Substance misuse is common in a lot of mental health conditions, but is especially prevalent in BPD. Those with BPD suffer from a distorted perception of themselves and others, which can lead to impulsive actions and unstable relationships, as well as living with intense and overwhelming emotions. People with BPD may turn to substance use to help cope with their disorder

Substance misuse is when substances, such as illegal drugs, medications or alcohol, are not used as intended but are instead used in a harmful way. It’s an unhealthy way to help cope with stress, distress or anxiety. Substance use can become an addiction.

Substances can be a way to disconnect from their feelings, but this relief is only temporary, and the person continues to chase temporary relief, which begins the cycle of addiction.

Addiction can exacerbate and magnify the symptoms of BPD. When BPD and addiction occur in tandem, it can lead to impulsive and destructive behaviour, mood swings, anger, depression, loss of concern for wellbeing, and instability.

Using the four skills learned in DBT can be useful when dealing with addictive behaviours:

• mindfulness – being aware of our feelings and accepting them without judgment
• distress tolerance – learning to pause and identify the stressor and our emotions, learning to deal with them in more healthy ways
• interpersonal effectiveness – being able to know how we feel and ask for help, talk about what we need or want
• emotional regulation – learning how to cope with the reactionary emotion, preventing an escalation