By Kathryn Millán, MA, LPC/MHSP

As many as one in five American adults deal with a mental illness each year.1 If not you, then someone you know has probably faced some type of mental health concern. Borderline personality disorder (BPD) is a diagnosis that has been largely misunderstood and can be especially difficult for both individuals and families to experience.

What Is Borderline Personality Disorder?

People who have borderline personality disorder may act impulsively, have extreme mood swings and an intense fear of abandonment. Their self-image and the way they view those close to them often changes, which makes relationships challenging. Without treatment, people with this condition may even harm themselves, threaten or attempt suicide and sometimes complete suicide.

Ballerina in the mirrorPeople who struggle with BPD may use drugs or alcohol to medicate the difficult emotions associated with their condition. While only 2.7 percent of the US population has BPD, as many as 78 percent of that population will go on to be diagnosed with a substance use disorder in combination with BPD.2

Unfortunately, the co-occurrence of BPD and an addiction can make recovery more challenging. People with BPD often get discouraged with traditional addiction treatment, and may be more likely to give up, get sidetracked with conflicts or relapse. For these reasons, quality treatment programs that treat both disorders at the same time are absolutely imperative, and may be life-saving.

What Symptoms Should I Look For?

If you suspect that you or someone you love might have borderline personality disorder, be on the lookout for these symptoms:

  • Intense fears of abandonment that lead to distress and acting out, in an irrational attempt to avoid intense emotional pain, often followed by embarrassment about those moments later on
  • Relationships with big ups and downs, in which your colleagues, friends or partners are highly valued one moment and regarded as bad in another moment
  • An unstable sense of self, not feeling sure who you really are
  • Impulsive or potentially destructive behavior that may or may not include self-harm
  • Suicidal threats and gestures or self-mutilating behavior
  • Difficulty regulating intense emotions
  • Fleeting moments or days of feeling emotionally numb, paranoid or dissociative3

A key experience that many people with BPD describe is that constantly experiencing such big emotions feels overwhelming, exhausting and sometimes embarrassing. Borderline personality disorder may also follow trauma experiences. For these reasons, it is a very good idea to seek treatment sooner than later.

When Substance Use Complicates Borderline Personality Disorder

It is very tempting to want to avoid such difficult and strong emotions, and that may be why, as stated before, up to 78 percent of BPD-diagnosed patients also struggle with substance use at some point in their lives.2

Substance use may mask difficult emotions for a little while, but it can also lead to regrets and a cycle of feeling abandoned, traumatized or in greater pain than before. Substance use disorders like alcoholism and drug addiction may cause some brief physical release, or they may serve as a way to self-harm. Either way, the long-term effects of substance use will eventually take a toll on physical, emotional and financial health if left untreated.

Substance use can also make symptoms of BPD appear worse than they would be without the addition of toxins. Alcohol abuse is a very good example of this. If acting impulsively is already a concern, adding alcohol can fuel the fire. Alcohol lowers inhibitions, can increase feelings of dissociation or numbness and can increase impulsivity. Many people who struggle with BPD experience crises or engage in devastating levels of self-harm when under the influence. Substance use and BPD do not mix well together.

Not all addictions are addictions to drugs or alcohol. Process addictions are psychological addictions to behaviors or non-addictive substance. Some common process addictions that may co-occur with (and ultimately worsen) BPD include gambling addiction, shopping addiction, eating or food addiction, sex addiction and even shoplifting addiction.

Treatment for Borderline Personality Disorder and Addiction

You may feel hopeless about your future, and you may question your ability to feel better. But there is hope. Borderline personality disorder is treatable, and people who deal with it go on to live much happier lives when they have the right treatment. Dialectical Behavior Therapy is one treatment modality that has changed thousands of lives.

If you struggle with both a mental health concern and an addiction, you need specialty recovery treatment for co-occurring disorders. These specialty programs work to treat two or more things at once: the addiction and the borderline personality disorder symptoms. By treating all issues under the same roof, you stand a better chance of feeling better faster and remaining healthy longer.

Skywood Recovery offers specialized treatment for co-occurring disorders that is led by an experienced team of licensed mental health providers and physicians. The staff at Skywood works to resolve past traumas and build better futures for all patients. Because Skywood offers individualized care for each person, your treatment plan will be unique and catered to your needs.


1 NAMI. Mental Health by the Numbers. 2018.

2 Kienast T, Stoffers J, Bermpohl F, Lieb K. Borderline Personality Disorder and Comorbid Addiction: Epidemiology and Treatment. Deutsches Ärzteblatt International. 2014.

3 Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed., American Psychiatric Association, 2013. Print.