Personality disorder and addiction

When it comes to personality disorders, harmful myths and misunderstandings are unfortunately all too common. From the notion that people with personality disorders are simply attention-seeking to the belief that they are dangerous or beyond help, these misconceptions only serve to fuel stigma and isolation and stop people from reaching out. One truth that cannot be disputed, however, is the immense difficulty experienced when living with both a personality disorder and addiction. At Recovery Lighthouse, we believe it is essential to understand the complexities of the relationship between personality disorders and addiction in order to address them effectively and make meaningful progress in recovery.

Personality disorder and addiction

What are personality disorders?

Personality disorders are a group of mental health conditions characterised by unhealthy, rigid and inflexible patterns of thinking, feeling and behaving. These patterns often lead to significant difficulties in relationships, work and social situations.

The most common types of personality disorders include:

  • Borderline Personality Disorder (BPD): People with BPD typically experience intense and fluctuating emotions, unstable self-image and tumultuous relationships. They often struggle with feelings of emptiness, fear of abandonment and impulsive behaviours, such as substance abuse or self-harm.
  • Narcissistic Personality Disorder (NPD): NPD is a highly misunderstood condition that carries a huge amount of stigma for sufferers. It often causes an inflated sense of self-importance, a constant need for admiration and a lack of empathy for others which can result in sufferers becoming extremely isolated.
  • Obsessive-Compulsive Personality Disorder (OCPD): People with OCPD are preoccupied with orderliness, perfectionism and control, often to the detriment of their relationships and personal well-being. They may have an excessive focus on details, rules and schedules, leading to significant distress if something seems out of place. Individuals with OCPD can also struggle with delegating tasks, relaxing and adapting to change.
  • Avoidant Personality Disorder (AvPD): Characterised by extreme shyness, fear of rejection and social inhibition, people with AvPD often avoid social situations and close relationships due to feelings of inadequacy and hypersensitivity to criticism. They may have a limited social circle and struggle with loneliness, low self-esteem and feelings of inferiority.
  • Antisocial Personality Disorder (ASPD): People with ASPD display a persistent disregard for the rights and feelings of others and engage in dishonesty, impulsivity and aggression. Due to these unwanted and uncontrollable traits, they may get into legal trouble, find it hard to fit into society and show no outward signs of remorse. People with ASPD often struggle with maintaining long-term relationships and can become extremely isolated.

What is dual diagnosis personality disorder and addiction?

Dual diagnosis is when there is a co-occurrence of a mental health and addiction disorder, which can be to substances like drugs or alcohol, or to behaviours like gambling or eating. The complex nature of co-occurring conditions often makes daily management and, crucially, effective treatment more challenging for a successful recovery. A dual diagnosis personality disorder can make it incredibly hard to manage and treat addiction without professional medical assistance.

Why is a co-occurring personality disorder and addiction so common?

The co-occurrence of personality disorders and addiction is common for a variety of reasons, each contributing to the complex relationship between these two conditions:

Emotional issues…

People with personality disorders often experience intense and fluctuating emotions, making it difficult for them to regulate their feelings and reactions to everyday situations. As a result, they may seek relief from these overwhelming emotions through substance use or addictive behaviours. For example, a person with BPD may use drugs or alcohol to numb feelings of emptiness or emotional pain, which can inadvertently lead to addiction.

Difficulties with interpersonal relationships…

Personality disorders often involve difficulties in forming and maintaining healthy relationships, as well as problems with communication and trust. These interpersonal challenges may leave people feeling isolated or misunderstood, leading them to seek comfort in substances or addictive behaviours.


Some people with personality disorders may turn to substances or addictive behaviours as a way to self-medicate their emotional pain or cope with distressing symptoms. For instance, a person with NPD may use alcohol to temporarily boost their self-esteem, while someone with AvPD might use drugs to alleviate their social anxiety. Unfortunately, this self-medication often exacerbates the underlying personality disorder and can lead to the development of addiction.

Impulsivity and poor decision-making…

Many personality disorders, such as antisocial and borderline personality disorders, are characterised by impulsivity and poor decision-making skills. These traits can make individuals more prone to engaging in risky or harmful behaviours, including substance abuse or other addictive behaviours.

Shared risk factors…

Personality disorders and addiction are thought to share some common risk factors, such as genetic predispositions, early life experiences and environmental influences. These overlapping factors can make a person more susceptible to developing both conditions, resulting in a higher prevalence of co-occurring personality disorders and addiction.

Challenges to overcome in rehab

Individuals with personality disorders may face unique challenges in rehab that make recovery from addiction more difficult than for someone without a dual diagnosis. Some of these challenges may include:

Difficulty forming trusting relationships…

In rehab, forming trusting relationships with therapists and peers is crucial for successful recovery as you can lean on your support network during difficult moments. However, people with certain personality disorders, such as BPD or AvPD, may have a hard time building and maintaining trust in their relationships.

Emotional instability…

Emotional instability is a common issue for individuals with personality disorders like BPD. This instability can manifest as sudden mood swings, impulsive actions or self-destructive behaviours that may interfere with the recovery process.

Personality disorder and addiction - emotionally unstable man

Resistance to change…

Some personality disorders, such as OCPD or NPD, may make it difficult for individuals to accept change or adopt new coping mechanisms. This resistance can hinder progress in rehab as you need to be open to change to make real progress.

Struggles with self-esteem and self-worth…

Low self-esteem and feelings of worthlessness are common among individuals with personality disorders, such as AvPD or DPD. These negative self-perceptions can affect the motivation to engage in treatment and work towards recovery.

How is addiction treated when a personality disorder is present?

Treating co-existing mental health and addiction disorders can be challenging, however, Recovery Lighthouse is a facility that not only adapts to your dual diagnosis but is ready to support you.

Before starting treatment at Recovery Lighthouse, it is essential to first speak to your GP about getting your personality disorder symptoms under control. They can help guide you on the best course of action and appropriate treatment options. Once your personality disorder symptoms are managed, you can begin the rehab treatment process.

Effective therapies for a co-occurring personality disorder and addiction

During rehab, various therapies can be effective in treating addiction and addressing the underlying personality disorder simultaneously.

These may include:

  • Dialectical behaviour therapy (DBT): DBT is a type of therapy that uses CBT and mindfulness techniques to help people become more aware of their thoughts and feelings, control their emotions, cope with stress and get along better with others. For people with BPD (for which this therapy was originally devised), DBT can provide emotional regulation skills and prevent them from acting on unhelpful feelings in unhealthy ways (such as using drugs or alcohol to cope.)
  • Group Therapy: Group therapy involves people with similar issues participating in professionally led therapy sessions together. Group therapy can have huge benefits for sufferers of all types of personality disorders. For people with NPD and addiction, for instance, group therapy can provide valuable insights into their patterns of behaviour and help them develop empathy, humility and build healthy relationships.
  • Holistic Therapies: Holistic therapies, such as meditation, yoga, art therapy or acupuncture, focus on treating the whole person, including their physical, emotional and spiritual well-being. This can help sufferers of all personality disorders relax, regulate their emotions and improve their ability to manage social anxiety and cope with stress. In turn, this can support their addiction recovery by reducing the need to rely on substances to self-medicate.
  • Aftercare: Aftercare is a crucial component of the recovery process, as it helps maintain the progress made during rehab. At Recovery Lighthouse, aftercare involves weekly group therapy sessions for a year to provide ongoing support, help individuals manage their addictions and prevent relapse.

Personality disorder and addiction - gong bath therapy

How to get help

If you or someone you know is struggling with a dual diagnosis personality disorder and addiction, Recovery Lighthouse can provide the support and expertise needed for a successful recovery. Reach out today to find out more about our treatment and take the first step towards a brighter and healthier future.

Frequently asked questions

Which personality disorder can cause the most issues when treating addiction?
Each personality disorder presents unique challenges when treating addiction, making it difficult to single out one as the most problematic. The specific issues faced during treatment may vary depending on the individual and the severity of their personality disorder. This is why a tailored approach, addressing the specific needs of the individual, can be crucial for successful addiction treatment when a co-occurring personality disorder is present.
Is rehab a cure for personality disorders?
While it is not a cure for personality disorders, participating in rehab can have significant benefits for people with co-occurring personality disorders and addiction. Many of the therapies used in addiction treatment can also help address the underlying thoughts, emotions and behaviours associated with personality disorders. This can lead to improved coping strategies, better interpersonal relationships and enhanced overall mental health. However, the management of a personality disorder is an ongoing process, often requiring long-term therapy and support.