Treating Borderline Personality Disorder and Alcohol Abuse Together: How Dual-Diagnosis Treatment Works

While it’s challenging to understand someone’s personal experience with borderline personality disorder, things get even more complicated when alcohol addiction is also involved. Together, BPD and alcohol abuse compound each other’s symptoms and risks. Luckily, the leading treatment centers have found that treating these disorders simultaneously offers the best recovery outcomes.

Borderline personality disorder can be very hard to understand from the outside. But it is also confusing for the person who suffers. It is a disorder characterized by unpredictability. People with BPD find instability in their relationships with others and even with themselves. This can intensify their fears and leave them feeling lonely and unsupported.

It can be extremely overwhelming to be in the mind and emotions of borderline personality disorder. It can feel as if they are just along for the ride of their doubts, fears, and feelings of worthlessness. If you know someone with BPD, they may be trying hard to rein in their reactions and sensitivity. Yet, without clinical treatment, recovery will always be at arms reach or further. Alcohol may seem like a reasonable way to cope with the symptoms of borderline personality disorder. It’s accessible and can numb the pain for a time.

However, when borderline personality disorder and alcohol abuse occur together, the risks are even greater for one’s overall well-being. Fortunately, expert attention and care can make an enormous difference in mental health, long-term safety, and quality of life.

What Risks Do Borderline Personality Disorder and Alcohol Abuse Pose Together?


The intensity of mood swings, fear of abandonment, and disconnection from oneself is distressing enough for someone living with borderline personality disorder. Beyond these symptoms, instances of self-harm and impulsivity are also very common. Hence, it can be a dangerous disorder when left untreated.

Self-medication with alcohol or other substances multiplies the dangers of BPD. Symptoms already present can become more serious, and alcohol can bring an additional layer of impulsivity and poor judgment. Let’s look at some of the symptoms possible with borderline personality disorder that are compounded by alcohol use disorder:

  • Intentional self-harm
  • Suicidal ideation and attempts
  • Unstable relationships with family and friends
  • Destructive or abusive romantic relationships
  • Disruptive challenges with working or going to school
  • Poverty or homelessness
  • Problems with the law
  • Overall emotional instability

In short, alcohol use as self-medication does not improve BPD symptoms, and it is counterproductive to recovery outcomes. BPD can also make alcohol abuse worse. And substance abuse is just one of the co-occurring disorders common alongside borderline personality disorder. Anxiety or depression disorders are often present simultaneously, as are eating disorders.

Not only are the symptoms complicated when borderline personality disorder and alcohol abuse are co-occurring, but this also makes an accurate diagnosis more difficult to reach. A BPD diagnosis already tends to be challenging to isolate. Symptoms can echo those of other disorders, particularly depression. With a substance abuse disorder also involved, it’s even more challenging to wade through the signs and symptoms to reach precise diagnoses.

It’s also that much more important that someone receives an accurate diagnosis so they can get the most appropriate and timely treatment. This challenge calls for an expert assessment. A residential treatment center is the best place to be for this evaluation because there are diverse and immersive treatment options readily available.

What Can You Expect from Dual-Diagnosis Treatment for BPD and Substance Abuse?


Co-occurring mental health disorders and substance use disorders are both common and alarming. The treatment itself for co-occurring disorders is more challenging, but these clients are in even more urgent need of help. Fortunately, quality options for dual-diagnosis treatment are becoming more common as well. In these long-term residential treatment settings, BPD and alcohol addiction are addressed as interrelated disorders and treated as such. Just as we’ve noted the layers of symptoms, dual-diagnosis treatment helps clients to work through the many layers of mental illness.

Treatment for Borderline Personality Disorder

Treatment for borderline personality disorder typically involves a combination of therapy and medication for the best recovery outcomes. Most notably, psychotherapy techniques can help bring greater awareness to negative thoughts and feelings, guide emotional regulation, and better navigate interpersonal relationships. These treatments include:

  • Cognitive behavioral therapy
  • Dialectical behavior therapy
  • Psychodynamic Psychotherapy

Treatment for Alcohol Use Disorder

One of the most powerful treatment approaches for alcohol use and other substance use disorders is a therapeutic community model. Peer support through structured groups and community living serves as an evolving support system. Many others in treatment are also working to pave their recovery journey with co-occurring mental health and substance use disorders. Together, they can share relatable stories and coping strategies that work. Meanwhile, a case manager will regularly ensure that a client’s work in addiction recovery is supporting their progress in BPD recovery, and vice versa.

The Benefits of Dual-Diagnosis Treatment

Both BPD and addiction pose serious short-term and long-term risks for an individual’s health and quality of life. It’s also true that having BPD can mean that a client is less likely to remain in treatment for alcohol abuse, and having alcohol use disorder can mean that a client is less likely to maintain treatment for BPD. A dual-diagnosis treatment model takes into account these complications. Treatment centers also take into account the importance of family involvement for critical support in recovery and for developing healthier relationships into the future. In other words, the best treatment is as well-rounded as the individuals who travel the recovery path.

BrightQuest is a long-term residential treatment program for people struggling with mental health disorders as well as co-occurring substance use disorders. Contact us to learn more about our renowned San Diego-area program and how we can help you or your loved one begin the journey toward recovery.