Borderline Personality Disorder and Addiction

drunPeople who have a mental health disorder are found to be more likely to struggle with addiction, also known as a substance use disorder (SUD)

drunPeople who have a mental health disorder are found to be more likely to struggle with addiction, also known as a substance use disorder (SUD).1 In fact, as of 2020, an estimated 17 million people in the U.S. had co-occurring mental health and substance use disorders.11

When a mental health disorder and SUD exist at the same time, it is considered a co-occurring disorder.1 A mental health disorder can include mood disorders, such as depression or bipolar disorder, as well as personality disorders, such as borderline personality disorder, or BPD.

This article will look at what BPD is, the symptoms of BPD, the connection between borderline personality disorder and addiction, and ways to effectively treat co-occurring disorders.

What is Borderline Personality Disorder?

Borderline personality disorder impacts a person’s ability to effectively manage and regulate their emotions and interferes with their daily functioning in many aspects of their life.2 It is marked by impulsive behavior, emotional reactivity, unstable interpersonal relationships, and poor self-image.

Individuals with borderline personality disorder:3

  • May be very promiscuous and move from one relationship to another.
  • Often engage in self-harm behaviors such as cutting.
  • Have a higher likelihood of developing other mental health disorders like eating disorders and substance use disorders.

There are no formal types of borderline personality disorders; however, personality disorders (PDs) as a diagnosis can fall into 1 of 3 clusters: Cluster A, Cluster B, and Cluster C. BPD falls under Cluster B personality disorders, along with others like:3

Traits and symptoms of BPD can vary from person to person. Common traits of Cluster B personality disorders include:

  • Impulsive, unpredictable, and often risky behaviors.4
  • Emotional sensitivity.4
  • Emotional reactivity.4
  • Conflicted and unstable relationships with others.3
  • Low self-esteem.3
  • Fear of rejection from others.3

Borderline personality disorder is diagnosed by a mental health professional, and diagnosis usually occurs in early adulthood or late adolescence.2 BPD is diagnosed more in females than in males, with 75% of BPD diagnoses being given to females.3

It’s common for BPD to co-occur with other disorders like anxiety, depression, bipolar disorder, substance use disorders, and post-traumatic stress disorder (PTSD).2, 5

What Types of Borderline Personality Disorder?

There aren’t types of borderline personality disorder; however, there is some research that categorizes BPD into subtypes.6 That research is limited and not sufficient to warrant any formal diagnosis of a type of borderline personality disorder.

Causes of Borderline Personality Disorder

The exact cause of BPD is largely unknown. However, researchers theorize that various risk factors play a role in the development of BPD. Risk factors that can contribute to the development of BPD can include:2

  • Having a family history of BPD or having a family member already diagnosed with BPD.
  • Experiencing trauma during childhood, which can include abuse, neglect, and abandonment.
  • Having unstable and unhealthy interpersonal relationships with family members growing up.
  • Being chronically invalidated by caregivers.
  • Changes in the areas of the brain that are responsible for emotional regulation and impulse control. (Note: It is unclear as to whether these brain changes are a result of BPD or contribute to the development of BPD.)


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