Borderline Personality Disorder and Substance Abuse Treatment

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It is common for someone who has borderline personality disorder, or BPO, to abuse alcohol and drugs as a way to make them feel better and to alleviate some of the symptoms that they are dealing with. While they may assume that this is making them feel better, it is actually making some of the symptoms much worse than before. If the patient is dealing with BPD and substance abuse, they will need to seek treatment for a dual diagnosis to finally get the relief that they need.

But what is borderline personality disorder and why is it a big deal? BPD is going to be a pervasive pattern of instability in self-image, interpersonal relationships, and a marked amount of impulsivity and no control in the patient. These will often show up in the adult life of the patient, so it is hard to recognize them sometimes.

What are the Symptoms of BPD?

If you are worried that you are dealing with borderline personality disorder, you will need to be able to recognize some of the symptoms that come with this disorder. Before the patient is able to get a diagnosis of this disorder, they need to have a minimum of 5 of the symptoms below:

  1. They have a fear that they are going to be abandoned. This fear will make them do actions to avoid it at all costs.
  2. The patient is going to have intense relationships that are not consistent at all. They can fluctuate from some highs and lows, with the patient idealizing the other person often and then turning around and devaluing them the next.
  3. The patient is going to do activities that are damaging to them, such as substance abuse, driving dangerously, over spending, and binge eating to name a few.
  4. They have many self-harming behaviors, including being suicidal.
  5. The patient is going to have what is known as reactivity of mood. They may have intense issues with depression and anxiety.
  6. The patient is going to have a persistent feeling that they are empty.
  7. The patient is going to have anger that is not appropriate for the situation and they may struggle to control the temper.
  8. The patient is going to have paranoid ideation or dissociative symptoms when they feel stressed.

When five or more of these are present, it is likely that the patient is dealing with borderline personality disorder. The problem comes when most of them are not going to realize that they are dealing with the condition, so they will turn to substance in order to try and self-medicate and make themselves feel better in the process.

How is Borderline Personality Disorder and Substance Abuse Related?

When someone is dealing with BPD are more likely to deal with risky behaviors and being impulsive quite often. This population is going to suffer from addictions because they will use that as a form of self-medicating to feel better and because this is one of the bad and impulsive decisions that they will be driven to do by their disorder.

Because of the lack of good decision making skills and impulsivity, you will find that the patient with BPD may struggle when they start using drugs or drinking alcohol. This can lead to an addiction that is going to make the situation worse. The substance is going to cause the BPD to be worse, but the symptoms of BPD will make the patient continue on with the substance as well. These two are going to aggravate each other and without the right treatment for the borderline personality disorder and the substance abuse, the patient will not be able to get better.

Considering a Dual Diagnosis for Substance Abuse and Borderline Personality Disorder

When the patient has borderline personality disorder, they may not realize that the problem in the first place. They may see the symptoms, but not know that they are suffering from a disorder at all. This can make it difficult for them to handle things and they will look to self-medicate with the substance. The substance is going to make things worse. Add in the impulsivity where the patient is likely to run into decisions head on without thinking about it, so they will go out and party or use the substance when they should not.

When the two disorders come together, there can be a lot of confusion for the patient and they will run into trouble trying to handle both of the conditions. The symptoms of the substance abuse are going to get worse and the BPD will get worse as well. The patient will need to take a look at some of the treatment options that are available.

Choosing the right treatment option will make a difference on whether the patient is able to get the care that they need to feel better. They need to find one that is able to handle a dual diagnosis. If they work on just one of the conditions at a time, they will miss out some of the issues that will happen with the disorder and they will fall back into their own habits again. There are many great treatment options available for the patient to utilize to feel better, and they will be able to provide therapy, medication, and more for the patent to get better.

What Services Are Included with Borderline Personality Disorder and Substance Abuse Treatment?

When the patient is dealing with both BPD and substance abuse at the same time, they need to work with a treatment center that is able to handle both of the conditions. There are several steps that will happen in the treatment center, even though there are some things that will be different in each facility that you choose. Some of the steps that the patient should look for when it comes to these treatment centers include:

  1. Intake evaluation: During this time, the treatment team will take time to screen and assess the patient to figure out what is going on and whether the personality disorder is present along with the addiction. They can then work with the patient in order to create an integrated treatment plan to help them see success.
  2. Detox: Now it is time for the patient to go through a detox phase. If they still have the substance in their bodies, they need to take the time to remove it before any of the other treatment options can happen. This can take three to five days for most patients. When they do it in a treatment center, they will have the benefit of medical professionals watching them and making sure that they are safe the whole time. This can help them in case they are seriously hurt during the withdrawal.
  3. Medical maintenance: Each patient is going to be unique based on their case and the treatment that they will get. Medication can be prescribed for some patients, especially when it comes to the borderline personality disorder. They can use this to treat some of the issues like the anxiety and the depression.
  4. Psychotherapy: therapists are often going to use some type of psychotherapy to help the patient learn some of the healthy coping skills that they need to handle the disorder, rather than using the drugs like they have in the past. There are different options that will fit under this depending on what the medical team thinks will work the best for the patient. Some of the options that are often used include:
    1. CBT: This is a good option that will take a look at the behaviors, feelings, and thoughts of the patient and then works to improve some of their core beliefs that are maladaptive. It can then help the patient to work on most positivity and how to deal with issues in a healthy way.
    2. DBT: This is dialectical behavior therapy and it is going to work more on mindfulness than some of the others. This helps the patient to regulate their emotions and improve their relationships while kicking out the destructive behaviors that are holding them back.
  5. Group therapy: While the other methods are going to focus on individual therapy, there will also be lots of changes for the patient to work in group therapy. This is going to help them to improve their relationships with others and form some of the bonds and support group that they need. They can learn more about the disorder and improve their forms of expression better than before.
  6. Aftercare planning: When the patient is done with their treatment, there will also be an aftercare plan to help them out. The point of this is to make sure that they are able to handle the borderline personality disorder and the sobriety even when they are done. They will have options like medication, therapy, and support groups to help the patient to stay healthy.

All of these steps are important to ensure that the patient is able to get some of the care and attention that they deserve. They will have their plan personalized based on what works the best for them and will help them reach recovery from BPD and addiction better than before.

Should I Do Inpatient or Outpatient Treatment?

There are two main options of treatments for borderline personality disorder and substance abuse. These include inpatient and outpatient options. Both can be effective and it will depend on what works the best for the patient and their lifestyle.

The first option is the outpatient treatment center. During this the patient will get the therapy, support groups, and more that they need. But they will be able to leave the facility when they need to for work, school and their families. They may need to stay at the facility for a few days for the detox and then they are able to leave each day. These are sometimes seen as not effective as some of the other options, but can work for those who can’t stay in the treatment center all the time during treatment.

The inpatient treatment is often better for both of these disorders because it allows the patient to have time with medical professionals and will get the patient away from some of the negative environment and triggers that are going to make them fall back into their bad habits. In these treatment centers, the patient is going to spend all of their time at the facility, living and eating there as well.

How Long Will Treatment Last?

When you are looking into borderline personality disorder and substance abuse treatment, you may wonder how long the treatment is going to last. This will often depend on the patient and what seems to work the best for them. For patients who are just getting started with treatment, a shorter period of time in the treatment is going to be the best. For those who have tried treatment in the past and were not successful, then the longer options may be necessary.

Most treatment programs for co-occurring substance use and BPD disorders are going to last 30, 60, or 90 days, though there are some that will last for a little bit longer if the patient needs it. The longer treatment periods are going to be the best option because the patient is given more time to learn about their disorder and the treatment options that are available. But the patient will be able to see some great improvements, no matter which treatment option they go with.

Choosing the Best Treatment for Borderline Personality Disorder and Drug or Alcohol Abuse

When it comes to dealing with a personality disorder and substance abuse, it is important to have the right medical team and treatment options to help you do better. This will ensure that you do not end up with worse symptoms than before and will make recovery that much sweeter. Take the time to look into the best treatment for borderline personality disorder and substance abuse and get your life back on track.