“…each disorder exacerbates the other and also predisposes to relapse in the other. At times, the symptoms can overlap or even mask each other, making diagnosis and treatment all the more difficult.
~Robert B. Pereira, Faces of Dual Diagnosis: a Canadian Perspective
One of the biggest barriers to effective addiction treatment is the fact that it very often co-occurs with other personality disorders, making real recovery from either illness that much harder. The National Bureau of Economic Research says there is a “definite connection between mental illness and the use of addictive substances”.
The Journal of the American Medical Association has reported that:
- Approximately 50% of people with a diagnosable personality disorder also have a substance abuse disorder.
- Percentage of drug addicts with a mental illness – 53%.
- Percentage of alcoholics with a mental illness – 37%.
When a personality disorder co-occurs with a substance abuse disorder, it is described as a “dual diagnosis”.
What Are Some Personality Disorders That Can Co-Occur with Substance Abuse?
Substance abuse disorders – alcoholism, illicit drug addiction, the misuse of prescription medications – and mental/personality disorders have a mutually-complicated relationship – each disorder can cause the other. Furthermore, when one condition worsens, so can the other.
For example, bipolar people may attempt to “self-medicate” with drugs or alcohol to ease the anguish of their condition. But at the same time, substance abuse can trigger the depressed or manic moods that characterize the disorder.
The precise underlying mechanisms that link personality disorders to substance abuse are as yet unknown but may involve complex interactions between psychological and biological factors.
The Substance Abuse and Mental Health Services Administration has said:
- Nearly 9 million American adults suffer from co-occurring disorders.
- Yet, just 7.4% ever receive treatment for both disorders.
- Over half – 55.8% – never get ANY treatment.
Some personality disorders that can be comorbid with substance abuse are:
- Depression– According to the National Institute of Health and the National Comorbidity Study:
- Almost one-third of people with depression will have a co-existing substance abuse disorder at some point in their life.
- Alcohol-dependent men have rates of depression that are three times higher than the population as a whole.
- Alcohol-dependent women have depression at four times the rate.
- Bipolar Disorder– According to the American Journal of Managed Care:
- Approximately 56% of people who are bipolar experience alcohol or drug addiction during their lifetime.
- Alcohol is the most commonly-abused substance of choice for bipolar people – 46% are addicted to alcohol or have abused alcohol in the past.
- 41% are addicted to drugs or have abused drugs in the past.
- Attention Deficit Hyperactivity Disorder(ADHD)–According to the American Psychiatric Association:
- Among adolescents and adults receiving substance abuse treatment, the rate of ADHD is between 25-30%, or four to six times greater than the general population.
- Conversely, approximately half of adults with ADHD will abuse or become dependent on alcohol or drugs.
- The likelihood that an adult with ADHD will develop a substance abuse disorder at some point in their life is twice that of those without ADHD –52% versus 27%.
- Adults with ADHD can take significantly longer to recover from comorbid substance abuse – 144 months versus 60 months.
- Post-Traumatic Stress Disorder (PTSD)–According to the U. S. Department of Veterans Affairs:
- Almost 75% of individuals who survive violent or abusive trauma self-report alcohol use disorders (AUDs).
- Likewise, approximately 33% of survivors of traumatic illnesses, accidents, or disasters self-report problems with alcohol.
- People who have continuing health problems or chronic pain due to past trauma are more likely to abuse alcohol.
- Among veterans with PTSD, 27% also abuse alcohol or drugs.
- Among veterans with substance abuse disorders, roughly 33% have PTSD.
- Up to 80% of Vietnam veterans have an AUD.
- Obsessive-Compulsive Disorder (OCD)– According to the Journal of Anxiety Disorders:
- More than 25% of people in treatment for OCD meet the criteria for a substance abuse disorder diagnosis.
- Schizophrenia–According to various studies, schizophrenic patients abuse the following substances at rates much higher than the general population:
- Alcohol – up to 65%
- Cannabis – up to 51%
- Cocaine – up to 23%
- Certain drugs – cannabis and amphetamines in particular – make the symptoms of schizophrenia worse.
- Chronic methamphetamine abuse can induce schizophrenia-like symptoms.
- Antisocial Personality Disorder (ASPD) – According to researchers at Marquette University:
- Up to 90% of individuals with ASPD abuse alcohol or drugs.
- Conversely, up to 50% of individuals in treatment for substance abuse disorders could meet a diagnosis for ASPD.
- Eating Disorders –According to The National Eating Disorders Association:
- More than half of women who seek treatment for bulimia nervosa – 55% – also meet the criteria for a diagnosis of an alcohol abuse disorder.
- Up to 40% of women who are being treated for alcohol abuse also have an eating disorder.
- More than half of men with an eating disorder – 57% – will have a substance abuse problem at some point in their life.
The incidence of comorbidity is increased when you consider the fact that many people with one disorder – PTSD, for example – can develop anxiety or depression as a result, thereby further increasing the chances that they will develop a substance abuse problem at some point.
All Drug Rehab Programs NOT Created Equal
When addiction co-occurs with a personality/mental disorder, it is absolutely crucial that the clinical staff treats both disorders. Many facilities are simply not equipped or staffed adequately to handle a dual diagnosis. This means that you only get partial treatment for ONE of your disorders – substance abuse.
It is important that you choose a drug rehab program that is CARF-Accredited to provide treatment for dual diagnoses. “CARF” stands for Commission on Accreditation of Rehabilitation Facilities. Programs so certified have met the highest accepted standards of mental health care.
The clinical staff at Northpoint Recovery specializes in the treatment of comorbid disorders and offers an evidence-based and wellness-focused treatment strategy that addresses the unique needs of a person suffering a personality/mental disorder along with their problems with substance abuse.