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Behavioral Health & Substance Abuse

BPD and Addiction

Substance Abuse is very common within the Borderline Personality Disorder (BPD) population. Drug and Alcohol Abuse can exacerbate the most destructive symptoms of BPD. People with BPD and Addiction face unique challenges when seeking treatment.  With the right integrated treatment, recovery is possible.
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Borderline Personality Disorder (BPD) and Addiction

Addiction is very prevalent among people with Borderline Personality Disorder. In fact, about 78% of people with borderline personality disorder struggle with addiction at some point in their lives.

The link between the two disorders isn’t talked about often, but it is important. It’s especially crucial for those struggling with either condition to understand that they aren’t alone.

Having either one of these diseases is isolating, but having both can feel impossible.  To overcome these conditions, we have to learn more about addiction and BPD. 

What Is Borderline Personality Disorder (BPD)?

People with borderline personality disorders can feel like they’re on an emotional roller coaster that won’t stop. The behavioral health disorder can cause extreme feelings of insecurity and irrationality.

The presence of these emotions causes a dichotomy.

Someone with BPD will want close relationships with those around them. However, because of an anxiety that’s centered around abandonment, they fear that these people will leave them. This fear leads them to push people away with obsession and irrationality so that they won’t get hurt if that person does decide to leave them.

Diagnosing Borderline Personality Disorder

In order to understand the inner workings of the condition, it’s important to understand the terms of diagnosis. A healthcare provider can diagnose a patient with BPD. To do so, the patient must meet five of the following nine symptoms of BPD:


Fear of abandonment manifested by drastic attempts to keep people from leaving


Volatile relationships as shown by quick changes from love to hate and hate to love


Unstable self-image as proven by uncertainty about one’s identity


Impulsive behavior that can include doing irresponsible or dangerous things that can harm oneself


Self-harming habits, including self-mutilation, suicidal ideation, and suicide attempts


Mood swings, such as irritability, anxiety, and dissatisfaction that can be sudden and last for days


Emptiness, defined as feeling alone or feeling like one is living a life without meaning


Anger that is uncontrollable, unreasonable, and may lead to physical altercations


Dissociation, which includes paranoia and disconnection from oneself

Although 75% of BPD patients are women, some experts believe that there may be a bias in diagnostic criteria. For example, we – as a society – are less likely to think of a man as emotional or volatile. On the other hand, seeing women in this light is more natural because of gender biases.

What Is a Substance Use Disorder?

A substance use disorder is a specific type of addiction. It’s the most common form of addiction, and it’s likely the kind of addiction that you think about first.

Substance use disorders involve using substances like alcohol, tobacco, or illicit drugs. Over time, the person may become so dependent on these substances that they feel like they need them to survive. Their everyday functioning will become impaired and their life could be in jeopardy.

Diagnosing Substance Use Disorder

A medical diagnosis of addiction needs to come from a psychologist, a psychiatrist, or an addiction specialist. They’ll perform a thorough evaluation.  They may ask questions about your everyday behaviors and any reasoning that you may have behind everything that you do. They’ll look at your overall health. Then, they can determine if something is affecting your health. 

From there, they may consider discussing treatment options that are available for you based on your stage of addiction. If they determine that you don’t have an addiction, they may consider starting with behavioral therapy. This can help you understand your urges and cravings better so that you can avoid forming an addiction in the future.

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What Causes Addiction?

Oftentimes, the first act of addictive behavior is voluntary. The first time you try a drink, the first time you gamble, and the first time you smoke a cigarette are all voluntary.

For some people, this voluntary action turns into a dependent relationship over time. Their brains alter with exposure to addictive behavior.  Everyone’s brain has a reward circuit that creates positive feelings toward positive experiences. At the same time, it can relate negative feelings toward negative experiences.

In someone with addiction, this circuitry doesn’t work the same way.  No matter the addictive behavior, someone with an addiction can perceive a feeling of euphoria as a feeling of positivity. This is because the euphoria/high that comes with performing the addictive behavior causes the brain to release dopamine. 

Dopamine causes the person to feel a sense of reward rather than regret. So, even if they’re performing risky behaviors, their brain associates those behaviors with happiness and positivity.

Over time, addiction takes over the brain and causes the person to need more and more of their addiction. If the patient doesn’t comply with what their body wants, they may start to experience unpleasant symptoms associated with withdrawal from the addictive behavior.

Now, they’re using the addictive behavior to feel normal.  Suddenly, a euphoric feeling turns to dependence and need. The chemical changes in the brain confirm addiction as a disease that can take over the entire body.

The Relationship Between BPD and Addiction

Borderline personality disorder can leave patients in social isolation. Because of their anxieties, it’s hard for these individuals to form healthy, lasting relationships.  Over time, this isolation and loneliness can lead patients to a dependence on other things. This leads patients with BPD to form addictions.

The majority of these addictive behaviors push patients towards dependence on drugs and alcohol. However, patients can become addicted to other substances or things, such as food, sex, gambling, smoking, and more.

Aside from the behavioral dependence on these substances and behaviors, addiction and BPD share some of the same symptoms:

To make matters worse, addictive behaviors can wear on the brain over time. These substances and activities can cause alterations in the patient’s brain structure. These changes may feel relieving at first, but they can cause instability later.

Eventually, all of these shifts in the brain will cause a change in brain functionality. This means that the brain will have trouble regulating chemicals like dopamine.

Patients who struggle with addiction and borderline personality disorder have co-occurring disorders. They both feed into one another as BPD makes the addiction worse and addiction makes BPD worse.

Does Addiction Make Borderline Personality Disorder Worse?

People with BPD look towards certain behaviors to try to help make their borderline personality disorder better. They’re looking for an escape from their own minds.   This can make their reliance on addictive behaviors even stronger.

The average person with addiction is performing addictive behaviors to feel normal. They’re escaping the withdrawal symptoms that could come with stopping the behavior.

On the other hand, a person with borderline personality disorder already feels disconnected. They already crave normalcy because their behavioral health condition makes them feel erratic and out of control.  Patients with BPD become addicted to the euphoric feeling before it even turns into a chemical addiction in the brain. Therefore, these patients are more likely to feel a stronger sense of dependence faster. This makes both conditions harder to treat.

Treatment for Addiction and Borderline Personality Disorder

Since these two conditions are intertwined, it’s important to address both issues at once.

The most common treatment method for addiction and BPD is dialectical behavior therapy (DBT). This treatment was created for patients with BPD. However, experts have expanded it to care for patients with BPD and addiction as well.

DBT focuses on mindfulness. With this, it encourages a positive outlook that presses for positive change in patients’ lives.  Before getting started, the patient must accept their conditions. They must also acknowledge the hard work that it’s going to take to overcome them. 

DBT is like other therapies for addiction and borderline personality disorder get. It encourages a change in thought and behavior patterns. These patients learn to control their emotions and work through their stress in positive, healthy ways.  Combined with counseling and other support, dialectical behavior therapy can be life-changing. This kind of comprehensive care can turn a patient’s life around for the better.

Addiction and borderline personality disorder aren’t easy to move on from. These kinds of conditions rewire your brain and change how you process information. Without proper individualized treatment and a little bit of rewiring, patients can fall back into old habits.

In short, these conditions are very difficult to treat. Patients may feel as if they’re starting all over. During the treatment, their mood swings, impulsivity, and lack of trust may make treatment even harder.

Patients may have trouble trusting and creating a relationship with their therapists. They may believe that the program is trying to change who they are.  BPD and addiction patients may drop out of the program before any changes can take place. As a result, they’re more likely to relapse into old habits.  This means that they’ll have to start their treatment again. They start from the beginning.

How to Begin Your Journey to Overcoming Addiction

If you or someone you know is struggling with addiction and borderline personality disorder, it’s time to get help. You can’t do this on your own.  You have two conditions that are altering your brain chemistry and making it harder to live your life. 

More importantly, this isn’t your fault. No matter the situation, these two conditions have affected your brain.

You didn’t make these changes yourself. You didn’t ask for this to happen.

If you’re ready to take control, reach out to us. Our family at New Method Wellness can help you take the first step.

Why We're One Best Dual Diagnosis Treatment Centers

Handpicked by Dr. Phil, New Method Wellness is a premier dual diagnosis addiction treatment center dually accredited by The Joint Commission. It has been singled out as one of the best drug and alcohol rehab centers in America, offering a unique 3:1 staff-to-client ratio that pairs every client with two therapists instead of one.

At New Method Wellness, we add another dimension to dual diagnosis treatment, and that is the integration of holistic therapy, such as massage/acupuncture therapy, equine therapy, and art therapy. As addiction therapists and substance abuse counselors work with clients to treat the substance use disorder and the co-occurring illness associated with it, holistic therapy adds meaning to life after treatment and sustains long-term recovery. Our 3:1 staff-to-client ratio ensures client success after treatment, as evidenced by our Extended Aftercare program.

For more information about New Method Wellness’s treatment programs, call 866-951-1824

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Clinically Reviewed By:

Deanna J. Crosby, M.A., LMFT, LAADC, Psy.D. (C)

Deanna Crosby is a Licensed Marriage and Family Therapist (LMFT) with over 20 years of experience working with clients in recovery. Her expertise has catapulted her into the spotlight. Featured on several episodes of the Dr. Phil Show as a behavioral health expert, DeAnna is a routine contributor for NBC News, The Huffington Post, Elle Magazine, MSN, Fox News, Yahoo, Glamour, Today, and several other prominent media outlets. 

After receiving her bachelor’s degree from the University of California in Irvine, Crosby did postgraduate work at Centaur University where she graduated at the top of her class with a CAADAC certification in Centaur’s chemical dependency program. Following her time at Centaur, Crosby received her Master of Counseling Psychology degree from Pacifica Graduate Institute, where she also attained a Doctoral Degree in Depth Psychology.

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From all of us at New Method Wellness co-occurring treatment center, we wish you peace and serenity in knowing that you or your loved one will get the necessary help.


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