People who deal with personality disorders and addiction can still get help and live healthy, productive lives as long as treatment adequately addresses both conditions. Integrated care that treats both issues simultaneously is key to long-term stability.
Personality disorders are not flaws of character or eccentric qualities. These are disorders that prevent you from thinking in healthy and functional ways. Individuals with a personality disorder are not always aware they are dealing with one because they believe their thinking or behavior is normal.
Most personality disorders show up in the teen or young adult years. They can hinder a person’s ability to reach their potential and cause problems forming appropriate relationships. The National Institute of Mental Health says that up to 9.1 percent of Americans may have one of the personality disorders.
Types Of Personality Disorders
The most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) says there are 10 distinct personality disorders. Studies show that people with personality disorders may also meet the criteria for another one. The DSM-5 also separates personality disorders into three clusters including “A,” “B,” “C.” Each cluster describes a different set of behaviors and symptoms.
Regardless of the cluster, personality disorders can greatly impact someone’s life if left untreated. They can affect a person’s ability to form healthy relationships and reach their full potential in various areas such as work, school, and personal goals. It is important for individuals to seek
Cluster A Personality Disorders
These personality disorders cause behavior that seems unusual to others. People who have a cluster A personality disorder may exhibit excessive paranoia or suspicions, and they often hold grudges. They may appear eccentric or adhere to unusual beliefs. Disorders belonging to this cluster are:
- Schizoid personality disorder
- Schizotypal personality disorder
- Paranoid personality disorder (PPD)
Cluster A personality disorders are often difficult to treat and can significantly impact an individual’s daily life. It is important for individuals with these disorders to seek professional help in order to manage their symptoms and improve their overall well-being.
Cluster B Personality Disorders
These disorders are characterized by symptoms that last for a year, beginning in the first years of adulthood, and cannot be caused by traumas or disorders. Symptoms of all or some of these disorders may include antisocial behaviors, difficulties maintaining relationships, and recklessness.
Research shows that family history may contribute to the development of cluster B disorders, which include:
- Narcissistic personality disorder.
- Histrionic personality disorder.
- Borderline personality disorder.
- Antisocial personality disorder.
An estimated 1.4 percent of Americans are affected by borderline personality disorder (BPD). More than any other personality disorder, people with BPD are likely to face co-occurring issues, such as anxiety disorders, substance use disorders, mood disorders, and impulse control disorders.
Cluster C Personality Disorders
These personality disorders are marked by excess anxiety and dread. They can cause problems in current relationships and difficulties forming new ones. Cluster C personality disorders include:
- Obsessive-compulsive disorder
- Dependent personality disorder
- Avoidant personality disorder
Cluster C personality disorders are characterized by fear, insecurity, and a need for control. People with obsessive-compulsive disorder may have an intense drive for perfection and order in their lives, often at the expense of relationships or personal well-being.
Getting A Diagnosis
Diagnosing a personality disorder is challenging because a lab, blood, or other conventional test cannot confirm or deny its presence. These tests can still be valuable in ruling out other medical conditions that cause unusual behaviors. As a result, doctors may run these during the assessment phase of care.
Doctors will also take down a patient’s family and medical history. Patients are then referred to a psychiatrist or psychologist if doctors find no physical cause for the behaviors displayed.
A mental health practitioner can then evaluate a patient and use the DSM-5 to assess whether they fit the criteria for any of the personality disorders described above.
What is the Link Between Personality Disorders and Addiction
A 2011 study published by Innovations in Clinical Neuroscience found that substance use disorders are common in people with personality disorders. People with BPD are especially at risk of a substance use disorder.
The study says the link between BPD and substance misuse is strong, and patients are most likely to abuse prescription medication. The study also found that:
- People with more than one psychiatric disorder are more likely to misuse substances than people with one confirmed disorder.
- Not all personality disorders present the same potential to misuse substances.
- Men and women with BPD present the same probability of abusing alcohol and recreational substances.
- People who abuse alcohol are 35 times more likely to be diagnosed with BPD than people who don’t drink excessively.
Why Are Personality Disorders and Addiction Linked?
As explained by the National Institute on Drug Abuse (NIDA), drug addiction is a mental illness because it changes the way a person’s brain works, shifting their priorities, decreasing their ability to control impulses, and developing a new hierarchy of needs.
A person who deals with personality disorders and addiction or other chronic conditions is said to have a co-occurring disorder or dual diagnosis.
Data shows that mental health issues and substance abuse are linked in the following ways:
- Genes can cause a person to be more susceptible to both drug abuse and mental health issues.
- Environmental factors can worsen a person’s genetic predispositions.
- Having a mental health condition may cause a person to turn to drugs for self-medication and enhance a drug’s ability to make that person feel pleasure.
Treating a co-occurring personality disorder can be a challenge because chronic drug use can also trigger mental health conditions, making it hard to pin down the cause of a mental illness. In addition, prescription medication can cause behavioral changes that resemble those of a personality disorder.
Treating Co-Occurring Disorders
The good news is that people with co-occurring disorders can find help and lead productive lives, regardless of the root cause of the disorder.
You are not alone if you deal with co-occurring disorders. The National Alliance on Mental Illness (NAMI) says that up to 9.2. million adults dealt with co-occurring substance use disorders and mental illnesses in 2018.
Per the National Institute on Drug Abuse (NIDA), effective treatments for substance use disorders:
- Deal with all aspects of a patient’s needs, not just addiction.
- Focus on any possible mental illnesses.
- Tailor treatment approaches to individual situations.
- Persist as long as necessary to ensure recovery.They are modified as the person progresses in recovery.
Common methods used in treatment programs for co-occurring disorders include:
- Therapy
- Medication-assisted treatment
- Dual diagnosis treatment
- Support groups
Therapy
The American Journal of Psychiatry supports the use of behavioral therapy to help those dealing with substance use disorders. This kind of therapy can also be valuable in addressing personality disorders. Some types of therapy include:
- Contingency management: Individuals get rewards for meeting goals. This therapy is effective in helping those with substance use disorders.
- Motivational interviewing: This type of therapy is meant to help people make better choices and address the things that keep them unmotivated or unable to meet goals.
- Evidence-based therapies and skills training: Therapies can help people understand the underlying effects and consequences of drug use. They also teach the skills necessary to stay sober, such as avoiding triggers and social situations that make substance use a temptation.
Medication-Assisted Treatment
Social Work in Public Health states that medications can be used to treat people with substance use disorders. They can manage symptoms of withdrawal, reduce or stop cravings, and prevent relapse as a part of medication-assisted treatment (MAT). Common medications include those designed to address the following:
- Smoking cessation tools: Chantix, bupropion, gums, patches, and lozenges. These tools can reduce cravings for smoking and lessen withdrawal symptoms.
- Medications for alcohol use disorders: Benzodiazepines, which should only be used in the short term, can reduce stress caused by withdrawal from alcohol. Disulfiram (Antabuse), naltrexone, and Campral can decrease the likelihood of relapse and mitigate cravings. In cases of severe alcohol addiction, medications are necessary to prevent life-threatening seizures during withdrawal.
- Medications for opioid use disorders: Methadone and buprenorphine are commonly used in MAT. They can decrease cravings, manage symptoms of withdrawal, and greatly reduce the likelihood of relapse during opioid detox.
- Addiction counseling and behavioral therapy: The Substance Abuse and Mental Health Services Administration (SAMHSA) says that everyone who receives MAT must receive counseling and behavioral therapy services.
Dual Diagnosis Treatment for Co-occurring Disorders
If a co-occurring disorder is not addressed during substance abuse treatment, relapse is highly likely. For this reason, everyone who enters addiction treatment or starts a recovery program undergoes a preliminary evaluation for various health issues. Physical and mental health are assessed, and treatment is expected to be modified as changes are deemed necessary. Through dual diagnosis treatment, people with co-occurring disorders receive clinical care that addresses their addiction and mental health disorders.
Those with co-occurring disorders may also benefit from psychiatric medication management. This involves working with a psychiatrist who specializes in treating mental health disorders and can prescribe appropriate medications to help manage symptoms. Regular monitoring and adjustments to the medication plan are important for optimal results.
Support Groups
Substance abuse and rehabilitation studies explain how peer support groups have a great track record of helping people in recovery as well as their loved ones. These groups are not the same as group therapy. Non-professionals lead support groups. They are a great way to form a community and share experiences with people with the same struggles. Well-known support groups include:
- 12-step groups, such as Alcoholics Anonymous and Narcotics Anonymous: These are perhaps the best-known support groups for those struggling with substance abuse. They provide a structure of accountability and support for those in recovery. Meetings can be found all over the world. AA, NA, and associated groups do have a religious association that some people don’t like.
- SMART Recovery: Studies show that alternatives to groups like AA can be just as effective as their more spiritual counterparts. Self-Management and Recovery Training (SMART) can provide support for people with substance abuse and other addictive behaviors like gambling. They use a four-point program to help people gain control of their issues.
- Women for Sobriety: WFS focuses on abstinence and sharing experiences with women who have faced substance abuse and other issues and building an understanding of how physical and mental deprivations can lead to substance abuse, aiming to teach members to become confident in their daily lives. Learn more about WFS at womenforsobriety.org.
A Path Forward in Addiction Recovery
Integrated treatment is the key to sustained recovery from personality disorders and substance abuse. Choose a treatment facility that offers a holistic approach to recovery, treating patients on all fronts.
If only one issue is treated, symptoms of the other disorder will likely lead to relapse of the treated tissue. When it comes to co-occurring disorders, you can’t achieve recovery unless you address the whole person.
Footprints to Recovery takes a comprehensive treatment approach, addressing both disorders simultaneously through therapy, counseling, and medication. This integrated method promotes progress across all aspects of life, paving the way for lasting recovery. If you would like to learn more about our program offerings, contact us today.
- Personality Disorders – National Institute of Mental Health (NIMH)
- What Are Personality Disorders in the DSM-5?
- Cluster A Personality Disorders: Types, Traits, Treatment, Support
- Cluster B Personality Disorders: Traits, Treatment, and More
- Co-Occurring Disorders: Mental Health & Addiction | Oxford
- Treatment | National Institute on Drug Abuse (NIDA)
- Behavioral Therapies for Drug Abuse – PMC
- Medications for Substance Use Disorders – PMC
- Medications, Counseling, and Related Conditions -SAMHSA
- Benefits of peer support groups in the treatment of addiction – PMC
