Borderline Personality Disorders and Substance Abuse Disorders


According to the National Alliance on Mental Illness (NAMI), around 1.4% of American adults suffer from a borderline personality disorder. Those suffering from a mental illness may turn to drugs and alcohol for a moment of relief. According to reports, this is the case for many of the 18.6 million American adults that suffered from a substance abuse disorder in 2017.

Although a little over one percent of the American adult population may seem like a small number, it translates into hundreds of thousands of individuals with doerline personality disorder. Dealing with borderline personality disorders and substance abuse disorders may feel impossible to overcome for those suffering from both.

While both health disorders must be managed for a person’s entire life, both are treatable. Detox, treatment, a thorough aftercare plan allows people to overcome simultaneous mental illness and addiction. With the right mindset and team, there is a way to live life to its fullest potential.

What Are Borderline Personality Disorders and Substance Abuse Disorders?


Researchers have found a definite relationship between substance abuse disorder and borderline personality disorders. It’s important to know what a borderline personality disorder is and what a substance abuse disorder is in order to understand the relationship between the two. Understanding the signs and symptoms of both along with what the respective criteria are can help individuals see why it’s necessary to get treatment immediately.

What Is a Borderline Personality Disorder?

A boderline personality disorder is a mental illness where individuals have a severely difficult time managing their emotions. About one in five American adults suffered from a mental illness in 2019 (51.5 million people). Yet, not all of them suffer from a severe mental illness.

Boderline personality disorder (BPD) is a serious mental illness that can uproot an individual’s life if left untreated. The National Institute of Mental Health (NIMH) writes that a serious mental illness is when a “mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. The burden of mental illnesses is particularly concentrated among those who experience disability due to SMI.” It may come as a surprise to some that a serious mental illness can qualify as a disability, but that is how much BPD affects people’s lives.

This kind of mental illness is classified as a personality disorder. Typically personality disorders involve difficulty maintaining relationships and issues with self-image. An alarming characteristic of BPD is that people suffering from it are more likely to self-harm. BPD can be taxing both emotionally and physically.

Signs and Symptoms of Borderline Personality Disorder

Knowing the signs and symptoms of borderline personality disorder can help individuals find the help that they need. Additionally, recognizing these signs in loved ones can help them overcome the worst of their symptoms quickly and safely.

These are common signs and symptoms of a borderline personality disorder per the Diagnostic and Statistical Manual (DSM):

  • Splitting – Splitting is when someone with BPD quickly switches between extreme opinions of a person. He or she may say they love a person one day and then hate this person shortly after.
  • Extreme fear of abandonment – Individuals with BPD may frantically act on the thought that friends and family may abandon them.
  • Self-destructive, risky behaviors – Making reckless decisions without thinking of the consequences later. Examples include unprotected sex and driving intoxicated.
  • Dissociating – Feeling like you’re watching your life go on from an outside perspective paired with stressful, paranoid thoughts. This can briefly lead to a psychotic break.
  • Self-harm – May involve cutting or hitting themselves and suicidal behavior.
  • Warped self-image – Often, people with BPD have a distorted sense of self, which deeply affects every facet of their lives.
  • Chronic boredom – Those with BPD may feel constantly bored or empty inside.
  • Upsetting emotions – BPD can make people feel intensely upset, anxious, and angry.

How Does Borderline Personality Disorder Happen?

Although many people suffer from BPD, medical professionals are unable to pinpoint an exact cause. That said, the medical community suspects certain reasons. While it’s not definite, specific factors may increase the chance of suffering from BPD later on in life.

If a child grows up in a cold and unstable environment, they may be more prone to developing BPD. Traumatic events (ie: abuse) can also lead to this mental illness. Also, BPD may be hereditary. People that have close family members with BPD may end up suffering it themselves.

The brain could play a large part in who suffers from BPD and who doesn’t. Irregular areas of the brain that control emotion and behavior may indicate BPD. Additionally, an imbalanced brain chemistry might indicate this as well.

What Is a Substance Abuse Disorder?


A substance abuse disorder, or substance use disorder, is when individuals are unable to stop consuming harmful substances even if they try. Substance use disorders are incredibly complex health conditions where people suffer physically and mentally.

Although individuals suffering from a substance use disorder may badly want to stop consuming drugs, they can’t because of a physical and psychological dependence. In some cases, abruptly abstaining from drugs when suffering from a substance use disorder can be quite dangerous.

When people consistently abuse drugs and alcohol heavily, it will likely change their brain functionality for the worse. While such people may originally feel euphoria and other pleasant effects from the substances, their substance use disorders are classified as addictions.

Signs and Symptoms of Substance Abuse Disorder

Substance use disorders have different signs and symptoms depending on the type of drug a person consumes. But, there is some overlap between all of them. While all the signs and symptoms below may not mean a person suffers from a substance use disorder, it’s always better to assume the worst and hope for the best considering how dangerous this medical condition can be.

Signs and symptoms of a substance use disorder may include: 

  • An increased desire for privacy
  • Difficulty maintaining relationships
  • Inability to keep up with important responsibilities at school and work
  • A lack of interest in personal hygiene
  • Irregular sleeping and eating patterns
  • Looking physically ill constantly (ie: bloodshot eyes and grey-looking skin)
  • Sudden spikes of energy paired with sudden lethargy
  • Needing money all the time even when though one has a stable income
  • Using drugs and alcohol in inappropriate settings

What Is The Link Between Borderline Personality Disorders and Substance Abuse?


It’s clear that the signs and symptoms of addiction and BPD overlap in many ways. Each medical health disorder exacerbates the other. For instance, BPD can cause people to engage in self-destructive, risky behavior such as using drugs and alcohol. Repeated substance abuse can turn into a substance abuse disorder, which will only make their actions more self-destructive.

It makes sense then that over 66% of those suffering from BPD abuse substances. Not only does BPD cause individuals to act against their best interest, but it also makes people feel intensely bored and upset. This may lead them to use drugs and alcohol to mask emotional pain.

Borderline Personality Disorder and Alcohol Use Disorder

A journal within PubMed reveals the link between borderline personality disorder and alcohol use disorder. It details a study where researchers examined alcohol cravings in social drinkers and those with BPD. They asked both groups to note when they craved alcohol over a period of 21 days.

The researchers observed that individuals with BPD were more likely to drink frequently and in inappropriate situations (like at work). This ran parallel to the fact that they had more cravings to drink alcohol than social drinkers. Borderline personality disorder and alcohol use disorder may occur for this reason.

Who Is At Risk For Borderline Personality Disorders and Substance Abuse Disorders?



Research indicates that 75% of individuals who suffer from BPD are women. Though, recent scientific literature suggests that men might be misdiagnosed with another mental illness instead of BPD. This could skew this statistic.

People Without Insurance

As said before, individuals with BPD may relieve emotional turmoil through drugs and alcohol. Those without insurance and BPD may not be able to afford to see a medical professional about what they are going through. This could make substance abuse the only way people with BPD feel like they can help the symptoms of their mental illness.

Those Who Have Another Mental Illness

Unfortunately, those with BPD often suffer from an additional mental illness. People with a diagnosed mental illness may not get the proper treatment until both mental illnesses are identified. This could also lead to substance abuse to feel relief.

Dual Diagnosis Treatment For Borderline Personality Disorders and Substance Abuse Disorders


A dual diagnosis is when people suffer from multiple health disorders at the same time. A dual diagnosis may also be known as a co-occurring disorder or comorbidity. People suffering from borderline personality disorder and addiction meet the criteria for a dual diagnosis. In this scenario, it’s crucial to treat both health disorders at the same time. Treating one disorder prior to the other one will result in ineffective treatment. Certain addiction treatment programs can help with both conditions.


Talk therapy is a powerful way to address the feelings people with BPD have. There are many forms of talk therapy, but dialectical-behavior therapy (DBT) is especially beneficial for those with a dual diagnosis.

DBT focuses on validation and mindfulness. It helps individuals with BPD accept the thoughts that they have, but see why it’s not in their best interest to act on them.

Medication-Assisted Treatment (MAT)

MAT can help individuals with a dual diagnosis quell withdrawal symptoms and symptoms of a mental illness. Unfortunately, there is no approved medication to treat BPD. However, there are medications a dual diagnosis treatment center may use to help with symptoms of BPD. For instance, they may prescribe antipsychotics and antidepressants to help regulate mood and disorganized thinking. MAT can also help individuals avoid physical and mental withdrawal symptoms associated with a substance use disorder.

Choose Harmony Ridge Recovery Center For Dual Diagnosis Treatment


At Harmony Ridge Recovery Center, we know how important it is to examine every factor that may lead to a substance use disorder. Although it may seem impossible, we are confident that we can help individuals overcome BPD and addiction through our dual diagnosis treatment programs. If you or a loved one suffers from a dual diagnosis, don’t hesitate to contact us now.


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