A recent study reported that approximately 63 percent of the people participating who were diagnosed with BPD (borderline personality disorder) also struggled with alcoholism. The same study showed that people who had alcohol use disorders were more than 3 times as likely to also have a diagnosis of BPD.
The correlation is clear. Although precisely why there’s a correlation between BPD and alcohol addiction is currently unknown, there are several theories.
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
- Substance use disorders
- 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?
Current research into personality disorder recovery has brought a deeper understanding of the challenges faced by those suffering from BPD and alcoholism. Although the answer to the question of a cure for BPD is still “no,” this deeper understanding has helped create more comprehensive and effective treatment options, making recovery possible.
While there is no cure for BPD, having the tools to effectively manage this disease offers a great deal of hope to these patients and their families. In fact, there is evidence that shows many people diagnosed with borderline personality disorder can lose the diagnosis within a few years because they no longer meet the criteria.
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
If you are suffering with BPD and alcohol dependency, the first step to recovery is to reach out and ask for help. Harmony Place’s dual diagnosis treatment program addresses your challenges concurrently to start you on the path to creating a happy life.