Drug and alcohol addiction has plagued communities for decades and the problem gets worse each passing year. The problem is compounded in people who struggle with mental health issues like borderline personality disorder. 

How do the two problems interact?

What Is Borderline Personality Disorder?

Borderline personality disorder (BPD) is a mental health disorder alternately called emotionally unstable personality disorder (EUPD). People with BPD often struggle with emotional extremes, failed relations and a distorted self-image. In these episodes, the individual is more likely to attempt self-harm or risky behavior.

In many cases, people with BPD have deep-seated emotional issues that stem from abandonment or loss. They suffer severe feelings of loneliness and emptiness. Their connection to reality is often fuzzy and distorted. Oftentimes, the episodes that trigger a person with BPD would seem like normal, manageable stress factors to other people.

How Many People Have Borderline Personality Disorder?

According to the National Alliance on Mental Illness, 1.4% of US adults suffer from borderline personality disorder. Roughly 10% of people with BPD die of suicide. People who struggle with the illness often go undiagnosed and are generally misunderstood by society. 

What Are the Symptoms of Borderline Personality Disorder?

People with BPD often struggle with emotional and confidence issues that stem from a distorted sense of self in relation to the outside world. Common characteristics include:

• Substance abuse – People with BPD often engage in drugs and alcohol to relieve feelings of stress and anxiety. Due to their compulsive behavioral traits, they’ll often overindulge and quickly get hooked on illicit drugs and booze. The effects that drugs have on mood and emotion can easily exacerbate BPD symptoms.
• Depression – BPD sufferers often feel extreme moods of doom, loss and despair. They often foresee extreme negatives in every possible outcome and declare situations hopeless. They might take breakups really hard, like end-of-life situations. They might disbelieve in their financial prospects and think of giving up on life.
• Eating disorders – BPD sufferers also have distorted body issues that can lead to eating disorders. A woman with BPD might never see herself as “thin enough,” even as her weight drops below healthy weight-height proportions. A man might not think he’s buff enough and resort to steroids. This can also manifest in fear of foods (extreme germophobia).

• Fear of abandonment – People with BPD often fear being alone and suffer separation anxiety when a partner leaves for a day of work. He/she might think that a regular parting from a friend, relative or romantic partner will be the last time they ever see each other. They can sometimes get clingy and over-possessive of people close.
• Doomed relationships – People with BPD typically have unstable relationships. They’ll act too clingy too soon and love bomb a potential partner. They’ll get jealous and possessive really quick and be paranoid about glances from third parties. Once they’re in a relationship, they’ll try to isolate the partner and make him/her feel that no one else will ever love them.
• Distorted self-image – This often feeds into the eating disorders of people with BPD. A woman who weighs only 90-100 lbs at standard adult height might think that she still needs to lose weight, even as her ribs stick out. A BPD sufferer might also feel ugly and distorted, despite having a perfectly symmetrical face. He/she might get addicted to plastic surgery.
• Impulsive behaviors – People with BPD often engage in hasty, impulsive acts out of fear, loss or the sense that this common everyday scenario is a once-in-a-lifetime opportunity. This could manifest through impulse buying, product hoarding and anxious behavior. A person might overestimate the ramifications of something and spend the day making unnecessary adjustments.
• Self-harm – The depression caused by BPD often leads to self-harm. This often occurs in surprise scenarios, where the person is shocked or depressed by new information or an unexpected occurrence. Regardless of the severity of the matter (which could be something benign to most people) the individual will get sudden suicidal urges.
• Wild mood swings – BPD sufferers often have extreme changes of mood, from 0-100. One moment they’ll be docile; the next highly agitated. It could be something benign or uneventful, like a missed TV show or word that the local market is closed due to snow. This can be awkward in public when a person gets suddenly agitated and acts out in front of others.
• Chronic emptiness – People with BPD often feel alone and empty, even when they do have enriching things and people in their lives. The person might fear that he/she is about to be abandoned by everyone close or that a seismic event will wipe them all away. Some BPD sufferers go from person to person, trying to suck as much out of as many people as possible to fill the void.
• Abrupt rage – BPD sufferers can get triggered easily and often fly into fits of rage or hysteria at the slightest notion or event. A person might misinterpret a statement or eye gesture and get easily enraged. Something might go wrong, such as an appliance or vehicle, and the person screams out loud and starts fidgeting and kicking things.

These are just some of the behaviors that can make people with BPD unpredictable, edgy and difficult to communicate with. All these issues can be severely impacted by the first symptom, drug and alcohol use.

What Are the Dangers of BPD?

People with BPD have difficulty coping in the world. This can cause problems at work, school and with society at large. In some cases, BPD sufferers are unable to hold employment or stay caught up in class due to constant episodes of paranoia, depression and agitation. Some of the common setbacks, difficulties and dangers BPD sufferers face include:

• Job termination – People with BPD often have trouble holding down jobs because their irritability and paranoia bring them into constant conflict with co-workers. They might get paranoid about their standing with the company and become secretive. This gives off a bad vibe that others detect. They could find themselves bouncing from job to job.
• Incomplete education – BPD sufferers have trouble completing degrees and staying in class because they constantly second guess themselves and their performance. The person might think he/she is constantly failing and tries to correct (non-existent) mistakes again and again. Eventually, the student might have a panic attack.
• Legal trouble – Due to their irritability, paranoia and mood swings, BPD sufferers are likely to wind up in fights. Some sufferers might over- or under-estimate their fighting ability if things escalate. A sufferer might do something drastic and commit some major act of violence over a perceived slight that didn’t occur. This can lead to fines and jail time.
• Domestic conflict – It’s difficult, if not impossible, to maintain a healthy relationship with a person who suffers from BPD. The person could have irrational mood swings over neutral or well-intended statements like “you look like you haven’t eaten.” They can also be clingy, jealous, competitive, toxic, spiteful and create drama in a marriage or domestic partnership.
• Self-harm – BPD sufferers often resort to self-abuse during episodes of despair. A person could get paranoid over the status of their romance, job, friendship or standing on social media and assume that all is lost. In today’s overly politicized world, the person might think that certain politicians or movements are out for them personally and try to end it all to avoid capture.
• Abusive relationships – BPD sufferers are often unable to have healthy relationships. Some go as far as to seek out toxic, unhealthy and abusive relationships. A woman sufferer might have low self-esteem and seek out men who’ll treat her the way she thinks she “deserves” to be treated. She might make passive-aggressive attempts to bring the worst out in her partner.
• Risky behavior – People with BPD are more prone to risky behavior. If mixed with drugs or alcohol, this could lead to reckless driving and use of firearms. It could also result in unwanted pregnancies and venereal disease through unprotected sex. The person’s belligerence or mood swings could lead to public flare-ups that end in fights and barroom brawls.
• Suicide/suicide attempts – A common end result of emotional low episodes where the BPD sufferer becomes despondent. Sufferers might think life is hopeless and everyone hates them. If they’ve already faced setbacks due to the other dangers of BPD (job loss, failed relationships) they might see no way out and not conceive of self-improvement.

People with BPD could easily fall into a downward spiral of self-loathing and drug abuse if the problem is not monitored or intervened on by loved ones.

What Causes Borderline Personality Disorder?

Like other types of mental illness (schizophrenia, bipolar disorder), the roots of BPD are hard to pinpoint. A person’s childhood and environment are generally suspected of being the two strongest determining factors, in addition to:

• Genetics – In some families, mental illness is common. BPD could be hereditary or passed on as a set of behaviors from parent to child. If a child is raised by a mother or father with a set of BPD-like characteristics (moodiness, irrational thinking, delusional thoughts, despondency), the child might inherit these traits. 
• Brain abnormalities – If the brain has some abnormality in its shape or limbic system, it could impact the way a person thinks and behaves. Some people who are violent or murderous have tumors that press against the aggression centers in the brain. Charles Joseph Whitman, the sniper behind the 1966 Texas tower massacre, is one example.
• Prenatal exposure – If the mother does drugs or drinks while pregnant, it could impact brain development in the offspring. Children fathered by older men (50+) are also more likely to have brain abnormalities.
• Childhood trauma – People who suffer sexual abuse as children or experience loss or abandonment often grow up with poor mental health and addictive personalities. If a child loses a parent, it could open a lifelong void that the person tries to compensate for with clingy, needy behavior.

There is no cure for borderline personality disorder but it can be treated and managed along with drug and alcohol addiction. 

Treatment for Borderline Personality Disorder

At behavioral addiction mental health counseling and treatment centers, counselors treat mental health disorders along with addiction. It’s easier to help a patient overcome his/her addiction if the co-occurring mental health issues are also addressed and dealt with properly. The therapy models used to treat BPD and addiction include the following:

• Dual diagnosis therapy – A form of counseling that gets to the root of a person’s addictive behavior. Usually, a person engages in drug abuse and irrational behavior due to childhood trauma and loss. It could be due to a sense of abandonment that they try to fill through drugs and clingy, obsessive/compulsive behavior.
• Cognitive behavioral therapy – Counseling that identifies the negative beliefs that are hardwired into a patient’s subconscious. People who abuse drugs and self-harm often have deep-seated beliefs that they’re worthless and there’s no hope in life. CBT identifies these thoughts and reverses them. This helps the patient change his/her behavior.
• Dialectical behavioral therapy – Often used in combination with CBT. DBT treats mood swings and suicidal tendencies. It’s built on four key principles: mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness.

Drug abuse feeds into mental health issues like BPD and vice versa. When you treat one, it’s easier to treat the other. People can conquer their addictive tendencies and regulate mental illness through a combination of these therapeutic modalities and general wellness practices.

Find Treatment for Drug Addiction, Alcoholism and Borderline Personality Disorder

Drug addiction and alcohol abuse are longtime societal ills that exacerbate mental health issues like borderline personality disorder. If someone you know struggles with addiction and/or BPD, call the treatment centers in your area and ask about their programs and financing options. Don’t let the problem claim the life of your loved one.