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Duel Diagnosis

Personality Disorder and Alcohol

Personalities make each of us who we are. They are sets of features and traits that make us feel, act and think in a certain way. Personalities can be shaped by our biology, environment and genetic makeup. While having healthy personalities can help us function daily and deal with life’s challenges, having a personality disorder can make facing everyday life a struggle. 

People with personality disorders may also deal with alcohol use disorder, which can amplify their issues. Sana Lake Recovery Center provides dual diagnosis treatment for personality disorder and alcohol use disorder so that they can take control of their lives and face each day with confidence. 

What is a Personality Disorder?

A personality disorder is a type of mental disorder in which someone has an unhealthy pattern of functioning, thinking and behaving. People with personality disorders have a hard time maintaining relationships and reacting to life changes, which can lead to other mental health issues like depression. They also tend to socially isolate themselves. Personality disorders usually begin in teenage years or early adulthood. 

If you have a personality disorder, you may not realize it since your behaviors seem natural to you. Many times, you may even blame others for your hardships. 

Types and Symptoms of Personality Disorders

The 10 major personality disorders can be grouped into three “clusters”: A, B, and C. Each cluster is defined by different symptoms and characteristics. If people have one personality disorder, they may more often than not have symptoms of other ones as well. 

Cluster A personality disorders are defined by unusual and odd behavior or thinking. These include paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder. 

Symptoms of Cluster A personality disorders include: 

  • Paranoid personality disorder 
  • Suspicion and distrust 
  • Fear 
  • Worry that someone is taking advantage of them 
  • Concern about hidden motives 
  • Schizoid personality disorder 
  • Withdrawing and isolating themselves from others 
  • Having trouble forming and keeping relationships 
  • Having jobs that require little interaction with others 
  • Forming bonds with animals and objects instead of people 
  • Schizotypal personality disorder 
  • Bizarre facial expressions 
  • Lack of close friends 
  • Excessive social anxiety 
  • Strange clothes 
  • “Magical thinking,” or believing you can influence people with your thoughts 

People with Cluster B personality disorders behave emotionally or dramatically, and they often have unpredictable behaviors. These include antisocial personality disorder, borderline personality disorder, histrionic personality disorder, and narcissistic personality disorder. 

Symptoms of Cluster B personality disorders include: 

  • Antisocial personality disorder 
  • Disregard for others’ feelings 
  • Impulsive and violent behavior 
  • Repeated run-ins with the law 
  • Consistent irresponsibility 
  • Borderline personality disorder 
  • Mood swings 
  • Unstable self-image 
  • Unstable relationships 
  • Periods of intense anxiety or anger 
  • Histrionic personality disorder 
  • Emotionally shallow 
  • Risky behavior 
  • Self-centered 
  • Excessively dramatic 
  • Narcissistic personality disorder 
  • Craving attention and admiration 
  • Feelings of jealousy, hurt and rejection often 
  • Disregard for others’ feelings 
  • Expect they should have special treatment 

Cluster C 

Those with Cluster C personality disorders feel constant fear and worry, and they’ll usually have anxiety, too. These include avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder. 

Symptoms of Cluster C personality disorders include: 

  • Avoidant personality disorder 
  • Low self-esteem 
  • Distrust of people 
  • Feeling inadequate 
  • Lack of confidence in building relationships 
  • Dependent personality disorder 
  • Overly dependent on others 
  • Doesn’t like being alone 
  • Constantly tries to please others 
  • Vulnerable to manipulation 
  • Obsessive-compulsive personality disorder (OCPD): This is different from obsessive-compulsive disorder (OCD). OCPD is characterized by an extreme concern with hard work and perfectionism. 
  • Hoarding items 
  • Rigid and stubborn 
  • Extremely tight budgets 
  • Can’t get rid of broken or worthless things 

Risk Factors of Personality Disorders

It’s hard to pinpoint the exact reason why personality disorders come about. Personality disorders are influenced by your environment, but genetics and biology also play a role. There are a few risk factors that have been shown to increase the risk of developing personality disorders: 

  • Being diagnosed with conduct disorder as a child 
  • Differences in brain chemistry and structure 
  • Having an unstable or abusive family life growing up 
  • Having a family history of personality disorders or other mental illnesses 

These risk factors are similar to those that can lead to substance use, especially alcohol use disorder. 

What is Alcohol Use Disorder?

Alcohol use disorder is now an umbrella term that includes alcohol addiction and misuse of alcohol. Because alcohol is legal and readily available in stores, it is one of the most commonly misused substances in the U.S. People with alcohol use disorder usually have trouble controlling how much they drink, have strong cravings to drink each day, or drink alone. They also can’t stop drinking even when it interferes with work or relationships. 

Other symptoms of alcohol use disorder include: 

  • Making excuses to drink 
  • Experiencing withdrawal (nausea, vomiting, shaking, tremors) when not drinking 
  • Having a high tolerance to alcohol (requiring more and more of it to get the same feeling) 

Personality Disorder and Alcohol: How Do They Interact?

It’s no secret that people with personality disorders like to turn to alcohol and other substances as a way to deal with their illness. Borderline personality disorder (BPD) is one of the most common and least understood personality disorders out there. People with BPD tend to have addictive personalities, and this, unfortunately, ties in well with alcohol use disorder. Alcohol already impairs judgment and dulls the senses, making it an attractive but dangerous substance of choice for those who have a personality disorder. 

The tricky part of co-occurring disorders is that it is unclear which condition causes another. While people with personality disorders tend to drink alcohol to escape their feelings, alcohol can also trigger symptoms of distress and isolation. Personality disorders can come with a wide range of symptoms, which is why those who misuse alcohol can develop symptoms similar to these. 

Personality disorder and alcohol use disorder have several signs and symptoms in common: 

  • Mood swings 
  • A pattern of unstable relationships 
  • Participating in risky behavior 
  • Lying and sneaking around 

Seeking Relief Through Alcohol: Coping Mechanisms and Consequences

Individuals with personality disorders may turn to alcohol as a means of coping with the symptoms and emotional turmoil associated with their condition. Alcohol, with its sedative effects and temporary relief from anxiety or depression, can offer a brief respite from the relentless internal struggles experienced by those with personality disorders. 

Exacerbating Symptoms: Alcohol's Impact on Personality Disorders

The apparent relief from drinking alcohol is fleeting and often accompanied by a host of adverse consequences. Alcohol consumption can fuel the symptoms of personality disorders, increasing impulsivity, mood instability, and interpersonal difficulties. 

The Vicious Cycle of Dysfunction: Interplay Between Alcohol and Personality Disorders

The co-occurrence of personality disorders and alcohol use can complicate the clinical picture, making it challenging to distinguish which condition causes the symptoms. 

Challenges in Social Functioning: Alcohol's Effect on Interpersonal Relationships

Individuals with personality disorders often experience difficulties in social functioning and interpersonal relationships. While drinking alcohol may seem like it “takes the edge off” and helps social anxiety and function, it can have the opposite effect. Alcohol use paired with a personality disorder can aggravate pre-existing symptoms, leading to heightened aggression or anxiety. 

Breaking the Cycle: Towards Integrated Treatment and Recovery

It’s important to understand that personality disorders and alcohol use influence each other in a two-way manner. Therefore, effective treatment for both conditions requires a comprehensive approach that addresses them simultaneously. 

Co-Occurring Disorders: Treatment for Personality Disorder and Alcohol Use Disorder

If you don’t treat personality disorder and alcohol addiction at the same time, you could gloss over a detail that may have led to the substance use disorder. 

If you have an addiction to alcohol and you’re admitted to a facility, your first course of treatment will be a medical detox. A detox is designed to flush harmful substances from your system. Alcohol comes with painful withdrawal symptoms, and these should be cared for by licensed clinicians. If you detox alone, withdrawal can be too difficult for you to handle. 

After 30 days in detox, your clinician and psychologist will design an aftercare program that will best treat your personality disorder and alcohol addiction. This will usually involve therapy and some kind of medication. Both outpatient and inpatient therapy options are available at Sana Lake Recovery Center. The best choice for you will depend on the severity of your situation. 

Dialectical behavior therapy (DBT) has been proven to be highly effective on people with personality disorders, especially borderline personality disorder. When it was first created, it was made specifically to treat BPD, but now it treats a wide range of illnesses. “Dialectics” means “balancing opposites,” and the core belief behind DBT is that acceptance can be balanced with change. Mindfulness is a large part of DBT sessions as well. 

DBT can help people with personality disorders and alcohol use disorders lead stable, purposeful lives by teaching them how to regulate their unpredictable emotions. 

People dealing with personality disorders and alcohol addictions need to have people in their corner who can prevent them from relapsing. Group therapy and other support groups like Alcoholics Anonymous (AA) will surround you with former users who have successfully recovered from alcohol addiction and co-occurring disorders. They can share their stories with you so that you don’t feel alone. 

In AA, you are assigned a sponsor who will keep you accountable and be a voice of reason when you’re faced with the urge to drink. 

Find Help for Personality Disorder and Alcohol at Sana Lake

Sana Lake Recovery Center has the best treatment for co-occurring disorders you’ll find in Missouri. Relapse rates are high for people with co-occurring disorders, which is why having quality dual-diagnosis treatment is so important. When you have people in your corner who want to help you through your personality disorder and alcohol addiction, it will be easier for you to find happiness.

Contact us today, and a member of our addiction treatment staff will get you on the path to sobriety. 

Grant, B. F., Stinson, F. S., Dawson, D. A., Chou, S. P., Dufour, M. C., Compton, W., … & Kaplan, K. (2004). Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 61(8), 807-816. 

Trull, T. J., Sher, K. J., Minks-Brown, C., Durbin, J., & Burr, R. (2000). Borderline personality disorder and substance use disorders: A review and integration. Clinical Psychology Review, 20(2), 235-253. 

Sher, K. J., Trull, T. J., Bartholow, B. D., & Vieth, A. (1999). Personality and alcoholism: Issues, methods, and etiological processes. In Handbook of personality disorders: Theory, research, and treatment (pp. 550-574). Guilford Press. 

Shillington, A. M., & Clapp, J. D. (2003). Self-report stability of adolescent substance use: Are there differences for gender, ethnicity and age? Drug and Alcohol Dependence, 71(3), 451-460. 

Linehan, M. M., Armstrong, H. E., Suarez, A., Allmon, D., & Heard, H. L. (1991). Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48(12), 1060-1064. 

Picture of Ashley Murry LCSW
Ashley Murry LCSW
Ashley Murry, LCSW, is the Chief Clinical Officer at Sana Lake Recovery. She oversees clinical operations, ensuring effective treatment strategies and compliance. Before this, she was Program Director at Gateway Foundation, managing care programs and collaborating with state departments. Ashley has also served as Director of Clinical Services at Treatment Management Company, improving staff retention and clinical standards. She holds a Master's in Social Work from the University of South Florida and a Bachelor's in Social Work from Saint Leo University. She is licensed in Florida, Arizona and Missouri.
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