It is common for individuals with borderline personality disorder (BPD) to experience a substance use disorder during their lifetime. Substances may provide temporary relief from emotional pain, but this relief often comes at a significant cost. Prolonged substance misuse worsens mood over time and heightens the risk of self-harm. Repeated misuse can lead to addiction in people with BPD.

Fortunately, integrated treatment programs can address both BPD and substance use disorders concurrently, improving outcomes for individuals with co-occurring conditions.

The Link Between Borderline Personality Disorder and Addiction

Borderline personality disorder causes immense emotional distress. People with BPD often turn to substance misuse to manage intense feelings, but this coping mechanism is unhealthy and may lead to addiction. Over time, BPD and addiction frequently occur together, making it essential to address both conditions through comprehensive treatment.

What Is Borderline Personality Disorder?

Borderline personality disorder (BPD) is one of ten personality disorders outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). A personality disorder is diagnosed when a person’s thinking, behavior, and emotions differ significantly from societal expectations. BPD symptoms include:

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  • Chronic emptiness
  • Unstable self-image
  • Intense fear of abandonment
  • Suicidal or self-harming behaviors
  • Unstable relationships
  • Rapid mood swings
  • Intense, inappropriate anger

What Causes Borderline Personality Disorder?

BPD is increasingly viewed as a trauma-related disorder, similar to PTSD. Up to 80% of individuals with BPD report childhood trauma, including emotional neglect, physical abuse, or sexual abuse. Additional contributing factors include:

  • Genetics: Approximately 50% of BPD risk is linked to genetic factors.
  • Maternal relationship issues: Poor attachment or separation from the mother increases BPD risk.
  • Family dysfunction: Unstable family environments, including parental substance misuse or mental illness, are associated with BPD.

Addiction and Borderline Personality Disorder

Co-occurring borderline personality disorder and addiction are common. Research highlights:

  • 26.7% of individuals in addiction treatment have BPD.
  • 75.28% of people with BPD develop a substance use disorder at some point.
  • Co-occurrence rates vary, with studies indicating 45.5% to 86.2% of individuals with BPD have addiction histories.

Substance Misuse as a Coping Mechanism

Substance use can temporarily soothe emotional pain for people with BPD. Some substances induce dissociation, while others help process emotions. However, this relief is short-lived and often exacerbates mood disorders, increases suicide risk, and complicates daily life.

Complications with Substance Misuse and BPD

Substance misuse can worsen BPD outcomes, including:

  • Declining mental health
  • Employment struggles
  • Poor academic performance
  • Risky behaviors

The cycle of substance misuse and emotional distress makes it harder for individuals to manage life stressors.

If you or someone you know has suicidal thoughts, contact the Suicide & Crisis Lifeline at 988.

Treatment Options for Borderline Personality Disorder and Addiction

Advancements in research have shown that BPD is treatable. With proper care, many individuals experience reduced symptoms or full remission. Effective treatments include:

Dialectical Behavior Therapy (DBT)

DBT, developed for BPD, teaches skills to manage emotional regulation, distress tolerance, and impulse control. A specialized form, DBT-SUD, addresses co-occurring BPD and substance use disorders, showing improved outcomes through integrated treatment.

Other Therapeutic Treatments

  • Trauma-focused therapies like EMDR
  • Mentalization-based therapy (MBT)
  • Acceptance and commitment therapy (ACT)
  • Cognitive behavioral therapy (CBT)

Integrated treatment combines therapy, medication management, and complementary approaches to address co-occurring disorders.

Integrated Treatment at The Recovery Village Indianapolis

The Recovery Village Indianapolis offers integrated care for co-occurring borderline personality disorder and addiction. Treatment levels include inpatient rehab for mental health, partial hospitalization, and intensive outpatient. Our programs feature therapies such as EMDR, provided by a multidisciplinary team of professionals dedicated to holistic recovery.

If you or a loved one is struggling with co-occurring BPD and addiction, contact a Recovery Advocate today to learn about integrated treatment options.