The growing health concern related to drug and alcohol addiction is posing a big challenge to America, and with co-occurring disorders commonly found in addicts, overcoming the challenge becomes a daunting task for federal and state governments. Borderline Personality Disorder (BPD) is a common co-occurring disorder affecting the addicts.
BPD can be defined as an emotionally painful disorder that is characterized by dysregulation of emotions, interpersonal relationships, behaviors, thinking processes and unstable self-image. People suffering from borderline personality disorder may tend to lose temper, have cognitive disturbances and end up being addicted to any substance or alcohol. Such conditions can lead to damaging behavior in addicts. And in such a situation, in spite of being strong-willed, people may end up feeling helpless and worthless. This completely transforms their perception about themselves.
According to a 2014 report by Substance Abuse and Mental Health Services Administration (SAMHSA), nearly 50 percent of individuals with BPD were suspected to be involved in prescription drug abuse in the past. Keeping the associated problems in mind, treating BPD is an uphill task for therapists.
Challenges in handling patients
Patients suffering from a combination of borderline personality disorder and substance abuse may try to resist the treatment. This may create a roadblock in adhering to a long-term treatment plan. In some cases, aggressive behavior of the patient may lead to life-threatening situations.
Methods such as Cognitive Behavioral Therapy and Dialectical Behavioral Therapy can be beneficial for co-occurring disorder patients. Sometimes patients may require medication as well. According to studies by Lee NK, Health Consultant, National Drug Research Institute, Curtin University, Perth, Australia, the most promising treatments include dialectical behavior therapy (DBT) and dynamic deconstructive psychotherapy (DDP). A combination of support and management from an experienced dual diagnosis treatment center can improve retention rates for inpatient rehab.
Relationship between therapist and patient
The rate of treatment dropout among patients with BPD and substance abuse disorders has been quite high. It is difficult for therapists to engage these patients in a therapeutic relationship. Varying moods of the patient can prevent a cordial relationship to develop between the patient and the therapist. There may also be a scope of passive or high resistance to treatment by such patients. They can stop attending sessions altogether, demotivating the energy of the therapist as well.
High relapse ratio: Depending on different addictive patterns, a relapse prevention program focuses on prevention from self-harm, noncompliance and risky behavior.
Dysfunctional relationships: A dual diagnosis patient craves for attention and love. However, due to an unstable interpersonal relationship, patients fear losing the loved ones and this usually adds to their problem. Families should be educated and made aware about the support that they can lend in the recovery process.
Suicidal thoughts: Individuals with BPD and substance addiction problem are at a higher risk of attempting suicides and indulging in self harm or self-mutilation.
A comprehensive approach that includes crisis management techniques should be considered to treat such patients. In fact, they require a proper residential treatment.
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