What Is a Co-Occurring Disorder?
A co-occurring disorder diagnosis is given when an individual simultaneously has more than one condition. Dual diagnosis is when you have a drug or alcohol use disorder and a personality disorder (or any mental health condition). If you have two or more mental illnesses, you must receive treatment for mental health specifically adapted for each one.
There’s no one-size-fits-all when it comes to addiction treatment, and additional specialization is required when a personality disorder is present. If you’re concerned that you might have a dual diagnosis, you should find a treatment facility that’s qualified and experienced in this type of treatment.
Personality Disorders and Substance Abuse
There are personality disorder clusters and not all personality disorders are more likely to be diagnosed alongside addiction, but an extremely high number of people with a SUD have a personality disorder. While cluster A personalities are least likely to be affected and cluster B personalities most likely, anyone with any personality type can become addicted to substances.
A wide range of risk factors and causes of addiction combine to increase a person’s likelihood. Having a personality disorder is a major risk factor.
Types of Co-Occurring Personality Disorder
The DSM-5 describes 10 personality disorders:
Cluster A Disorders
The three cluster A disorders are characterized by erratic and eccentric behavior. They are:
- Schizotypal personality disorder: Someone with this disorder might display strange behavior and eccentric speech patterns and have unusual perceptions of ordinary circumstances. They’re often terrified of social situations.
- Schizoid personality disorder: People with schizoid personalities have no desire to interact with others and are exclusively concerned with their own lives. They don’t care about social norms and rarely respond appropriately to emotions or situations.
- Paranoid personality disorder: People with paranoid personality demonstrate pathological personality traits. That means suspicion and paranoia are part of their everyday life, and they interpret all experiences as validation of their fears of persecution.
Cluster B Disorders
Cluster B disorders are typified by impulsivity and intense emotions, thoughts and behaviors that are often dramatic and highly destructive to their relationships. There are four:
- Borderline personality disorder: Borderline personality involves extreme emotional instability, unstable identity and intense fear of abandonment. People with this illness tend to push people they love away while also demonstrating unhealthy clinginess. Self-harm and suicidal thoughts are common.
- Narcissistic personality disorder: People with this condition have developed a disproportionately large ego as a defense mechanism. They’re incredibly envious of other people, lack empathy and demonstrate an extreme sense of entitlement.
- Histrionic personality disorder: People with histrionic personality have an excessive need for attention and will go to great lengths to get it, even if it puts them at risk of harm.
- Antisocial personality disorder: Antisocial personality is common among people with a criminal background. It involves a lack of empathy, disregard for rules, high levels of aggression and inferior impulse control.
Cluster C Disorders
Anxiety and fear are the driving forces behind the three cluster C personality disorders:
- Dependent personality disorder: People with dependent personalities require constant care, validation and comfort from others. They view themselves as profoundly incapable and helpless, causing them to hand power over to others.
- Avoidant personality disorder: Avoidant personalities feel deeply unwanted and unlovable, often believing they’re a burden to the world. Because of their excessive fears of rejection and embarrassment, they avoid situations that could trigger them, causing significant functional impairment.
- Obsessive-compulsive personality disorder: Unlike OCD, obsessive-compulsive personality disorder specifically makes the individual obsessed with perfection and order. They’re highly critical of themselves and others, making them controlling, risk-averse and lacking in patience.
Addressing Substance Use Disorders That Stem From Personality Disorders
Millions of people struggle with co-occurring substance use disorders and mental illness, and science has come a long way to help them in recent years. Even people with multiple diagnoses in Austin, Texas, can find joy and relief through addiction and mental health treatment. According to NIDA, there are specific criteria all addiction treatment programs must fulfill, including:
- Addressing the underlying causes of addiction and not just the symptoms
- Assessing them to see if any other mental illnesses are present and providing treatment
- Customizing treatment programs according to that person’s specific needs
- Offering ongoing support
- Updating and refining programs as you progress through recovery
When you seek treatment for co-occurring personality disorders and addiction, you’ll receive a mixture of the following treatments:
- Individual behavioral therapy — for example, CBT, DBT or EMDR
- Education about addiction
- Education about your personality disorder
- Medication management if necessary
- Ongoing mental health evaluation
- 12-step group sessions
- Recovery-oriented group therapy
- Life skills training
- Relapse prevention
- Nutrition education
- Experiential therapy
Which Personality Disorder Is Most Frequently Seen Alongside Substance Use Disorders?
Borderline personality disorder and antisocial personality disorder are the two personality disorders most frequently seen alongside addiction. Below is some theory suggesting why:
- BPD: Borderline personalities are typified by extreme emotional reactions and chronic difficulty handling stress and triggers. When someone with this disorder feels upset, it impacts them intensely, and they lack the coping mechanisms to self-soothe. Addictive substances can provide the necessary relief almost instantly, and their lack of impulse control makes resisting temptation harder.
ASPD: Individuals with antisocial personalities don’t have the same regard for rules or follow social norms as most people. They’re prone to aggression, lying, irresponsibility and a lack of remorse, which makes them more susceptible to addiction. People with ASPD often get into trouble with the law, have little direction and lead stressful lives, all of which make substance abuse more likely.
Is Treating Patients With Personality Disorders More Difficult Than Other Mental Disorders?
There’s a stigma around treating personality disorders that are thankfully dissolving. If you have a personality disorder, speak to the staff at treatment facilities to find out whether they can cater to your needs. If they’re hesitant about accepting people with PDs, choose a different rehab that’s experienced and capable.
With professional support and guidance, anyone with a personality disorder can learn how to thrive without substances. It might take a little more time to heal following a dual diagnosis than addiction alone, but anyone can do it.
Dialectical behavior therapy has been designed with personality disorders in mind. They involve in-depth psychotherapy sessions in which you gain insights into addiction, mental health, your triggers and effective coping mechanisms. You can gain control over your symptoms by learning how to manage your emotions, process trauma, and understand yourself.
Other Mental Health Disorders Frequently Seen Alongside Substance Addiction
Other psychiatric disorders that are seen alongside alcohol and drug use disorders include:
Dual Diagnosis Alcohol and Drug Addiction Treatment for Co-Occurring Disorders
Psychiatric comorbidity urgently requires specialized treatment from experienced, compassionate addiction experts. Contact us and reach out to a mental health clinician at Alta Loma, near Austin, Texas, or reach out by phone at 866-457-3843 today for immediate service.