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Borderline Personality Disorder and Alcoholism

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“The doctors had done all they could after detoxing me and said I was ‘in Gods hands.’” shares Michelle C. in her Heroes in Recovery story.“ Over the next few weeks, doctors diagnosed me with borderline personality disorder [and other issues]. I had self-medicated with…alcohol to the point of near death – to total mental shutdown. Eventually, I was…moved on to intensive outpatient where I learned about my diagnosis and the disease of addiction.”

“[However,] I didn’t pursue recovery beyond the time period of treatment. After six months I thought, ‘Well, I’m cured now.’ I wanted that anesthetized feeling again because all the things underneath, those disorders, were never dealt with. I didn’t continue pursuing the program of recovery. I thought I was physically and mentally stable, so I didn’t need a recovery program. I was different… or was I?”

After being pardoned following a ten-year prison sentence for selling drugs in order to support her habits, Michelle C. finally began getting help to understand the root causes of her addiction.Today I enjoy being a daughter, sister, wife, mother, nana,” beams Michelle C. “Choose life! Choose recovery.”

Many people are living a story similar to Michelle’s. But perhaps they are not sharing the same happy ending at this point in their journey. Michelle came to the end of herself. She wanted to get back to the person she was before addiction took over. And she realized that being resolute and resilient in her recovery efforts didn’t end with her release from the treatment center.

What Is Borderline Personality Disorder? Doesn’t “Borderline” Mean It’s Barely a Problem at All?

No, BPD is a very serious condition. It’s a mental disorder marked by a pattern of ongoing instability in mood, behavior, self-image, and functioning. It is often characterized by impulsive actions and unstable relationships. There may also be an overwhelming sense of loneliness. This condition may produce intense episodes of anger, depression, and anxiety. These may last from a few hours to several days.

Individuals with BPD often have co-occurring mental health issues, as is the case for Michelle C. An alcohol or drug use disorder is just one possible dual diagnosis. It may also be accompanied by a mood or anxiety disorder. Or perhaps an eating disorder.

Whatever combination of factors may be involved, the chance that self-harm may occur, including suicidal thoughts and behaviors, is much greater for people with BPD than it is for the general public.1

BPD usually begins by early adulthood. The condition seems to be at its worst during young adulthood. With advancing age, it is possible that the condition may improve on its own.

If symptoms of BPD exist, there is hope for recovery. Many people with this condition, through responsible and diligent efforts, come to live happily ever after.2

Alcoholism in Patients Who Have BPD

About 78% of adults with BPD also develop a substance-related disorder or addiction at some time in their lives. (When two or more mental health issues are involved, this is referred to as a dual diagnosis.)

Such dual-diagnosis patients are more impulsive and clinically less stable than BPD patients who have no substance dependency. They display more suicidal behavior, are more likely to drop out of treatment, and tend to have shorter periods of abstinence.

The combination of BPD and a substance use disorder (SUD) requires a special therapeutic approach.3

What Draws BPD Patients to Alcohol?

Woman drinking beerThe co-occurrence of alcoholism with BPD is thought to be at least partially due to the fact that alcohol is a central nervous system depressant. Since sufferers of BPD have intense emotional outbursts, alcohol may help them to turn down the intensity of these feelings.

So, while BPD may not actually cause alcoholism, those that suffer from BPD may seek whatever quantity of alcohol is necessary to numb the BPD symptoms. In seeking to continually suppress these intense feelings, repeated episodes of drinking may eventually result in an alcohol use disorder.

As part of the vicious cycle, BPD causes poor impulse control. As a result, binge drinking may occur. This can further fuel the development of alcoholism. Leading a balanced emotional life can become extremely challenging for these individuals. Professional diagnosis and treatment becomes necessary. Without it, the effects of these mutually perpetuating disorders can become very difficult to control.4

Treatment of Co-occurring Disorders Is a Big Challenge

Seeking help for one disorder can be a daunting task in itself. So, when two or more mental health issues are involved, it can feel really overwhelming. Michael’s House offers a tailored approach to each individual and can help make this process easier and more manageable. But treating all disorders at the same time is critical in managing each individual condition.

A commonly used treatment strategy for helping such dual-diagnosis patients is derived from Cognitive Behavioral Therapy. CBT is designed to help people change their core beliefs and inaccurate perceptions.

Dialectic Behavior Therapy for Substance Use Disorders (DBT-SUD) –This approach was designed specifically for BPD patients with co-occurring substance dependence.It teaches mindfulness. The idea is for patients to become more conscious of their thoughts. Through this strategy, better coping skills are practiced. This helps patients fend off any tendencies toward both self-harm and substance abuse. Out of this, patients can hopefully develop healthier relationships with other people as well.

Implementation of DBT-SUD consists of:

  • Weekly individual therapy (as the psychotherapy process builds,future therapeutic steps are developed).
  • Weekly group therapy for refinement of coping skills.
  • Participation in self-help groups and addiction counseling.
  • Continued coaching via telephone.
  • Ongoing tracking of the patient by a therapist.3

Following detox, alcohol rehab addresses all of the components of addiction: social, physical and psychological. And then, after formal treatment, aftercare is an essential part of the recovery process.

Dual-Diagnosis Patients Need Integrated, Comprehensive, Care

Integrated treatment is at the core of proven, evidence-based care today for dual-diagnosis patients.It’s the type of care offered at Michael’s House. All impacting conditions are treated simultaneously. This makes a more complete and lasting recovery possible.

So, at Michael’s House, a multi-disciplinary team (addiction and mental illness specialists) complement each other’s contributions in working toward the healing of the whole person. Knowledgeable and experienced, these highly trained professionals are well-equipped to provide comprehensive, holistic care.

Michael’s House understands and recognizes that each patient has unique needs and circumstances. That means that every patient’s treatment plan is customized. For more information or to make a reservation, call us today at 760.548.4032. Start down the road to recovery – a recovery that you can maintain for a better life!


1Borderline Personality Disorder.” National Institute of Mental Health. August 2016. Accessed 8 September 2017.

2Borderline Personality Disorder (BPD).” Substance Abuse and Mental Health Services Administration, 12 May 2017.Accessed 8 September 2017.

3Borderline Personality Disorder and Comorbid Addiction.” Deutsches Arzteblatt International, Volume 111, Issue Number 16, Pages 280-286. April 2014.Accessed 8 September 2017.

4 “An Introduction to Co-occurring Borderline Personality Disorder and Substance Use Disorders.” In Brief, Substance Abuse and Mental Health Services Administration, Volume 8, Issue 3. 2014.Accessed 8 September 2017.

5Co-occurring Disorders.” Substance Abuse and Mental Health Services Administration.8 March 2016.Accessed 8 September 2017.