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Alcohol and BPD

What is BPD? Warning Signs of Alcohol Abuse, Effects of Alcohol and BPD & Dual Diagnosis Treatment

What Is BPD?

Borderline personality disorder (BPD) creates unrealistic but very real feelings of being unstable or alone. Some people with this condition suffer significantly if they are left alone. They may be impulsive and display actions that push other people away from them. Yet, most people with BPD fear abandonment and need to feel they belong.

This very misunderstood mental health disorder can have serious consequences, especially when left untreated. It was first called BPD in the 1930s. At that time, professionals believed people with these symptoms were in a state of mental illness between neurosis and psychosis but that they did not have the same level of mental health break that a condition like schizophrenia offers.

Over time, we’ve learned that BPD is a type of mental health disorder. A good way to understand what makes it different is to consider it a type of disorder related to emotional regulation rather than a disorder of thought processes. Most often, people with BPD develop the condition in early adulthood, though it can occur at any age. People with it can see improvement if they seek help and learn more about what their emotions and thought patterns mean.

What Is Borderline Personality Disorder Like?

alcohol and bpd
Borderline personality disorder (BPD) creates unrealistic but very real feelings of being unstable or alone.

Borderline Personality Disorder, or BPD, is a mental disorder that has been misinterpreted, misunderstood, and misdiagnosed over the years. It is characterized by mood swings, changes in behavior and confidence, and sabotaging relationships. This can make it seem like a complicated issue, but it’s simple at its core. People afflicted with BPD are more in tune with the feelings of others than people without the disorder. 

People with BPD, or ‘borderline Empathy’ as coined by a 1975 paper, don’t just perceive others’ emotional state but experience it themselves. Naturally, this causes a great deal of undue stress on a person, especially when they don’t understand why they’re feeling what they’re feeling. Eventually, it can reach the point where their mental health begins to deteriorate. The variety of symptoms that many cases experience is tied to this underlying cause.

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Most Common Symptoms of Borderline Personality Disorder

People with Borderline Personality Disorder may experience mood swings and display uncertainty about how they see themselves and their role in the world. As a result, their interests and values can change quickly.

People with Borderline Personality Disorder also tend to view things in extremes, such as all good or all bad. Their opinions of other people can also change quickly. An individual who is seen as a friend one day may be considered an enemy or traitor the next. These shifting feelings can lead to intense and unstable relationships.

Other signs or symptoms may include:

  • Efforts to avoid real or imagined abandonment, such as rapidly initiating intimate (physical or emotional) relationships or cutting off communication with someone in anticipation of being abandoned.
  • A pattern of intense and unstable relationships with family, friends, and loved ones, often swinging from extreme closeness and love (idealization) to extreme dislike or anger (devaluation).
  • Distorted and unstable self-image or sense of self.
  • Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating. Please note: If these behaviors occur primarily during a period of elevated mood or energy, they may be signs of a mood disorder—not Borderline Personality Disorder.
  • Self-harming behavior, such as cutting.
  • Recurring thoughts of suicidal behaviors or threats.
  • Intense and highly changeable moods, with each episode lasting from a few hours to a few days.
  • Chronic feelings of emptiness.
  • Inappropriate, intense anger or problems controlling anger.
  • Difficulty trusting is sometimes accompanied by an irrational fear of other people’s intentions.
  • Feelings of dissociation, such as feeling cut off from oneself, seeing oneself from outside one’s body, or feelings of unreality.

Not everyone with Borderline Personality Disorder experiences every symptom. Some individuals experience only a few symptoms, while others have many. Symptoms can be triggered by seemingly ordinary events. For example, people with BPD may become angry and distressed over minor separations from people to whom they feel close, such as traveling on business trips. The severity and frequency of symptoms and how long they last will vary depending on the individual and their illness.

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Alcohol and BPD

Alcohol has become an all too common form of self-medication for many people dealing with mental illness. This is frequently the case in individuals suffering from disorders who are looking to dull their senses and temporarily escape from their reality. People with BPD are no different in this regard; however, addiction can develop more quickly and become more severe.

A trait that people diagnosed with BPD tend to share is an addictive personality, not just for a single substance, but anything that can provide some kind of stimulus. While the full reasons behind this are not understood, the severity of the issue is clear. Individuals with BPD can develop an addiction to anything from alcohol, to narcotics, to spending or giving away money they don’t have. In any case, the addiction is always detrimental to the health of the afflicted.

Some of the specific traits of BPD are an intense fear of abandonment, paranoid and highly suspicious natures, “flipping” a conversation and deflecting making a partner or spouse feel as though they actually are the one with a problem, and an inability to actually offer a sincere apology without projecting fault (i.e. “I’m sorry you got so mad!”), and setting up situations where conversations can be almost impossible to carry on due to the way a person with BPD will set themselves up to be rejected, thus proving their greatest fears.

alcohol and bpd
Alcohol and BPD are co-occurrent disorders that may be treated with a dual diagnosis rehab treatment.

When alcohol is introduced into these situations, it is highly likely to be used in excess because the person with the disorder is so unable to regulate themselves they “overuse” and will often have no memory of the confrontations.

Does Alcohol Make BPD Worse?

While BPD can trigger someone to abuse alcohol, the opposite is also true. Because of the range of symptoms individuals with BPD can express, there is much confusion when it comes to diagnosis. These symptoms vary so greatly that it is common for there to be overlap with other disorders. This is why people who have chronically abused alcohol over a long period of time can develop similar symptoms to BPD. This makes it difficult for people with an alcohol use disorder, or AUD, to recover, as their mental state fights against sobriety and makes them feel like they need alcohol.

The overlap of symptoms between people with BPD who have turned to alcohol addiction, and, conversely, people who have an alcohol addiction that has developed symptoms of BPD, makes it harder to be recognized as a legitimate disorder. This feeds negative connotations of people suffering from BPD and creates a perception that they have the disorder because they are alcoholics. In reality, BPD is one of the least understood common disorders we have in society, and the factors that influence it can vary greatly from person to person.

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How Does Alcohol Affect BPD

Unhealthy Coping

Alcoholics tend to use alcohol as a coping mechanism. Be it stress, day-to-day problems, or other emotions. So do people with BPD. Borderlines are also likely to use alcohol regularly and in excessive amounts, often a warning sign of alcoholism.

Unstable Behavior

Alcohol, especially with chronic or long-term use, alters brain function, so it can cause mood swings and angry outbursts, often seen with BPD. Alcohol can also affect memory and concentration, both of which are common for borderlines in times of stress or dissociation.

Borderlines are already impulsive and have a high risk of self-harming behavior. Alcohol makes people lose their inhibitions just the same and increases the risk of suicide. Combined, the two make things worse. Alcohol abuse can easily push a person over the edge, especially if they’re already close to it.

While alcohol often feels like a cure for symptoms of depression and anxiety, it actually worsens both over time. In regards to BPD, it can exaggerate all symptoms, which are probably not mild, to begin with.

alcohol and bpd
Alcohol and BPD may have several effects, like unhealthy coping, unstable behavior, and a dysfunctional lifestyle.

Dysfunctional Lifestyle

Alcoholism can lead to neglect in self-care, relationships, work, and finances. Something that many people with BPD have to deal with even if they’re sober. A person with alcoholism may be missing out on responsibilities due to drinking or a hangover, while a person with BPD may do so because they believe socializing leads to them being hurt.

To cover up these faults, alcoholics may lie about their use or act in a manipulative way. This is something borderline people are often accused of and may do subconsciously as a means of preventing abandonment.

Codependent Relationships

Borderlines can get easily attached to a person and have a hard time letting go of a relationship, even if it gets violent. It is also not uncommon for someone with BPD to end up with someone with harmful narcissistic traits. Those people tend to exhibit the exact characteristics the borderline yearns for. They appear caring, but they end up controlling or abusive. But due to fear of abandonment, it is not easy to leave, even if things get bad. Likewise, alcoholics, especially women, tend to end up in codependent relationships, especially if their partner is an alcoholic too.

A Traumatic Past

The causes behind BPD are unclear but are believed to be a mix of genetic predisposition and how the person was raised, with childhood trauma playing a significant part. With alcoholism, there is also usually some sort of underlying issue, not necessarily a disorder, but some reason for why a person turns to alcohol.

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Warning Signs of Alcohol Abuse

As stated by the National Institute on Alcohol Abuse and Alcoholism, these are the signs to be aware of in terms of this condition: 

  • Appearing intoxicated more regularly
  • Appearing tired, unwell, or irritable
  • An inability to say no to alcohol
  • Becoming secretive or dishonest
  • Drinking more, or longer than one intended
  • Want to cut down or stop drinking, or tried to, but haven’t been able to do so 
  • Spending a lot of time drinking, being sick, or getting over the aftereffects
  • Experiencing craving, a strong need, or an urge to drink
  • Founding that drinking, or being sick from drinking, often interferes with taking care of your home or family, job troubles, or school problems
  • Continuing drinking even though it was causing trouble with family or friends
  • Giving up or cutting back on activities that are important or interesting to you, in order to drink
  • More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)
  • Continuing to drink even though it was making you feel depressed, anxious, or adding to another health problem, or after having had a memory blackout
  • Having to drink much more than you once did to get the effect you want. Or finding that your usual number of drinks has much less effect than before
  • Finding that when the effects of alcohol are wearing off, you have withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating.

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