Personality Disorder Treatment & Addiction Rehab | Dual Diagnosis

Personality Disorder Treatment in Addiction Recovery

According to the 2024 National Survey on Drug Use and Health (NSDUH), approximately 21.2 million adults, ages 18 and older, had a co-occurring mental illness and substance use disorder in the past year. Of those individuals, nearly 6.9 million had conditions that were considered a serious mental illness.

Because the two often go together, understanding personality disorders and how they impact substance use can help you determine whether you or someone you love needs help.

What Are Personality Disorders?

Personality disorders are mental health conditions that cause disruptive patterns of thinking as well as changes to behavior and mood. Individuals with a personality disorder may have difficulty relating to others.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there are 10 types of personality disorders that can be divided into three main clusters. 

Cluster A Personality Disorders 

These disorders are characterized by unusual or abnormal thinking or behaviors. They include:

• Paranoid personality disorder
• Schizoid personality disorder
• Schizotypal personality disorder

Cluster B Personality Disorders

These disorders are characterized by dramatic or erratic behaviors, including emotional instability and impulsivity. They include:

• Antisocial personality disorder (ASPD)
• Borderline personality disorder (BPD)
• Histrionic personality disorder
• Narcissistic personality disorder 

Cluster C Personality Disorders

These disorders are characterized by severe anxiety and fear. They include:

• Avoidant personality disorder
• Dependent personality disorder
• Obsessive-compulsive personality disorder

Individuals with personality disorders often experience intense emotional instability, impulsivity, an unrealistic view of themselves and others, and antisocial behaviors. These behaviors often lead to difficulties in intimate, professional, and family relationships. 

Personality Disorders and Substance Use

Separately, personality and substance use disorders can be incredibly difficult to manage. When they occur together, they often interact in ways that intensify symptoms, complicate diagnosis, and make treatment more challenging.

Therefore, an integrated approach that addresses both conditions simultaneously offers the best chance of long-term recovery. For instance, someone might participate in BPD addiction treatment to address both substance use and a diagnosis of bipolar disorder. 

Symptoms like impulsivity and emotional dysregulation can significantly compound the difficulty of treatment when personality and substance use disorder occur together because these symptoms reinforce each other.

Impulsivity increases the likelihood of acting on cravings without thinking about the consequences, making it harder to maintain sobriety or follow an individualized treatment plan. 

Moreover, emotional dysregulation can drive individuals to use substances as a way to self-medicate to find relief.

Together, they worsen a cycle that includes overwhelming emotions that trigger substance use, substance use that disrupts emotional stability even more, and impulsivity that makes breaking the cycle extremely difficult.

Some individuals turn to substance use to ease the distress caused by the symptoms of emotional dysregulation, including anger, anxiety, fear, or mood instability.

As well, the impulsivity and risk-taking behaviors that are common among people with a dual diagnosis personality disorder may lead to earlier experimentation with substance use, increasing the risk of developing addiction. 

Why Dual Diagnosis Care Matters

Individuals facing a co-occurring substance use and personality disorder need integrated care that understands how each influences the other in ways that make treating one without the other less effective. 

By addressing the two together, individuals learn to break the cycle where their mental illness triggers their substance abuse, learn healthy coping skills that improve emotional regulation and create a plan to recognize and handle their triggers and behaviors that worsen each other.

For these individuals, relapse prevention planning and aftercare are critical tools to support long-term recovery. 

Our Treatment Approach 

At Evolve Recovery Center, our highly qualified team of addiction professionals utilizes a mix of behavioral therapies and interventions to help individuals facing co-occurring personality and substance use disorders. 

Dialectical behavioral therapy (DBT) is the foundation of our personality disorder treatment rehab. DBT is especially helpful because it focuses on the main challenges that are characteristic of both emotional dysregulation and impulsivity.

DBT helps individuals to better understand and manage their intense emotions, develop strategies for coping with crisis or distress, and increase their awareness of their thoughts, emotions, and urges. Furthermore, it helps individuals develop tools to improve their communication and relationship skills.

We also utilize cognitive behavioral (CBT) and other behavioral interventions to support recovery. CBT is useful in the treatment of both conditions because it targets the thoughts and learned behaviors that drive substance use and worsen the symptoms of personality disorders.

Our goal-oriented approach offers stability and structure that improve emotional regulation and decision making. Through an understanding of how thoughts, feelings and actions are connected, individuals can focus on breaking bad habits and developing positive skills that support recovery. 

In addition to our integrated approach to treatment, we believe that a structured environment where boundaries are clearly defined offers the stability and predictability where individuals can stabilize, build healthier coping skills, and gradually replace harmful patterns with healthier ones.

Skills Developed in Treatment

For many with this dual diagnosis, emotional regulation and distress intolerance are drivers of their substance abuse. Developing healthier coping skills not only improves the symptoms of personality disorders but also helps to support long-term sobriety. 

Through individual and group therapy, we help you to understand the connection between mental health and substance use, learn ways to identify and cope with triggers and develop healthier coping skills that promote stability and long-term recovery. 

Long-Term Recovery Planning

The work doesn’t stop after completing our inpatient treatment program. Maintaining long-term recovery takes work. 

We work with you to develop an individualized recovery plan that includes continued therapy to reinforce the skills you learned during treatment and support networks that assist you after you leave. We also connect you with local outpatient providers who can continue to work with you on skill development, emotional regulation skills, and accountability that is critical for long-term recovery.

Our Evolve Alumni Network gives you a place to connect with peers who understand the struggle of living with a personality disorder and addiction at the same time. Here you can share updates and receive the ongoing support you need to live a healthier, happier life outside of treatment.

Frequently Asked Questions