPD and substance use disorders can safely overcome this dual diagnosis at an addiction treatment center that offers drug detox, addiction therapy, and psychotherapy.

What are the Signs and Symptoms of Borderline Personality Disorder?

Those who suffer from BPD are often extremely sensitive to their environments and can experience extreme agitation or fear when sudden or unexpected changes take place. For instance, someone with BPD may experience intense, unwarranted panic or anger when someone they care about arrives late to an appointment.

Fear of abandonment can cause those with BPD to act impulsively and inappropriately when faced with the threat of being separated from someone important to them. Some may go so far to attempt suicide or perform self-mutilation to keep these important individuals near.

People with BPD tend to have a pattern of intense, unstable relationships and may idealize potential lovers and caregivers very early on in the relationship. They may demand to spend lots of time with these individuals, and divulge highly personal and intimate information too soon. However, people with BPD can quickly devalue those they once idealized if they feel these individuals are not available or giving enough in the relationship.

Here are other signs and symptoms of BPD:

  • Intense fear of being abandoned, or abandonment
  • Unstable interpersonal relationships
  • Identity disturbance, or having a persistently unstable self-image and sense of self
  • “Splitting” – thinking in a black and white way
  • Extreme sensitivity to rejection
  • An inability to tolerate being alone
  • Chronic feelings of emptiness or boredom
  • Sudden changes in opinions and plans about career, sexual identity, values, and types of friends.
  • Displays of intense, inappropriate anger, or difficulty with controlling anger
  • Intense, unstable mood swings
  • Impulsive behavior in at least two areas that can cause self-damage, such as drug abuse and binge eating
  • Paranoid thoughts related to stress
  • Severe dissociative symptoms where a person feels cut off from themselves, or like they have lost touch with reality
  • Repeated acts of suicidal behavior such as wrist cutting or intentional drug overdose

If you or a loved one is exhibiting any of the above signs and symptoms of BPD, getting professional help now can prevent this mental disorder from becoming worse and opening the door to other disorders including drug addiction. Those who suffer from drug addiction and BPD can experience a range of worsened physical, mental, and emotional health problems, as well as the risk for overdose, suicide, and death.

How Does Borderline Personality Disorder Interact with Addiction?

Many symptoms of BPD can lead to substance use disorders, which is why these two disorders commonly coexist as co-occurring disorders. For instance, unstable mood swings can influence people with BPD to abuse alcohol and drugs to mask and cope with symptoms like anxiety and depression, while impulsive behavior can lead to the use of dangerous, deadly drugs like heroin, cocaine, and methamphetamine.

Since BPD and drug addiction share many of the same symptoms, using substances of any kind can complicate the true diagnosis for BPD. A missed diagnosis or misdiagnosis can lead to worsened overall health when certain symptoms go untreated or are treated inconclusively or incorrectly. BPD and drug addiction also share a number of the same risk factors and can worsen one another when one or both conditions are left untreated.

How are BPD and Addiction Treated?

Long-term psychotherapy is the ideal treatment for BPD, which may include cognitive-behavioral therapy, dialectical behavioral therapy, or transference-focused therapy, among many others. There is no set time length for BPD treatment using psychotherapy since the length of treatment depends largely on the individual, and on whether they also suffer from any other co-occurring disorders like drug addiction. Treatment for BPD can take anywhere from several weeks to several months, or longer, in severe cases.

BPD and Substance Use Disorders

Those who suffer from both BPD and drug addiction can overcome both disorders at an addiction treatment center that offers detox and psychotherapy. Drug detox may come before psychotherapy or happen at the same time, depending on the drug of abuse and detox method being used. For instance, a person overcoming heroin addiction using a medically assisted detox may spend between one and two weeks recovering from heroin dependence before beginning therapy, since heroin withdrawal symptoms are similar to flu symptoms and can be debilitating for patients.

Drug Detox

People with BPD who need drug detox are often urged to recover under direct medical supervision as part of an inpatient detox program. Some with BPD may react unpredictably during detox, and require medical supervision for their safety and to reduce the risk for potential complications such as suicide. An inpatient drug detox offers 24/7 medical supervision and access to trained therapists and counselors who can support BPD patients throughout recovery.


Individual and group therapies are both highly respected treatment options for BPD and drug addiction. These therapies help patients identify and avoid triggers for their conditions so they can navigate society in the healthiest possible manner without relapsing. Cognitive and behavioral therapies are also commonly used to treat BPD and drug addiction since these therapies help patients identify and improve negative thought-processes and behaviors driving each condition.


Medications may be used as part of a dual diagnosis treatment to treat certain symptoms of BPD and the substance use disorder. For instance, those who suffer from BPD-driven anxiety may be prescribed benzodiazepines that help them relax. Those recovering from certain drug use disorders like opioid addiction may use medications like methadone or buprenorphine to reduce and manage drug cravings and withdrawal symptoms. Talk to your doctor about your options for medications that may help enhance your recovery from BPD and drug addiction.