We all get swept away by our emotions from time to time. Without these powerful internal experiences, life would be dull and meaningless. But for someone with borderline personality disorder, or BPD, these emotions are so overwhelming that they can destroy relationships and seriously impair social functioning. BPD is also associated with a high rate of impulsivity, self-destructive behavior, and substance abuse. In fact, according to Innovations in Clinical Neuroscience, up to 72 percent of individuals with BPD struggle with drug or alcohol abuse at some point in their lives.
People with BPD have trouble regulating their emotional responses and controlling their urges. The emotional instability of BPD can be so severe that it triggers psychotic reactions, such as delusional thinking, paranoia, and hallucinations. Yet in spite of the intensity of their reactions to everyday life, people with BPD often describe themselves as feeling “numb” or “dead” inside. These feelings of numbness and emptiness can lead to self-injury and repeated suicide attempts.
The National Institute for Mental Health indicates that BPD affects just under 1.5 percent of the American population. BPD is not always easy to recognize. People with BPD may have symptoms that resemble other forms of mental illness, such as depression, bipolar disorder, or anxiety. They may also have co-occurring psychiatric conditions, such as a substance abuse problem or eating disorder, that mask BPD.
Only a mental health professional can make a definitive diagnosis of BPD; however, there are a few red flags you can look for:
- A history of broken relationships
- An unstable sense of personal identity
- Dramatic mood swings
- Extreme anxiety about being left alone or abandoned
- Episodes of intense anger or violence
- Patterns of self-destructive behavior, such as cutting or substance abuse
- Thoughts of suicide or suicide attempts
BPD is more common in females than in males, and symptoms may begin to manifest themselves in childhood or adolescence. Yet a lot of people suffer with this debilitating psychological disorder for years before they receive help — and many are never diagnosed at all.
Who Is at Risk?
The cause of BPD is unknown, but psychiatric research suggests that the disorder has its roots in childhood. The typical profile of an adult with BPD includes a background of emotional neglect and physical or psychological deprivation. Many people with BPD are survivors of sexual, physical, or verbal abuse in childhood. At this vulnerable age, traumatic experiences can have a profoundly destructive impact on one’s personality. Having a family history of BPD or other forms of serious mental illness can also make you more susceptible to developing this disorder.
BPD and Substance Abuse
Addictive behavior and poor impulse control are hallmark signs of BPD. People with this disorder have trouble controlling their urges. This pattern of impulsivity makes them vulnerable to behaviors such as:
- Alcohol and drug abuse
- Pathological gambling
- Sex addiction or love addiction
- Binge eating and food addiction
- Compulsive spending
Addiction can provide a temporary distraction from the painful emotions and anxiety of BPD, but this destructive behavior ultimately makes the symptoms of the disorder worse. Substance abuse also makes BPD more challenging to treat in a mental health setting. A rehab program for co-occurring BPD and substance abuse must include therapy for both this complex psychiatric condition and the addictive behavior, otherwise treatment is unlikely to be effective.
Reaching for Help
Many people with BPD are haunted by feelings of fear, emptiness, and hopelessness. But with the right set of therapeutic tools, it is possible to recover from BPD and to create a meaningful, fulfilling life. Dialectical behavior therapy, or DBT, has proven highly effective at treating even the most serious cases of BPD and substance abuse. Based on the practices of mindfulness and self-acceptance, DBT can help patients learn to regulate their emotions, manage their impulses, and develop a stronger sense of self. Additional components of an intensive residential treatment program for BPD include:
- Antidepressant or anti-anxiety medications
- Holistic therapies that emphasize mindfulness, such as meditation or yoga
- 12-step groups or other spiritually based recovery programs
- Counseling and education for families and partners
If you are, or a loved one is, struggling to cope with the effects of BPD and substance abuse, the personalized treatment programs at Axis can help you find a new sense of hope and meaning. Call our intake counselors at any time for answers and support.