Nearly half of people with BPD will struggle with alcohol use at some point in their lives. It’s not just about drinking too much—it’s often about trying to manage overwhelming emotions, soothe inner pain, or escape the chaos that BPD can bring. For many families, this combination is confusing and heartbreaking. But understanding why these two challenges so often go hand-in-hand can bring clarity, compassion, and hope for more effective support and healing.
A quick look at borderline personality disorder
BPD affects how a person manages emotions, relates to others, and sees themselves. It’s often described as a disorder of emotion dysregulation—meaning people with BPD feel emotions more intensely, more frequently, and for longer periods of time than others. These emotional highs and lows can lead to impulsive behaviors, rocky relationships, and a fragile or shifting sense of identity.
Symptoms of BPD
- Extreme high and low moods, without an even middle ground
- Feelings of emptiness
- Difficulty controlling anger
- Suspicious of other people and their actions
- Depression
- Anxiety
- Negative self-image
- Suicidal and self-harming thoughts and behaviors
Other conditions often co-occur
Most people diagnosed with BPD also meet criteria for at least one other psychiatric disorder, like:
- Mood disorders like bipolar and depression
- Anxiety disorders
- PTSD and trauma-related conditions
- Substance use disorder
- Eating disorders
- Another personality disorder
The connection between BPD and alcohol addiction
There’s no single answer as to why people with BPD are more prone to drug and alcohol misuse. Instead, there are a few popular theories that may explain the connection.
Shared personality traits and genetics
Both BPD and alcohol use disorder (AUD) are linked to impulsivity, emotional instability, and disinhibition.
Emotion dysregulation
The high highs and low lows of borderline personality disorder can make alcohol especially appealing. People with BPD experience emotions more intensely, and when drinking, it can make pleasurable experiences seem euphoric. On the other hand, drinking can be used to reduce emotional pain—which can quickly become a habit.
Developmental and environmental factors
Childhood trauma (especially abuse or neglect), poor attachment, and early family dysfunction are commonly implicated in both disorders.
Integrated treatment can help
Recovery from alcohol addiction is possible, and so is learning to manage the symptoms of BPD. Treatment for these co-occurring disorders considers both at the same time. That means that when your loved one stops using alcohol, they’ll learn more about the impulsive, disinhibited behaviors that BPD causes. They’ll also find healthier ways to regulate their emotions that don’t involve turning to drugs or alcohol.
Red Oak offers co-occurring borderline personality disorder and alcohol addiction treatment for men. Our team will work closely with your loved one to create a personalized treatment plan that’s meaningful for their future in recovery.
The Red Oak approach
Many of our clients find success in treatment with a combination of medication-assisted treatment (MAT), behavioral and talk therapies, group support, and experiential outdoor therapies at our center in the beautiful Blue Ridge Mountains.
Our team of clinicians are experienced in delivering a wide range of therapies, including:
- Cognitive-behavioral therapy (CBT): This can be a very effective treatment program for both substance abuse and BPD. This type of behavioral therapy works through thoughts and feelings to address negative thinking patterns.
- Dialectical behavior therapy (DBT): A method originally developed specifically for people with BPD, which has since been found to be helpful for substance abuse and other mental health concerns. DBT focuses on developing skills in four key areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
- Medication-assisted treatment (MAT): Withdrawal symptoms and cravings can be very severe, depending on the addiction. MAT makes cravings more manageable so that skills learned in therapy can be learned more effectively.
- Medication management: There is no specific medication for BPD, but some people respond well to prescriptions that manage co-occurring conditions like depression, anxiety, and PTSD.
- Experiential therapy: Being outdoors and in nature can be very therapeutic. Being on a campus like Red Oak’s in Western North Carolina allows clients to take full advantage of the wilderness environment as part of the treatment experience.
Treatment at Red Oak Recovery® considers the whole person with therapies that work to improve both physical and mental well-being. Recovery is possible, and we’re here to help.
Reach out for help today
Our gender-specific campus for men can be the right place for your husband, son, or brother to find a new way forward. Each one of our clients receives a full intake assessment so our masters-level clinicians can design a plan that meets their individual needs—and your loved one will receive the same. They’ll work in two to three one-on-one sessions with a certified therapist every week and have group sessions with peers and family.
Don’t wait to reach out. Call 828.382.9699 or contact us online and let us help.
