woman struggling with drug addiction and borderline personality disorder

Approximately 78% of adults with borderline personality disorder (BPD) also develop a substance use disorder (SUD) or drug addiction at some point in their lives. Studies have shown the prevalence of the relationship between drug addiction and mental health disorders as a result of their shared risk factors.

Understanding Borderline Personality Disorder (BPD): Signs, Symptoms, and Causes

Borderline personality disorder (BPD) is a personality disorder and mental health condition that affects nearly 1.6% of the general population. BPD is 1 of 4 cluster-B disorders in The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which includes borderline, antisocial, narcissistic, and histrionic. Individuals with BPD are hypersensitive to rejection and, as a result, struggle with instability in emotions, self-image, behaviors, and interpersonal relationships.

Symptoms of borderline personality disorder (BPD) include:

  • Fear of abandonment
  • Unstable relationships
  • Rapid mood changes
  • Distorted self-image or sense of self
  • Impulsive and risky behaviors
  • Recurrent thoughts of self-harm or suicide
  • Chronic feelings of emptiness
  • Extreme anger issues
  • Stress-related paranoia

The severity of the symptoms of BPD may vary from patient to patient. However, the patterns of impulsivity, emotional and relational instability, and suicidal behavior are relatively common.

woman with drug addiction and personality disorder

The causes of BPD are often comprised of genetic predisposition, neurobiological dysfunction, and environmental factors. More specifically, the development of BPD is frequently associated with a family history of BPD, childhood maltreatment and trauma, and neurological differences in the amygdala, hippocampus, and medial temporal lobes.

Patients with borderline personality disorder (BPD) are at higher risk for comorbid disorders such as mood disorders, anxiety disorders, substance abuse disorders, eating disorders, and attention deficit hyperactivity disorder (ADHD).

The Connection Between Substance Abuse and BPD

One of the most prevalent comorbidities with BPD, also known as co-occurring disorders or dual diagnosis, is substance use disorders (SUDs). Substance use disorders (SUDs) can include alcohol use disorder (AUD), opioid use disorder (OUD), amphetamine use disorder, and other drug-related disorders and addiction. The interaction between BPD and drug addiction involves a combination of elements, including emotional dysregulation, trauma, impulsive behaviors, and environmental, genetic, and neurobiological factors.

Emotional Dysregulation and Coping Mechanisms

Emotional instability and dysregulation are prevalent in most patients with BPD, encompassing intense emotional experiences and difficulties managing them. Individuals with borderline personality disorder (BPD) may turn to alcohol or drugs as a means to self-medicate or cope with these overwhelming emotions. While substances may provide temporary relief or numb the emotional pain, it is only a short-term solution to the internal struggle. Mental health conditions, specifically personality disorders, are only exacerbated by substance abuse. Drugs and alcohol can aggravate BPB symptoms, resulting in more intense emotions and dangerous behaviors.

Certain substances may worsen existing or facilitate mental health issues, including severe anxiety, depression, self-harm, and suicidal ideation. When someone struggles with one or more mental health disorders, such as BPD and depression, or BPD and drug addiction, this is known as a co-occurring disorder.

Impulsivity and Risk-Taking Behavior

Impulsivity is another common symptom of BPD, which often causes patients to act recklessly or engage in harmful behaviors. This may include substance abuse, which also facilitates users to engage in abnormal or risk-taking behaviors. Those with BPD who typically struggle with extreme emotions and feelings of emptiness might seek out drugs or alcohol for that escape or immediate gratification. Just as drugs and alcohol can encourage risky behaviors, those with BPD who engage in substance abuse may find themselves in potentially life-threatening situations.

Trauma and Environmental Factors

Early childhood trauma, such as abuse or neglect, is found in up to 70% of patients with BPD. A history of interpersonal trauma is also a risk factor for substance abuse or developing a drug or alcohol addiction. Individuals with or without BPD may use drugs or alcohol as a coping mechanism for unresolved trauma to help escape traumatic memories or feelings. Some individuals take antidepressants or anti-anxiety medications to treat borderline personality disorder (BPD), which can negatively interact with drugs and alcohol.

Shared Genetic and Neurobiological Factors

The neurobiological differences in patients with BPD often include impaired neuropeptide functions, particularly a dysregulation in serotonin and dopamine neurotransmitters. Certain substances, including cocaine, amphetamine, methamphetamine, MDMA (ecstasy), cannabis, alcohol, and nicotine, can influence brain chemicals such as dopamine and serotonin.

Dopamine plays an integral role in the reward system, controlling motivation and desire, whereas serotonin releases feelings of happiness and well-being. BPD is typically treated with selective serotonin reuptake inhibitors (SSRIs) or mood stabilizers, which patients may seek out from drugs or alcohol. The serotonin and dopamine release achieved from certain substances can lead individuals to develop a tolerance and eventually substance use disorder (SUD).

man in drug and alchol rehab treatment

Dual Diagnosis Treatment: Drug Addiction and BPD

Treatment for co-occurring disorders like drug addiction and BPD requires an integrated approach that addresses both substance abuse and personality disorders. The most effective treatment for borderline personality disorder (BPD) involves a combination of psychotherapies and supportive care.

Dialectical behavior therapy (DBT) is a psychotherapy employed in the treatment of BPD as well as substance use disorders (SUDs). DBT is a form of psychotherapy that helps patients with emotion management, improves interpersonal relationships, and reduces self-destructive behaviors. Cognitive behavioral therapy (CBT) is another effective treatment for both BPD and drug and alcohol addiction.

Drug and alcohol rehab centers with addiction and mental health treatment programs are essential for those with co-occurring disorders. Coastal Detox offers dual-diagnosis treatment in South Florida for individuals struggling with addiction and mental illness.

If you’ve been seeking treatment for a co-occurring disorder or substance use disorder, our drug and alcohol detox center in Stuart, FL, is here for you! Choose recovery and reach out today!