Personality Disorders and Addiction

personality disorders and addiction

One of the most common barriers between addiction and effective treatment is the lack of attention paid to underlying mental health conditions. Upwards of 50% of all individuals suffering from addiction have a co-occurring personality disorder, which makes a significant impact on the severity of the addiction. If left undiagnosed, treatment will only address the addiction and ultimately fail to recognize a major trigger for the evolution of drug and alcohol abuse.

Granite Mountain Behavioral Health offers treatment programs for those suffering from co-occurring substance abuse and personality disorders. It’s important to understand the relationship between the two disorders and seek treatment that addresses both simultaneously. 

What is a Personality Disorder? 

According to the Diagnostic and Statistical Manual of Mental Disorders, a personality disorder can be diagnosed if there are significant social and personal impairments that correspond with pathological personality traits.

Essentially, the parts of the brain that makeup personality and perception are different than the “standard” brain, causing some level of impaired or different modes of behavior. To be diagnosed, these characteristics also have to be:

1. Relatively stable across time and consistent across situations

2. Not considered normal for the individual’s social circle/ developmental upbringing 

3. Not solely due to the direct effects of a substance or a general medical condition

Types of Personality Disorders

Personality disorders are divided into three groups known as “clusters”. Clusters are formed with personality disorders that exhibit similar behavioral patterns and symptoms

Cluster A: Cluster A is defined as disorders that display “odd and eccentric” behaviors and include 

  • Paranoid Personality Disorder
  • Schizoid Personality Disorder
  • Schizotypal Personality Disorder 

Cluster A tends to exhibit characteristics such as lack of interest in social relationships, inability to pick up on social cues, inappropriate responses, and peculiar thoughts.

Cluster B: Cluster B is defined as disorders that display dramatic erratic and emotional behaviors. These include:

  • Antisocial Personality Disorder
  • Borderline Personality Disorder
  • Histrionic Personality Disorder
  • Narcissistic Personality Disorder  

Cluster B tends to exhibit traits such as habitual lying, inability to accept responsibility, aggression, and not being in tune with reality.

Cluster C: Cluster C is defined as displaying fearful or anxious personality traits. These include

  • Avoidant personality disorder
  • Dependent personality disorder 
  • Obsessive-compulsive personality disorder 

Cluster C exhibits traits such as low self-esteem, dependence on others for self-acceptance, fear of embarrassment, and control issues. 

Eating Disorders

Eating Disorders are not traditionally defined as a personality disorder, but as of late have been conjoined for their influence on eating behaviors and general personality behaviors. According to the National Eating Disorders Association, more than half of those who seek treatment for bulimia nervosa also meet the criteria for a diagnosis of an alcohol or substance abuse disorder.

Some personality disorders such as borderline personality disorder or obsessive-compulsive disorder are more common than others. Many times people exhibit traits of multiple and receive a dual diagnosis of 2 or more personality disorders. It takes a professional evaluation and a thorough review of one’s mental health history to come to a formal diagnosis. 

Who is at Risk for Personality Disorders? 

There is no known source for the formation of a personality disorder, however, there are a few factors that have been shown to play a role in increasing the risk of development. Some of these factors include: 

  • Having family members with mental illnesses or personality disorders.
  • Being verbally, sexually and/or physically abused
  • Living in an unstable, chaotic family environment
  • Exhibiting odd behaviors as a child 
  • Being neglected, bullied, or subjected to trauma.

Additionally, more women than men are diagnosed with a personality disorder at some point in their lives, and the most common age for diagnosis is between the ages of 18 and 24 (although original onset is between the ages of 6-12)

How Addiction Affects Personality Disorders

Addiction is relatively common for people diagnosed with pre-existing personality disorders. Since these disorders can cause a lot of mental stress and cause people to feel isolated from society, they often turn to addiction to cope.

There have been numerous studies on the relationship between addiction and co-occurring substance abuse, and research has shown that anywhere from 65-80 percent with addiction have been previously diagnosed with a personality disorder. 

Although it is not believed that addiction creates personality disorders, substance abuse can intensify or create some of the symptoms that correspond with personality disorders. For this reason, addiction can be dangerous to the mental health of those who have a drug or alcohol use disorder. 

Although the intention of using drugs may be to lessen the side effects of a personality disorder, the outcome is a temporary numbing of the emotions associated with the experience of having a mental health disorder. 

What Type of Substance Abuse Commonly Co-Occurs with Personality Disorders?

Addictions vary in type and severity since everyone has a different chemical makeup, personal history, and genetic base. Depending on the type of personality disorder you have, different drugs will have specific effects on each symptom. Some people combine multiple drugs and mix them with their prescribed medications. Others have had a drug (or alcohol) of choice. Some of the more common addictions that co-occur with personality disorders include:

Regardless of the type of addiction, any addiction will affect personality disorders negatively. Having a personality disorder and being addicted to drugs can intensify symptoms, worsen mental health, and make treatment more complicated.  

Addressing a Dual Diagnosis for Addiction and Personality Disorders

If someone is suffering from co-occurring addiction and personality disorder, they need to be professionally evaluated and diagnosed by a clinical doctor. Receiving a dual diagnosis can be intimidating, but having both conditions considered when coming up with a treatment plan is crucial. 

Once there is the presence of addiction and a personality disorder, each condition affects the severity and symptoms of one another. Treating one without taking the other into consideration would likely lead to an unsuccessful recovery. 

Having two or more co-occurring conditions dramatically increases the complexity of both the condition and treatment approaches.

Substance abuse can significantly increase the severity of personality disorder symptoms and behaviors, and can also create the formation of new symptoms. For this reason, a professional will need to perform a thorough evaluation to understand which disorder is creating which reactions. 

Once the patient and doctor understand the foundation of each co-occurring disorder, they will be able to design a personalized treatment plan that successfully addresses the patient’s needs. 

Treating Personality Disorders & Addiction 

Treatment for a dual diagnosis of personality disorder and addiction should have a combination of professional services directed at addressing both the mental and physical effects of both conditions. Most treatment plans with combine:

  • Detox: to thoroughly cleanse the body of any and all substances abused 
  • Depression/Anxiety medications: to help stabilize mental health and 
  • Talk Therapy (CBT, ACT therapy): To verbally work through struggles past traumas, emotional wounds, and current recovery challenges
  • Dialectical Behavioral Therapy: DBT helps people build mindfulness, tolerance, interpersonal skills, and emotional regulation
  • Nutritional Therapy: To help rebuild the immune system and improve organ function
  • Meditation & Yoga: to incorporate mindfulness and relaxation techniques
  • Relapse Prevention: To ensure relapse is avoided 

Medication is commonly used to address various personality disorders but is carefully monitored and prescribed to make sure it does not feed into any pre-existing addictions. Licensed professionals will be able to adjust doses and types of medication to meet the individual needs of patients. 

Working closely with a therapist or psychologist will enable individuals to address both mental illness and substance addiction, which can aid in discovering the root causes of their development. Unresolved childhood trauma, insecurities, genetics, and PTSD from past experiences can be a major factor in the development of both conditions. 

Alternative approaches should always be considered in a treatment program. Services like meditation, yoga, acupuncture, and herbal therapy can all greatly reduce stress levels and improve the mind-body connection. This inner strength will aid patients in overcoming recovery and mental health challenges throughout their treatment program. 

Start Your Recovery Today 

Granite Mountain Behavioral Healthcare provides comprehensive services designed to address all aspects of addiction and mental health conditions. Our staff is there for you all the way from the initial assessment and detox program to in house rehabilitation services. Clients have access to all of our evidence-based approaches, each having been shown clinically to fight addiction from a variety of angles. 

Our goal is to give our clients the highest quality care and have them leave with the tools and confidence they need to maintain sobriety and regain control of their lives. Call us anytime at (877) 389-0412 to start your journey. You can also contact us here. 

Article Reviewed by Gregory Struve

Gregory StruveGreg received a Master’s in Counseling from the Adler Graduate School in 2006. He trained at one of the top trauma and anxiety treatment centers in the world until 2008 when he became a faculty member at Grand Canyon University. From 2011 to 2016 he directed a program that leads the field in terms of innovative treatment of anxiety and trauma. During that time he even made several appearances on A&E’s intervention.