How alcohol affects people with Borderline Personality Disorder (BPD)

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Borderline personality disorder (BPD) and alcoholism are commonly co-existing conditions, and the consequences of this relationship could be very severe.

Understanding the condition itself, the reasons people with BPD are more susceptible to alcoholism and the potential consequences helps you see the affect alcohol can have. Addiction itself is a psychological condition, and when it occurs alongside another mental illness the risks are exacerbated. Although alcohol is legal, it is potentially a very damaging substance, particularly when it is misused in order to solve other problems in the individual’s life.

Borderline personality disorder

BPD is basically a dysfunctional method of dealing with fear and emotional pain. The result of this fear is a generally erratic personality, with emotional “episodes,” unstable relationships, disproportionately intense anger for a given situation and a profound sense of “emptiness” on the inside. Someone suffering from the condition will be dramatic, emotionally needy and often manipulative. One of the common symptoms of the condition is risky behaviour, which can take the form of excessive spending sprees or the use of alcohol and drugs. It basically causes a problem with impulse control, which contributes to the erratic nature of their personality.

Self medication

One of the effects alcohol has on people with BPD is to effectively dampen the symptoms of their condition. Alcohol shares many properties of a depressant, which means that it reduces activity in parts of the brain. For somebody with BPD, this is actually often a positive aspect of the drug, because it basically turns down the constant chatter and obsessions of the sufferer’s mind. A sufferer describes the effect on her blog as “numbing my mind. Quieting the obsessive ruminations. Stilling the self-hatred and worthlessness that I created.”

Immediate gratification

A characteristic trait of BPD is the inability to control their impulses, so they’re always searching for instant gratification. According to University of Madrid researcher Gabriel Rubio, around 50 percent of alcoholics have co-existing problems with impulse-control. In combination with the assumption that alcohol can be used to dampen the effects of the condition, this search for immediate gratification makes drinking the preferred solution to their problems. Psychological therapy is often seen as a long-drawn out process, and the erratic nature of the individual’s personality often means they don’t stick with one therapist for very long. Alcohol apparently “solves” the problems pretty much immediately, so individuals increasingly turn to it for support.


Alcohol is an addictive drug, and this is especially likely when it is being used to solve problems. This means that someone using alcohol to manage the effects of their condition will eventually become physically dependent on it. Addiction to any substance alters the neurochemistry of the brain, and it has to adapt in order to continue functioning as normal. This causes tolerance – where the individual needs more of the substance to achieve the same effects – and dependence. The individual needs alcohol to feel normal, and stopping drinking will cause unpleasant withdrawal symptoms.

Physical risks

There are severe risks if alcohol abuse continues. Alcohol’s main negative effect is on the liver, and alcoholic liver disease is a three-stage process. After developing alcoholic fatty liver and moving to hepatitis, cirrhosis can develop. The liver tissue is gradually replaced with scar tissue, which affects liver functioning and can be fatal. Alcohol abuse can also lead to liver cancer, pancreatitis and diabetes. The only way to avoid these symptoms is to find suitable psychological treatment which takes into account both the BPD and the alcoholism. You should also seek medical assistance during withdrawal (after stopping drinking) if the individual is drinking heavily.