Borderline Personality Disorder (BPD) & Alcohol: Does Alcohol Make BPD Worse?

May 25, 2017

Harmony Place Team

Alcoholism & Borderline Personality Disorder

Alcoholism, or alcohol use disorder, and borderline personality disorder (BPD) often co-occur, creating complex challenges for treatment. BPD is a mental health condition characterized by intense emotions, unstable relationships, impulsive behavior, and difficulty regulating moods. Individuals with BPD may use alcohol as a way to cope with emotional pain, reduce anxiety, or manage stress, which can increase the risk of developing alcoholism.

The combination of BPD and alcoholism can exacerbate symptoms of both conditions. Alcohol use may intensify mood swings, impulsivity, and risky behavior, while the emotional instability of BPD can make it harder to maintain sobriety. Treating co-occurring BPD and alcoholism typically requires an integrated approach that addresses both conditions simultaneously. Evidence-based therapies, such as dialectical behavior therapy (DBT) for BPD and cognitive-behavioral therapy (CBT) for addiction, are often combined with medical management and supportive counseling. Early intervention, consistent therapy, and a strong support system are crucial for improving outcomes and helping individuals achieve long-term recovery.

Can Alcoholism Cause BPD?

Alcoholism does not directly cause borderline personality disorder (BPD). BPD is a complex mental health condition that typically develops from a combination of genetic, biological, and environmental factors, often including childhood trauma, neglect, or emotional instability. However, chronic alcohol use can worsen emotional regulation, impulsivity, and interpersonal difficulties, which are core features of BPD, making symptoms appear more pronounced or difficult to manage.

While alcoholism cannot create BPD on its own, long-term substance abuse can contribute to behaviors and emotional patterns that mimic or exacerbate borderline traits. This is why co-occurring alcohol use disorder and BPD require integrated treatment, addressing both the addiction and the underlying emotional and behavioral challenges. Managing alcohol use can help reduce symptom severity and improve the effectiveness of therapies designed for BPD.

Common Genetic Pathways

The common genetic pathways theory asserts that if a causal relationship exists between a gene and a higher risk of borderline personality disorder, the same gene may also increase the risk of alcohol use disorder. BPD and like personality disorders are commonly found among family members, which indicates that certain people may have a genetic predisposition to BPD.

Research suggests that there is not a single, specific gene for BPD. It appears that the genes that increase risk for the disorder may be passed on by people who have the disorder itself, or a related disorder, such as:

Bipolar disorder
Depression
Substance use disorders
ADHD
Post-traumatic stress disorder

One current theory is that some people are more likely to develop BPD due to their biology or genetics, and harmful childhood experiences that can further increase the risk.

Corresponding Environmental Causes of Borderline Personality Disorder

The environmental cause theory contends that events in childhood could create a predisposition to BPD and alcohol abuse. Mistreatment such as physical abuse, sexual abuse, emotional abuse, neglect or parental insensitivity are possible precursors to the onset of BPD and alcohol use disorder.

Although a direct causal relationship has not been established, the number of people suffering from borderline personality disorder who report a form of childhood abuse or neglect is statistically significant.

Brain scans of people who were subjected to some form of abuse as a child show evidence of trauma. Specifically, there was a reduction in the size of the hippocampus. The hippocampus is involved in determining how people respond to stress.

BPD and Alcohol/Drug Self-Medication

Manipulative and dramatic behaviors, impulsivity and emotional instability contribute to misunderstandings about borderline personality disorder. The behaviors exhibited are the result of intense emotional pain, such as fear, insecurity or rage. Alcohol may be used to numb the pain and, over time, the use of alcohol as a numbing device develops into an addiction.

Stimulation of the Endogenous Opioid System (EOS)

The endogenous opioid system functions to relieve pain and reward and reinforce behaviors. Medical experts believe that BPD symptoms may be related to the EOS not functioning in the manner for which it was designed.

A recent study suggests that alcohol stimulates the EOS system. If this is the case, it is possible that people with BPD turn to alcohol to activate the system designed to relieve their pain.

BPD Dual Diagnosis Challenges

Behavioral similarities between BPD and alcohol addiction make proper diagnosis difficult. It is not uncommon for someone to be diagnosed with one but not the other. It can take years before someone is properly diagnosed as having BPD with co-occurring alcoholism.

In dual diagnosis treatment, this often means that early stages of treatment are focused on helping the person stop abusing substances, and then dealing with the BPD symptoms. One of the most successful approaches to treating both BPD and substance abuse disorder is dialectical behavior therapy, or DBT.

Can Borderline Personality Disorder Be Cured?

Borderline personality disorder cannot be “cured” in the traditional sense, but it can be effectively managed with treatment. Many individuals with BPD experience significant improvement in symptoms over time, especially when they engage in evidence-based therapies such as dialectical behavior therapy (DBT), cognitive-behavioral therapy (CBT), or schema-focused therapy. These treatments help individuals regulate emotions, reduce impulsive behaviors, improve relationships, and develop healthier coping strategies.

Medication may also be used to manage specific symptoms such as mood swings, anxiety, or depression, but it does not treat the core personality disorder. With consistent therapy, support, and coping skills, many people with BPD can lead fulfilling lives and maintain stable relationships. Early intervention and ongoing treatment are key to achieving long-term improvements in functioning and quality of life.

The Reality of Not Treating BPD and Addiction

The long-term ramifications of going without treatment are devastating. People with untreated borderline personality disorder can struggle to keep a job or develop and maintain healthy relationships. An estimated 70 percent of people with BPD engage in self-harm, and the successful suicide rate may be 50 percent higher than in the general population.

It’s common to feel helpless when dealing with the intense emotions, emptiness, anger and other symptoms of the disorder. The symptoms of BPD can impact every aspect of your life. But even amid the suffering and chaos this condition causes, many people learn ways to cope and increase their quality of life.

Co-Occurring Disorders Treatment Is Essential for BPD

For a person who suffers from borderline personality disorder and alcohol use disorder, it is unreasonable to expect that they can be treated independently. Treating BPD without addressing the alcohol addiction or treating the substance abuse without addressing the BPD is like treating cancer by removing half of the tumor.

Unfortunately, because accurate diagnoses can be challenging, sometimes patients go years – even decades – with well-meaning providers only addressing half of the problem. Long-term, successful borderline personality disorder recovery requires concurrent treatment.

BPD and Alcohol Abuse Treatment

Although the person with BPD needs to be aware of their dual diagnosis, awareness alone is not enough. To fully participate in the process, the person must accept the diagnosis and embrace the treatment options for both. There must be a willingness to eliminate alcohol from the equation.

Alcohol abuse negatively impacts reasoning and intensifies impulsive behaviors, making it unlikely that the person can fully participate in their own treatment and recovery. Alcohol enhances the impulsivity common with BPD and clouds the ability to make healthy decisions about treatment and recovery.

BPD and Addiction Recovery

Recovery from a personality disorder doesn’t remove impulsive thoughts. Effective treatment empowers the individual with the tools to take control of the thoughts, rather than the other way around.

With control comes the power to create a happy, fulfilling life. No more waking up in the morning trying to reconstruct the events of the previous night. No more living with the shame of regret when the blanks are filled in.

You will learn to manage the negative ramifications and experiences that BPD brings into your life in healthy and constructive ways, instead of using addiction to mask the symptoms.

The First Step in Your New Journey

Embarking on the path to overcoming substance abuse doesn’t have to be overwhelming. At Harmony Place, we prioritize creating a supportive and personalized environment with an individualized treatment plan tailored to your loved one’s specific needs. Our compassionate team of treatment specialists works closely with each individual, guiding them towards a life free from alcohol dependence.

Harmony Place offers a range of comprehensive inpatient rehab programs designed to help individuals cleanse their system, gain insight into their mental health, and restructure their lives. We provide ongoing support to ensure a successful recovery journey and sustained happiness. If you’re considering options like Anthem alcohol rehab treatment, Optum alcohol addiction treatment, or Aetna and BCBS alcohol rehab, our dedicated admissions consultants are here to help. Navigating insurance coverage for alcohol rehab and understanding how to pay for alcohol addiction treatment shouldn’t be barriers to accessing the help you need. Contact us today to learn more about how we can support your loved one’s recovery.

For a private consultation and more information on our programs, call us today at 855-652-9048.

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Chris P

I've been to 12 rehabs over the last 20 years and NO other place has touch like Harmony Place! From the owner right down to the cleaning lady, everyone here is kinda and warm. God has blessed this place and I feel privileged to have come through here. I recommend anyone who is going through their struggle with mental health or substance abuse to pick up the phone and come! You won't regret it!

Joseph S

This place is incredible, kind, loving, patient, rigorous, educative, caring and the best place for recovery. Ill be part of the alumni crew

Monica G

I had very good experience at Harmony Place From first day I came, staff was very kind and make me feel welcome and safe. Everyone was friendly and always try to help me. The therapists are very good and caring. They listen to me and help me understand my problems better. I learn many things from them and feel stronger because of their support. The nurses also very nice and professional. They always check on me and make sure I am okay. Food was good and facilities were clean and comfortable. It help me feel more relaxed and focus on my recovery. Management also doing very good job. Everything was organized and you can see they really care about patients. I am very thankful for this place and all the people who work here. I recommend this center to anyone who needs help.

Denton

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Tyler

A treatment center where the owners truly care about your recovery and after care.. cannot recommend enough

Jodana S

If you want to detox painlessly this is the place! The staff is A1. They truly care about us. The groups are awesome . Residential is crazy awesome! You live in a mansion. With a private chef who makes the best food. Community meeting that gets results fast, they care about your opinions. Pool and Jacuzzi are beautiful. If your struggling with addiction this is the house you should come to. I LOVE HARMONY PLACE!!!!! Thank you to all the staff they go above and beyond to make this experience comfortable therapeutic. Don't spend another day in your addiction come to Harmony Place right now!

Cass

I’ve been to 4 treatment centers before Harmony Place, and I can tell you without a single doubt that this is the absolute best by FAR. The past ones were luxury Residential Treatment centers that just treated every single client the same not tailoring to each individual, and were basically just in it for the money, dropping the ball each time. I can also tell you that I’ve never met the CEOs, but here, David comes to the facility almost every single day, and makes sure he get to know every individual here. He is incredibly kind, and was even willing to transfer me to another facility with a higher level of trauma therapy due to me having a lifetime of trauma and PTSD that just is going to take a long time to tackle. He truly cares about all of the clients having all of the tools that we need before getting released to the real world. No more of other CEO would ever be willing to miss an opportunity at making more money and even paired with my IMPECCABLE case manager to find a different facility that was more trauma based. My case manager, Sam, goes absolutely above and beyond in every single aspect. She makes sure you have a smooth transition into aftercare, provides out of this world advice when it comes to sobriety, and takes the time out of her day to make sure that FMLA and short-term disability are completely taken care of during your stay. I’ve never met a case manager that could ever compare to Sam. Ever. I feel lucky to have met her, genuinely. Marissa, my therapist, is SO SWEET, actually listens to you, and provides advice and therapy tailored to each individual’s experience. She’s handled every mood I’ve been in, never judged me, and allowed me to feel safe enough to tell her things I’ve never told any person or therapist in my 29 years of life. I’ve been going to therapy for the past 15 years, and none of those therapists even come close to how amazing she is. I’ve been to 4 other treatment centers in my life and none even come close to Harmony Place. The facility is clean, organized, and high-end. I would recommend Harmony place to my family, friends, and anyone seeking treatment. I feel SO BLESSED to have landed in their hands. THANK YOU TO EVERYONE IN THE CLINICAL STAFF BEYOND WORDS. I love you guys ❤️❤️❤️❤️❤️❤️. I feel more confident than ever in my Recovery.

Gabe H

Where to begin.. Harmony is a place that will forever be a part of my story as the first step in my recovery journey. I’m so grateful for this program. The staff is very friendly, and many of them understand what addiction is like, for they themselves have recovery stories of their own. They have an awesome team of therapists, group facilitators, nurses, RA technicians, medical and health professionals, a wonderful case manager for aftercare that cares deeply for your next steps; making sure you are set up for success. They have a wonderful admissions team (shoutout to Marielle who was so kind and understanding of my messed up situation). Everyone is very relatable and friendly. They invest heavily in the importance of diet and nutrition too - there’s a full time professional chef. I gained all the weight I lost and wanted back in the first two weeks lol. On top of the intensive programming they do throughout the day, they take us out to experience various kinds of outside groups to get a taste of the real world, and also take us on social outings during the weekend. If you’re serious about getting better this place will meet you where you’re at and prepare you to launch with a renewed mind and heart.

Monica P

I can't begin to explain just how amazing Harmony Place is. In fact, when we sit down with the owner, Jeff, and clinical director, David, on Monday mornings to have a house meeting, they ask us what they could be doing better. A bigger blender for smoothies is the ONLY thing we could come up with. Let me begin by addressing some negative reviews. If you notice many of them are from people, or are referring to people who have been asked to leave. It is because of harmony places protection of their clients that provide ideal conditions for healing and progress. There is a screening process that it is implemented where they make sure the clients they admit are ready to start a life of sobriety. Some people slip through the cracks. Some people find out a few days or weeks in that they've changed their minds. Some are inappropriate and break rules. It happens. When Harmony Place ask people to leave, It's because they are protecting the people who are here that want treatment. In effect, they're providing exactly what I needed for a genuine start to recovery. When I began my search for a treatment center, my requirements were that the facility's provide an environment in which its residents all want to be there and that it is ethically ran. I got that and so much more at Harmony Place. As well as a structured routine, they also provide a confidential and nurturing environment where one feels safe and where profound healing can begin. Their program offers a sound foundation where further progress in sober living is almost guaranteed. In group meetings, we enjoy getting to know ourselves again and with deeper understanding about why we are the way we are. We are provided with skills to handle real life. Its here that I've come to understand that its not addiction that has driven me to make a mess of my life. It is the trauma that I endured and not processing it correctly that lead to poor thinking patterns that opened the door to addiction resulting in poor life management. So we start at the bottom. Trauma. They help us understand that trauma has led to our own toxicity, what that trauma looks like and how to get out of our own way. Process groups help us learn how to take accountability and foster healthier relationships. I learned here that changing the way I think is absolutely possible and imperative to the healing process. Harmony Place offered me hope when I previously felt I was unfixable and a support team that truly loves me. Even after I leave here, I have contacts that almost demand I keep in touch and an alumni meeting where I can return to the facility on Thursday nights. I wasn't a 12 stepper when I came here but my first experience with it was not one where I was ready to stop using. I understand now that the steps will work for me. It's certainly is not the only modality that they teach. In one group, we are provided an opportunity to sit with a recently retired medical doctor to just ask questions. Another is with a nutritionist. There are a handful of people IN recovery that come to lead groups that are all accredited highly specialized where I felt understood and not judged. The knowledge I have gained here is life changing. It is also versatile and relatable for all types of people. my favorite group was dialectical behavioral therapy. There are breathing classes and sound bath groups and I started doing yoga in the morning. There's a dharma meeting they take you offsite that focuses on Buddhist values. A fantastic onsight chef provides three meals and you can have special requests. We facilitated our own Movie nights during free time. I cant forget to mention you get your own one on one meetings with your assigned primary therapist and there is comprehensive medical support complete with 24/7 nurses and a doctor that shows up throughout the week. If this is what you need to recover and you have mediCAL, cancel your mediCAL and get insurance Harmony Place accepts if you can. There are people to help you with that as well. Just call. Many, many thanks to the staff. ✔️Another life changed.🙏

Cody B

This is such an amazing place truly changed my life. I would recommend this place to anybody if they’re looking for a strong recovery house that truly cares about your recovery and not about just money So if you’re ready to change your life, don’t miss out on the greatness of harmony because this place is where it’s at