Approximately 57.8 million people, or 1 in 5 adults in the United States, struggle with mental health issues each year. An estimated 28% of those individuals have been diagnosed with a comorbid personality disorder or with two or more mental health conditions or addictions. When a link exists between addiction and mental illness, diagnosis and treatment can be challenging. However, both must be addressed for a successful outcome. This article covers the connection between mental illness and addiction, some of the most common disorders and their treatment challenges and options.
The Connection Between Personality Disorders and Substance Use
Personality disorders are mental health conditions that change the way a person thinks, behaves, reacts and relates to others. Most comorbid conditions are long-lasting and, without proper treatment, can affect daily life. Unfortunately, only half of adults with mental illness seek help due to the stigmas associated with treatment, cost of care or lack of access. As a result, many turn to drugs and alcohol to self-medicate and find relief. This long-term drug and alcohol use often leads to addiction.
Addiction symptoms tend to be more severe for those with a history of mental illness. Higher relapse rates, more extended hospital stays and an increase in treatment dropout rates are also noted. Because personality disorders affect behaviors, emotions and relationships, it can be more challenging for an individual to fully take part in and understand the importance of their treatment.
Common Personality Disorders Linked to Addiction
While almost any personality disorder can occur with addiction, some are more frequently associated with it.
Borderline Personality Disorder
An individual with borderline personality disorder has difficulty regulating their emotions. They go through periods where they seem extremely agitated or angry and even act recklessly. Individuals with BPD have a hard time keeping a job or maintaining their schoolwork and often struggle with personal relationships. Those with BPD are at higher risk for suicide, depression, anxiety, self-harm and addiction, so getting help is extremely important.
Antisocial Personality Disorder
An antisocial personality disorder is a mental health condition that causes aggression toward people and animals. A person with an ASPD seems to care only about themselves and displays a lack of regard for the feelings and rights of others. They’re manipulative, violent and cruel and always seem angry. They also engage in reckless behaviors, such as substance abuse.
Depending on the severity of the condition, a person may break the rules or resort to serious crimes, such as the destruction of property and theft. Children with ASPD tend to skip school and are often disruptive in class. ASPD affects men more than women and may be caused by genetics and a history of childhood neglect.
Dependent Personality Disorder
Individuals who seem helpless and rely on others to take care of them may have a dependent personality disorder. They often seem clingy and needy, have a hard time making decisions on their own and constantly need reassurance. Those with a DPD turn to alcohol and drugs as a coping mechanism.
Avoidant Personality Disorders
People with an avoidant personality disorder are extremely shy and tend to avoid social situations. They don’t like speaking up in school, have low self-esteem and struggle to form friendships. Individuals with AvPD tend to get their feelings hurt easily, and the fear of rejection keeps them from trying new things and taking part in activities. Many times, an individual with AvPD turns to drugs and alcohol as a way to ease their discomfort in social settings.
Narcissistic Personality Disorder
Narcissists are arrogant and selfish and need to impress others or feel important. Individuals with narcissistic personality disorder often have inflated feelings of self-worth, expect to be treated better than others and can get angry when this doesn’t happen. Substance abuse can help mask any underlying insecurities and personal issues.
Challenges in Dual Diagnosis Treatment of these issues
Dual diagnosis treatment poses some unique challenges for anyone trying to recover from substance addiction. Most treatment facilities require an individual to be sober before starting mental health treatment because each condition influences the other. The most common challenges include:
- Undiagnosed symptoms. Symptoms of addiction and mental illness often overlap, which can make proper diagnosis difficult. For example, someone with depression may turn to alcohol as a way to cope, but alcohol addiction can lead to depression.
- Costs. Some insurance companies cover mental health treatments but not substance addiction. Others may expect a single physician to provide a full range of treatments. This can make it difficult for a person with a comorbid personality disorder to get the care they need.
- High relapse rates. The inability to control and manage emotions can increase the relapse rates for substance abuse.
- Therapy issues. Individuals with personality disorders who experience emotional outbursts or have difficulties with relationships may be disruptive in group therapy sessions or may not be able to form alliances with providers.
- Lack of access. Some locations don’t have adequate resources to provide comprehensive treatment options for those with comorbid disorders.
Effective Treatment Strategies for Co-Occurring Disorders
The treatment for co-occurring disorders requires a combination of therapy, support and medication to address substance abuse and personality disorders. Some of the most successful strategies include:
Cognitive Behavioral Therapy
Sometimes called talk therapy, cognitive behavioral therapy helps individuals identify and change how they think and respond in certain situations. CBT can help address addiction and personality disorder symptoms at the same time.
Dialectical Behavior Therapy
Dialectical behavior therapy is another form of talk therapy for individuals with borderline personality disorders or those who feel emotions more intensely than others. It’s also sometimes used to treat eating disorders, PTSD and depression. Patients learn mindfulness techniques, tolerance, emotional regulation and how to communicate with others.
Medication-Assisted Treatment
Medication-assisted treatment is a short-term solution to help individuals struggling with a personality disorder and addiction deal with intense withdrawal. Common medications used in MAT include methadone, buprenorphine and naltrexone.
Integrated Dual Diagnosis Treatment
Integrated dual diagnosis treatment ensures addiction and personality disorders are addressed through therapy and other supports at the same time. It may include behavioral therapies, medication, support groups and inpatient or outpatient care.
Getting Help for a Comorbid Personality Disorder
If you or someone you love has a comorbid personality disorder and needs help, contact Restore Mental Health to speak to one of our counselors. We can provide information on the available treatment options and get you focused on recovery.
