Personality Disorders & Addiction | Symptoms, Risk Factors, & Treatment

Manish Mishra, MBBS

Medically Reviewed By: Manish Mishra, MBBS

on July 28, 2023

Personality disorders are a type of psychological disorder that can impair a person’s emotional and mental health. They also commonly occur alongside substance use disorders, which is best addressed by mental health care providers and a personalized dual diagnosis treatment plan.

A personality disorder occurs when a person’s personality develops so far outside the cultural norm in some way that it makes it difficult for one to live a functional and healthy life.

There are 10 different personality disorders recognized by the DSM-5, each defined by characteristic, inflexible, problematic, and long-lasting patterns of thinking and behavior. 

Each of these personality disorders can occur alongside other personality disorders as well as many other mental or behavioral issues, including substance use disorder (drug addiction).

Unfortunately, when a personality disorder is present alongside a substance use disorder, the negative effects of both conditions are increased

This makes treatment and recovery more complicated. However, recovery is possible with a personalized dual diagnosis treatment program like the one hosted by Ohio Recovery Center.

Types Of Personality Disorders

The personality disorders recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are commonly grouped as follows:

Cluster A

  • paranoid personality disorder: involving a strong distrust and suspicion of others and a predisposition towards seeing others’ actions as malicious
  • schizoid personality disorder: a person’s personality becomes detached or isolated, causing them to seem or to be indifferent to others
  • schizotypal personality disorder: characterized by eccentric or extremely bizarre beliefs, perceptions, speech, and behavior that can make it hard to relate or interact with others

Cluster B

  • borderline personality disorder: a person struggles to regulate their emotions, experiencing mood swings and heightened anger, anxiety, or depression that may result in unstable relationships, self-harm, eating disorders, and other issues
  • histrionic personality disorder: characterized by a pattern of excessive emotionality and overt, unusual, and attention-seeking behavior
  • narcissistic personality disorder: involving a heightened sense of self-importance, arrogance, entitlement, and exploitation of others
  • antisocial personality disorder: characterized by disregard for the concerns of others, impulsivity, aggression, and deceit

Cluster C

  • avoidant personality disorder: a persistent fear of social situations and criticism provoking an avoidance of social interaction
  • dependent personality disorder: involving a strong psychological need to be with, validated, and taken care of by others that interferes with self-direction
  • obsessive-compulsive personality disorder: distinct from obsessive-compulsive disorder and defined by a need for order and control, inflexibility, and problems with decision making

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Common Symptoms Of Personality Disorders

While the signs, symptoms, and diagnostic criteria for each specific disorder can vary, they all generally involve:

  • extreme, inflexible, and persistent negative personality traits
  • difficulty dealing with stress and negative emotions
  • abnormal behavior
  • problems maintaining healthy relationships both at home and in the workplace
  • periods of disconnection from reality
  • avoidance of other people or authentic relationships

Symptoms Of Substance Use Disorder

A substance use disorder (SUD) is a diagnosable medical condition that occurs when a person’s misuse of a particular substance, be it legal, controlled, or illicit, becomes harmful, compulsive, and unmanageable.

Commonly abused substances in the United States today include alcohol, cannabis, opioid drugs (oxycodone, heroin, fentanyl, etc.), benzodiazepines (Valium, Xanax, Klonopin, etc.), amphetamine drugs (crystal meth, Ritalin, Adderall, etc.), and cocaine.

Substance abuse and addiction is associated with a host of symptoms that include:

  • an inability to fully control one’s own substance use
  • problems with one’s relationships and social connections
  • lack of interest or difficulty keeping up with one’s passions and personal or professional responsibilities
  • increasingly risky patterns of substance use and drug-seeking behavior
  • varying negative health effects (e.g. cardiovascular problems linked to cocaine abuse, liver problems linked to alcohol abuse, or constipation linked to heroin abuse)
  • experiencing cravings and other withdrawal symptoms when one attempts to cut back or stop their substance use

Risk Factors For Co-Occurring Personality Disorders & SUD

With exceptions, most personality disorders begin to develop during adolescence and become ingrained by early adulthood. Once a personality disorder forms, it’s common to begin using drugs or alcohol as a form of self-medication to help deal with negative thoughts and feelings.

Alternatively, those who begin abusing drugs or alcohol and develop a serious substance abuse disorder will sometimes also develop a personality disorder due to the psychological and personality changes associated with severe SUD, as well as the traumatic experiences and victimization those with SUD may experience.

Other common risk factors that can put a person at higher risk for developing these specific comorbidities include:

  • genetic predisposition
  • difficult or traumatic experiences (especially childhood experiences)
  • early patterns of substance abuse
  • other psychiatric disorders

Dual Diagnosis Treatment For Co-Occurring Personality Disorders & SUD

Dual diagnosis treatment provides care for those struggling with both alcohol or drug addiction and some other mental health disorder, including personality disorders. 

This is a highly personalized treatment approach often provided in an inpatient/residential treatment setting.


The primary tool used by clinicians when treating these specific disorders is psychotherapy/behavioral therapy, which are commonly used to treat both personality disorders and SUD.

Whereas cognitive behavioral therapy (CBT) can help participants better direct their thoughts, feelings, and behaviors related to substance use and mental health symptoms, dialectical behavioral therapy (DBT) may be employed to help participants better control and navigate their emotions and emotional responses. 

Many other forms of psychotherapy can also be used as needed.


No medications are approved to treat personality disorders, though antidepressants, sedatives, and certain other meds may be used to manage a person’s symptoms and support their recovery. 

Medication-assisted treatment programs (MAT) may also be recommended to support either opioid or alcohol use disorder recovery.

Ohio Recovery Center (ORC)

At ORC, we host primary treatment services for mental illnesses and addiction, including:

  • medical detox services
  • inpatient substance abuse treatment
  • dual diagnosis treatment for co-occurring disorders
  • behavioral therapy
  • medication-assisted treatment
  • aftercare support

To learn if our mental health and addiction treatment center is a good fit for yourself or a loved one, please contact us today.

  1. American Psychiatric Association - What are Personality Disorders?
  2. National Alliance on Mental Illness (NAMI) - Substance Use Disorders
  3. National Institute on Mental Health (NIMH) - Substance Use and Co-Occurring Mental Disorders
  4. National Library of Medicine: MedlinePlus - Personality Disorders

Written by Ohio Recovery Center Editorial Team

© 2024 Ohio Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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