Addiction Recovery

Borderline Personality Disorder: The Signs, Symptoms, and the Role BPD Plays in Substance Abuse

What is BPD?

BPD, or borderline personality disorder, is a serious (and treatable) medical condition. BPD can be impossible to live with, but help is available.

Written by

brian-mooreBrian Moore

Content Writer

Reviewed by

jeremy-arztJeremy Arzt

Chief Clinical Officer

Addiction Recovery

November 28, 2023

Despite the increasing awareness about mental health disorders and the emergence of treatment methods like behavior therapy, many conditions in the domain of mental health remain misunderstood.

Borderline personality disorder, or BPD, is one such condition.

Many confuse BPD symptoms with bipolar disorder, anxiety disorder, or even dissociative identity disorder. It is not just the symptomology; even the treatment of borderline personality disorder seemed impossible until recently.

Lately, BPD has been spoken about as a treatable condition. BPD cannot be treated quickly, and no medications can promise to turn around BPD. The treatment of borderline personality disorder needs a combined approach with the involvement of psychiatric care, counseling, and medicine, just like these facets of treatment are also associated with helping someone diagnosed with bipolar or chronic depression. The characteristics of borderline personality disorder can be hard to comprehend, which is why the following discussion could be helpful.

Borderline Personality Disorder by the Numbers:

It is estimated that nearly 1.6% of the adult U.S. population suffers from BPD. Nearly 75% of people who are diagnosed with BPD are women.

What Is Borderline Personality Disorder?

BPD, or borderline personality disorder, is often defined as a mental health condition with some typical symptoms, such as acute mood fluctuations and irrational fears. A chronic condition, BPD, comes with many hard-to-decode behavior patterns, and the person might seem too stubborn to acknowledge the problem or seek help.

A person with BPD might easily slip into social isolation because of these patterns, and all this while, they might not even realize that their behavior seems unreasonable to the world. For example, people with BPD could have an irrational fear of abandonment and be dangerously impulsive. BPD also manifests in the form of insecurity & instability in interpersonal relationships. Such people could have extreme difficulties in talking about their emotions or even managing their range of emotions across everyday situations at home or school.

BPD can also lead to bouts of anger, and along with increasing impulsiveness, the person might show signs of dangerous behaviors. Someone with BPD is likely to have issues like a tendency to self-harm or drive recklessly. These symptoms make it difficult for the person to groom relationships. With the person more likely to show strangely dramatic or respond unusually in social interactions, relationships at home and work can take a beating.

Borderline Personality Disorder Versus Bipolar Disorder

It is easy to confuse bipolar disorder with borderline personality disorder as both conditions lead to the person developing an incoherent, socially challenged personality type. Both states also share symptoms of sudden fluctuations in mood and similarly irrational behavior patterns. However, bipolar is slightly distinct from borderline personality disorder (BPD).

Signs of BPD include sudden and quicker changes in mood or behavior, but this often happens when facing stress. This might happen with a person with BPD who finds themselves in situations that make him anxious, such as interacting with others.

Bipolar disorder symptoms are slightly different, where the mood swings are not so acute, and the fluctuations are much more restricted. People diagnosed with bipolar disorder are also vulnerable to energy levels rising and dipping during the day. Such people might feel drained of any energy to complete their everyday chores—a trait not that common among people with BPD.

The confusion also comes from many people with bipolar disorder being diagnosed with accompanying mental health disorders such as substance abuse disorder, anxiety disorder, or ADHD [attention-deficit/hyperactivity disorder] and people with bipolar & BPD showing suicidal tendencies. 

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What Causes BPD? Common Borderline Personality Disorder Causes

The condition can develop due to one, multiple, or a combination of reasons, such as:

BPD: Childhood Trauma

Suffering from sexual abuse during childhood is among the more common causes of Borderline Personality Disorder. People who have suffered severe emotional trauma or physical abuse as a child are also vulnerable to developing BPD. Witnessing domestic violence during childhood, deaths in the family, parent separation, or growing up in a violent and abusive neighborhood are also probable causes.

In addition, homes with a parental substance use disorder can make the kids more vulnerable to developing BPD.

BPD: Genetics

Borderline personality disorder might run in the family. Though there is no guarantee of BPD being common across siblings and cousins, there have been many cases of BPD showing a genetic pattern.

BPD: Brain Chemistry

In some people diagnosed with BPD, dysfunction related to brain activity could be the underlying cause. This can cause a problem in managing emotions and overall behavior patterns.

BPD: Are Some People More Prone to Borderline Personality Disorder?

It is difficult to predict if someone is inclined to develop borderline personality disorder. Even when the condition actually sets in, the signs and symptoms of borderline personality disorder can be very hard to recognize for the family and even close friends. However, some trends have been noticed.

Many types of personality disorders seem to show up during the teen years. As the teenager moves towards maturing as a young adult, the personality obviously develops, and this is when some borderline personality disorder symptoms might show up—again, it is not a certainty that friends or family will spot the signs as they can be interpreted as undergoing a phase of change or reacting to stress. Another trend in the niche of mental health care suggests that most types of personality disorders, including borderline personality disorder, are diagnosed among people above 18.

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BPD and Genetics

Although it is not certain that BPD has genetic causes, it might be more common in some families. If you or your loved one has a family history of BPD, it might be a good idea to get a consultation to ensure that this problem is diagnosed and managed as early as possible. Similarly, if someone already suffers from other mental health conditions such as depression or anxiety, there might be a risk of developing borderline personality disorder.

People with psychological health problems like anorexia or bulimia too are within the high-risk population for developing BPD. Another condition that can make a person more vulnerable to BPD is PTSD or post-traumatic stress disorder, where the person already suffers from anxiety and depression due to an unpleasant event in the past.

BPD and Addiction: The Relationship Between Substance Abuse & Borderline Personality Disorder

It is hard to assume if being addicted to drugs or having a substance abuse problem can make someone more susceptible to developing borderline personality disorder. Still, there is an interesting link between addiction and BPD.

Many professionals in the treatment world often come across people with a drug addiction co-occurring along with borderline personality disorder. BPD and addiction can worsen the collective symptoms and make the diagnosis hard. A good rehab center will value the opinion of a mental health expert who can help diagnose BPD. This is valuable for creating a customized rehabilitation program—yes, people with co-occurring conditions need more psychological assistance. Treatment includes multiple behavior therapy modalities.

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What Are the Signs & Symptoms of Borderline Personality Disorder?

The easier way to spot borderline personality disorder early is by noticing the symptoms. But this is not easy. This personality disorder presents symptoms like many other mental health conditions. However, knowing the following symptoms might be helpful if you pay close attention:

BPD: Sudden Mood Changes

People with BPD often have a reputation for being extremely moody. Sometimes, mood fluctuations can be acute within a brief period. The mood variations can come with unreasonable feelings of hatred, anxiety, love, sadness, or just irrational ranting about an assumed situation. While the mood swings might last for just a few hours, they can be dramatic and even border on getting violent.

BPD: Impulsive & Dangerous Behavior

This behavior pattern is perhaps the most challenging symptom of borderline personality disorder to diagnose. The person might seem uncaring and unconcerned about the health and safety of others, including the family. This shows up in reckless driving or a gambling obsession. The person might seem driven towards experimenting with substance abuse or have an uncontrollable need to binge eat or look for unsafe sexual activities. None of these are easy to identify as borderline personality disorder symptoms.

BPD: Paranoid Thinking

Many personality disorders come with this symptom. The person can overthink, feeling paranoidly apprehensive or scared about the most common scenarios. The fear of the worst can look like hallucinations (worsened if the person is also using possibly hallucinogenic drugs). These BPD symptoms can be exacerbated by stress. These paranoid thoughts are sporadic and temporary—they come and go without a pattern.

BPD: Suicidal Behavior

People with BPD can develop suicidal tendencies. While the intent to self-inflict a cut might not always be about ending one's life, this tendency to self-harm can get chronic, and the self-inflicted injury can get fatal as it happens in people who self-harm by inflicting burns on their bodies. The person might also repeatedly threaten to do so. Such self-destructive acts can accompany every instance of rejection or anxiety.

BPD: Fear of Abandonment

People with BPD might have irrational fears of being alone. Some might react to the smallest durations of being without friends or family. A person with borderline personality disorder can feel neglected unusually; these feelings often come with frustration and anger. To others, this might seem like a strange obsession to be surrounded by others or just another mood swing. A BPD person might closely check the family's whereabouts and might insist on tagging along everywhere, uninvited.

An interesting contradiction to this borderline personality disorder symptom lies in some BPD people self-isolating, fearing that getting too close might eventually lead to rejection. It takes an experienced mental health expert to decode these symptoms and establish BPD as the cause.

BPD: Poor Self-Image

People with BPD often have a distorted perception of themselves. The person can feel unusually guilty without committing anything wrong. The person might be caught in a vicious cycle of fearing the worst and constantly evaluating oneself. This can bring about abrupt changes in mood and overall behavior.

For instance, a wedding announcement from a friend might bring about feelings of abandonment or being left behind, along with comparisons and a feeling of having failed in life. This tends to sabotage the good, more constructive activities, affecting normal behavior associated with productivity at work or school. This constant self-evaluation can pull down a person's performance in maintaining social relationships or preparing for an upcoming examination.

BPD: Anger Management Problems

Most people with BPD might appear to always be in a bad mood. The person could show a pattern of getting intensely angry over certain unalarming situations. The smallest argument or discussion might be enough to get the worst reaction. A person with BPD can be prone to shooting angry tirades or using sarcasm in an unwarranted way.

Not everyone with borderline personality disorder shows all of these symptoms. Along with the varying number of symptoms, the severity and frequency of the symptoms might also vary a lot. Typically, people with BPD struggle to nurture and maintain good personal relationships. The tendency of sudden fluctuations in mood and thinking patterns affects relationships. BPD can affect all social and personal relationships, from marriages to friendships and workplace dynamics.

How Is Borderline Personality Diagnosed?

Just as someone's personality continues to evolve, the range of personality disorder symptoms can also present many changes. This is why personality disorders can seem impossible to diagnose. Whether the person suffers from a disruptive psychological condition or BPD, the thinking patterns will not look healthy.

Sometimes, diagnosing BPD can look very similar to a generalized anxiety disorder or depression. This is why approaching a licensed mental health professional, like a psychiatrist or psychologist, rather than a general physician is more likely to help diagnose this condition. Similarly, clinical social workers who work with rehab centers might be able to spot borderline personality disorder that might have otherwise gone undiagnosed.

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How Is Borderline Personality Disorder Treated?

There is no single definitive treatment for Borderline Personality Disorder (BPD), as each individual may respond differently to various forms of therapy. Treatment typically involves a combination of medication and psychotherapy, with the goal of improving symptoms and helping individuals manage their emotions and behavior more effectively.

Medication may be prescribed to help manage specific symptoms of BPD, such as depression, anxiety, impulsivity, or mood swings. Some commonly prescribed medications for BPD include antidepressants, mood stabilizers, and antipsychotics. However, medication alone is not typically considered an effective treatment for BPD.

BPD: Dialectical Behavioral Therapy, Cognitive Behavioral Therapy, & More

The most widely used form of psychotherapy for BPD is Dialectical Behavioral Therapy (DBT), which focuses on helping individuals learn skills to manage their emotions, interpersonal relationships, and impulsive behaviors. This type of therapy often involves both individual and group sessions.

Other types of psychotherapy that may be helpful for individuals with BPD include Cognitive Behavioral Therapy (CBT), Psychodynamic Psychotherapy, and Schema Therapy. These therapies can help individuals identify and change negative patterns of thinking and behavior that contribute to their symptoms.

Other Ways BPD Is Treated

In addition to medication and psychotherapy, other forms of treatment may also be beneficial for individuals with BPD. These can include alternative therapies such as art therapy, yoga, or mindfulness techniques. It's important for each individual to find a treatment plan that works best for them.

While there is no cure for BPD, many individuals are able to manage their symptoms and live fulfilling lives with proper treatment and support. It's important for individuals with BPD to have a strong support system, whether it be through family, friends, or a support group.

With the right combination of therapy, medication, and support, individuals with BPD can learn to effectively manage their symptoms and lead fulfilling lives.

Tired of BPD Running Your Life? The Edge Treatment Center Can Help

If you or a loved one are struggling with borderline personality disorder, know that there is hope and help available. At The Edge Treatment Center, we offer comprehensive and evidence-based treatment for BPD.

Guided by a trauma-informed philosophy, our team of experienced therapists and medical professionals will work with you to develop an individualized treatment plan that addresses your specific needs and challenges. We believe in a holistic approach to treatment, addressing not just the symptoms of BPD but also underlying issues and co-occurring disorders.

In addition to traditional therapy sessions, we also offer alternative therapies such as yoga, meditation, and equine-assisted therapy. These can be powerful tools for managing emotions and promoting overall well-being.

At The Edge Treatment Center, our goal is to help individuals with BPD regain control of their lives and find lasting recovery. Through ongoing support and guidance, we strive to empower our clients to live fulfilling and meaningful lives beyond their diagnosis.

Don't let BPD continue to run your life. Contact us today to learn more about our treatment options for borderline personality disorder and take the first step toward a brighter future.

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