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Treatment for Borderline Personality Disorder and Addiction in North Carolina

Medically Verified: 2/1/24

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All of the information on this page has been reviewed and verified by a certified addiction professional.

The National Institute of Mental Health defines borderline personality disorder as “an illness marked by an ongoing pattern of varying moods, self-image, and behavior.”[1] Individuals suffering from this condition commonly struggle with interpersonal relationships, impulsive behaviors, intense mood swings, and a fleeting self-image. Borderline personality disorder (BPD) causes individuals to view things in black and white, causing their image of friends, family, and loved ones to shift often. This makes it difficult for the individual to maintain healthy relationships.

Because of this, people with borderline personality disorder often turn to drugs and alcohol to cope. While the substances temporarily provide relief, this leads to addiction and the exacerbation of BPD symptoms. These co-occurring disorders must be treated professionally and simultaneously for treatment to be effective. Treatment for borderline personality disorder and addiction in North Carolina typically involves dual diagnosis care, clinically proven BPD therapies, and medication.

The Co-Occurrence of Borderline Personality Disorder and Addiction

According to The National Institutes of Health, “Borderline personality disorder (BPD) affects 2.7% of adults. About 78% of adults with BPD also develop a substance-related disorder or addiction at some time in their lives.”[2] This means that more than half of the individuals diagnosed with BPD also struggle with addiction.

One of the biggest factors that cause these conditions to co-occur is the prevalence of impulsive behaviors associated with BPD. Additionally, individuals with borderline personality disorder are more vulnerable to developing an addiction because of their yearning desire to soothe their extreme moods and emotions. With that being said, it is more common for a borderline personality disorder to precede substance abuse. However, some individuals may develop BPD after abusing drugs and alcohol.

Comorbid borderline personality disorder and addiction is dangerous. Abusing drugs and alcohol will only exacerbate the symptoms of BPD, causing the individual more suffering in the long run. The treatment of comorbid BPD and addiction is complicated, however, with evidence-based dual diagnosis practices, recovery is possible.

Evidence-Based Treatment for Borderline Personality Disorder and Addiction

Comorbid borderline personality disorder and addiction must be treated simultaneously. If an individual were only treated for one condition, the secondary condition would cause a relapse in the other. Because of this, dual diagnosis treatment centers in North Carolina combine traditional addiction treatment practices with evidence-based BPD therapies.

Dialectical Behavior Therapy for Substance Use Disorders (DBT-SUD)

Dialectical Behavior Therapy (DBT) is the most commonly used treatment for borderline personality disorder. When a patient has comorbid BPD and addiction, they will be treated with a form of DBT called Dialectical Behavior Therapy for Substance Use Disorders (DBT-SUD). DBT-SUD combines traditional DBT methodologies with addiction prevention strategies.

DBT-SUD helps patients develop healthy coping mechanisms to manage their emotions, cope with distressing events, and improve interpersonal relationships. Additionally, patients will be taught problem-solving techniques to prevent themselves from relapsing on drugs and alcohol.

Schema-Focused Therapy

Schema-focused therapy is a form of treatment that helps patients with BPD and addiction to uncover and work through their maladaptive schemas. To explain, schemas are unhealthy patterns that typically develop as a result of unmet needs during early childhood. Experts have found that BPD and addiction may be linked to early childhood trauma, making schema-focused therapy extremely effective for these co-occurring disorders.[3]

Schema-focused therapy addresses the following schemas:

  • Disconnection and rejection
  • Impaired autonomy and performance
  • Impaired self-control, boundaries, and limits
  • Issues with putting oneself before others
  • Overviilance and inhibition

Mentalization-Based Therapy (MBT)

Mentalization-based therapy (MBT) teaches patients to understand how their actions are influenced by their current mental states. This is extremely effective for BPD, as individuals with this condition struggle with rapidly shifting moods and impulsive behaviors that they later regret after experiencing an episode. MBT teaches patients with BPD how to recognize and work through uncomfortable emotions before they lead to damaging behaviors.

Additionally, mentalization-based therapy is a great tool for addiction recovery as issues with substance abuse stem from a desire to self-medicate uncomfortable emotions. MBT helps addicts learn how to identify the emotions that trigger their addictive behaviors. This teaches them how to replace the negative coping mechanism of substance abuse with positive coping mechanisms.


Medication is tricky when it comes to the co-occurrence of BPD and addiction. Technically, there is no medication for borderline personality disorder. However, individuals may be prescribed anti-anxiety medications for the symptoms of depression and anxiety that their BPD causes.

Additionally, while there are medications for addiction, BPD increases the individual’s chances of abusing those medications. Because of this, medication-assisted treatment (MAT) for addiction must be utilized with extreme caution among patients diagnosed with BPD.

Continued Care

When it comes to treatment for addiction and BPD, continued care is vital for one’s recovery. Both conditions cannot be cured, however, they can be managed. In other words, individuals in recovery from BPD and addiction must continually practice their recovery techniques to avoid a relapse.

Continued care for BPD and addiction may include:

  • Ongoing individual therapy for both conditions
  • Group counseling
  • Family therapy
  • Sober living programs
  • Addiction support groups such as AA or SMART Recovery
  • Support groups for BPD
  • Alumni meetings

Find Treatment for Borderline Personality Disorder and Addiction in North Carolina

Treating borderline personality disorder and addiction can be challenging, however, dual diagnosis treatment programs like Carolina Recovery Center are experienced in the treatment of co-occurring disorders.

Carolina Recovery Center provides each patient with an individually-tailored, comprehensive treatment plan that includes evidence-based approaches to addiction and BPD treatment. By combining behavioral therapies, pharmacotherapies, group counseling, and addiction education, we provide our patients with a solid foundation of recovery.

Contact us today for more information on our dual diagnosis treatment program in North Carolina.