Borderline personality disorder (BPD) is a mental health condition that is characterized by a distorted perception of one’s self, personal relationships, and life in general. Many people with BPD use drugs or alcohol to cope with their symptoms. However, self-medicating a mental health condition is never successful, and it often leads to the development of a substance use disorder. Studies show that between 50-78% of adults with BPD develop a substance use disorder at some point in their lives.[1,2]

Individuals struggling with BPD and addiction may find it difficult to find a treatment approach that works. Due to the complexity of these conditions, many health providers show some uncertainty when it comes to treating them. At Worbun Addiction Treatment, our multifaceted dual diagnosis treatment in Massachusetts helps patients identify, treat, and cope successfully with their specific needs. Treatment for borderline personality disorder and addiction typically involves behavioral therapy and medications.

Signs and Symptoms of BPD

According to the National Institute of Mental Health, borderline personality disorder is marked by an ongoing pattern of changing moods, self-image, and behaviors that result in impulsivity and unstable relationships. Individuals with BPD may experience episodes of anger, anxiety, and depression. They may also have interests, beliefs, or hobbies that change quickly and unexpectedly due to how they see themselves and their place in the world.[3]

Another common trait among people with BPD is changing opinions of friends and loved ones quickly. In the eyes of a person with BPD, Someone who is seen as a close, trustworthy friend one day may be considered a liar, enemy, or traitor the next day. These perception shifts and behavior changes that occur in people with BPD can make it difficult for them to maintain stable relationships and practice self-care.

Other signs and symptoms of BPD include:

  • Extreme fear of abandonment
  • Patterns of unstable relationships
  • Distorted and unstable self-image
  • Impulsive behaviors (substance use, spending sprees, unsafe sex, reckless driving)
  • Self-harm
  • Suicidal thoughts, behaviors, or threats
  • Intense and shifting moods
  • Intense episodes of anger
  • Difficulty trusting others
  • Feelings of dissociation
  • Feelings of emptiness, depression, and anxiety

The Relationship Between BPD and Addiction

Due to prolonged feelings of emptiness, depression, and anxiety, as well as the challenges that come with unstable relationships and self-image, many individuals with BPD use drugs or alcohol to cope. The impulsivity that comes with BPD can further fuel addiction by making these individuals more likely to abuse substances, go on binges, and be unable to control their substance use.

Using drugs and alcohol to cope is a temporary solution. Substances may be able to temporarily ease symptoms of BPD but drug and alcohol addiction will only make BPD worse by exacerbating symptoms of instability and impulsivity.

Borderline personality disorder and addiction also have many shared risk factors, including genetics, family history, brain chemistry, environment, and past experiences. These risk factors can increase the likelihood of both BPD and substance abuse in individuals. Studies have found that people with BPD tend to have more severe addictions than people without this comorbidity.[2]

Because a key component of treating both conditions is addressing risk factors and causes of the disorder, dual diagnosis treatment programs can successfully treat borderline personality disorder and addiction at the same time.

Treatment for Borderline Personality Disorder and Addiction

BPD and addiction are both chronic illnesses that cannot be cured but can be managed with evidence-based treatment. The following therapies may be used during treatment:

Dialectical Behavior Therapy (DBT)

DBT is the most widely used therapy for borderline personality disorder.[1] It was originally developed as a way to help individuals manage their behaviors in times of crisis, like suicidal thoughts or self-harm. DBT helps individuals increase their self-awareness and mindfulness so they can become more aware of their moods, emotions, and behaviors. The therapy enables patients to tolerate painful emotions and communicate effectively.[4]

Cognitive Behavioral Therapy (CBT)

CBT is the primary type of therapy used in the treatment of addiction, but it can also be used for co-occurring borderline personality disorder. The goal of CBT is to help patients identify and understand negative behaviors so they can replace them with positive ones.[3] CBT can also introduce individuals to a variety of healthy coping skills.

Schema-Focused Therapy

Schema-focused therapy is a psychotherapy that can help patients identify unmet needs in their childhood or life that have led to negative behavioral patterns. It helps patients meet their needs in a healthy manner as well as reframe negative thoughts by turning them into positive ones.

Mentalization-Based Therapy (MBT)

MBT is a form of psychotherapy that helps patients identify their own thoughts and feelings to help create a healthy perception of certain situations. The idea behind MBT is to encourage patients to think before they act.[5] This can help reduce impulsive behaviors related to borderline personality disorder and addiction.


There are no medications that are currently approved to treat BPD. However, patients who struggle with depression, anxiety, or mood swings may benefit from medications that can treat their symptoms, such as antidepressants or mood stabilizers. Alternative medications like buprenorphine, naltrexone, and methadone may be used to treat certain types of addictions, but medication assisted treatment is not the primary treatment approach for either borderline personality disorder or addiction.

borderline personality disorder and addiction

Get The Care You Need and Deserve

Woburn Wellness Addiction Treatment is a leader in the addiction treatment field, with proven success in facilitating long-term recovery. Our team of top clinical & medical experts specializes in treating addiction coupled with mental illness, ensuring that each person receives individualized care. Call us – we’re available 24/day, 7 days/week.

(781) 622-9190

Find Treatment for Borderline Personality Disorder and Addiction Today

People with substance use disorder may struggle with denial and be reluctant to go to treatment. Similarly, people with BPD may struggle to trust strangers and develop new relationships. As a result, people with BPD and addiction may be hesitant to go to rehab for mental health treatment. Despite a person’s reluctance to care, BPD and addiction are treatable conditions and affected individuals can benefit greatly from individualized care.

At our drug and alcohol rehab in Massachusetts, we know that it isn’t easy to ask for help. That’s why our team of professionals is dedicated to meeting each and every patient with compassion and understanding. If you or a loved one are in need of evidence-based treatment, please give us a call today.


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