BPD And alcohol scaled
Written by: THE BALANCE
Medically reviewed by Dr. Sarah Boss, MD
Last updated: February 7, 2026
Fact checked
Quick Summary
  • Borderline Personality Disorder (BPD) and Alcoholism are two mental health conditions that often occur together.
  • BPD is a mental illness characterized by intense and unstable emotions, impulsive behavior, and distorted self-image.
  • Alcoholism, on the other hand, is a chronic disease characterized by the compulsive need to drink alcohol despite its negative consequences.
Reading time: 9 min

Borderline Personality Disorder (BPD) and Alcoholism are two mental health conditions that often occur together. BPD is a mental illness characterized by intense and unstable emotions, impulsive behavior, and distorted self-image. Alcoholism, on the other hand, is a chronic disease characterized by the compulsive need to drink alcohol despite its negative consequences.

Studies have shown that individuals with BPD are more likely to struggle with alcohol abuse and addiction compared to the general population. In fact, up to 60% of individuals with BPD have reported alcohol abuse or dependence at some point in their lives. This high rate of co-occurrence between BPD and Alcoholism raises questions about the nature of the relationship between these two conditions.

Borderline Personality Disorder (BPD) is a mental illness characterized by intense and unstable emotions, impulsive behavior, and distorted self-image. Alcoholism, on the other hand, is a long-term disorder that causes a strong desire to drink and makes it hard to stop drinking. While these two conditions may seem unrelated, research has shown that there is a strong link between BPD and alcoholism. (source: Centers for Disease Control and Prevention)

Alcohol Blackouts and Personality Changes

One of the most severe consequences of alcoholism is alcohol blackouts. Alcohol use disorders are classically recognized when an individual’s alcohol consumption or abuse causes significant difficulties in school, education, relationships, work, or health. Some people with alcohol use problems or alcoholics will drink to the point where their memories are blank; this is described as a blackout. During an alcohol blackout, an individual cannot recall events that occurred while they were drinking. This is because alcohol interferes with the brain’s ability to encode memories.

For individuals with BPD, alcohol blackouts can have serious consequences. The intense emotions and impulsiveness that are associated with BPD can be exacerbated by alcohol, leading to risky and dangerous behavior. In addition, the memory loss associated with alcohol blackouts can make it difficult for individuals with BPD to understand the root causes of their behavior and to make positive changes. (source: National Institute of Mental Health)

Split Personality Changes When Drinking

Alcohol can also trigger severe personality changes in individuals with BPD. This is because alcohol interferes with the brain’s ability to regulate emotions and control impulses. As a result, individuals with BPD may behave in ways that are out of character when they are drinking. This can include engaging in impulsive and risky behavior, lashing out at others, or engaging in self-harm.

Borderline Alcoholic (source: American Psychiatric Association)

The term “borderline alcoholic” is often used to describe individuals with BPD who struggle with alcohol abuse and addiction. This term highlights the close relationship between BPD and alcoholism, as well as the severe consequences of combining these two conditions.

Individuals with BPD who are also struggling with alcoholism are at a higher risk of developing other mental health problems, such as depression and anxiety. They are also at a higher risk of experiencing negative consequences related to their drinking, such as job loss, financial problems, and legal trouble.

BPD And Alcohol Blackouts [4]

Alcohol blackouts are a common and dangerous consequence of alcoholism. For individuals with BPD, alcohol blackouts can be particularly concerning because they can lead to impulsive and risky behavior. Additionally, alcohol blackouts can make it difficult for individuals with BPD to understand the root causes of their behavior and to make positive changes.

Studies have found that individuals with BPD are more likely to struggle with alcohol addiction. In fact, research has shown that up to 60% of individuals with BPD also have a co-occurring substance use disorder, with alcohol being the most common substance of abuse. This is significantly higher than the general population, where only about 10% of individuals struggle with both a mental illness and a substance use disorder.

There are several things that could make it more likely for people with BPD to become alcoholics. One of the most significant is the presence of comorbid conditions, such as depression and anxiety. People with BPD often have strong emotions, such as feelings of emptiness and boredom, which can make them try to self-medicate with alcohol to feel better. (source: Substance Abuse and Mental Health Services Administration)

Additionally, individuals with BPD may also struggle with impulsive behavior, which can lead them to engage in risky behaviors, including excessive alcohol consumption. This impulsiveness can also make it difficult for individuals with BPD to control their alcohol consumption once they start drinking.

Multiple reasons are likely responsible for the high co-occurrence rate of borderline personality disorder and alcohol use disorder. First, it is possible that AUD and BPD share genetic pathways. Thus, some of the genes that increase an individual’s risk for BPD may also increase their risk for AUD.

Second, BPD and AUD may share common environmental origins. For instance, victimization, maltreatment, or abuse, including sexual or physical abuse, neglect, or emotional abuse, has been associated with both BPD and AUD. (source: World Health Organization)

Individuals suffering from BPD may use alcohol to alleviate the strong emotional responses that are a defining characteristic of the disorder.

Since people with BPD commonly experience intense emotions, self-medicating with alcohol may result in addiction or dependence.

Borderline personality disorder and alcohol addiction co-occur commonly since some people with BPD use alcohol to deal with and lower the intensity of their symptoms, such as: (source: NIMH, 2024)

  • Intense and chaotic feelings
  • Aberrant self-perception
  • Overwhelming worry and fear
  • Rage and anger
  • Emotional emptiness
  • Depression

As both disorders share many genetic pathways, there may be a genetic link between borderline personality disorder and alcoholism.

Another possible reason for the co-occurrence of alcohol use disorder and BPD, as well as cocaine and opiate usage, the three substances most closely associated with BPD, is discussed in the aforementioned study. [8]

Certainly, alcohol, cocaine, and opiates, all stimulate the endogenous opioid system (EOS), whose primary purpose is to alleviate pain and act in reinforcement and reward behaviors. Since BPD symptoms have been linked to EOS dysfunction, it is possible that people with BPD are more likely to abuse these three substances, which stimulate the EOS.

Symptoms of borderline personality disorder and signs of alcohol addiction share many similarities. Because of this, it might be difficult to determine whether a patient has one or both disorders. Among the many similarities between BPD and alcoholism are:

Unhealthy Coping [9]

Typically, alcoholics use alcohol as a coping technique. Whether it be stress, daily issues, or other emotions. So do individuals with BPD. Additionally, borderlines are inclined to consume alcohol frequently and excessively, which is generally a warning indication of alcoholism.

Unstable or Unpredictable Conduct

Alcohol changes the way the brain works, especially when it is used often or for a long time. Because of this, it can cause mood swings and violent outbursts, which are typical of BPD. Also, alcohol can make it hard to remember things and pay attention, both of which are common problems for borderlines during times of dissociation and stress. [10]

Borderlines are already aggressive and have a high likelihood of engaging in self-destructive behavior. Alcohol causes individuals to lose their inhibitions and raises the risk of suicide. Together, they make matters worse. Alcohol abuse can easily push a person over the edge, especially if they are already on the verge.

Despite the fact that alcohol frequently feels like a remedy for anxiety and depression it ultimately worsens both conditions over time. All BPD symptoms, which are presumably not moderate, to begin with, may be exacerbated.

Dysfunctional Lifestyle (source: NHS, 2023)

Negligence in self-care, relationships, jobs, and finances can result from alcoholism. Even when sober, many individuals with BPD must deal with this issue. An individual with alcoholism may avoid obligations due to alcohol drinking or a hangover, but an individual with BPD may avoid responsibilities because they feel socializing would result in them being harmed.

To conceal these flaws, alcoholics may cheat or lie about their drinking or engage in manipulative behavior. This is a common accusation against borderline individuals, who may subconsciously engage in this behavior to prevent desertion.

Dependency in Relationships (source: NICE, 2009)

Borderlines can become easily attached to others and have difficulty ending relationships, especially if they become aggressive. It is also not uncommon for someone with BPD to get involved with or be in a relationship with a narcissist in a way that is not healthy. Narcissists frequently exhibit the characteristics that the borderline seeks. They appear compassionate but are ultimately dominating or abusive. But because of a fear of being left alone, it is hard to leave, even if the situation gets worse.

In the same way, alcoholics, especially women, often end up in codependent relationships, particularly if their partner is also an alcoholic.

Learn how to recognize a codependent relationship, as well as how to leave one. (source: NHS, 2022)

A Tragic or Painful Past

The causes of BPD are unknown but are assumed to be a combination of genetic susceptibility and upbringing, with childhood trauma being a significant factor.

Alcoholism is typically accompanied by an underlying problem, not always a disorder, but a reason why an individual turns to alcohol. (source: StatPearls, 2024)

Borderline Personality Disorder and alcoholism are two conditions that can have a significant impact on mental health. To treat and help people with these conditions effectively, it is important to know how they are related. With the right combination of therapy, medication, and support, individuals with BPD and alcoholism can learn to manage their symptoms and live healthy and fulfilling life.

FAQs

Do Most Alcoholics Suffer From Personality Disorders?
While alcoholism and personality disorders are often co-occurring, not all alcoholics suffer from personality disorders. However, research has shown that individuals with certain personality disorders, such as BPD, are more likely.
What Is The Impact Of BPD and Alcoholism On Mental Health?
The relationship between BPD and alcoholism can have a significant impact on mental health. Alcohol can worsen symptoms of BPD, including intense emotions, impulsive behavior, and a distorted self-image. This can lead to further difficulties in managing one’s emotions, which can in turn lead to increased alcohol consumption and a vicious cycle of alcohol abuse and BPD symptoms.
Furthermore, alcohol can also interfere with the effectiveness of medications and therapies used to treat BPD. This can make it more difficult for individuals with BPD to manage their symptoms and can lead to further deterioration of their mental health.

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