BPD and Addiction: Overcoming Treatment Barriers with Individualized Care

Borderline personality disorder and addiction often go hand in hand. Although treating both disorders concurrently can be a difficult process, Dialectical Behavior Therapy can make it easier for you to take control of the emotional instability that underlies your problems so that you can start paving your own road to recovery.

Before I knew that there were other ways to live with BPD, I drank just to make it through the day. When I sobered up, every flash of anger become a hundred times worse, and urges to self-harm were more frequent and intense. Drinking gave me a sense of temporary relief and tranquility. but those feelings of calm were always followed by rebound feelings of rage.

Borderline Personality Disorder is characterized by intense, unpredictable mood swings and an unstable self-image. For those who live with BPD, the world can feel like a battleground of intense emotions, one in which rage, despair, and elation are constantly at odds with one another.  To cope with this tidal wave of emotions, many fall into patterns of substance use as a way to escape from the chaotic nature of their daily lives. But prolonged substance abuse can prevent those who struggle with it from addressing BPD directly, and in that sense, it only masks the symptoms—it doesn’t help them manage the disorder.

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Dual Treatment of Borderline Personality Disorder and Substance Use Disorder


Despite prevailing cultural notions that paint people who live with BPD as being particularly resistant to treatment, there’s a lot of research that says otherwise. There’s a growing number of treatment options designed specifically for people with BPD, and they’re turning those cultural notions around. According to one study, “BPD psychopathology progressively improves” with the right treatment, “with impressive remission rates of 40% to 50% in 2 years and 70% to 80% by 10 years.”

The problem, it seems, is finding ways to support those who struggle with both BPD and Substance Use Disorder (SUD) in sticking those programs out. One study found that during the treatment of cocaine addiction, BPD was the only disorder from Axis II consistently connected to a negative outcome in terms of compliance with treatment and subsequent abstinence. Another found that people with BPD were more prone to unplanned discharges during the treatment of alcohol use disorder than those without BPD.

It’s data that raises some really serious questions about how treatment programs and communities can better support those who live with both BPD and SUD. What we can learn from it, however, is that people seeking treatment for both disorders need access to comprehensive, compassionate, individualized treatment that meets exactly their needs—preferably in a residential treatment center, where they can be supported by round-the-clock care.

Dialectical Behavior Therapy


If you live with BPD and SUD, the idea of treating both can seem like an insurmountable task, but with the proper knowledge and a network of supports in place, it’s possible to overcome the obstacles that threaten recovery. Originally designed to help people suffering from suicidal thoughts and self-harming behaviors, Dialectical Behavior Therapy (DBT) is now universally recognized as the first-line treatment for those with BPD. DBT has also been shown to be effective at treating SUD alone, as well as BPD and SUDsimultaneously, so it’s a therapy that has all of its bases covered.

In the past, your biggest obstacle to recovery may have been the extreme highs and lows you experienced every day, and, perhaps, your inability to cope with them. DBT is an ideal therapy for this problem as it encourages you to acknowledge that these emotions exist, non-judgmentally, and then recognize the fact that they aren’t serving you, and therefore must be changed. Through the solidification of a strong client-therapist relationship early on in the process, DBT can help you establish a trusted, supportive relationship with someone who understands what you are feeling and can advocate for you when the going really gets tough. At the end of it all, you’ll have a better understanding of yourself, the disorder you live with, and the strategies that are best used to manage it.

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Paving the Road to Recovery


Substance use may mask the symptoms of BPD, but it doesn’t address the disorder in the long-term, and can even make it worse. Over time, you may notice your emotions becoming more extreme and your thoughts of self-harm more intense, and relief may start seeming like a faraway dream. But individualized treatment can help: through therapist-led DBT, you can learn to face your emotions head-on and gain the coping skills you need to manage your BPD without alcohol or substance use. Once you’ve learned to see your emotions objectively, you can focus on moving forward without being controlled by them. It’s no easy task, but it’s possible, and the right residential treatment program can help you get there.

Bridges to Recovery offers comprehensive residential treatment for people suffering from borderline personality disorder and co-occurring substance abuse disorders. Reach out to us to learn how you can address both of your disorders in a non-judgmental and compassionate residential treatment setting.

Lead Image Source: Unsplash User Alexandre Chambon