Borderline personality disorder (BPD) is a difficult condition to understand but can have major impacts on the lives of people with the condition and those close to them.
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V), BPD is, “A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts.” For a diagnosis of BPD, a person must have at least five of the following:
- Avoidance of real or imagined abandonment
- Alternating between extreme highs and extreme lows, which leads to unstable relationships
- Unstable self-image, or changing personal identity
- Impulsive and dangerous behavior around binge eating, sex, spending money, substance abuse, reckless driving, etc.
- Suicidal thoughts, behaviors, and actions that happen repeatedly throughout a person’s life
- An unstable mood that lasts for days or hours and can change just as quickly
- Difficulty controlling anger
- Paranoia during periods of extreme stress
BPD’s lifetime prevalence in the United States is about 6%; 1 in 16 American adults have the condition. Women are about three times as likely to be diagnosed with BPD as men, but some surveys show that men and women suffer from BPD in equal numbers. This statistic implies that men with BPD may be under-diagnosed and under-recognized.
Can Alcohol Abuse Cause BPD?
While alcohol use and misuse can worsen symptoms of BPD, it does not cause the disorder. The causes of BPD are a combination of genetic factors and environmental factors. Certain genes are linked to BPD and can be “turned on” by poor coping skills passed down by parents or manifested in a stressful childhood. Abuse and neglect contribute to developing BPD.
Does Alcohol Affect BPD Symptoms?
If a person has BPD, their moods are intense and can change quickly, from hour to hour. They may have an irrational fear of being abandoned or alone. Alcohol amplifies emotions and can make BPD symptoms more intense.
Severe alcohol abuse can hurt relationships and make it harder to keep friends. Someone with BPD may find themselves drinking alcohol to help with their intense emotions. Unfortunately, this kind of self-treatment can drive away friends and family, fueling the underlying fears of abandonment and rejection. In this way, co-occurring BPD and alcohol abuse create a self-destructive cycle that may require psychiatric treatment.
Treatment Options for BPD and Co-occurring Alcohol Addiction
A special kind of therapy called dialectical behavioral therapy (DBT) treats BPD. This type of therapy helps people identify negative thinking patterns and encourages mindfulness and healthy coping skills. DBT is available for both outpatient (people in the community) and inpatients (people in a hospital or drug rehab) treatment.
Co-occurring alcohol use disorder and BPD likely requires more intensive psychiatric care. DBT will not treat alcohol abuse and does not work as well for BPD when alcohol abuse is present. The best option is usually rehab treatment. Alcohol addiction is far more difficult to treat when it happens in someone with BPD and rehab can address this issue by treating both conditions at the same time.
Key Points: Borderline Personality Disorder & Alcohol
Keep in mind the following key points regarding BPD and alcohol:
- BPD is a pattern of intense and unpredictable emotions that affect relationships with other people
- Alcohol abuse does not cause borderline personality disorder
- BPD is caused by a mixture of genetic factors (inherited from family) and a stressful childhood
- Alcohol abuse can intensify the symptoms of BPD
- About 85% of people with BPD have another mental health or substance use disorder
- Addressing BPD and alcohol abuse together may require professional treatment in a rehab center
If you live with BPD and a substance use disorder, such as an alcohol use disorder, contact The Recovery Village to speak with a representative about how addiction treatment can help you. At The Recovery Village, each patient receives individualized care that addresses their addiction and any co-occurring mental health disorders. You deserve a healthier future, call today.
Lenzenweger, Mark F, et al. “DSM-IV Personality Disorders in the National Comorbidity Survey Replication.” Biological Psychiatry, 2007. Accessed June 13, 2019.
Mayo Clinic. “Borderline Personality Disorder – Symptoms and Causes.” 2018. Accessed June 13, 2019.