Why Do So Many People With BPD Struggle With Substance Use?  episode artwork

EPISODE · Nov 7, 2025 · 33 MIN

Why Do So Many People With BPD Struggle With Substance Use?

from BPD Diaries: Stories and Science · host Stephanie Schildknecht

Your Addiction is a Solution (And That's the Problem)It’s not about partying, it’s about survival. For someone with BPD, substance use isn't the primary problem, it's a maladaptive solution to the problem of unbearable emotional pain. In this episode, we get real about the powerful link between BPD and addiction/substance use. If you've ever felt shame about your substance use, this episode offers a path to radical self-forgiveness and explains the integrated treatments (like DBT-SUD) that can help you build a life worth living, sober.Trigger Warning: This episode contains a frank discussion of addiction, substance abuse, and other sensitive topics. Listener discretion is advised.🌱 Have questions, stories, or something you’d like us to cover? We’d love to hear from you. Email us at [email protected]⁠⁠⁠⁠⁠ and let’s keep the conversation going.🎧 Looking for meditations made for emotional regulation, BPD, and more? Check out  Empowered Heroes Meditations  on ⁠⁠⁠⁠Spotify.If you’d like more support in your journey toward BPD recovery, Steff offers 1:1 sessions using evidence-based tools from DBT and Mindfulness to help you heal. Email for a free 30-Minute Consultation: 📩 [email protected] or check out the website: www.bpdsupport.org📚 Referenced Research Includes:Bornovalova, M. A., Lejuez, C. W., Daughters, S. B., Rosenthal, M. Z., & Lynch, T. R. (2005). Impulsivity as a common process across borderline personality and substance use disorders. Clinical psychology review, 25(6), 790-812. https://doi.org/10.1016/j.cpr.2005.05.005Kienast, T., Stoffers, J., Bermpohl, F., & Lieb, K. (2014). Borderline personality disorder and comorbid addiction: epidemiology and treatment. Deutsches Ärzteblatt International, 111(16), 280. doi: 10.3238/arztebl.2014.0280Linehan, M. M., Schmidt, H., Dimeff, L. A., Craft, J. C., Kanter, J., & Comtois, K. A. (1999). Dialectical behavior therapy for patients with borderline personality disorder and drug-dependence. American Journal on Addictions, 8(4), 279-292. https://doi.org/10.1080/105504999305686Mattingley, S., Youssef, G. J., Graeme, L., Sloan, E., Manning, V., & Hall, K. (2024). Negative urgency, distress tolerance, and symptoms of substance use, eating, and borderline personality disorders in treatment‐seeking young people. Journal of Clinical Psychology, 80(2), 261-278.  https://doi.org/10.1002/jclp.23579Nabel, J., Bertele, S., Stapel, B., Scharn, N., & Kahl, K. G. (2025). Unseen dualities: underdiagnosis of substance use disorders in borderline personality disorder. Frontiers in Psychiatry, 16, 1539611. https://doi.org/10.3389/fpsyt.2025.1539611Trull, T. J., Freeman, L. K., Vebares, T. J., Choate, A. M., Helle, A. C., & Wycoff, A. M. (2018). Borderline personality disorder and substance use disorders: an updated review. Borderline personality disorder and emotion dysregulation, 5(1), 15. https://doi.org/10.1186/s40479-018-0093-9Zanarini, M. C., Frankenbur, F. R., Weingeroff, J. L., Reich, D. B., Fitzmaurice, G. M., & Weiss, R. D. (2011). The course of substance use disorders in patients with borderline personality disorder and Axis II comparison subjects: A 10‐year follow‐up study. Addiction, 106(2), 342-348. https://doi.org/10.1111/j.1360-

Your Addiction is a Solution (And That's the Problem)It’s not about partying, it’s about survival. For someone with BPD, substance use isn't the primary problem, it's a maladaptive solution to the problem of unbearable emotional pain. In this episode, we get real about the powerful link between BPD and addiction/substance use. If you've ever felt shame about your substance use, this episode offers a path to radical self-forgiveness and explains the integrated treatments (like DBT-SUD) that can help you build a life worth living, sober.Trigger Warning: This episode contains a frank discussion of addiction, substance abuse, and other sensitive topics. Listener discretion is advised.🌱 Have questions, stories, or something you’d like us to cover? We’d love to hear from you. Email us at [email protected]⁠⁠⁠⁠⁠ and let’s keep the conversation going.🎧 Looking for meditations made for emotional regulation, BPD, and more? Check out  Empowered Heroes Meditations  on ⁠⁠⁠⁠Spotify.If you’d like more support in your journey toward BPD recovery, Steff offers 1:1 sessions using evidence-based tools from DBT and Mindfulness to help you heal. Email for a free 30-Minute Consultation: 📩 [email protected] or check out the website: www.bpdsupport.org📚 Referenced Research Includes:Bornovalova, M. A., Lejuez, C. W., Daughters, S. B., Rosenthal, M. Z., & Lynch, T. R. (2005). Impulsivity as a common process across borderline personality and substance use disorders. Clinical psychology review, 25(6), 790-812. https://doi.org/10.1016/j.cpr.2005.05.005Kienast, T., Stoffers, J., Bermpohl, F., & Lieb, K. (2014). Borderline personality disorder and comorbid addiction: epidemiology and treatment. Deutsches Ärzteblatt International, 111(16), 280. doi: 10.3238/arztebl.2014.0280Linehan, M. M., Schmidt, H., Dimeff, L. A., Craft, J. C., Kanter, J., & Comtois, K. A. (1999). Dialectical behavior therapy for patients with borderline personality disorder and drug-dependence. American Journal on Addictions, 8(4), 279-292. https://doi.org/10.1080/105504999305686Mattingley, S., Youssef, G. J., Graeme, L., Sloan, E., Manning, V., & Hall, K. (2024). Negative urgency, distress tolerance, and symptoms of substance use, eating, and borderline personality disorders in treatment‐seeking young people. Journal of Clinical Psychology, 80(2), 261-278.  https://doi.org/10.1002/jclp.23579Nabel, J., Bertele, S., Stapel, B., Scharn, N., & Kahl, K. G. (2025). Unseen dualities: underdiagnosis of substance use disorders in borderline personality disorder. Frontiers in Psychiatry, 16, 1539611. https://doi.org/10.3389/fpsyt.2025.1539611Trull, T. J., Freeman, L. K., Vebares, T. J., Choate, A. M., Helle, A. C., & Wycoff, A. M. (2018). Borderline personality disorder and substance use disorders: an updated review. Borderline personality disorder and emotion dysregulation, 5(1), 15. https://doi.org/10.1186/s40479-018-0093-9Zanarini, M. C., Frankenbur, F. R., Weingeroff, J. L., Reich, D. B., Fitzmaurice, G. M., & Weiss, R. D. (2011). The course of substance use disorders in patients with borderline personality disorder and Axis II comparison subjects: A 10‐year follow‐up study. Addiction, 106(2), 342-348. https://doi.org/10.1111/j.1360-

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Why Do So Many People With BPD Struggle With Substance Use?

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Your Addiction is a Solution (And That's the Problem)It’s not about partying, it’s about survival. For someone with BPD, substance use isn't the primary problem, it's a maladaptive solution to the problem of unbearable emotional pain. In this...

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