Alcohol & Borderline Personality Disorder

Learning about alcohol use in relation to borderline personality disorder (BPD) is important.

Alcoholism is a serious concern with many severe implications when it stands alone.

For those affected by BPD as well, there are even more worrying issues related to alcohol use because of how the two conditions manifest and exacerbate each other.

In the UK, it’s reported that 1 in 100 people have BDP. [1] It’s incredibly common for people with BPD to use and abuse alcohol for various reasons.

Finding out why this is and what options there are around treatment means that people are in the best place to support themselves and others close to them.

What are the Different Personality Disorders?

There are ten types of personality disorders, which are grouped into three “clusters”. These mental health conditions are grouped by certain features that they have in common.

In cluster A, people tend to exhibit strange or odd behaviours:

  • Paranoid Personality Disorder
  • Schizoid Personality Disorder
  • Schizotypal Personality Disorder

In cluster B, people tend to exhibit erratic and dramatic behaviours:

  • Borderline Personality Disorder
  • Antisocial personality disorder
  • Histrionic Personality Disorder
  • Narcissistic Personality Disorder

In cluster C, anxiety drives behaviour:

  • Avoidant Personality Disorder
  • Dependent Personality Disorder
  • Obsessive-compulsive Personality Disorder

Each of these is a psychiatric disorder that can be diagnosed. All are capable of having severely detrimental effects on interpersonal relationships and the person’s quality of life.

What is Borderline Personality Disorder?

Borderline Personality Disorder is a mental health disorder. People who have it struggle in particular with emotional regulation and this tends to cause major issues in various areas of their life.

The NHS explains that someone with BPD “will differ significantly… in terms of how he or she thinks, perceives, feels or relates to others”. [2] There are various signs and symptoms of BDP, including:

  • Severe mood swings.
  • Disturbed patterns of thinking and cognition.
  • Unstable relationships with family and friends.
  • Intense fear of abandonment.
  • Chronic feelings of emptiness.
  • Impulsive and destructive behaviours (sometimes aggressive behaviour).
  • Increased risk of self-harming and suicidal thoughts and behaviours.

Understandably, being unique, each person with a BPD diagnosis will experience it differently. Some people experience more symptoms and frequency of symptoms than others.

The causes of BPD…

While it can be difficult to pinpoint the absolute causes of BDP, there are particular risk factors that make it more likely. These factors are related to the brain structure, genetics, and a person’s environment.

The brain can differ in structure and also in functioning for people who have BPD. This is especially apparent in the part of the brain that deals with emotional regulation and impulse control.

If there is a family history of BPD, then there is a genetic predisposition for the condition making it more likely for other people in the family to also develop it.

Many people with BPD have experienced traumatic life events.  This might be linked to sexual abuse, emotional abuse, experiencing unstable relationships with themes of abandonment, and around substance abuse.

While these factors are apparent for many people with a BPD diagnosis, it’s not set in stone. There are many people without these risk factors who develop BPD and there are many people who have these risk factors who don’t go on to develop BPD.

BPD & the Increased Risk of Addiction

Alcohol addiction

Addiction is actually a serious threat to many people who have mental health conditions. The reason for this is because of how distressing it can be to live with uncomfortable symptoms.

It’s understandable that people sometimes want to dull emotional pain or uncontrolled thoughts.

While using substances seems an “easy” option because of their immediate effects, the negative impact on a person’s mental health from alcohol and drugs exacerbates BPD.

People with BPD not only have lowered impulse control, but they can also experience extreme emotions and be at an increased risk of having an addictive personality.

These factors can lead to the development of alcoholism, addiction to illegal street drugs and pharmaceutical drugs, and also to behavioural addictions such as gambling, porn, and shopping.

BPD and co-occurring alcoholism introduces a whole new level of complexity to a person’s ability to manage their mental and physical health.

What is Alcohol Use Disorder?

Alcohol use disorder (AUD) is a condition that affects the brain, mind, and behaviour. It’s characterised by a person’s inability to control alcohol use.

Despite how much the person might want to stop drinking, they won’t be able to. In fact, for some people – where dependency forms – it becomes dangerous to quit unless through a medically-overseen detox.

People who have AUD will constantly think about drinking, try to get alcohol, and will feel they need it in order to face the day and get through life. The condition can lead people to lie and manipulate or become secretive about their alcohol use. It’s a condition that impacts mental and physical health.

As alcohol use goes on, a person builds up a tolerance. This means that they need more alcohol to feel an effect. Some people will start drinking larger amounts or move to stronger alcohol.

In other cases, people might move towards mixing alcohol with other substances in order to feel an effect.

Alcohol withdrawal occurs when alcohol starts to leave the body and the person experiences mental and physical effects such as anxiety, mood swings, sweating, shaking, sickness, diarrhoea, and seizures.

Borderline Personality Disorder & AUD as a Co-Occurring Disorder

Due to there being many similarities in the presentation of alcohol-related issues and BPD, it can sometimes be difficult to diagnose one or the other, or the two as a co-occurring condition.

As an example, changeable moods and experiencing intense feelings can be the result of BPD or of an AUD, or of the two co-existing.

To gain a diagnosis, your healthcare provider is likely to assess you on more than one occasion and is also likely to want to interview people close to you in order to get a well-rounded view of how your mental health and brain functioning has been affecting you over a period of time (or since symptoms have been present).

Some people develop alcohol addiction because they started using alcohol as a way to manage BPD symptoms. This is known as self-medication. Others will have been drinking first and have developed symptoms that mimic BPD.

When you develop co-occurring borderline personality disorder and alcohol use disorder, it’s really important you’re supported around your mental health as well as for the substance abuse.

What Makes Alcohol Use More Likely for People Who Have BPD?


As with the majority of mental health disorders, people are more likely to use alcohol if they have BPD.

One reason that AUD and BPD can develop as a co-occurring condition is because they both have the same risk factors linked to a genetic predisposition, the environment, and brain structure.

Research shows that people with BPD actually experience more alcohol cravings. [3] Due to the extreme emotions typical of BPD, alcohol cravings can be more pronounced and drinking becomes more desired as a way to try and dull the emotions.

Other people with BPD find alcohol a source of entertainment whether they’re with others or drinking alone. Finally, people with BPD are more likely to indulge in self-harming activities and alcohol abuse can function as a form of self-harm.

Of course, any level of binge drinking or regular alcohol use then raises the likelihood of alcohol addiction and dependency forming. At this point, treatment for a dual diagnosis is essential.

Treatment for a Dual Diagnosis


It’s really important that you find a specialist treatment provider who understands both alcohol addiction and borderline personality disorder. Sadly, research shows that substance abuse and BPD are a lethal combination.

Quite literally, the two together greatly increase the risk of suicide. [4]

To improve future mental and physical health outcomes, it’s essential that alcohol-related problems are addressed in order to then effectively treat BPD. This improves the quality of life in the future.

Treatment options in relation to alcohol use are varied.

If you have BPD or suspect it, then it’s beneficial to find a specialist rehab clinic so you can be supported to achieve sobriety before seeing a professional about managing your BPD.

Rehab Treatment for Alcohol & BPD


Opting for a private inpatient treatment rehab to be treated for alcohol addiction means you’ll be supported by a team of specialists who will support you through a range of approaches to becoming sober.

Rehab clinics offer comprehensive treatment. This means that there are staff who concentrate on your physical health, others on your mental and emotional health, and finally those who cover holistic approaches which tend to tackle the mind-body connection as well as the innate philosophical drive.

While rehab clinics mainly focus on addiction, there are those that specialise in mental health conditions as well. This is the type of clinic recommended for those who have a dual diagnosis.

In these environments, you’ll receive therapies that will help you to develop emotion regulation skills which are essential for people with BPD.

A key treatment on offer for people who experience intense emotions whether in relation to addiction or BPD is dialectical behavioural therapy. These sessions focus on giving you the skills to regulate your emotions successfully.

This is essential as a healthy coping strategy because it supports you to manage alcohol cravings as well as emotional triggers.

Some residents at rehab are prescribed anti-depressants and anti-anxiety medications (i.e. selective serotonin reuptake inhibitors or benzodiazepines) by the on-site doctor or psychiatrist. Each person is individually assessed, however, to identify whether this would be suitable.

Alcohol Detox at Rehab

detox healthy food

In relation to alcohol dependency, residents begin with a seven to ten-day detox which includes a Librium prescription. This medication is important in managing withdrawal symptoms so that the patient is safe and isn’t at risk of seizures.

After detox, the treatment focus turns to psychological and holistic therapies in order to address the neurological, trauma-induced, and personality-based drives behind addiction.

Other Places That Offer Rehabilitation Support for Alcohol Use Disorder


In the UK, there are other places – aside from rehab – you can go to that offer people support around addiction and recovery.

  • Alcoholics Anonymous
  • NHS alcohol and drug services
  • SMART Recovery groups
  • Narcotics Anonymous (Cocaine Anonymous is also growing as a fellowship)

Are You Interested in Treatment?

If you’re keen to find an effective treatment approach, you can contact Rehab 4 Alcoholism at 0800 111 4108 for support on finding a private rehab clinic, or your local GP to be sign-posted to an NHS alcohol and drug services hub.

Private clinics are substance-free environments where you’ll stay for a period of around four weeks to become sober. NHS clinics offer outpatient facilities, so you’ll remain living at home but go to the clinic for appointments.

Final thoughts…

It’s clear that when alcohol use disorder co-occurs with BPD, the risks of both can lead to seriously worrying outcomes. Not only are both conditions worsened by the impact of the other, but they can quite literally lead to death through the increase in suicide risk.

It’s critical to receive treatment for both conditions. This offers a way of learning skills and participating in therapeutic work which provides a healthy basis to recover from.

If you’re interested in rehabilitation treatment, contact Rehab 4 Alcoholism for support on how to find the right rehab clinic for you in treating both conditions.


Is alcohol good for BPD?

The short answer is no, alcohol is not good for BPD. In fact, the effects of alcohol on brain chemistry and emotions can make BPD symptoms worse.

Is alcohol a trigger for BPD?

Alcohol use can cause severe mood swings and heightened emotions, which is very similar to BPD symptoms. However, alcohol use is not a causation factor for BPD.

Factors underlying BPD are linked to brain structure and function, genetics, and a person’s environment.

Does alcohol alter your personality?

Alcohol use can alter your personality through the effect it has on your moods and emotions. Rehabilitation and achieving sobriety can return emotional balance and help ground a person back to their authentic self.