Breaking The Shame Cycle In Recovery
David Hampton ❘
I am convinced that we are as addicted to shame as we are to substances and compulsions. Let's consider how shame can become a shame cycle.
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Addiction and mental illness often go hand in hand. In fact, SAMHSA estimates that 8.9 million adults with substance use disorders also have a mental health disorder. Some of the most common co-occurring disorders include alcoholism and antisocial personality disorder, Marijuana addiction and schizophrenia, Cocaine addiction and anxiety disorders, Opioid addiction and PTSD, and Heroin addiction and depression.
As Mental Health Awareness Month comes to a close, we thought we’d shed some light on a lesser-known condition that co-occurs with addiction: borderline personality disorder (BPD). BPD is a serious mental illness marked by instability in moods, behavior, and relationships, according to the National Institute of Mental Health.
Approximately two-thirds of people with borderline personality disorder abuse alcohol or drugs.
The co-occurrence of borderline personality disorder and substance use disorder causes extreme emotional imbalance, increases the likelihood of poor treatment outcomes, and elevates the chance of suicide. Because of these things, a proper diagnosis and specialized treatment program are paramount to recovery.
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Those with borderline personality disorder have difficulty regulating their emotions, which leads to severe mood swings, impulsivity, instability, poor self-image, and trouble with personal relationships. These factors make those with BPD more prone to high-risk behaviors, such as promiscuity and substance use, and compulsive behaviors, like eating disorders and gambling.
There is no medical test to diagnose borderline personality disorder. Instead, a mental health professional must complete a comprehensive psychiatric interview, which can include a medical evaluation, a review of past medical records, and speaking with not only the patient but also their friends, family, and previous doctors. A BPD diagnosis is not based on any particular symptom. Instead, according to the Diagnostic and Statistical Manual of Mental Disorders and the National Alliance on Mental Illness, 5 or more of the following symptoms indicate borderline personality disorder:
Some people with borderline personality disorder use drugs and alcohol in an attempt to cope with their volatile moods or to “numb the pain.” However, the use of these substances can make many of the symptoms of BPD worse.
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Substance use disorders and borderline personality disorders often present with similar symptoms, making a dual diagnosis difficult. As stated on dualdiagnosis.org, the following symptoms characterize both BPD and addiction:
Given the volatile nature of both borderline personality disorder and addiction, treating these co-occurring disorders can be very difficult. One major challenge is getting the patient to not only follow the treatment plan but also stay in it. Because of the mood swings and paranoia that present with BPD, the patient-therapist relationship can be rocky; many patients drop out of treatment. Relapse rates for dual diagnoses are also very high, so sticking with treatment is critical for co-occurring borderline personality disorder and addiction patients.
Finding a program that specializes in treating co-occurring disorders, with experience working specifically with BPD patients, is extremely important.
Because of the physical dependence that can accompany drug and alcohol addiction, addressing the substance use issue is necessary and sometimes requires detox: the process of removing toxins from the body left over from extended drug and alcohol use. With the patient clean and clear-headed, therapies to address both borderline personality disorder and substance use disorder will be much more successful.
Of the few studies that have researched the effectiveness of treatment for co-occurring BPD and addiction, several treatment options seem to show promise:
Although there is no official cure for borderline personality disorder or addiction, both conditions are completely treatable. If you or someone you know needs help finding a treatment program, please contact a treatment provider today.
Jeffrey Juergens earned his Bachelor’s and Juris Doctor from the University of Florida. Jeffrey’s desire to help others led him to focus on economic and social development and policy making. After graduation, he decided to pursue his passion of writing and editing. Jeffrey’s mission is to educate and inform the public on addiction issues and help those in need of treatment find the best option for them.