BPD and Addiction Comorbidity

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BPD and Addiction Comorbidity

Exploring the challenges of BPD comorbidities and links between borderline personality disorder and addiction.

— by Kyle Lakey

Borderline Personality Disorder (BPD) is a severe psychiatric and mental health disorder that affects how an individual relates to others and interacts with the world. According to the National Institute of Mental Health, borderline personality disorder is a mental illness that is marked by impulsivity and instability in moods, intense and unstable interpersonal relationships, poor self-image, and self-destructive behavior. Individuals with BPD often exhibit a wide range of symptoms that sometimes even overlap with other mental illnesses.

These symptoms include:

  • chronic feelings of emptiness
  • loneliness or boredom
  • low self-esteem
  • extreme emotional reactions
  • intense fear of abandonment
  • intense and unstable relationships.
  • pathological impulsivity
  • recurring thoughts of suicide or self-harm

The exact cause of BPD is unknown. However, it is thought to be a combination of genetic factors, environmental influences, and psychological issues that may contribute to the disorder. Stressful events or trauma during childhood may play a role in the development of BPD, as may psychological influences such as cognitive distortions or maladaptive coping strategies.

It’s important to note that borderline personality disorder is a complex disorder that cannot be cured but is treatable. Fortunately, a few treatment options are available to help people with BPD manage their symptoms and break their chaotic cycles.

How is BPD Connected to Substance Abuse?

There is often a connection between borderline personality disorder and addiction, and many people who suffer from one also suffer from the other. Additionally, many people with borderline personality disorder have co-occurring mental health disorders, such as depression and anxiety, which can further increase their risk for substance abuse. People who suffer from BPD often face a higher risk of transition to addiction than those without the disorder, which stresses the importance of understanding both conditions and how they intertwine.

There are several reasons for this connection. First, people with BPD often turn to drugs or alcohol as a way to numb their intense emotions. Additionally, impulsive behaviors such as compulsive spending, risky sexual activity, and binge eating are common in both BPD and addiction. Finally, people with BPD often have trouble regulating their emotions, which can lead to using substances as a way to cope with overwhelming feelings of self-harm or suicide.

The Challenges Facing Addiction While Living with BPD

Living with BPD and struggling with addiction can be incredibly challenging, both for the person with the condition and for their loved ones. Some of the specific difficulties that people with BPD may face include difficulty regulating emotions, impulsivity, and unstable relationships. Many people with BPD also struggle with self-harm and suicidal thoughts. These challenges can make it difficult to maintain stable employment or relationships and can lead to social isolation, substance use as self-medication, and ultimately further stigmatization.

It is important for individuals with BPD to have a strong support system, including mental health professionals, family, and friends. By building a support system, individuals with BPD can receive the care and understanding they need to manage their condition and lead fulfilling lives.

Dealing with Unstable Moods, Behavior, and Relationships

Borderline personality disorder can be an extremely isolating and difficult mental illness, affecting individuals’ feelings of security and happiness. People with BPD experience an intense fear of abandonment, often shattering into impulsive behaviors such as drug abuse or promiscuous sex. In addition, they have difficulty regulating their emotions and often struggle with depression, erratic behaviors, and impulsivity. Symptoms are often further complicated by the cycle of drug or alcohol addiction. As impulsivity and erratic behavior are traits of both mental disorders, it is understandable why many with BPD turn to substance abuse as an outlet or coping mechanism.

Even when this occurs unintentionally, the consequences can often be harsh, leading to longer-lasting mental health issues or a lifetime of difficulty in managing substance abuse disorders. Furthermore, research indicates that individuals with BPD might be predisposed to developing addictions due to their emotional dysregulation and tendency toward depression. This ultimately shows how the link between BPD and addiction is a two-way street that can result in devastating effects.

Coping with Self-Harming Impulsivity, and Feelings of Loneliness and Emptiness

People with borderline personality disorder are often tormented by a deep sense of loneliness and emptiness. If a person with BPD is not able to manage negative emotions in a healthy way, they may use drugs to dull the pain, yet this can cause further complications in their lives. Individuals with BPD who are relying on substances to numb the pain can fall into a cycle of addiction that can be incredibly difficult to escape from amid the often tumultuous emotions they experience. As such, it is important for those suffering from BPD to find healthier outlets in order to cope with their feelings and prevent addiction from developing.

Borderline personality disorder and addiction can be a vicious cycle. Substance abuse can worsen the symptoms of borderline personality disorder, making it more difficult for people to manage their emotions and maintain healthy relationships. Suffering prolonged bouts of a negative or depressive emotional state can easily spawn suicidal thoughts or cause impulsive self-harming behavior. To make matters worse, substance abuse can increase the risk of people acting on these impulses.

Treating Borderline Personality Disorder and Addiction

There is hope for treatment and recovery for those dealing with both borderline personality disorder and substance use disorder. Although BPD can be difficult to manage, there are effective treatments available that can help individuals gain control over their symptoms and lead healthier lives.

Caring for yourself is of the utmost importance. Both addiction and borderline personality disorder can cause immense amounts of turmoil in an individual’s life. Those suffering from either of these conditions may feel isolated, scared, or even ashamed. When left untreated, these mental illnesses can have drastic consequences. With the right insight into triggers and behavior patterns, individuals can work together to heal from both co-occurring disorders.

Fortunately, a variety of resources are available to help those in need. Additionally, healthcare providers offer tailored solutions to treat each person’s specific illness. It is important to keep in mind that everyone experiences the road to recovery differently and that healing takes time.

If you or someone you care about is suffering from borderline personality disorder or addiction, please consider seeking help from a professional. Mental health professionals have the necessary training to provide effective treatment and address any further concerns that may arise throughout the process. With their guidance, those living with either condition can work towards meaningful recovery and lasting quality of life. Seeking support from professional care is essential in navigating these difficult conditions.


Cognitive Behavioral Therapy (CBT) is often used to help patients learn how to improve their relationships, manage their emotions, reduce impulsivity, and change negative thought patterns that can lead to substance abuse. Dialectical Behavior Therapy (DBT) is another common treatment option that focuses on helping individuals develop better coping skills to manage difficult emotions and effectively communicate with others. Other treatments, such as psychoeducation, motivational interviewing, and family therapy, can also be helpful in managing BPD symptoms.


BPD is a complex condition that can manifest in a variety of ways. Some BPD symptoms may be similar to other severe mental illnesses like bipolar and complex PTSD. There is currently no FDA-approved BPD medication. However, healthcare specialists may prescribe medication to treat coexisting conditions. Medications such as antidepressants, mood stabilizers, and atypical antipsychotics may be prescribed to help people with BPD manage their symptoms. However, medication should not be seen as a cure for BPD, and it is important to work with a mental health professional to determine the appropriate medication and dosage.

Support Resources for BPD and Addiction

While therapy is an important part of treatment for both BPD and addiction, there are other support resources available as well. Peer support groups, such as those offered by the National Alliance on Mental Illness (NAMI) or the National Education Alliance for Borderline Personality Disorder (NEA-BPD), can provide a sense of community and connection for individuals with BPD and their loved ones. Furthermore, groups like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) offer support for people struggling with alcohol or substance abuse. These groups can offer a safe space for individuals to share their experiences and learn from others who are going through similar challenges.

It is important for individuals with BPD and addiction to explore different support resources and find what works best for their unique needs and circumstances. By building a support system that includes mental health professionals, friends, family, and peer support groups, individuals with BPD and addiction can receive the care and understanding, they need to manage their conditions and lead fulfilling lives.

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