personality disorders and substance abuse

Personality disorders and substance abuse are some of the most common co-occurring disorders. Symptoms of personality disorders usually persist over years and affect every part of a person’s life. As a result, it’s very common for patients to use alcohol and drugs as a coping mechanism.

Those who suffer from personality disorders and addiction may feel hopeless or helpless. They may not know where to turn. The stigma that surrounds both mental health disorders and substance abuse can make it even more challenging for people to reach out for help. But, individuals who struggle with co-occurring disorders can find healing, treatment, and support through a dual diagnosis program such as ours here at North Jersey Recovery Center.

What are Personality Disorders?

The term “personality disorders” refers to a group of mental health disorders. Even though each disorder has different symptoms and affects people’s lives in different ways, they all involve unhealthy thinking and behavioral patterns that persist for many years.

An individual who suffers from a personality disorder may find it difficult to relate to others, deal with problems that arise in day-to-day life, or maintain relationships. Personality disorders are known to be some of the most severe types of mental disorders. This is mainly because these disorders have a significant effect on a person’s ability to function in a way that’s socially normal.

Many people with personality disorders may avoid seeking help. Even though the symptoms of personality disorders can be very difficult and stressful, many people believe there is no solution to their problems. However, with the right treatment, such as education and therapy, change is possible.

Causes of Personality Disorders

Personality disorder symptoms usually begin in childhood and persist throughout a person’s life. In most cases, people with a personality disorder experienced some kind of childhood trauma, especially parental abuse.

Neglect, physical abuse, and sexual abuse are very strong risk factors for both personality disorders and substance abuse. In addition, people from lower socioeconomic backgrounds are more likely to develop a personality disorder. Genetics may also play a role.

Types of Personality Disorders

There are 10 personality disorders currently recognized by the DSM-5. These are divided into three groups, called “clusters,” that each has relatively similar symptoms.

Cluster A Personality Disorders

There are three personality disorders in Cluster A. This group of disorders presents as symptoms that seem odd, eccentric, or strange to others. A person who has a Cluster A personality disorder might feel disconnected from others or experience strange and frightening sensory perceptions.

Paranoid Personality Disorder

People with paranoid personality disorder feel that the world is a dangerous place. They are preoccupied with the feeling that others want to harm them and that they are constantly in danger. Other common symptoms of paranoid personality disorder include:

  • Intense, unfounded suspicion of others
  • Hypervigilance against small threats
  • Tendency to hold a grudge or be overly defensive
  • Tendency to keep secrets

Schizoid Personality Disorder

Schizoid personality disorder is not the same as schizophrenia, but it does share some of the same characteristics. While schizoid personality disorder does not involve hallucinations or delusions, other common signs include:

  • Disinterest in sex
  • Disinterest in others
  • Inability to relate to others
  • Limited emotional expression
  • Disinterest in forming relationships

Schizotypal Personality Disorder

Those with schizotypal personality disorder may be seen as strange or eccentric by others. They may have strange behavioral patterns that make it difficult to form close relationships and odd beliefs that others find off-putting. Other signs of schizotypal personality disorder include:

  • Flat/emotionless demeanor
  • Social anxiety and a lack of close friends
  • Odd speech, dress, and behavioral patterns
  • Belief in magic, telepathy, or the supernatural
  • Strange perceptions, including hearing voices

Cluster B Personality Disorders

Cluster B personality disorders, sometimes referred to as “dramatic” personality disorders, have symptoms related to extreme outbursts of emotion, contentious relationships with others, and unpredictable thought patterns. If you have a cluster B personality disorder, you might find it very difficult to maintain long-term relationships, make well-thought-out decisions, or feel confident in your identity.

Antisocial Personality Disorder

People with antisocial personality disorder find it difficult to care about the feelings and rights of others. They might commit crimes, exhibit aggressive behavior, and have a lack of remorse for their behavior. Other symptoms include:

  • Poor temper
  • Impulsive behavior
  • Inability to hold a job
  • Repeated criminal activity over years
  • Frequent lying and manipulation of others
  • Inability to form genuine relationships with others

Borderline Personality Disorder

Borderline personality disorder, or BPD, is one of the most well-known personality disorders. This disorder is characterized by intense mood swings, impulsive behavior, and risk for self-harm. People with BPD are especially likely to also suffer from addiction and substance abuse. Common symptoms of borderline personality disorder include:

  • Frequent emotional outbursts
  • Strong fear of abandonment
  • Feeling detached from reality
  • History of many short relationships
  • History or threat of self-harm or suicide
  • Unstable sense of self/personal identity

Histrionic Personality Disorder

The word “histrionic,” meaning overly dramatic or emotional, refers to a person’s tendency to exaggerate things for approval from others. Histrionic personality disorder is diagnosed four times more often in women than men. Symptoms include:

  • Inappropriate seduction
  • Highly sensitive to criticism
  • Easily influenced by others
  • Intense desire for approval from others
  • Manipulating or lying to others to gain attention
  • Exaggerated emotional and behavioral displays
  • Attention-seeking behavior beginning in childhood

Narcissistic Personality Disorder

Another well-known personality disorder is narcissistic personality disorder (NPD). Characterized primarily by an extremely elevated view of yourself, this disorder is sometimes called “megalomania” and usually begins by early adulthood. Other symptoms of NPD include:

  • Little or no empathy
  • A sense of superiority or arrogance over others
  • Strong need for admiration and compliments
  • Inability to maintain meaningful relationships
  • Manipulates other people to achieve goals
  • Strongly defensive against criticism

Cluster C Personality Disorders

Finally, Cluster C, also called the “anxious” cluster, is made up of avoidant, dependent, and obsessive-compulsive personality disorder. These disorders are grouped together because they all exhibit long-term patterns of fearful thoughts and behavior. If you have a Cluster C personality disorder, you might alter your behavior to gain the approval of others and avoid uncomfortable social situations.

Avoidant Personality Disorder

Avoidant Personality Disorder (AvPD) is identified by the long-term, frequent avoidance of social situations. While people with other personality disorders may avoid social interaction due to a lack of interest, people with AvPD avoid social situations based on a fear of rejection. Other common AvPD traits include:

  • Low self-esteem
  • Intense social anxiety
  • A feeling of inferiority to others
  • Extreme sensitivity to rejection and criticism
  • A tendency to abandon relationships for fear of failure or rejection
  • Repeated avoidance of intimacy despite a desire for close relationships

Dependent Personality Disorder

Secondly, dependent personality disorder is diagnosed when a person is chronically dependent on other people to an unreasonable degree. People with dependent personality disorder look to other people for all their needs and feel isolated when relationships end. Other symptoms include:

  • Inability to make a decision alone
  • Extremely low self-confidence
  • Avoidance of basic self-care tasks
  • Sensitivity to criticism and rejection
  • Inability to live independently

Obsessive-Compulsive Personality Disorder

Finally, obsessive-compulsive personality disorder (OCPD) is associated with extreme perfectionism, attention to detail, and orderliness. OCPD is not the same as obsessive-compulsive disorder and is the most commonly diagnosed personality disorder in the US. Symptoms include:

  • Limited emotional expression
  • Perfectionism that interferes with efficiency
  • Extremely rigid moral and ethical framework
  • Excessive preoccupation with lists, schedules, and rules
  • Obsession with controlling circumstances and surroundings

The Connection Between Personality Disorders and Substance Abuse

Personality disorders and addiction are two of the most commonly co-occurring mental disorders. In fact, up to 73% of all patients treated for a substance abuse disorder also have a personality disorder.

The reason that these disorders are so closely connected is that personality disorders have long-term symptoms that affect every aspect of a person’s life. People with personality disorders and addiction usually feel that they need to use alcohol or drugs to deal with the symptoms of their personality disorder.

In addition, one of the most important symptoms of many different personality disorders is a lack of impulse control. This is a significant risk factor for developing addiction and can help explain why personality disorders and substance abuse so often go hand-in-hand.

Dual Diagnosis Personality Disorders and Addiction Treatment

If you’re dealing with personality disorders and addiction, there is help. Dual diagnosis treatment centers are most effective at treating both personality disorders and substance abuse because they treat both disorders simultaneously. This allows patients to recover from the physical effects of substance abuse while also learning new, healthy coping mechanisms for their personality disorders and addiction symptoms.

At North Jersey Recovery Center, we strive to offer the best of care to each of our clients. We understand that some substance use disorders co-occur with mental health disorders. Individuals who suffer from dual diagnoses should have access to treatment services that address their specific and unique needs. This is why we offer a dual diagnosis program. As we help to end addiction in your life, we also want to help you work through the symptoms and effects of your mental health challenges.

North Jersey Recovery Center is highly qualified and experienced in treating personality disorders and addiction. Contact us today to get started on your recovery journey. Allow us to be a part of your next chapter!

Reviewed for Medical & Clinical Accuracy by Laura Riley

Medical Reviewer

Laura comes to NJRC with 23 years of vast clinical experience in hospital, residential, outpatient, and community outreach settings where she has worked, supervised clinical teams, and volunteered. She has provided substance abuse and mental health counseling, clinical coordination, and advocacy to individuals, families and groups, and specializes in co-occurring disorders for both adults and adolescents.