Borderline Personality Disorder and Substance Abuse

Most people experience subtle mood swings throughout the day, like feeling sad when a loved one leaves in the morning and excited when that same person returns. It’s just part of the experience of being human, and often, experts aren’t at all alarmed by emotions that wax and wane throughout the day. However, people with borderline personality disorder (BPD) experience extreme shifts in mood on a regular basis, feeling constantly overwhelmed by emotions.

It can be hard to live with BPD, and not surprisingly, many people who have this condition are tempted to medicate with drugs, alcohol or both to provide relief. However, this form of self-medication is remarkably dangerous.

Signs and Symptoms of BPD

Young black couple arguingThe Diagnostic and Statistical Manual of Mental Disorders, or DSM, published by the American Psychiatric Association, offers the most official and up-to-date definition of BPD. The DSM-5, the current version, lists the following behaviors as potential symptoms of BPD:

  • Paranoia
  • Huge reactions involving panic, rage or depression when the person feels abandoned in some way
  • Intense or inappropriate anger
  • A longstanding pattern of intense and difficult relationships with others
  • Sudden changes in goals, values, feelings or opinions, which develop due to a distorted or unstable self-image
  • Feelings of boredom or emptiness that the person considers chronic
  • Suicidal thoughts or suicide attempts
  • Impulsivity, manifesting with behaviors that include reckless spending, unsafe driving, unprotected sex or binge eating
  • Moods that are intense and transient1

These symptoms are often present strongly in people with BPD and cause obvious and debilitating detriment to their lives.

The Mayo Clinic suggests that BPD can run in families, so in some cases, a person’s behavior might be familiar to a close relative’s, but some people who have BPD have no family history of the disorder at all, and their behaviors might seem wild and unusual.2 In either case, it’s likely that the person experiencing these symptoms feels isolated and alone and may be tempted to use drugs or alcohol to cope.

Medicating With Drugs

It is estimated that about 50% of people with BPD also meet the criteria for substance use disorder.3 Sometimes, substanceabuse begins during an episode of impulsivity. When people with BPD feel wild and out of control, they might be tempted to binge on all sorts of addictive substances simply because they’re unable to control their urges or that they are invincible.

People with borderline personality disorder might also abuse drugs in an attempt to end a life. The deep depression and feelings of abandonment that come with BPD often leads to suicidal ideations and attempts, and intentionally inducing a fatal overdose may be tempting.

In addition, some addictive drugs have the power to make people temporarily feel good. They may boost feelings of euphoria and connectedness, and that might make life with BPD feel just a bit less bleak. As a way to escape, people with BPD may continue to use these substances to feel better and become addicted.

Consequences of Substance Abuse

While people who have BPD might think that their substance abuse is actually helpful, it will only worsen their condition and complicate their lives. The substances make the hard work of recovery difficult to complete, and no matter how much a therapist might try to help someone to get better, concurrent drug abuse makes healing much more difficult.

In addition, some substances—like hallucinogenic drugs—can make the symptoms of borderline personality disorder much more extreme. Because some people with BPD experience episodes of psychosis and hallucinations, taking certain drugs will only exacerbate their BPD symptoms.

Intense intoxication on a regular basis can also make it difficult for people to form close relationships with others. They might be too impaired to really listen to what others have to say, for example, and they might be too euphoric to help support someone else through a depressing time. The drug use can work to make people even more alone, isolated and distraught, and in some cases, that can also make people feel even more suicidal.

How BPD Is Treated

There are a number of different medications that can be used to assist people with BPD, including the following:

  • Antidepressants
  • Anti-psychotics
  • Mood stabilizers
  • Anti-anxiety agents

However,medications alone are rarely enough to help a person with BPD achieve wellness. In most cases, people with this disorder need both psychotherapy and medication in order to heal. This kind of work can take place individually, but some therapists hold group sessions in which many people with BPD come together to work on a recovery plan.

The best chance of recovery for individuals with BPD and substance abuse is in a treatment center that specializes in co-occurring disorders. By treating both disorders simultaneously while recognizing the way they affect each other, patients have a much better outlook at recovery.

At, Michelle shares her story of years of substance abuse while also having BPD. She found a new life after committing to treatment and healing. She encourages others that it’s worth it and says, “Choose life! Choose recovery…. along the journey you too can find peace within yourself and achieve serenity, drug free! Recovery is a beautiful thing, don’t put it off, start today! It works if you work it so work it you’re worth it!”

If you or someone you love is suffering from BPD and substance abuse, please call us today at our 24 hour, toll-free helpline. The Oaks at La Paloma is a Memphis area residential treatment center that specializes in co-occurring disorders. We can help your loved one and your whole family heal. Our knowledgeable and caring admissions coordinators can answer all your questions and get you started on your journey to a healthy life today.

1Borderline Personality Disorder.” NIH, August 2016. Accessed 5 October 2017.

2 Mayo Clinic Staff, “Borderline personality disorder: causes.” Mayo Clinic, July 30, 2015. Accessed 5 October 2017.

3An Introduction to Co-Occurring Borderline Personality Disorder and Substance Use Disorders.” SAMHSA, Fall 2014. Accessed 5 October 2017.

Further Reading