Borderline personality disorder (BPD) and addiction

Borderline personality disorder is a mental health condition that affects the way people think, feel and behave. BPD is thought to affect around 1% of people with men and women equally likely to suffer from the condition. The causes of BDP are not yet fully understood but research suggests that borderline personality disorder causes are likely a combination of genetic, environmental and social factors.

Common BPD symptoms include:

• Fear of abandonment
• Intense and unstable emotions, such as anger, sadness or anxiety
• Impulsive behaviour, such as reckless driving, substance abuse or binge eating
• Self-harm or suicidal behaviour
• Difficulty forming and maintaining relationships
• Distorted sense of self-identity
• Chronic feelings of emptiness

BPD is often misunderstood and stigmatised, leading to a number of common misconceptions about the condition. One common misconception is that people with BPD are deliberately manipulative or faking symptoms as a way of getting attention. Another misconception is that BPD is untreatable but while it can certainly be a challenging condition to treat, many people with BPD are able to manage symptoms effectively and lead happy, fulfilling lives.

While all people with BPD experience similar symptoms and difficulties, there are four different subtypes of BPD. Understanding the different subtypes can help clinicians tailor treatment to the specific needs of each individual. The four main types of BPD are:

• Discouraged borderline: This subtype of BPD is characterised by feelings of worthlessness, self-hatred and a sense of being trapped. People with this subtype may be more likely to engage in self-harm or suicidal behaviour.
• Impulsive borderline: The main symptoms of impulsive borderline are impulsive and reckless behaviour, such as substance abuse, binge eating or reckless driving. Sufferers may also struggle with anger and aggression.
• Petulant borderline: This subtype often causes feelings of anger, resentment and entitlement. Sufferers are often quick to blame others for their problems and may struggle with maintaining relationships.
• Self-destructive borderline: This is often characterised by self-harm and suicidal behaviour. People may also have issues with substance abuse and other behaviour despite the negative consequences.

It is important to note that many people with BPD may exhibit borderline personality disorder symptoms from more than one subtype. This is why doctors need to work closely with each individual to identify their specific BPD symptoms and tailor borderline personality disorder treatment accordingly.

Dual diagnosis is a term that describes the co-occurrence of a mental health and addiction disorder. BPD and addiction often co-occur with BPD suffering often abusing drugs or alcohol as a way to cope with their intense emotions or due to impulsive or self-destructive tendencies. Conversely, addiction-fuelled substance abuse also worsens BPD symptoms, making it more difficult to manage the condition and resulting in an inescapable cycle.

Simultaneous BPD and addiction can be challenging to treat because both conditions need to be considered at the same time. If only one condition is treated without proper support being given for the other, one or both are likely to get worse, leading to an increased chance of relapse.

Some common co-occurring BPD and addictions include:

• BPD and sex addiction
• BPD and drug addiction
• BPD and porn addiction
• BPD and alcohol addiction
• BPD and social media addiction
• BPD and weed addiction

There are several reasons why addiction and BPD co-occur so often. These include:

• Self-medication: People with BPD may turn to drugs or alcohol as a way to cope with their intense emotions or impulsivity. Substance use can provide temporary relief from these symptoms, but it can also lead to addiction.
• Related causes: BPD and addiction are thought to share many of the same genetic, environmental and social risk factors which increase the chances of developing an addiction for BPD sufferers.
• BPD-related behaviours: People with BPD may engage in impulsive behaviours, such as reckless driving or binge eating that can also lead to addiction. They may also struggle with self-harm or suicidal behaviour which can increase the risk of substance abuse.
• Emotional instability: People with BPD may experience intense emotions, such as anger or sadness, that can be difficult to manage. Again, drugs, alcohol and addictive behaviour can provide a temporary escape, but can also worsen the underlying condition.
• Addiction to BPD medicine: Certain drugs that are used to treat and manage BPD can also be highly addictive, particularly if used other than as prescribed.

Addiction and borderline personality disorder are difficult enough to manage and treat on their own, let alone when they are triggering and fuelling each other. Treating addiction in the presence of BPD can be very difficult, but it is possible with the right approach. People with BPD may face unique challenges in rehab treatment, such as difficulty forming relationships with their therapists or other clients or feeling a sense of abandonment. At Banbury Lodge, we have a team of experienced clinicians who are trained in working with people with BPD and addiction and who provide a supportive and compassionate environment that is tailored to the specific needs of each individual.

Our recovery programmes are designed to help address addiction while also helping to manage BPD symptoms with many addiction counselling therapies also providing huge benefits for both conditions. These include:

Cognitive-behavioural therapy (CBT)
Cognitive-behavioural therapy (CBT): CBT can help you identify and change negative patterns of thinking and behaviour that can contribute to both your addiction and BPD symptoms. CBT will enable you to develop coping skills to manage overwhelming emotions, prevent impulsive behaviours, develop a more positive outlook on life and reduce the risk of relapse.
Dialectical behaviour therapy (DBT)
Dialectical behaviour therapy (DBT): Dialectical behaviour therapy (DBT) is a structured talk therapy that was actually developed in the late 1980s specifically to treat individuals with BPD. DBT can help you develop skills to manage intense emotions and improve interpersonal relationships. For BPD sufferers, DBT can be very effective in reducing self-harm behaviours and improving emotional regulation skills.
Group therapy
Group therapy: Group therapy provides a supportive environment where individuals can share their experiences and learn from one another. If you suffer from BPD and addiction, group therapy can help you feel less alone and more connected to others which is crucial for recovery. Additionally, group therapy can help you develop social skills and improve your interpersonal relationships, both of which can be major factors in preventing relapse in the future.
One-to-one therapy
One-to-one therapy: One-to-one therapy provides a safe and confidential space for you to explore your thoughts, feelings and behaviours. For individuals with addiction and BPD, individual therapy can be particularly beneficial in addressing the unique challenges that come with managing both conditions simultaneously.
Mindfulness and meditation
Mindfulness and meditation: Mindfulness-based therapies can help individuals develop awareness and acceptance of their thoughts and emotions. If you have BPD and addiction, mindfulness and meditation can help you improve emotional regulation skills which can help you cope with difficult moments without turning to substances.
Holistic therapies
Holistic therapies: Holistic therapies, such as yoga, art therapy, and sound therapy can help individuals manage stress and improve overall well-being. For BPD sufferers, holistic therapies can be particularly beneficial in reducing anxiety and improving negative moods, both of which are common symptoms.
Aftercare
Aftercare: Aftercare is an important component of addiction treatment because it helps people maintain their recovery over the long term. At Banbury Lodge, we offer weekly group therapy sessions for a year after treatment. This provides ongoing support and peer connection for people in recovery which is crucial for BPD sufferers who often feel abandoned and have trouble maintaining relationships.

If you or a loved one is struggling with addiction and BPD, it is important to seek professional help as soon as possible. Contact Banbury Lodge today to learn more about how we can help you overcome addiction and also make BPD easier to manage. This combination can totally transform your life and help you build a bright and happy future.