For a long time, the link between mental disorders and addictions has been of interest to researchers, who have, incidentally, confirmed that existing mental health problems significantly increase the likelihood of addiction. All possible types of personality disorders have been reported among patients who abuse various substances, but it is borderline that ranks particularly high in the statistics. There are several theoretical explanations for this phenomenon.
Table of contents:
- Addictions - but which ones?
- Borderline, addictions and gender
- Contributing factors of borderline
- Painkillers and borderline
- Cocaine and borderline
- Alcohol and borderline
Borderline is characterised by a lack of impulse control, anger and intense emotions. Self-image is sometimes disturbed in many patients and interpersonal relationships are significantly impaired. Borderline is a very common disorder that may require both inpatient and outpatient treatment. Understanding and appropriate treatment is extremely important, if only because of the high suicide rate among people with borderline, which can be as high as 7%. The extent of the disorder's prevalence is also worrying - in the United States, for example, it covers as much as 5.9% of the population. And while various mental illnesses and disorders can definitely be linked to the risk of addiction, it is worth emphasising that psychiatric disorders do not bring the same level of risk - using specific examples, we can say that personality disorders imply a much higher probability of addiction than, for example, schizophrenia.
Addictions - but which ones?
Statistics published by the journal Clinical Psychology Review show that borderline criteria are met by 14.3% of alcohol abusers, 16.8% of cocaine abusers and 18.5% of painkiller abusers. On the other hand, up to 44.3% of those with borderline are addicted to something. As can be seen, the aforementioned data, collected among both in-patients and out-patients, clearly indicate the co-occurrence of the aforementioned disorders. It should be added that there is an increased tendency for these problems to co-occur among younger people compared to older people, although age is not the causal factor. Rather, the presence of childhood trauma, which is a common substrate for borderline and addiction, is an important issue.
Borderline, addictions and gender
Subsequent studies have shown that males are significantly more likely than females to co-occur with borderline and addiction , with males showing significantly more frequent alcohol dependence. Other studies of in-patients have shown that substance abuse is also higher among in-patients who are male than female.
There are theories that men with borderline are much more likely to end up in prison, while women are more likely to end up in hospital for treatment. Others dispute similar claims, citing that men are over-represented in the substance abuse and borderline group because they create far more problems by failing to cope with their abuse. Men with borderline also tend to be paranoid, passive-aggressive, narcissistic and anti-social, which somehow automatically increases the propensity for addiction.
Addictions in the course of borderline, photo: panthermedia
Contributing factors of borderline
There is a theory that substance abuse can lead to borderline and vice versa. Chronic drug abuse, for example, can result in decreased serotonin levels and thus greatly increase the propensity for self-destructive and impulsive behaviour. Those who have a neurobiological tendency towards borderline may also be more sensitive to the effects of abusing different substances.
Of course, non-biological factors are not insignificant. Some researchers argue, for example, that the loss of an important relationship and other major stressors combined with substance abuse can lead to borderline. According to another hypothesis, people with borderline in such situations may turn to various substances for self-medication. The 'self-medication' theory is a psychoanalytically proven theory of addiction. Its genesis is not complicated - according to it, when considering addiction issues, we need to take into account the emotional and psychological dimensions of the patient. The context of the specific life situation in which the patient finds himself becomes important. Addiction is designed to modulate emotional states that are unbearable for the addict, and psychoactive substances help to modulate them. The self-medication hypothesis includes painkillers, cocaine and alcohol and refers to the way they interact with the addict's internal states. Given that these three substances are most prevalent among borderline patients, this theory requires detailed research.
Painkillers and borderline
Painkillers, in natural or synthetic form, are designed to reduce the pain experienced. As already mentioned, approximately 18.5% of borderline patients abuse painkillers. According to the self-medication hypothesis, people who have problems with anger and aggression are most likely to have experienced them in the past. Proponents of this theory argue that the abuse of painkillers has an adaptive function, drowning out the anger and aggression experienced by the addict.
Cocaine and borderline
According to other previous research, nearly 16.8 per cent of cocaine addicts also exhibit borderline personality disorder. The drug increases self-confidence, provides a sense of elevated mood, reduces fatigue, increases energy levels and productivity. The researchers divided cocaine addicts into two groups - high energy and low energy. The low-energy ones feel boredom, emptiness and fatigue, while the high-energy ones tend to seek the excitement and new sensations that the drug provides. Essentially, cocaine abusers seek to rid themselves of feelings of emptiness, boredom, depressive states and anxiety.
Alcohol and borderline
Alcohol acts as a kind of depressant that relaxes and calms those who use it. According to the self-medication hypothesis, alcohol abusers often experience rigid, restrained emotions. They avoid anxiety by dissociating from them, creating a rigid protective system. Alcohol use helps to shed this protective layer and release the restrained emotions. About 14.3 % of borderline patients abuse alcohol.
As can be seen from the examples above, there is a close link between substance abuse and psychiatric disorders, especially in terms of personality disorders and borderline.
Awareness of this close correlation can help those around patients, as well as therapists and doctors, to find the best possible treatment for people struggling with this particular disorder.
