Last Updated:

May 16th, 2025

Borderline Personality Disorder and Addiction | Symptoms and Support Options

What are personality disorders?

Personality disorders are mental health conditions that affect how a person thinks, feels, relates to others and manages day-to-day life. While everyone has their own quirks and ways of handling emotions or relationships, a personality disorder involves patterns of behaviour and inner experience that are deeply ingrained and significantly different from cultural expectations. These patterns can make life feel difficult not only for the individual but also for the people around them.

According to the Cassel Hospital charity, personality disorder affects around 4.4% of adults in the UK, which equates to roughly one in every 23 people. This highlights just how common the condition is, even though it often goes unnoticed or misunderstood.

man-with-Personality-Disorder

What are the different types of personality disorder?

There are ten recognised personality disorders by the DSM-V, each with its own set of traits and challenges. In this section, we focus on 5 personality disorders with a focus on signs and symptoms:

Borderline personality disorder (BPD)

People with BPD often experience intense emotions that shift rapidly and feel overwhelming. Relationships may become unstable, and the fear of abandonment can be difficult to manage. Mood swings and impulsive decisions are common, sometimes leading to self-destructive behaviour.

Symptoms may include:

  • Intense and unstable relationships
  • Fear of abandonment or rejection
  • Impulsive or risky behaviour
  • Self-harming or suicidal thoughts during emotional lows

Antisocial personality disorder (ASPD)

ASPD is marked by a persistent disregard for the rights of others, often beginning in childhood or teenage years. Individuals may act deceitfully, break rules or behave aggressively without remorse. They may also struggle with empathy and responsibility.

Symptoms may include:

  • Disregard for laws or social norms
  • Aggressive or violent behaviour
  • Lack of guilt or remorse
  • Frequent lying or deceit

Narcissistic personality disorder (NPD)

NPD involves an inflated sense of self-importance and a strong need for admiration. People with this disorder may seem confident, but underneath, they often struggle with self-esteem and are highly sensitive to criticism.

Symptoms may include:

  • Grandiose sense of self-worth
  • Need for excessive admiration
  • Sense of entitlement
  • Lack of empathy

Avoidant personality disorder

This disorder is characterised by extreme sensitivity to rejection or criticism. People with avoidant personality disorder may appear shy or socially withdrawn but their behaviour is driven by deep-rooted fear of being judged or embarrassed.

Symptoms may include:

  • Avoiding social situations due to fear of criticism
  • Feelings of inadequacy or inferiority
  • Reluctance to take personal risks
  • Desire for relationships but difficulty forming them

Obsessive-compulsive personality disorder (OCPD)

OCPD involves a preoccupation with order, control and perfectionism. Unlike OCD, which involves specific obsessions and compulsions, OCPD is more about rigid thinking and a need for control in everyday life and relationships.

Symptoms may include:

  • Excessive attention to detail and rules
  • Perfectionism that interferes with completing tasks
  • Rigidity in beliefs and routines
  • Reluctance to delegate tasks to others

The remaining five personality disorders are as follows:

  • Paranoid personality disorder
  • Schizoid personality disorder
  • Schizotypal personality disorder
  • Histrionic personality disorder
  • Dependent personality disorder

 

Is there a link between addiction and personality disorders?

There is a clear connection between personality disorders (PDs) and substance use disorders (SUDs), with comorbidity commonly seen in clinical settings. Borderline personality disorder (BPD) and antisocial personality disorder (ASPD) are especially linked with addiction, appearing more frequently in those seeking help for substance issues.

While PDs affect around 10% to 14.8% of the general population, this figure rises significantly among those being treated for addiction, ranging from 34.8% to 73%. Although both alcohol and drug use disorders are associated with PDs, the prevalence is notably higher in cases involving drugs, suggesting a stronger relationship between certain personality traits and drug misuse.

woman-with-Personality-Disorder

What comes first, the personality disorder or the addiction?

As with many co-occurring conditions, the relationship between PD and addiction can go both ways. However, current research leans towards the personality disorder often coming first. Evidence from both longitudinal and retrospective studies suggests that personality traits present in adolescence or early adulthood, can increase the risk of developing a substance use disorder later on.

That said, it’s important to remember that while PD can act as a risk factor, it isn’t a necessary condition for addiction to develop. Some people may struggle with substance use without ever meeting the criteria for a personality disorder.

What causes make those with PD more likely to develop an addiction?

Several pathways may explain why people with personality disorders are more vulnerable to substance misuse. These aren’t strict rules but rather ways of understanding how certain personality traits and coping mechanisms can influence addiction risk.

Behavioural disinhibition pathway

This is one of the most well-researched pathways and helps explain the strong link between PDs like ASPD and BPD and substance use. Traits such as impulsivity, a disregard for consequences and a tendency to seek out risky experiences can all contribute to early experimentation with substances and ongoing use. For people with these traits, drugs or alcohol may feel like a natural extension of their impulsive or risk-taking behaviours.

Stress-reduction pathway

This pathway focuses on those who are emotionally reactive, anxious or high in neuroticism. For these individuals, substances can become a way to cope with overwhelming feelings or stressful events. This pattern is often described as self-medication and is especially relevant in cases involving alcohol. In fact, research has found this pathway to be more common among females, with many developing alcohol use disorders later in life as a way of dealing with emotional distress.

Reward-sensitivity pathway

Some people are naturally drawn to new experiences, intense sensations or high levels of stimulation. For individuals who score high on traits like novelty-seeking and extraversion, substances, particularly stimulants like cocaine, can feel especially rewarding. In this case, it’s not about dulling emotional pain but about enhancing experiences and chasing pleasure, which can gradually evolve into dependence.

How are personality disorders and addictions treated in rehab?

Treating personality disorders requires a flexible and thoughtful approach, and when addiction is also present, it becomes even more important to consider the specific type of personality disorder involved. Each condition brings its own challenges, so rehab must be tailored to meet both emotional and behavioural needs.

Treatment usually begins with detox, where the focus is on safely clearing the body of drugs or alcohol while offering support through any withdrawal symptoms.

From there, the focus moves into therapy, often combining methods like Dialectical Behaviour Therapy (DBT), Cognitive Behavioural Therapy (CBT) and one-to-one counselling to address both the addiction and the personality traits that may be driving it.

As progress is made, aftercare becomes essential, providing continued support, structure and strategies to reduce the risk of relapse.

What are the next steps?

If you’re struggling with addiction and think a personality disorder may be playing a role, we’re here to help. Call Addiction Helper today for free, confidential advice and guidance on the right treatment options for you. Recovery is possible and it starts with reaching out.

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Our compassionate team are ready and available to take your call, and guide you towards lasting the lasting addiction recovery you deserve.

Frequently Asked Questions

Is Wellbutrin available in the UK?
Wellbutrin is not widely available in the UK for depression. Instead, Bupropion is prescribed as Zyban, mainly for smoking cessation rather than as an antidepressant.
Is Wellbutrin a stimulant?
Wellbutrin may have stimulant-like effects due to how it increases dopamine and norepinephrine levels. However, it is not classified as a stimulant like amphetamines or ADHD medications.
Can Wellbutrin cause weight gain?
Wellbutrin could affect weight, but it is more commonly linked to weight loss rather than gain. However, individual responses may vary, and some people may experience increased appetite.

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