Alcohol and BPD: The Effects on Young Adults

Written by, Janet Hamm-Tuverson, Director of Addictions Counseling Services at Optimum Performance Institute in Woodland Hills, CA

Young adults grappling with borderline personality disorder (BPD) and alcohol often face an uphill battle when it comes to emotional regulation and can experience an increase in BPD symptoms from drinking and partying.  

Here’s what parents of young adults need to know about the complex relationship between alcohol and BPD, including warning signs, effects, and supportive strategies for handling these co-occurring issues and their potential negative consequences on mental health. 

Alcohol and BPD: What are the Warning Signs? 

If you’re a parent and wondering what alcohol and BPD can look like in young adults, watch out for signs such as increased impulsivity, unstable relationships, extreme mood swings, and self-destructive behavior.  

There are other important warning signs that parents should be aware of when it comes to BPD and alcohol addiction, both individually and when they occur together. These warning signs can help identify the root causes of self-destructive behavior and allow for early intervention and treatment. 

Identifying BPD in Young Adults 

BPD typically surfaces in late adolescence or early adulthood and is characterized by intense emotional instability, impulsive behaviors, and turbulent relationships.  

Other key signs of borderline personality disorder (BPD) are:  

1. Emotional Instability: Rapid and intense mood swings that can last a few hours or days. 
2. Impulsive Behavior: Reckless actions without consideration of consequences, such as reckless driving or overspending. 
3. Intense Interpersonal Relationships: Patterns of unstable relationships, swinging between extremes of idealization and devaluation. 
4. Fear of Abandonment: Extreme fear of being left alone, leading to frantic efforts to avoid real or imagined separation. 
5. Chronic Feelings of Emptiness: Persistent feelings of emptiness or boredom. 
6. Inappropriate Anger: Frequent intense anger or difficulty controlling anger. 
7. Identity Disturbance: Unstable self-image or sense of self, with frequent changes in goals, values, and aspirations. 
8. Self-Damaging Behavior: Recurrent suicidal behavior or self-mutilation, like cutting or burning. 
9. Dissociation or Paranoid Thoughts: Stress-related paranoia or severe dissociative symptoms, feeling detached from reality. 

If you think your young adult is showing any of these signs, a BPD assessment can be a starting place to identify possible symptoms of BPD. It’s important to note that a trained and licensed mental health professional should always make an official diagnosis of BPD.   

Recognizing Drinking and Alcohol Use in Young Adults 

When considering young adults, it’s crucial to discern between social drinking and problematic alcohol use that might signal deeper issues. Here are some signs that drinking may be crossing into risky territory: 

• Increased Tolerance: The need to consume more alcohol to achieve the same effects, suggesting an escalation in use. 
• Withdrawal Symptoms: Experiencing physical symptoms like shaking, sweating, nausea, or emotional symptoms such as irritability when not drinking. 
• Neglecting Responsibilities: Skipping classes, falling behind on assignments, or poor work performance due to drinking or recovering from its effects. 
• Social or Recreational Sacrifices: Giving up hobbies or social events they once enjoyed in favor of drinking. 
• Drinking in Dangerous Situations: Using alcohol in situations where it is physically hazardous, such as drinking and driving or mixing alcohol with prescription medication against a doctor’s advice. 
• Loss of Control: Drinking larger amounts or over a longer period than intended, often expressing a desire to cut down or stop drinking but being unable to do so. 
• Continued Use Despite Problems: Continuing to drink even when it causes or worsens health problems, both physical and mental. 

Understanding these signs can help in recognizing behaviors that might look like typical young adult behavior but are veering into alcohol misuse, which can be particularly dangerous for those with underlying mental health conditions like BPD. 

Alcohol and BPD Co-Occurrence 

When BPD and alcohol use occur together, the combination can lead to an amplification of symptoms and a complex clinical picture. Here are expanded signs of this co-occurrence: 

• Increased Risk-Taking Behavior: Alcohol and BPD can cause young adults to engage in more impulsive and riskier behaviors than usual, including reckless driving, unsafe sex, or unplanned financial expenditures. 
• Worsened Emotional Dysregulation: Alcohol and BPD can significantly impair emotional control, leading to more frequent or severe episodes of anger, sadness, or anxiety, which are often quick to surface in young adults with BPD. 
• Rapid Mood Swings: While mood instability is a hallmark of BPD, alcohol use can cause even more rapid and intense fluctuations that are difficult to manage. 
• Interpersonal Relationship Strain: The combination of alcohol and BPD can lead to more frequent conflicts and misunderstandings with friends and family, often resulting from heightened emotional intensity and impulsivity. 
• Compromised Treatment Efficacy: Alcohol can interfere with the effectiveness of psychological therapies and medications prescribed for BPD, reducing their effectiveness and complicating recovery efforts. 
• Dual Dependency: There is a potential for developing a dependency on alcohol as a coping mechanism for dealing with the emotional pain associated with BPD, leading to a cycle of drinking for young adults struggling with both alcohol and BPD. 

Recognizing these signs is critical for caregivers, mental health professionals, and the individuals themselves to understand the complexities of dealing with both BPD and alcohol use. This awareness is the first step toward seeking and providing appropriate support and treatment. 

Are Young Adults With BPD More Likely to Drink? 

Young adults with borderline personality disorder (BPD) are more likely to engage in alcohol use compared to their peers without the disorder.  

A key study published in the Journal of Personality Disorders titled “Substance Use in Borderline Personality Disorder” highlights that individuals with BPD are significantly more likely to use substances such as alcohol to cope with their intense emotions and unstable relationships. 

People often use this coping mechanism to alleviate the distress caused by difficult thoughts and interpersonal struggles, which increases their risk of developing a substance use disorder, specifically alcohol abuse.  

How Does Alcohol Use Affect Young Adults with BPD? 

Alcohol can have several effects on young adults with BPD, including worsening their emotional instability and impulsivity, leading to heightened conflicts and risky behavior.  

Mental Health Effects 

Alcohol use in young adults with borderline personality disorder (BPD) can have profound and detrimental effects on mental health. These effects often worsen the core symptoms of BPD and introduce added challenges: 

• Worsening of Mood Instability: Alcohol can dramatically increase the frequency and intensity of mood swings associated with BPD, making mood stabilization even more difficult. 
• Increased Depressive Symptoms: Individuals with BPD are already at a higher risk for depression, and alcohol use can deepen the severity of depressive episodes, potentially leading to increased suicidal ideation and behaviors. 
• Anxiety Amplification: Alcohol may initially seem to reduce anxiety, but it often causes heightened anxiety levels as it wears off, contributing to a vicious cycle of drinking to relieve anxiety. 
• Impaired Judgment and Increased Impulsivity: Alcohol impairs cognitive function and decision-making, which can lead to more impulsive behavior, poor judgment, and regrettable decisions in individuals with BPD. 
• Heightened Emotional Sensitivity: Alcohol can make individuals with BPD more emotionally reactive, particularly in interpersonal relationships, which are already a source of considerable stress for many with the disorder. 
• Compromised Coping Skills: Reliance on alcohol can undermine the development and utilization of healthy coping mechanisms, which are crucial for managing BPD effectively. 

Understanding these mental health impacts is essential for managing the dual challenge of BPD and alcohol use, as each can fuel the other, creating a complex cycle of worsening symptoms and increased drinking. 

Physical Effects 

The physical consequences of alcohol use are significant and can compound the difficulties faced by young adults with BPD: 

• Neurological Impact: Chronic alcohol use can lead to long-term changes in brain chemistry, affecting areas critical for mood regulation, impulse control, and judgment—functions already compromised in BPD. 
• Gastrointestinal Issues: Alcohol can irritate the gastrointestinal tract, leading to problems such as gastritis, ulcers, and in severe cases, gastrointestinal bleeding. 
• Immune System Suppression: Regular alcohol use can weaken the immune system, making the body more susceptible to infections, which can further complicate overall health. 
• Increased Risk of Accidents and Injuries: Impaired coordination and judgment increases the risk of accidents and injuries, which can have serious, long-lasting consequences. 
• Cardiovascular Problems: Excessive drinking can lead to high blood pressure, heart disease, and stroke, even in younger adults who might not otherwise be at high risk for these conditions. 
• Liver Damage: Alcohol is metabolically processed in the liver, and excessive use can lead to conditions such as fatty liver, hepatitis, and ultimately, cirrhosis. 

Both the mental and physical effects of alcohol use can severely affect the health and quality of life of young adults with BPD. Recognizing these effects is critical in seeking the right treatments and interventions that address both BPD and alcohol use comprehensively. 

If you or your young adult son or daughter is struggling with any of these effects of co-occurring BPD and alcohol use, contact the Optimum Performance Institute team today. We’ll help walk you through the process of finding treatment that helps young people overcome difficult mental health and substance use issues.

Does Alcohol Make BPD Worse? 

Alcohol can significantly worsen BPD symptoms in young adults. It impairs judgment, increases impulsivity, and can lead to heightened emotional reactions, which may aggravate the core symptoms of BPD. 

What are the Dangers of Untreated BPD and Alcohol Use? 

There are many dangers of untreated BPD with co-occurring alcohol consumption that parents should be aware of. One of the biggest dangers to young adults includes worsening mental health issues, such as an increased risk of self-harm and suicidal behavior. Other short and long-term consequences of untreated BPD and alcohol use include mental illnesses and conditions such as anxiety and depression, difficulties in school, education, relationships, work, and negative impacts on overall health. 

Short-Term Effects 

Short-term effects of alcohol use and BPD can include: 

• Increased risk of accidents and injuries 
• Immediate deterioration in personal and professional relationships 
• Heightened risk of suicide attempts and self-harm 

Long-Term Effects 

Long-term effects of alcohol use and BPD can include: 

• Memory loss 
• Impaired problem-solving skills  
• Physical effects such as liver damage  
• Mental health decline and worsening BPD symptoms 

How Can I Help My Young Adult with BPD Struggling with Alcohol Use? 

The best way to help a young adult with BPD and alcohol use is to provide them with support, understanding, and access to appropriate treatment options. Additionally, creating a safe and non-judgmental environment where they feel comfortable discussing their struggles can make a significant difference in their recovery journey. 

Supporting a young adult with both borderline personality disorder (BPD) and alcohol use issues requires a multifaceted approach tailored to address the complex nature of these interlinked challenges. Here are specific strategies to consider: 

1. Openly Communicate About Their BPD and Drinking 

• Create a Safe Space for Discussion: Foster an environment where your young adult feels safe and not judged. This can encourage open dialogue about their feelings and challenges. 
• Educate Yourself and Your Young Adult: Understanding both BPD and the effects of alcohol can help both of you recognize the triggers and patterns that lead to drinking. 
• Discuss the Consequences: Have honest conversations about the physical and mental health effects of alcohol, especially how it can worsen BPD symptoms. 

2. Create Support Systems for Young Adults with BPD 

• Encourage Engagement with Therapy: Support them in attending therapy regularly, whether it’s DBT Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), or another suitable therapeutic approach. 
• Explore Group Therapy and Support Groups: Encourage participation in BPD and substance use support groups, where they can learn from others facing similar challenges. 
• Utilize Online Resources: Online forums and resources can also provide support and help them feel less isolated in their experiences. 

3. Set Boundaries on Alcohol Use in Your Home 

• Establish Clear Rules: Communicate your expectations about alcohol use within the home. This helps in creating a supportive environment that discourages substance use. 
• Be Consistent and Fair: Ensure that all family members are treated equally concerning the rules set about alcohol use to avoid feelings of resentment or misunderstanding. 

4. Find Treatment Options 

• Integrated Treatment Programs: Look for integrated mental health treatment programs that address both BPD and substance use. Integrated treatment is often more effective than treating each condition separately. 
• Medication Management: Consult with healthcare providers about medications that can help manage BPD symptoms and cravings for alcohol. 
• Regular Monitoring and Adjustments: Treatment plans should be regularly reviewed and adjusted based on the young adult’s progress and any setbacks. 

5. Encourage Healthy Lifestyle Changes 

• Promote Physical Activity: Regular exercise can help manage stress, improve mood, and reduce urges to use alcohol. 
• Support Nutritional Habits: A balanced diet can improve overall well-being and mental health. 
• Advocate for Regular Sleep Patterns: Good sleep hygiene can reduce mood swings and stress levels, helping to manage BPD symptoms more effectively. 

6. Plan for Crisis Management 

• Develop a Crisis Plan: Work with your young adult and their healthcare provider to create a plan that addresses potential crises, particularly how to handle intense emotional distress or urges to drink. 
• Keep Emergency Contacts Handy: Ensure that everyone knows whom to contact in case of an emergency, such as their therapist, a trusted healthcare provider, or a crisis hotline. 

By maintaining patience and compassion throughout the process while implementing these strategies, you can provide significant support to a young adult wrestling with BPD and alcohol use issues. 

Moving Forward Together on Alcohol Use and BPD 

Understanding the interplay between alcohol and BPD is crucial for parents who are looking to help a young adult who may be struggling. If you are seeking guidance or support for a young adult with BPD, start your healing journey by contacting or calling Optimum Performance Institute at 818-906-4884. We empower young adults to navigate their path to recovery and help families restore balance and create joy with the guidance of licensed and caring medical professionals.