Substance Abuse and Personality Disorders: How can they be related?

As the underlying causes of substance abuse and personality disorders are similar, it’s not uncommon for them to coexist. When this happens, the symptoms of both disorders are magnified.

Substance abuse is the excessive use of illegal or legal substances, including recreational and prescription drugs such as alcohol, heroin, cocaine, and so on. Substance abuse not only puts you in danger, but also others around you in terms of safety and mental well-being. 

Past research has found that when a person is diagnosed with personality disorders, it increases the likelihood of developing other mental conditions such as Anxiety, Depression, or drug addiction. However, we must realise that coming to terms with two mental disorders and reaching out for help is a huge step in itself in treating them. 

Also read: What is the difference between alcohol dependence and alcohol addiction?

Cluster B Personality Disorders like Borderline Personality Disorder (BPD), Antisocial Personality Disorder (APD), Histrionic Personality Disorder (HPD), and Narcissistic Personality Disorder (NPD) are significantly connected to substance abuse. 

According to an Indian Journal of Psychological Medicine article, BPD and APD  are mainly found to be associated with substance abuse. Perhaps because the characteristics of this group are more likely to make you act compulsively. It is easy to give into the urges readily and seek instant gratification from the drugs readily available.

Nevertheless, It is not to say that there is no way out and nothing can be done. Substance abuse and Personality Disorders are treatable mental conditions that can be worked upon with the right help from experts. 

Borderline Personality Disorder (BPD) and Substance Abuse

Borderline Personality Disorder (BPD) is characterised by 

• Impulsive behaviours, 

• Relationship and emotional instability, 

• Distorted self-image, 

• Feelings of emptiness, and 

• Suicidal thoughts.

It is estimated that about half of the population diagnosed with BPD has a history of drug use.

With BPD, you form a learned psychological dependence on tobacco or drugs like cocaine or alcohol to cope with the agitation and emptiness inside. Needless to say, this is a temporary fix and it often makes you end up feeling worse about the situation that triggered you to abuse drugs or alcohol. 

Moreover, when substance abuse co-occurs with BPD, the effects of both conditions get intensified. So, symptoms such as irritability, impulsive or destructive behaviours, and depression can worsen.

Antisocial Personality Disorder (APD) and Substance Abuse

Antisocial personality disorder (APD) is characterised by a lack of empathy and regard towards other people. One of the defining symptoms of this disorder is acting out impulsively and failing to consider the consequences of your actions on others. 

This can lead to a higher rate of alcohol abuse and alcoholism. The aggressiveness and irritability you experience can also result in poor personal relationships. 

There comes a point where you can no longer spend on drugs or alcohol, this becomes a struggle for the family financially. This can lead to frequently lying and tricking others into lending money. Regardless, illicit drugs can continue giving easy, temporary relief. 

Also read: Can I Talk to My Therapist About My Illicit Drug Use?

Histrionic Personality Disorder (HPD) and Substance Abuse

Histrionic Personality Disorder (HPD) is a Personality Disorder where you constantly seek attention and display exaggerated emotions. Similar to APD, extreme emotional reactions and suicide threats are used to manipulate others.

You learn to indulge in substance abuse as a means to cope with personal and work problems. The tendency to dramatise and exaggerate can also lead you to exhibit risky behaviours, such as injecting substances and indulging in risky sexual behaviours.

Personal relationships seem more intimate to you than with this Personality Disorder. After separation from a friend or a breakup from a romantic relationship, you may experience extreme sadness and hopelessness. In such cases, alcohol or taking drugs may be used to seek comfort from negative feelings. 

Narcissistic Personality Disorder (NPD) and Substance Abuse

This type of Personality Disorder is distinguished by 

• Self-centredness, 

• Lack of empathy for others, 

• An inflated sense of self,

• An expectation of special treatment, and 

• A sense of entitlement

This Personality Disorder can make you resort to drug and alcohol abuse to cope with the discrepancy between your perceived self-image and reality. Like APD, it can also cause you to manipulate others into taking drugs if there is a personal gain.

While Substance Abuse and Personality Disorders each have different symptoms, they still complement each other in different ways for different people. If you are unsure about what kind of help you can seek, talk to our experts.