Mental health
Borderline personality disorder and addiction
Published October 22, 2024 · 7 min read · Updated April 2026
Reviewed for accuracy by licensed clinical professionals.
BPD and substance use disorders co-occur in approximately 50-70% of cases, one of the highest co-occurrence rates in psychiatry.
Why they co-occur
Emotional dysregulation is central to BPD. Substances provide temporary emotional regulation. Impulsivity is a core BPD trait. Unstable relationships create chronic distress. Self-harm and substance use serve similar functions.
DBT: The treatment
Dialectical Behavior Therapy was designed for BPD and adapted for addiction. Teaches emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness. DBT addresses both conditions simultaneously.
Frequently asked questions
Why do BPD and addiction co-occur?
Both involve emotional dysregulation and impulsivity. Substances temporarily manage the intense emotions BPD produces.
What treatment works for BPD and addiction?
DBT is the gold standard, designed to address emotional dysregulation that drives both conditions.
Can BPD be treated?
Yes. DBT produces significant improvement in BPD symptoms, reducing both self-harm and substance use.
Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.