Borderline personality disorder (BPD) is a potentially debilitating condition in which a person’s self-perception is distorted, and this significantly impedes their ability to maintain healthy, stable relationships. Those who suffer from BPD are often perceived as dramatic, two-faced, and manipulative and engage in behavior that experts believe serve as dysfunctional means to cope with emotional instability and pain and fear.
Substance abuse and BPD often occur together, and the interaction between them can be volatile and unpredictable. People with BPD, as with other mental illnesses, are more likely to use substances than others as a means of self-medication to escape feelings of fear and abandonment.
In fact, studies have revealed that about two-thirds of those who experience BPD have abused substances at some point in their lives. Unfortunately, substance abuse tends to exacerbate some of the more concerning symptoms of BPD, such as anger and severe depression.
In an effort to surmount their overall sense of emotional emptiness, people with BPD may also engage in self-harm, such as cutting. They are also more vulnerable to suicidal thoughts and attempts, especially if substance abuse is present.
Symptoms of BPD may include the following:
- Intense mood swings
- Hypersensitivity to emotions
- Profound depression or anxiety
- Suicidal thoughts and behaviors
- Irrational perceptions of others
- Paranoia and delusions
- Intense anger or aggression
- Lack of or unstable sense of self
- A deep fear of abandonment
- Feelings of desolation
- Manipulative impulses
The effects of BPD often leave sufferers with a profoundly poor sense of self-worth. Their impulsive behavior and moodiness often push others, causing them to be isolated and withdrawn.
This isolation can result in extreme depression or anxiety, as people with BPD tend to have an intense fear of being alone or abandoned. Ironically, individuals with BPD often push others away and prevent themselves from experiencing close, meaningful relationships due to the fear of being abandoned by that loved one in the future.
What Causes BPD?
Although the exact origins of BPD are unknown, there are a few credible theories regarding how this complex personality disorder can develop. Factors believed to contribute to the development of BPD include the following:
Childhood Trauma and Family Dysfunction
Children who are brought up in families where they feel neglected, abandoned, or are emotionally, physically, or sexually abused are more likely to develop BPD as teenagers or young adults. This unhealthy environment can contribute to rampant substance abuse and severe mental illness later in life.
More to the point, BPD is believed to result from neglect or abuse during the stage of childhood development in which a child learns how to trust and rely on others. As a result, people with BPD grow up to lack this vital aspect of interpersonal relationships.
BPD and other personality disorders are often found among close family members, such as parents and their children. This fact suggests that some individuals may have a genetic propensity for developing BPD. Experts believe that certain inherited inclinations or personality attributes, such as aggression, may increase the risk of BPD when coupled with environmental factors.
Brain Chemistry and Neurobiology
Anomalies in the areas of the brain responsible for mood, emotional, and behavioral regulation are thought to be at least partially responsible for the emotional instability and unpredictable, impulsive behavior displayed by those with BPD. Research has found that some regions of the brain, such as the amygdala, hippocampus, and orbitofrontal cortex, maybe be different in those with BPD.
BPD may also be caused by imbalances in certain neurotransmitters, which are naturally-occurring brain chemicals that directly impact how people feel and behave. These include dopamine, serotonin, and adrenaline, which are chemicals responsible for the regulation of many emotions and urges.
How BPD and Addiction Overlap
Many of the neurological and environmental factors that are thought to contribute to BPD are also strongly correlated with substance abuse. Many who suffer from addiction were raised in environments in which heavy drinking or drug use was present, and this experience in and of itself may inflict trauma on children.
Compounding matters, a history of childhood abuse or other trauma also raises the risk of substance abuse later in life. Events such as these often compel the individual to seek a means to escape adverse feelings, such as anger, resentment, fear, and pain.
When it comes to addressing BPD and addiction concurrently, the similarities between the symptoms of the two can make both conditions challenging to identify and diagnose appropriately. Treatment can be especially difficult when the person’s antisocial and manipulative propensities make them frustrating and unpleasant to work with.
For example, both BPD and addiction may be characterized by the following:
- Impulsive, self-destructive actions
- Manipulative and deceitful behaviors
- Unstable and tense relationships
- Legal, financial, or employment issues
- Mood instability that ranges from profound depression to manic states of high energy
- A lack of concern for one’s own safety and wellbeing
- An insistence on engaging in risky behavior despite incurring adverse effects
Treatment for Borderline Personality Disorder
BPD and addiction can and should be addressed simultaneously in treatment centers that offer dual diagnosis programs. These programs generally offer therapy, counseling, and pharmacological interventions for both mental illness and substance use disorders.
The most common and effective approach used to treat both these conditions is cognitive-behavioral therapy (CBT). CBT is featured in rehab facilities to help people identify the thought patterns that contribute to their impulsive, unhealthy, and addictive behavior. Likewise, CBT teaches patients how to manage their moods and emotions better, so they are less likely to resort to the use of substances as a means of coping.
Treating borderline personality disorder is especially challenging because people with BPD often make demands of their therapists that are unreasonable, and insist on having constant contact with those who are treating them. They are often perceived as dependent and needy due to an inclination to seek out caregivers who can meet and enable their profound emotional needs.
Making treatment even more challenging, people with BPD may turn against their treatment provider, and become hostile and paranoid without any apparent reason. Understanding the emotional underpinnings of borderline personality disorder is vital for professionals who attempt to treat this severe psychiatric disorder.
In addition to psychotherapy, people who receive comprehensive treatment can attend classes and counseling sessions that concentrate on relapse prevention. This training is critical for those with co-occurring disorders such as these, as rates of relapse tend to be high. Relapse prevention can be fostered through peer group support meetings, where people who have been diagnosed with both BPD and addiction can share coping strategies and address the difficulties of living with these two conditions.
Psychiatric drugs and medication to treat addiction can also be powerful tools when used as part of a broader treatment plan. Many BPD patients discover that medications intended to restore balance to levels of neurotransmitters (e.g., antidepressants) can be beneficial. Moreover, addiction treatment medications such as naltrexone and Suboxone can also help by minimizing withdrawal symptoms and reducing cravings for alcohol or opioid drugs.
Getting Help for BPD and Addiction
If you or a loved one is suffering from BPD and addiction, contact Harmony Treatment and Wellness as soon as possible to discuss treatment options and learn how we help people recover from both disorders and reclaim their lives.
You can experience the fulfilling life you deserve! Contact us today!