Personality Disorder and Addiction

Clinically, personality disorders are defined as ‘pervasive, maladaptive, and chronic patterns of behaviour, cognition, and mood.’ The main difficulty with these types of disorders is that several different kinds manifest and present in varying ways. This can make defining the catch-all term’ personality disorder’ somewhat difficult. In general, however, personality disorders can lead to potential difficulties with:

• Emotional regulation
• Distress management
• Social relationships
• Thought patterns
• Self-perception
• Short-term loss of contact with reality

These symptoms can be exacerbated in periods of high stress.

One major risk associated with these types of conditions is an increased tendency to engage in harmful activities, such as self-harm, heavy drinking, recreational drug use and suicide attempts.

There are ten types of personality disorder. These diagnoses are arranged into three key categories. These are:

1. Suspicious personality disorders
2. Emotional and impulsive personality disorders
3. Anxious personality disorders

There are three types of suspicious personality disorder. These include:

• Paranoid personality disorder
• Schizoid personality disorder
• Schizotypal personality disorder

Paranoid personality disorder is linked with feelings of paranoia and difficulty trusting others. This can include feeling threatened and finding it difficult to unwind.

Schizoid personality disorder is linked with a significant detachment from other people, leading to people appearing emotionally and socially ‘blunt’ or distant.

Schizotypal personality disorder is linked with eccentricities that may read as social awkwardness or intense difficulties interacting with others.

There are four types of personality disorders in this category. These are

• Antisocial personality disorder (ASPD)
• Borderline personality disorder (BPD)
• Histrionic personality disorder
• Narcissistic personality disorder

Antisocial personality disorder (ASPD) is associated with impulsive, irrational, potentially dangerous or criminal activity.

Borderline personality disorder (BPD) is associated with difficulty managing emotions, impulsivity, altered self-perception and difficulties in relationships with others.

Histrionic personality disorder is associated with ‘pervasive attention-seeking behaviours and exaggerated emotional displays.’

Narcissistic personality disorder is associated with grandiosity, an increased need for admiration and a reduced tendency to empathy.

In this category, there are three diagnosable conditions:

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

Avoidant personality disorder symptoms include intense social anxiety, fear of rejection, low self-esteem and longing for deeper relationships.

Dependent personality disorder symptoms include having very low confidence, difficulty making decisions and needing social support to complete daily tasks.

Obsessive-compulsive personality disorder symptoms include preoccupation with details, devotion to work, stubbornness and perfectionism.

If you frequently find yourself experiencing emotional distress and struggling with both your relationships with others and yourself, you may be dealing with a personality disorder. These types of conditions can sometimes be late diagnosed, as they may at first be viewed as a type of treatment-resistant anxiety or depression.

Personality disorders are multifaceted. Theories into their causation have suggested that:

• Childhood trauma (neglect, abuse or violence)
• Absent or distanced parental support in childhood
• Genetic inheritance

may all play a part in the development of these types of conditions.

People with personality disorders may also experience addictions of some kind. In the standard population, 10 to 14.8% of people have a personality disorder. In an addiction treatment population, personality disorders can be present in between 34 and 73% of individuals. [20] This indicates a very high comorbid relationship between personality disorder and addictions. This could be due to many reasons, such as:

• Prolonged emotional distress
• Lower distress tolerance
• Difficulties with crisis management
• Increased impulsivity
• Tendency towards maladaptive behaviours as a coping mechanism

There is a particularly strong connection between antisocial personality disorder and borderline personality disorder and drug addiction. Individuals with these diagnoses may develop a psychological dependence on substances, including alcohol, prescription medications and illegal drugs such as cocaine, cannabis and heroin.

In most cases, the reasons for drug use are often heavily intertwined with symptoms of personality disorders. This means that rehab treatment that addresses both is likely to be most effective. This holistic or ‘multidimensional’ mode of support can be useful in managing short-term distress and reducing the risk of relapse in the future.

If you are struggling with symptoms related to a personality disorder, there are several places you can seek help. These include:

• a primary care clinician or psychiatrist
• a support group
• a mental health charity (Mind)
• a mental health treatment facility 
• a specialist rehab service 

Therapies

The most frequently utilised therapy for people with personality disorders is dialectical behavioural therapy. A type of psychotherapy focusing on reducing risk, managing distress and increasing emotional control, DBT aims to reduce the risk of engaging in harmful activities as a method of coping.

Medication

There are no medications specifically created to treat personality disorders. However, many people with a diagnosis in this category use the following:

• antidepressants
• antipsychotics
• mood stabilisers

It is important to note that some substances (including alcohol) may interact with these medications. It is always essential to discuss your substance use with a medical professional before beginning prescription medication for your mental health.

If you are struggling with an addiction, you may find that the symptoms of your personality disorder and your addictive behaviours begin to feed into one another. The best way to address this is by accessing support from industry professionals with experience treating comorbid conditions. For some people, this may make the option of residential rehab feel more desirable.

Addiction is a difficult journey, but you don’t have to go through it alone. If you have a dual diagnosis, we can support you in overcoming your addiction. Contact us today to start your path to recovery. At UKAT, we believe everyone deserves stable mental health and a life free from substance abuse. Our expert team is ready to help you take the first step toward that future.