When someone has a personality disorder, understanding their behavior or knowing how to help can be challenging — especially when addiction complicates the picture. Substance use often worsens symptoms, fueling the struggles of both conditions. In fact, addiction and personality disorders are closely linked, often creating a cycle that makes recovery feel out of reach.
Understanding this relationship is the first step toward helping your addicted loved one break the cycle and find effective, long-term solutions. In this blog post, we’ll explore the connection between addiction and personality disorders, how specific disorders contribute to substance use, and the importance of treating both conditions together.
What is a Personality Disorder?
People with personality disorders think, feel, and behave in ways that can make everyday life harder. These differences often affect how they see themselves and others, manage emotions, and relate to people at work or in social situations. They may also struggle to handle stress or adapt to changes, which can impact their relationships and daily functioning.
Personality disorders are in three groups: cluster a, cluster b, and cluster c. Each group has different types of conditions. The types of personality disorders in each group share some similar features. But they also have their unique symptoms.
Some personality disorders include:
- Paranoid personality disorder
- Schizotypal personality disorder
- Antisocial personality disorder
- Borderline personality disorder
- Narcissistic personality disorder
- Dependent personality disorder
- Obsessive-compulsive personality disorder
Most people with personality disorders were born with genetics that may have played a role in their diagnosis. However, not everyone with these genes will develop a personality disorder. Other factors, like environment and upbringing, may also play a role.
How Do Personality Disorders Affect Addiction?
Personality disorders and addiction are often interconnected. People with personality disorders may turn to drugs or alcohol to manage intense emotions, numb psychological distress, or feel a sense of control. Drug use can cause personality changes on its own, but it goes further than that if the user has a personality disorder. Substance use often worsens the symptoms of a personality disorder, creating a harmful cycle that can make both conditions harder to treat.
Here’s how specific personality disorders can contribute to or be impacted by addiction:
Borderline Personality Disorder (BPD)
People with BPD often experience intense emotions, impulsivity, and unstable relationships, which can make daily life overwhelming. BPD and drug abuse frequently overlap, as people with this disorder may turn to drugs or alcohol to escape overwhelming feelings of emptiness, fear of abandonment, or emotional pain. Though substances might provide temporary relief, they can worsen symptoms like mood swings and impulsive behaviors, creating more conflict and instability in relationships.
Substance use also feeds into the impulsivity associated with BPD, leading to dangerous or self-destructive decisions, such as using larger amounts or combining substances without considering the risks. This can increase feelings of guilt or shame, further reinforcing their reliance on drugs or alcohol to cope.
Narcissistic Personality Disorder (NPD)
People with NPD often feel a need to appear confident and seek admiration, but this can hide underlying feelings of insecurity. Narcissism and drug use often go hand in hand, as substances may be used to boost self-esteem or cope with feelings of failure. Addiction can amplify traits like irritability and grandiosity, particularly when they feel criticized or their need for admiration isn’t met.
Substance use might initially help them cope with setbacks, but as addiction develops, it can erode the sense of control they strive to maintain. This can lead to heightened frustration, outbursts, or even further isolation if their behavior alienates others. Their reluctance to admit vulnerability or seek help may delay treatment, deepening the impact of both the addiction and the personality disorder.
Antisocial Personality Disorder (ASPD)
People with ASPD often act impulsively, disregard rules, and have difficulty feeling empathy. These traits make addiction more likely and can lead to riskier behavior. Substance use may drive actions like breaking the law to access drugs, with little thought about the consequences or harm caused to others.
Once addicted, their symptoms often worsen. Substance use can fuel impulsivity, leading to more frequent or severe risk-taking, such as driving under the influence or engaging in illegal activities to obtain drugs. The inability to empathize with others can make them indifferent to the harm their addiction causes to family, friends, or society, deepening social isolation and conflict.
Schizotypal Personality Disorder
People with schizotypal personality disorder often feel isolated and misunderstood, which can lead to using substances as a way to ease social discomfort or cope with feelings of alienation. However, substance use, particularly drugs like marijuana or hallucinogens, can worsen symptoms such as paranoia, distorted thinking, and unusual perceptions.
As these symptoms intensify, their social anxiety and mistrust of others may grow, pushing them further into isolation. This can make it harder to seek support or maintain relationships, which could otherwise act as protective factors against addiction. The combination of heightened paranoia and reliance on substances can create a self-reinforcing cycle where their symptoms feed their addiction, and the addiction worsens their mental health.
Obsessive-Compulsive Personality Disorder (OCPD)
People with OCPD often have rigid standards for themselves and others, leading to high levels of stress when things don’t go as planned. Substances might initially offer relief, allowing them to let go of their need for control or perfection temporarily. Eventually, though, addiction can disrupt their carefully maintained routines, creating more stress and internal conflict.
As their substance use continues, guilt and shame about losing control can become overwhelming, further fueling the need to self-medicate. Their rigid thinking may also make it harder for them to seek help, as they might feel ashamed to admit they have a problem or believe they should be able to handle it independently. This cycle of stress, guilt, and substance use becomes a destructive loop that can be hard to break.
Avoidant Personality Disorder (AvPD)
Avoidant personality disorder is characterized by extreme sensitivity to criticism and a deep fear of rejection, which often leads to social withdrawal. Substances may temporarily relieve these feelings, making social interactions less intimidating in the short-term — but worsening their sense of inadequacy and reinforcing social avoidance in the long run.
As they rely more on substances, their ability to handle social interactions diminishes, further increasing their isolation. They might avoid seeking treatment out of fear of being judged or misunderstood, which delays recovery and allows their addiction to deepen. The cycle of withdrawal and substance use creates an environment where their fears grow stronger, and the tools they need to break the pattern feel farther out of reach.
How to Treat Addiction and Personality Disorders
Treating addiction and personality disorders together, known as dual diagnosis treatment, is essential because these conditions often feed into each other. Addressing just one can leave the other untreated, leading to relapse or ongoing struggles.
Dual diagnosis programs focus on both conditions simultaneously and comprehensively. It tackles the root causes of both addiction and personality disorders, giving people the tools they need to break the cycle and maintain long-term recovery.
Types of Treatments Used in Dual Diagnosis Programs
- Cognitive-Behavioral Therapy (CBT): Helps identify and change harmful thoughts and behaviors that contribute to addiction and personality disorder symptoms.
- Dialectical Behavior Therapy (DBT): Focuses on managing intense emotions and building skills like mindfulness and emotional regulation.
- Group Therapy: Provides a supportive environment to share experiences and learn from others facing similar challenges.
- Individual Therapy: Offers one-on-one sessions to address personal struggles and develop tailored strategies for recovery.
- Medication Management: Uses prescribed medications to manage symptoms like anxiety, depression, or mood swings.
- Family Therapy: Works to improve communication and rebuild trust within family relationships while educating loved ones about both conditions.
Find Help for Addiction and Personality Disorders
If you or a loved one is struggling with both addiction and a personality disorder, addressing both conditions together is key to lasting recovery. Dual diagnosis treatment can help you uncover the root causes of your struggles, manage symptoms, and build healthier habits for the future.
Our outpatient addiction treatment programs offer therapies like CBT, DBT, and family support to treat addiction and personality disorders simultaneously. With personalized care, you can take the first step toward regaining control and finding balance. Contact us today to learn more about our programs and how we can help.