When Personality Disorders and Addiction Are Co-Occurring

Personality disorders are often misunderstood, or else misrepresented in our popular culture. A personality disorder is serious: It distorts an individual’s self-perception, and makes it extremely difficult to maintain stable, steady relationships. Those who struggle with a personality disorder may be more likely to struggle with behavior that is deceptive, manipulative or even abusive. To make matters worse, personality disorders and addiction often go hand in hand.

When they do, they are called co-occurring disorders. Treating co-occurring disorders presents a unique set of challenges, but recovery is possible—and it starts with receiving a dual diagnosis. With dual diagnosis, a caregiver can identify the true root of the problem, and offer an action plan for a lifetime of freedom—both from illness and from addiction.

What are Common Signs of Personality Disorders?

How do you know if you or a loved one has a personality disorder? There are several telltale signs and symptoms. A few of the most common and discernable ones include:


  • Vigorous efforts to avoid the feeling of abandonment
  • The inability to maintain personal relationships with people
  • Wild mood fluctuations

Other Common Signs of Personality Disorders

  • A hard time controlling anger
  • An unsteady or ever-changing sense of the self.
  • Suicidal behavior.

The problem, of course, is that some of these symptoms are also hallmarks of drug or alcohol addiction—something that makes proper diagnosis that much more challenging to come by.

[banner_image_section title=”Learn More About How to Get Help for Addiction”]1st Step Behavioral Health will work with you to address both substance abuse and mental health disorders and the impact they have on your recovery.[/banner_image_section]

What are Common Signs of Addiction?

Of course, there are also several telltale signs and dead giveaways for addiction. Here are just a few of them:

  • Growing tolerance—needing higher and higher doses of a substance to achieve the same effect.
  • Feeling shaky, sick, or melancholy when the effects of the substance wear off.
  • Hiding your substance use, or hiding the negative effects of it.
  • Being unable to stop using the substance in question, even when recognizing its negative impact.
  • Losing interest in hobbies, passions, or relationships that used to be meaningful.

Any of these signs could point to a struggle with addiction.

What is the Connection Between Personality Disorders and Addiction?

Obviously, there is some overlap between personality disorders and addiction. Some of that overlap is summarized here:

  • Both involve behaviors that are impulsive and self-destructive.
  • Both can be accompanied by significant mood swings.
  • Both can encompass behavior that is manipulative or deceitful.
  • Both tend to leave a trail of unstable jobs, relationships, legal problems, and personal finances.

Does this mean that personality disorders cause addiction, or vice versa? Not necessarily. Personality disorders can have a number of causes, including genetics, dysfunctional family environments, neurological factors, and brain chemistry. Indeed, it may be the case that addiction and personality disorders are caused by the same imperfections of the brain.

Determining the true relationship between the two conditions requires a careful diagnosis in a dual diagnosis facility.

Understanding the Need for Treatment in a Dual Diagnosis Case

Because personality disorders and addiction can have overlapping symptoms, it can be difficult to know where one condition ends and the next begins; indeed, it is all too often the case that the presence of addiction masks the underlying problem of the personality disorder. Dual diagnosis care provides insight into both conditions, ensuring that the root issue is addressed—not just the external symptoms.

The initial diagnosis is just the first step, of course. Ongoing treatment is needed to control the symptoms of the personality disorder, and to provide a foundation for lifelong freedom from addiction. Indeed, addiction recovery is possible, but only when clinical treatment is sought. That’s why 1st Step offers dual diagnosis care that places an emphasis on lifelong health, freedom, and recovery.

Learn More About How to Get Help from Co-Occurring Conditions

Hope and help are available for those with personality disorders, addiction, and other co-occurring conditions. The first step is to seek help. Learn more about getting help, for yourself or for a loved one, by contacting 1st Step today.

Reviewed for Medical & Clinical Accuracy by Brittany Polansky, MSW, LCSW

Brittany has been working in behavioral health since 2012 and is the Assistant Clinical Director at our facility. She is an LCSW and holds a master’s degree in social work. She has great experience with chemical dependency and co-occurring mental health diagnoses as well as various therapeutic techniques. Brittany is passionate about treating all clients with dignity and respect, and providing a safe environment where clients can begin their healing journey in recovery.