A dual diagnosis for addiction and borderline personality disorder can be an immense challenge when it comes to treating both conditions successfully. People with BPD have a much higher risk of substance abuse as well, they are impulsive and prone to mood swings and rages, and they are often highly unstable. Many studies show that more than half of the people who are diagnosed with BPD also have substance abuse problems, and some studies put the rate of these co-occurring disorders as high as 70%. Patients with this type of dual diagnosis can be especially difficult and challenging to treat because of the various symptoms and the impulsivity that these individuals exhibit. Many people with addiction and BPD can be resistant to treatment even though the research shows that the longer these individuals are in treatment the better the outcome will be.
Another big challenge when it comes to treating people who have both borderline personality disorder and addiction is establishing a healthy and positive client therapist relationship. People with BPD can see the therapist as someone helpful and a great source of support but this can change very quickly. As soon as the patient feels criticized, rejected, or disapproval in any form the therapist can be viewed as an enemy. This often leads to missing therapy appointments or even discontinuing therapy completely. This cycle can be just as frustrating for the therapist as it can be for the patient. People with this type of dual diagnosis typically engage in dysfunctional relationships and they have higher than normal relapse rates, and both of these issues can also pose serious challenges during therapy.