Borderline personality disorder (BPD) can be an extremely debilitating condition in which an individual’s self-perception is distorted, significantly impeding their ability to forge and maintain healthy, stable relationships. Those who experience BPD are often perceived by others as dramatic and manipulative and engage in behavior that experts believe serves as a dysfunctional mechanism to deal with emotional instability, pain, and fear.
BPD and substance abuse often occur together, and the interaction between them can be volatile and unpredictable. As with other mental health disorders, individuals with BPD are more likely to use substances than others as a method of self-medication to escape or numb feelings of trauma, fear, and abandonment.
In fact, research has shown that about two-thirds of those who suffer from BPD have abused substances at some point in their lives. Unfortunately, substance abuse tends to worsen many of the most concerning BPD symptoms, such as anger and profound depression.
In an effort to overcome an overall sense of emotional emptiness, individuals with BPD may also engage in self-harm, such as cutting. They are also more vulnerable to suicidal ideations and attempts, especially if a substance abuse is occurring.
Symptoms of BPD may include the following:
- Intense mood swings
- Emotional hypersensitivity
- Extreme depression or anxiety
- Suicidal ideations and behaviors
- False perceptions of others
- Paranoia and delusions
- Intense aggression or anger
- Lack of or unstable sense of self
- A deep fear of abandonment
- Feelings of emptiness
- Manipulation tactics toward others
The effects of BPD often leave those who experience it with a profoundly low sense of self-esteem and self-worth. Their impulsive behavior and mood swings often push others away, causing them to feel isolated and withdrawn.
This loneliness can lead to extreme depression or anxiety, as individuals with BPD experience an intense fear of abandonment. Ironically, they often push others away and prevent themselves from developing close, meaningful connections with others due to the fear of future rejection of loved ones or potential intimate relationships.
What Causes BPD?
Although the precise origins of BPD are not fully understood, there are credible theories regarding how this complicated personality disorder can develop. Common factors believed to contribute to the development of BPD include the following:
Having a History of Childhood Trauma and Family Dysfunction
Children raised in family environments where they feel unsafe, neglected, abandoned, or are physically, sexually, or emotionally abused are more likely to develop BPD as teens or young adults. This unhealthy upbringing can contribute to excessive substance abuse and severe mental health issues later in life.
More to the point, borderline personality disorder is believed to most commonly result from neglect or abuse during a stage of childhood development in which a child learns how to trust and rely on others. As a result, individuals with BPD grow up being denied this vital aspect, which is needed to form healthy interpersonal relationships.
Genetics and Heredity
BPD and similar personality disorders are often found among close family members, such as parents and their children. This fact may imply that some people may have a genetic inclination for developing BPD. Experts believe that certain inherited vulnerabilities or personality attributes, such as aggression, may increase the risk of BPD developing when found in combination with certain environmental factors.
Brain Chemistry and Neurobiology
Anomalies in regions of the brain involved in emotional and behavioral regulation are believed to be responsible, at least in part, for the emotional instability and impulsive behavior typically exhibited by those with BPD. Studies have found that some brain regions, such as the amygdala, frontal cortex, and hippocampus, may be different among those with BPD.
BPD may also be affected by imbalances in certain neurochemicals or naturally-occurring chemicals that directly influence how people feel and behave, such as dopamine, adrenaline, and serotonin.
How Addiction and BPD Overlap
Many neurological and environmental factors believed to contribute to the development of BPD are also significantly correlated with substance abuse. Many who suffer from addiction were brought up in environments in which excessive drinking or illicit drug use occurred. This experience alone could inflict severe trauma on children.
Making matters worse, a history of childhood abuse or other trauma also increases the risk of substance abuse later in life. Events such as these seem to compel the individual to find ways of escaping from adverse feelings such as resentment, anger, pain, and fear.
When it comes to addressing addiction and BPD concurrently, the similarities between the two conditions’ symptoms can make both disorders challenging to identify and diagnose correctly. Treatment can be especially challenging when the affected individual’s antisocial and manipulative inclinations mean that potential mental or medical health providers find them frustrating and unpleasant with which to work.
For instance, both BPD and addiction may be hallmarked by the following:
- Impulsive, self-destructive actions
- Manipulative, deceitful, and cunning behaviors
- Unstable and strained relationships
- Legal, financial, or employment problems
- Mood instability that fluctuates between profound depression to mania
- Lack of concern for one’s own personal safety and well-being
- Insistence on engaging in risky behavior despite the incurrence of adverse effects
Treatment for Borderline Personality Disorder
BPD and substance abuse can and should be addressed concurrently in a treatment center that offers dual diagnosis programs. These programs should provide psychotherapy, counseling, group support, and pharmacological interventions for both mental illness and substance use disorders.
The most common method that can be effectively used to treat both these disorders simultaneously is cognitive-behavioral therapy (CBT). CBT is typically a key feature of rehab facilities to help people identify the thought patterns and feelings that contribute to their impulsive, unhealthy, and addictive behavior. Likewise, CBT teaches individuals how to manage their moods and emotions better, so they are less likely to turn to the use of substances as a method of coping.
Treating BPD can be particularly challenging because people with this condition often make unreasonable or irrational demands of their therapists and often insist on having constant contact with those who are treating them. They are often perceived as frustrating, dependent, and needy due to a propensity to seek out caregivers and health providers who can meet and enable their profound emotional needs.
Making treatment even more complicated, individuals diagnosed with BPD may turn against their treatment provider and become hostile and paranoid without any clear reason. Understanding BPD’s emotional underpinnings is vital for professionals who attempt to treat this severe, debilitating psychological disorder.
People who receive comprehensive treatment for addiction and/or BPD can attend educational classes and counseling sessions that focus on relapse prevention. This training is essential for those with co-existing disorders such as these, as relapse rates tend to be high. Relapse prevention can be promoted through peer group support meetings. Here, individuals diagnosed with addiction and BPD or other mental health disorders can share coping strategies and address the specific challenges of living with these conditions.
Psychiatric medications to treat mental health issues and addiction can also be powerful tools when used as part of a multi-faceted treatment plan. Many BPD-affected individuals discover that certain medications intended to restore balance to levels of neurochemicals (e.g., antidepressants) can be helpful.
Getting Help for BPD and Addiction
Just Believe Detox and Just Believe Recovery centers offer comprehensive addiction treatment programs designed to address symptoms related to co-occurring mental health conditions, such as borderline personality disorder, depression, anxiety, and more. Methodologies, services, and activities we feature include behavioral therapy, counseling, group support, health and wellness education, art and music therapy, aftercare planning, and more.