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Borderline Personality Disorder (BPD) and Addiction: What You Should Know
Alcohol use disorder, commonly called alcoholism, can ruin the lives of everyone it affects. And dealing with alcohol use disorder is no easy task, both for the person experiencing the disorder and their family and loved ones. While only a licensed clinician can diagnose alcohol use disorder, the information below will introduce this disorder, its characteristics, and your options for treatment at Absolute Awakenings top-rated alcohol rehab program in NJ.
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Table of Contents
Key Points
- Borderline Personality Disorder (BPD) affects a significant portion of individuals in the US, while addiction issues have also surged in the past few decades.
- The co-occurrence of BPD and addiction presents unique challenges, requiring integrated treatment to address both conditions simultaneously for more effective outcomes.
- BPD, characterized by unstable emotions, relationships, and self-image, often leads to impulsive behavior and self-harm. Dual diagnosis statistics reveal a high prevalence of substance use disorders alongside BPD.
- Co-occurring BPD and addiction issues can complicate diagnosis and treatment, necessitating comprehensive, individualized care.
Borderline personality disorder (BPD) affects approximately 10% of all people in outpatient care and up to 20% of all people in inpatient care.[1] Addiction issues, meanwhile, have grown exponentially over the past few decades, with nearly 1 in 3 adults having either a substance use disorder or any mental health condition over the past year.[2]
Both personality disorders and substance use disorders can present many unique challenges on their own—and far more so when they occur simultaneously. Individuals struggling with borderline personality disorder and addiction will likely benefit from structured, holistic treatment in which each of these conditions is treated at the same time.
What Are Personality Disorders?
Personality disorders are enduring patterns of behavior, cognition, and inner experiences that deviate significantly from societal norms and expectations.[3] These patterns are deeply ingrained and manifest across various situations, leading to distress for the individual and difficulties in relationships and daily functioning.
These conditions often involve distorted self-perception, unstable emotions, and problematic interpersonal dynamics, all of which can lead to increasing isolation and challenges across several environments (home, work, school, etc.).
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), there are four main categories of personality disorders:[4]
- Cluster A: Dysfunctional patterns of thinking and behavior, lack of interest in social connections
- Commonly associated with paranoid personality disorder, schizotypal personality disorder, and schizoid personality disorder.
- Cluster B: Dysfunctional patterns of unpredictable behavior and/or overly emotional thinking patterns
- Commonly associated with narcissistic personality disorder, borderline personality disorder (BPD), histrionic personality disorder, and antisocial personality disorder.
- Cluster C: Consistent patterns of thinking or behaviors
- Commonly associated with avoidant personality disorder, obsessive-compulsive personality disorder, and dependent personality disorder.
What is Borderline Personality Disorder?
Borderline Personality Disorder, or BPD, is a complex mental health condition characterized by consistent behavior patterns. Some of these patterns include intense and unstable relationships, self-image, emotions, and behavior.[5] Individuals with BPD often experience extreme emotional fluctuations, rapidly shifting between feelings of love, anger, and emptiness. They may struggle with self-identity, frequently feeling unsure about who they are and what they want in life.
This condition can lead to impulsive behaviors, self-harm, and difficulty regulating emotions. Individuals with BPD might also fear abandonment and exhibit intense efforts to avoid it, sometimes resulting in turbulent interpersonal dynamics.
BPD can be challenging to manage, but with the right treatment, including therapy and support, individuals can work towards emotional stability and improved quality of life. Substance abuse and borderline personality disorder together will require integrated and holistic interventions that address each disorder individually with mindfulness of whole-person healing.
What Are Substance Use Disorders?
Substance use disorders involve the persistent use of substances such as drugs or alcohol, despite their detrimental effects on an individual’s physical, mental, and social well-being. Such disorders are characterized by a loss of control over substance use, increased tolerance, withdrawal symptoms, and preoccupation with obtaining and using the substance. Substance use disorders can range from mild to severe and can lead to a range of negative consequences, including health problems, legal issues, and strained relationships.
According to the DSM-5, a substance use disorders can typically be diagnosed by the following criteria, with most addictions requiring at least two items being present:[6]
- Taking a substance in increasing amounts or for a longer amount of time than was initially intended.
- A desire to cut down on using the substance and/or unsuccessful efforts to stop.
- A lot of time is spent obtaining, under the influence, or recovering from the substance’s effects.
- Cravings to use the substance.
- Substance use impairs your ability to fulfill obligations at work, at school, or at home.
- You continue to use the substance despite your usage causing significant social or relational issues.
- Reducing or stopping your recreational and/or social activities as a result of substance use.
- Using the substance when it is dangerous to do so (such as driving a car).
- Ongoing substance use despite the knowledge that it may cause or worsen other physical or psychological issues.
- Tolerance, as defined by either:
- Requiring higher or more frequent doses of the substance to achieve the desired effect, building up a tolerance;
- Withdrawal symptoms when substance use is stopped (Note: no documented withdrawal symptoms need to be present for hallucinogens, PCP, or inhalants).
Personality Disorder and Substance Use Disorder Statistics
Around 9% of adults in the US have some kind of personality disorder [7], and around 6% of the global population. BPD and antisocial personality disorder are the most frequently diagnosed personality disorders in the US, with BPD having a prevalence rate of 1.4% of the population (for adults over the age of 18).[8]
An estimated 78% of adults with BPD also go on to develop a substance-related disorder or addiction at some point in their lives.[9] Around 9.5 million, or 3.8% of adults over the age of 18, have both a substance use disorder and a mental illness.[10]
What Is The Correlation Between Personality Disorders And Substance Use?
BPD and addiction issues, also known as co-occurring or dual-diagnosis issues, are very common. Research suggests that individuals with certain personality disorders may be more susceptible to substance misuse as a way to cope with their emotional pain, impulsivity, or social isolation.[11] Conversely, substance abuse and addiction can also contribute to the exacerbation of existing traits of a personality disorder, as people suffering sometimes turn to drugs or alcohol to ease their pain.
The co-occurrence of these disorders can complicate diagnosis and treatment approaches, requiring a comprehensive understanding of both conditions and a holistic, unique treatment plan.
Treating Personality Disorders and Addiction
Addressing the complex interaction between BPD and substance use disorders requires an integrated and tailored treatment approach. Therapy, both individual and group-based, often plays a crucial role:
- Dialectical Behavior Therapy (DBT) has shown promise in treating individuals with both borderline personality disorder and substance use disorders, as it addresses emotional dysregulation and maladaptive coping strategies.
- Cognitive-behavioral therapy (CBT) and Motivational Interviewing (MI) are also commonly used to target substance use and related behaviors. In severe cases, residential or inpatient treatment may be necessary for stabilization.
Additionally, some individuals may find it necessary to engage with the structure of inpatient treatment in order to begin the recovery process from dual diagnosis issues like BPD and addiction, where 24/7 support and structure can help them to break free from destructive cycles, learn essential coping skills, and receive intensive therapeutic interventions.
Inpatient or residential programs offer a controlled, tranquil environment that minimizes external triggers and provides a safe space for individuals to explore the deep-rooted connections between their personality disorder traits and substance use tendencies.
This immersive approach allows individuals to fully focus on their healing journey while a multidisciplinary team of professionals tailors treatment to their unique needs, fostering emotional regulation, self-awareness, and the foundation for a healthier, more stable future.
Absolute Awakenings Editorial Guidelines
At Absolute Awakenings, we take information integrity seriously. We have dedicated our resources to ensure that all content published to our blog is medically sound. As such, all content on our blog has been thoroughly reviewed by a doctorate level clinician such as a Medical Doctor, or Psy.D, so that you can trust all of the data we publish.
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Frequently Asked Questions About Borderline Personality Disorder, Addiction, and Dual Diagnosis
Can substance use cause a personality disorder?
Substance use can exacerbate existing personality traits, potentially resembling a personality disorder. However, a personality disorder is a complex and ingrained pattern that isn’t solely caused by substance use alone.
Is it possible to treat both disorders simultaneously?
Yes, integrated treatment plans that address both disorders together tend to yield better outcomes. Treating one without the other can lead to poorer outcomes as opposed to full dual diagnosis treatment.
Do all personality disorder types relate to substance abuse in some way?
While some personality traits might make individuals more prone to substance use, not all personality disorders are equally linked to addiction issues.
Can medications help with these co-occurring disorders?
Medications can play a role in managing symptoms of both personality disorders and substance use disorders, but they’re typically used in conjunction with therapy and a comprehensive treatment plan.
Is recovery possible with these co-occurring disorders?
Yes, recovery is possible, but it requires dedication, time, and professional support. Many individuals have successfully managed and overcome the challenges of these co-occurring disorders and gone on to lead fulfilling lives.
Sources
[1] An Introduction to Co-Occurring Borderline Personality Disorder and Substance Use Disorders How Common Is BPD? (n.d.). https://store.samhsa.gov/sites/default/files/d7/priv/sma14-4879.pdf on August 30th, 2023
[2] Administration (SAMHSA), S. A. and M. H. S. (2023, January 4). SAMHSA Announces National Survey on Drug Use and Health (NSDUH) Results Detailing Mental Illness and Substance Use Levels in 2021. HHS.gov. https://www.hhs.gov/about/news/2023/01/04/samhsa-announces-national-survey-drug-use-health-results-detailing-mental-illness-substance-use-levels-2021.html on August 30th, 2023
[3] Robitz, R. (2013). What Are Personality Disorders? American Psychiatric Association. https://www.psychiatry.org/patients-families/personality-disorders/what-are-personality-disorders on August 30th, 2023
[4] National Institute of Mental Health. (n.d.). NIMH» Personality Disorders. Www.nimh.nih.gov. https://www.nimh.nih.gov/health/statistics/personality-disorders on August 30th, 2023
[5] National Institute of Mental Health. (2018). Borderline Personality Disorder. Www.nimh.nih.gov. https://www.nimh.nih.gov/health/topics/borderline-personality-disorder on August 30th, 2023
[6] McNeely, J., & Adam, A. (2020, October 1). Table 3, DSM-5 Diagnostic Criteria for Diagnosing and Classifying Substance Use Disorders [abc]. Www.ncbi.nlm.nih.gov. https://www.ncbi.nlm.nih.gov/books/NBK565474/table/nycgsubuse.tab9/ on August 30th, 2023
[7] Cleveland Clinic. (2018). Personality Disorder | Cleveland Clinic. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/9636-personality-disorders-overview on August 30th, 2023
[8] National Institute of Mental Health. (n.d.). NIMH» Personality Disorders. Www.nimh.nih.gov. https://www.nimh.nih.gov/health/statistics/personality-disorders on August 30th, 2023
[9] Kienast, T., Stoffers, J., Bermpohl, F., & Lieb, K. (2014). Borderline Personality Disorder and Comorbid Addiction. Deutsches Aerzteblatt Online, 111(16). https://doi.org/10.3238/arztebl.2014.0280 on August 30th, 2023
[10] National Center for Drug Abuse Statistics. (2020). NCDAS: Substance abuse and addiction statistics [2020]. National Center for Drug Abuse Statistics. https://drugabusestatistics.org/ on August 30th, 2023
[11] Kienast, T., Stoffers, J., Bermpohl, F., & Lieb, K. (2014). Borderline Personality Disorder and Comorbid Addiction. Deutsches Aerzteblatt Online, 111(16). https://doi.org/10.3238/arztebl.2014.0280 on August 30th, 2023
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