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Dual Diagnosis: Personality Disorders and Substance Use

man on couch talking with therapist about personality disorders and substance abuse

Substance use disorders are quite common and strongly correlated to various mental health concerns. When this occurs, this is called a dual diagnosis or a co-occurring disorder. If an individual struggles with both a personality disorder and a substance use disorder, they require a comprehensive and individualized dual diagnosis treatment plan. Dual diagnosis treatment can be an effective way to address both disorders simultaneously.

What Are Personality Disorders?

At its core, a personality disorder drastically affects the manner by which an individual perceives themselves and those around them, in a capacity that severely impedes their ability to function in their life, altering the way they think, feel and behave. Personality disorders can make it difficult to:

  • Cope with stress
  • Handle day-to-day issues
  • Take care of work- or school-related responsibilities

Additionally, those with personality disorders often experience intense hardships related to creating and maintaining relationships. Existing relationships are often tumultuous and can be fraught with tension.

The Criteria for Personality Disorders

According to DSM-5 criteria for personality disorders, a person must meet the following criteria, as sourced directly from the guidelines:

A. Significant impairments in self (identity or self-direction) and interpersonal (empathy or intimacy) functioning.

B. One or more pathological personality trait domains or trait facets.

C. Impairments are relatively stable across time and consistent across situations.

D. Impairments are not better understood as normative for the individual’s developmental stage or socio-cultural environment.

E. Impairments are not solely due to the direct physiological effects of a substance (e.g., a drug of use, medication) or a general medical condition (e.g., severe head trauma).

Understanding Different Personality Disorders

There’s a wide range of personality disorders, each with its own set of symptoms. To be diagnosed with a personality disorder, an individual must meet the criteria laid out in the DSM-5 for that specific disorder.

The different types of personality disorders are grouped into three clusters based on similarities in symptoms:

Cluster A personality disorders are characterized by odd or eccentric thinking and behavior. Examples of Cluster A disorders include paranoid personality disorder, schizotypal personality disorder, and schizoid personality disorder.

Cluster B personality disorders are characterized by dramatic, overly emotional, or unpredictable thinking and behavior. Examples of Cluster B disorders include antisocial personality disorder, borderline personality disorder, histrionic personality disorder, and narcissistic personality disorder.

Cluster C personality disorders are characterized by anxious, fearful thinking and behavior. Examples of Cluster C disorders include avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder.

Personality Disorders and Substance Use Disorders

How are personality disorders and substance use disorders related? Those with personality disorders often turn to drugs or alcohol to self-medicate in an attempt to cope with the symptoms they’re experiencing. Substance use can quickly turn into abuse and, eventually, addiction.

When an individual struggles with both a personality disorder and a substance use disorder, this is called a dual diagnosis. Dual diagnosis treatment is an effective way to address both disorders simultaneously.

Treating personality disorders and substance use disorders often requires a comprehensive, long-term treatment plan that includes medication, therapy and other support services.

Effective Treatment for Personality Disorders and Substance Abuse

Like substance abuse and addiction, personality disorders are treated by a variety of psychotherapies or “talk therapies” and, at times, certain medications. What is fortunate about this similar approach is that in some instances, one form of therapy may have the dual benefit of treating both simultaneously. A dynamic method of therapy that is often employed within substance abuse programs actually originated as a means to treat borderline personality disorder. Dialectical behavior therapy has a number of applications in treating some personality disorders and substance abuse. Cognitive-behavioral therapy has also shown promise. This type of therapy seeks to change self-defeating patterns of thinking and behaving.

Therapy is one of the most important treatment methods for personality disorders, as it can help patients learn how to cope with symptoms, develop healthy coping mechanisms and change negative patterns of thinking and behavior. Therapy can also help patients manage stress and triggers, build a support system and develop a relapse prevention plan.

Find Balance Today at Vertava Health Mississippi

If you’re faced with both a personality disorder and a substance abuse disorder, look no further. Vertava Health Mississippi can assist you in finding the proper dual diagnosis care to meet your unique needs so you can begin working towards a more balanced life, body, and mind. Contact us today at 844.951.1931 and set forth on the path towards sobriety.