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Treating Borderline Personality Disorder (BPD) & Drug or Alcohol Addiction

People with borderline personality disorder (BPD) often have difficulty managing their emotions and behaviors. BPD commonly co-occurs with substance use disorder (SUD), and is the most common personality disorder seen in treatment settings such as the best depression and anxiety treatment centers in Delhi. People with BPD may benefit from treatment that includes medication and psychotherapy from the best rehabilitation centres in India.

Borderline Personality Disorder is a Cluster B personality disorder, distinguished by highly emotional, erratic, and dramatic behavior. People with BPD often have unstable relationships, poor impulse control, negative self-image and affect, and heightened impulsivity. People with BPD often have difficulty seeing people and their actions in shades of gray, but instead view them as strictly good or bad.

People with BPD often have unstable relationships. Their self-image and perceptions of others can change rapidly and dramatically, making it hard to maintain meaningful relationships.

Criteria for diagnosing BPD are outlined in the Diagnostic and Statistical Manual for Mental Disorders, 5th edition (DSM-V), which states that a person with BPD must have the following symptoms:

Impulsive behaviors are defined as those that people engage in without any regard for the consequences. When one acts impulsively, it's typically after feeling stress or anxiety. People who are more likely to engage in impulsive acts are not able to think about the future consequences of their behavior. Some examples of impulsive acts include binge eating, substance use, reckless spending, and sex.

Intense feelings of emptiness are present in BPD because the person lacks a sense of internal meaning or purpose. This feeling of emptiness is a symptom of the disorder itself. The person may seek out people who will act as a surrogate for the missing internal sense of purpose, and this will help them to feel fulfilled by giving them a false sense of purpose. It is not uncommon for people with BPD to assume the identity of someone they are close to in order to form a sense of self, to the point where the lines between their identity and another person's can completely blur. A person with BPD may also have temporary abandonment concerns regarding a relationship when they feel they are being blamed, criticized, or are not being heard by the other person. They may feel that the other person is going to leave them, and that they will be left with a sense of emptiness once again.

Highly intense mood swings are like a roller coaster. They last for several hours to a couple of days, and can be really scary.

People in interpersonal relationships often seem to alternate between two extremes - either idealizing the other person or devaluing them. This can be very intense and unstable, and it can make it hard to maintain a healthy relationship and thus require treatment at the top luxury rehabilitation centres in India.

Episodes of intense negative emotions, usually lasting a few hours but sometimes lasting a few days; Stress can sometimes make us feel like we're out of our minds or even detached from our bodies. These are called periods of stress-related paranoia or dissociative symptoms.

Recurring suicidal thoughts, gestures, or behaviors can be extremely distressing for both the individual experiencing them and their loved ones. If you or someone you know is exhibiting any of these signs, it's important to seek professional help immediately from the best rehabilitation centers in India.

Everyone gets angry from time to time. However, if you find that you have strong, intense periods of anger that are difficult to control, it may be a sign of a bigger problem. If this sounds like you, it's important to seek professional help to address the issue, from the top rehab centres in India.

It is only natural to want to know more about something that might be affecting you, but it is important to remember that only a professional can give you an official diagnosis. The best thing to do if you think you might have BPD is make an appointment with a psychiatrist, psychologist, social worker, or mental health counselor, available at the best rehab centers in India.

After speaking with you about your symptoms and how they affect various areas of your life, the doctor will conduct a thorough assessment. Once other potential causes have been ruled out, they will offer a diagnosis and discuss the next steps for you to take.

If a person has BPD and addiction, this is known as a co-occurring disorder, or dual diagnosis. Co-occurring disorders are when 2 or more mental disorders occur at the same time. Generally speaking, each disorder can affect the course, progression, and treatment of the other.

For decades, clinicians and researchers have recognized that borderline personality disorder (BPD) and substance use disorders (SUDs) are often diagnosed within the same person. [1][2][3][4]

BPD often co-occurs with other mental disorders, such as depressive and bipolar disorders, post-traumatic stress disorder, attention-deficit/hyperactivity disorder, and eating disorders. Personality disorders are also common among people with BPD.

The most frequent comorbid psychiatric disorders in BPD patients are anxiety and affective disorders, including posttraumatic stress disorder. The overall lifetime prevalence for these comorbidities is approximately 85%, followed by substance-related disorders with a lifetime prevalence of 78%. [5]

Even though having BPD doesn't mean someone will become addicted, and the same goes for addiction not leading to BPD, there are some overlapping risk factors for both disorders. Things like genetics and environment can play a role in both disorders, which might help explain why having BPD is so common among people with SUDs.

Since people with BPD are predisposed to impulsive and self-destructive behaviors, it's likely that they would be inclined towards SUDs, or behaviors such as binge drinking and drug misuse, which can lead to substance use disorders. Likewise, increased substance use can lead to greater emotional instability, exacerbating the symptoms of BPD.

Both Borderline Personality Disorder and Substance Use Disorder share several risk factors - for example, a family history of either or both disorders, genetic predisposition, or similar brain areas being impacted which control emotion and impulse. Additionally, environmental factors such as adverse childhood experiences can play a role.

Having risk factors does not mean that you will develop BPD or SUD. Some people develop one or both disorders without any risk factors. The presence of one or more risk factors means that you are at increased risk compared to someone without any risk factors. Research has shown that SUD + BPD patients did have a higher risk of having experienced emotional and physical abuse, neglect, or family violence in childhood compared to SUD patients, suggesting that child abuse and family violence are BPD-specific risk factors in patients with SUDs. [6]

When a loved one is dealing with co-occurring BPD and SUD, it can be a difficult and frightening experience. However, there are many ways you can help them get the treatment they need from the top drug treatment centers in India. You can provide moral support, help with making appointments and travel arrangements, or simply be there to listen. There are also many support groups available for both patients and loved ones.

If you or a loved one is struggling with co-occurring borderline personality disorder and addiction, know that you are not alone and there is hope at the best rehabilitation centers in India for alcohol and drugs. Many substance use rehab facilities and best luxury rehabs in India, like Sanctum wellness and healing, offer comprehensive programs that provide effective care for both disorders. Sanctum is a luxury addiction treatment facility in New Delhi, India, that specializes in treating co-occurring disorders. If you are ready to take the first step in your journey to wellness, contact us today.

At our facility, we offer a comprehensive range of care to those struggling with addiction, including medical detoxification and inpatient rehabilitation. Our detox program is designed to help you safely and effectively withdraw from substances, while our inpatient rehab program provides you with the tools and resources you need to manage BPD symptoms and achieve long-term sobriety.


  • 1. Gunderson JG. Borderline personality disorder: a clinical guide. Washington, D.C.: American Psychiatric Press; 2001.
  • 2. Leichsenring F, Leibing E, Kruse J, New AS, Leweke F. Borderline personality disorder. Lancet. 2011;377:74–84.
  • 3. Paris J. Borderline personality disorder: a multidimensional approach. Washington DC: American Psychiatric Pub; 1994.
  • 4. Trull TJ, Sher KJ, Minks-Brown C, Durbin J, Burr R. Borderline personality disorder and substance use disorders: a review and integration. Clin Psychol Rev. 2000;20:235–53.
  • 5. Tomko RL, Trull TJ, Wood PK, Sher KJ. Characteristics of borderline personality disorder in a community sample: Comorbidity, treatment utilization, and general functioning. J Pers Disord. 2013 Epub ahead of print.
  • 6. Wapp M, van de Glind G, van Emmerik-van Oortmerssen K, Dom G, Verspreet S, Carpentier PJ, Ramos-Quiroga JA, Skutle A, Bu ET, Franck J, Konstenius M, Kaye S, Demetrovics Z, Barta C, Fatséas M, Auriacombe M, Johnson B, Faraone SV, Levin FR, Allsop S, Carruthers S, Schoevers RA, Koeter MW, van den Brink W, Moggi F; IASP Research Group. Risk Factors for Borderline Personality Disorder in Treatment Seeking Patients with a Substance Use Disorder: An International Multicenter Study. Eur Addict Res. 2015;21(4):188-94. doi: 10.1159/000371724. Epub 2015 Apr 1. PMID: 25832736; PMCID: PMC4869722.

AUTHOR - Dr. Danish Hussain (MBBS, MD Psychiatry, MIPS)
Dr. Danish received his M.D. Psychiatry and M.B.B.S. degrees from Rajiv Gandhi University of Medical Sciences (Bangalore, Karnataka). He has worked at the Manipal Multispecialty Hospitals Bangalore, following which has continued to undergo regular training from prestigious institutes from all over the world. Dr. Danish serves as Assistant Professor and Head of Department of Psychiatry at AFSMS & RC and is a member of Indian Psychiatric Society. Dr. Danish uses a holistic approach with his patients and brings his expertise at practice to treat varied behavioral health problems from Addiction disorders to Depression, Anxiety, Personality disorders and OCD. Dr. Danish’s goal is to educate and inform the public on addiction issues and help those in need of treatment find the best option for them.

REVIEWED BY - Sudipta Rath (M. Phil in Clinical Psychology)
Sudipta Rath has completed her MPhil in clinical psychology from Utkal University in Odisha (India) in 2020 and is currently practicing in New Delhi as a clinical psychologist at dual diagnosis facility. She is a licensed RCI practitioner specializing in all forms of psychotherapy. Addiction and mental health are personal subjects for her, and her goal is that she can give a helping hand to those seeking healthy and lasting recovery.

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