Borderline personality disorder (BPD) is a mental health condition that stems from early childhood trauma. This condition causes shifting self-images, unmanageable emotions, impulsive behaviors, and a pattern of unstable relationships. Untreated BPD can cause an individual’s life to become unmanageable, affecting their ability to perform daily tasks.
Additionally, individuals with untreated BPD attempt to self-medicate their uncomfortable emotions through the use of drugs and alcohol. This often leads to addiction, causing the individual to struggle with a co-occurring substance use disorder.
According to the National Library of Medicine, about 75% of individuals with borderline personality disorder have a substance use disorder at some point in their lifetime.[1]
People with dual diagnoses must receive professional treatment for both conditions simultaneously. Treatment for borderline personality disorder and addiction involves medication management, behavioral therapy, and peer support.
How Does Addiction Affect Borderline Personality Disorder (BPD)?
A borderline personality disorder is characterized by poor emotional regulation. These individuals often struggle with intense emotional reactions that they cannot slow down or control.
The common character traits associated with borderline personality disorder include:
- Rapid changes in mood that include episodes of dysphoria, rage, or transient dissociation
- Intense emotional reactions, often relating to perceived or real abandonment
- Self-destructive and impulsive behavior, including self-harm, suicide attempts, and substance abuse
- Interpersonal difficulties that cause a pattern of intense and unstable relationships
- Chronic feelings of emptiness or numbness
- An unstable and shifting sense of self
One of the main reasons that people with BPD experience self-harming behavior is because the physical act of pain serves as a distraction from intense and uncontrollable emotions. Oftentimes, substance abuse is used as a distraction for similar reasons.
Unfortunately, self-harm and substance abuse only provide temporary relief. Over time, people with BPD who abuse substances as a coping mechanism will develop an addiction. This increases their self-destructive impulses, leading to further disinhibition, emotional crises, and intentional acts of self-harm.
Additionally, people with comorbid BPD and addiction are at an increased risk of suicidal ideation and behavior. This is because addiction furthers their unstable sense of self, leading to interpersonal conflicts that eventually cause the individual to become isolated.
What is Treatment Like For Borderline Personality Disorder (BPD) and Addiction
Because substance use disorders exacerbate an individual’s symptoms of borderline personality disorder, receiving professional dual diagnosis treatment is imperative. Dual diagnosis treatment addresses both the individual’s issues with addiction and BPD to prevent one condition from furthering the symptoms of the other.
This is typically achieved through an integrated care program that includes medical detox, behavioral therapy, and relapse prevention planning.
Medical Detox
The first step in treatment is detoxification.
Before an individual can focus on treating the psychological aspects of their co-occurring disorders, they must become physically stabilized by removing the drugs from their body and overcoming symptoms of withdrawal.
Depending on the type of drug an individual was addicted to, they may receive tapering medications to soothe severe symptoms of withdrawal and curb intense drug cravings. Additionally, the patient’s vitals will be monitored on a 24/7 basis to ensure they are safe and comfortable throughout the entire detoxification process.
Dialectical Behavior Therapy
Once an individual has overcome their symptoms of withdrawal, they can begin behavioral therapy. For comorbid addiction and BPD, most dual diagnosis treatment programs use an evidence-based therapy model known as dialectical behavior therapy (DBT).
This type of therapy was created to treat borderline personality disorder and has been found beneficial in the treatment of addiction as well. DBT is often used during individual therapy and group counseling sessions. This allows individuals to receive both one-on-one treatment and peer support.
Dialectical behavior therapy for co-occurring BPD and addiction is known as DBT-SUD. For addiction, this type of behavioral therapy helps individuals to:
- Become aware of urges to drink, learn to tolerate them, and learn to reduce them.
- Increase motivation to stop using alcohol or drugs
- Manage difficult emotions without the use of alcohol or drugs
- Increase the reinforcement of healthy behaviors through coping mechanisms and community support
According to the National Library of Medicine, “Dialectical behavior therapy aims to address the symptoms of BPD by replacing maladaptive behaviors with healthier coping skills, such as mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance.”[2]
Medication Management
When it comes to treating BPD, there is no psychotropic medication intended to treat this condition. However, some symptoms can be managed through the use of mood stabilizers, anti-psychotics, or anti-depressants. This is because individuals with BPD experience rapid mood swings, symptoms of anxiety, and bouts of depression.
Aftercare Planning
Once an individual completes therapy and is considered emotionally stable, they will begin working on an aftercare plan with their therapist. Aftercare planning is intended to prevent individuals from relapsing after they leave the safety and comfort of their dual diagnosis treatment program.
Aftercare may include the following services:
- Continued individual and group therapy
- Continued medication management if needed
- Access to sober living and halfway programs
- Counseling groups
- Alumni support meetings
- 12-step addiction support meetings
- List of triggers for BPD and addiction and positive coping mechanisms to use
Find Treatment for Borderline Personality Disorder and Addiction in New Jersey
Individuals who suffer from a combination of BPD and substance abuse must attend an integrated care program that simultaneously addresses both conditions. Dual diagnosis treatment programs in New Jersey are designed to help individuals recover from co-occurring disorders.
New Jersey Interventions can help you or your loved one gain the resources you need to find a reputable dual diagnosis treatment program. Contact us today for more information on how to get started.
References:
Medically Reviewed: April 25, 2022
All of the information on this page has been reviewed and verified by a certified addiction professional.