Borderline Personality Disorder (BPD)
By The Recovery Village Ridgefield
Last Updated: May 30, 2023
Editorial Policy | Research Policy
Borderline personality disorder (BPD) is a mental health disorder. BPD can be treated with psychotherapy and psychiatric medications. The mental health disorder was not completely understood until the 1970s. The name comes from the fact that initially, the symptoms of BPD were thought to be on the borderline of other mental health disorders. In 1980, however, the disorder was recognized as a standalone diagnosis. Some common BPD symptoms and characteristics include:
- Instability in interpersonal relationships
- Volatile emotions
- Shifting self-image or self-identity
- Risky behaviors
- Suicidal behavior
- Shallow relationships
- Extreme sensitivity to outside influences
- Feeling intense abandonment
People who have BPD are known to see the world in black and white or extremes. They often miss all of the nuances of human behavior and relationships. Those who have BPD have a tendency to have an intense attachment to others and then demonize them. This process is known as “splitting”. Because people with BPD tend to push others away, they isolate themselves. Then they form new relationships and begin the process again.
People with BPD can also have misperceptions of the world, their surrounding environments and their relationships. This may seem like some type of delusion disorder to some, but it actually comes from a person with BPD having strong emotions that overwhelm regular cognitive functioning.
There are some medications that can help with BPD symptoms. For example, antipsychotic medications like Zyprexa, Geodon or Seroquel can be useful during reactive episodes of psychoses. Antidepressants and antianxiety medications can also be used to treat the symptoms of borderline personality disorder. There is a lot of debate, however, about doctors tending to overmedicate patients with this condition.
In most cases, psychotherapy tends to be the most recommended treatment for BPD. It is true that medications do help the symptoms, but they don’t help patients discover new coping skills or learn how to regulate their emotions. Because suicidal ideation is so common with BPD patients, suicidality should be assessed carefully and monitored during treatment. In some severe cases, hospitalization is also recommended.
Dialectical behavior therapy (DBT) is most commonly used in BPD treatment. DBT combines practices that are based in Eastern philosophies. DBT helps patients to learn how to accept the intense negative emotions and not identify with them. Patients in DBT also work to be in control of their emotions.
BPD and Addiction
Many patients who have mental health disorders also have substance use disorder. This is known as co-occurring disorders. According to research published in Innovations in Clinical Neuroscience, having a psychiatric disorder increases the chances of also having substance use disorder. With BPD specifically, the association is very strong. The treatment of substance abuse and BPD at the same time is often difficult due to:
- Interpersonal issues with the therapist, which only the most experienced therapists can work through
- Difficulty working with a group therapeutically
- Relapse prevention efforts must address substance abuse and also risky behaviors like refusing to take psychiatric medications that have been prescribed
It can be difficult to differentiate between substance use disorder and borderline personality disorder in some cases as they have many things in common. For example, both disorders are characterized by mood swings, self-destructive behaviors, manipulative actions and instability in jobs, relationships and finances.
For those patients who have a duel diagnosis of borderline personality disorder and substance use disorder, it is important that they are treated for both conditions concurrently. For this reason, it’s essential that the patient find a drug or alcohol rehab center that treats co-occurring disorders. At the Recovery Village Ridgefield, a team of addiction specialists and healthcare professionals will work together to formulate an individualized treatment plan for all patients, taking into account any co-occurring disorders that may also need to be treated.
The Recovery Village Ridgefield is located in the Pacific Northwest, convenient to Tacoma, Eugene, Seattle and Portland. It is the location of healing for many patients. If you are suffering from a duel diagnosis of borderline personality disorder and substance use disorder, you don’t need to suffer any longer. Help is one phone call away.
Our Recovery Advocates are ready to answer your questions about addiction treatment and help you start your recovery.