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Alcoholism and Borderline Personality Disorder

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Updated April 22, 2014

Unfortunately, borderline personality disorder (BPD) frequently co-occurs with other conditions that impact mental health. Alcoholism is one disorder that is common among people with BPD. Read on to learn more about the prevalence of alcoholism in BPD, the reasons that alcoholism and BPD occur together so often, and how to get help for yourself or a loved one with alcoholism and BPD.

The Prevalence of Alcoholism in BPD

There is a remarkable overlap between substance abuse disorders and borderline personality disorder. One study found that about 60% of patients in psychiatric hospitals who have been diagnosed with BPD also have a co-occurring substance use disorder (the symptoms and course of BPD and the substance use disorder overlap). The most common substance use disorder among people with BPD is alcoholism. It has been estimated that about 50% of people with BPD in inpatient treatment settings are also alcoholics.

Effects of Co-Occurring Alcoholism and BPD

Unfortunately, there is also evidence that people with both BPD and alcoholism have more difficulties in their lives and are less responsive to treatment than people who have only one of the disorders. For example, people with alcoholism and BPD are less likely to stay in substance abuse treatment, have more distress and suicidal thoughts, and are more likely to engage in other addictive behaviors (such as binge eating or gambling) than those with alcoholism who do not also have BPD.

Why Do Alcoholism and BPD Co-Occur So Frequently?

Why do people with BPD also often develop alcoholism? Most likely, several factors that account for the high rate of co-occurrence. First, BPD and alcoholism may share common genetic pathways. That is, some of the genes that put people at higher risk for BPD may also create higher risk for alcoholism. Also, there may be common environmental causes for alcoholism for BPD. For example, experiences of maltreatment in childhood (such as physical or sexual abuse, or emotional abuse or neglect), have been linked to both BPD and alcoholism.

But, there may also be other reasons for the link between alcoholism and BPD. Individuals with BPD may use alcohol to decrease the intense emotional experiences that are a hallmark of BPD. Because people with BPD have strong emotions frequently, casual use of alcohol may lead to abuse or dependence.

Getting Help for Alcoholism and BPD

If you or someone you care about is struggling with alcoholism and BPD, they need to get help. These two conditions are not easily tackled alone. These resources can help you find help:

You may also want to consider Alcoholics Anonymous.

Learn more about alcoholism from About.com's Guide to Alcoholism, Buddy T.

Sources:

Zanarini MC, Frankenburg FR, Hennen J, Reich DB, & Silk KR. "Axis I Comorbidity in Patients with Borderline Personality Disorder: 6-Year Follow-up and Prediction of Time to Remission." American Journal of Psychiatry, 161:2108–2114, 2004.

Miller FT, Abrams T, Dulit R, & Fyer M. "Substance Abuse in Borderline Personality Disorder." American Journal of Drug & Alcohol Abuse, 19:491–497, 1993.

Morgenstern J, Langenbucher J, Labouvie E, & Miller KJ. "The Comorbidity of Alcoholism and Personality Disorders in a Clinical Population: Prevalence Rates and Relation to Alcohol Typology Variables." Journal of Abnormal Psychology, 106: 74–84, 1997.

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