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Personality Disorders and Addiction Treatment for Women

Line drawing of a butterfly with NDFWPersonality is the way a person thinks, feels, and behaves that makes them different from other people. Many people suffer from personality disorders. Many people also suffer from personality disorders and substance abuse

Personality is affected by:

  • Experiences
  • Environment (life situations, surroundings)
  • Inherited traits


What is a Personality Disorder?

Typically, a person’s personality stays the same throughout his or her life. A personality disorder is a long-term way of thinking, feeling, and behaving that veers off significantly from the expectations of society. This causes distress or problems with functioning and lasts over time. 

As a result, people living with personality disorders will need some sort of behavioral therapy to treat their conditions. Behavioral therapy is clinical psychology that treats mental health disorders. Behavioral therapy also changes the unhealthy behaviors that individuals may exhibit. 

People usually start showing signs of a personality disorder in their late teens or early adulthood. These disorders can affect people for a long time if they go without treatment. Personality disorders affect the way people are able to do at least two of the following things:

  • React emotionally
  • Relate to other people
  • Control their behaviors
  • Think about themselves

How Common Are Personality Disorders?

Among severe mental disorders, personality disorders are the most common. Often, personality disorders occur alongside substance use disorders, anxiety disorders, and/or mood disorders (i.e. depression or bipolar disorder). Personality disorders and substance abuse, in particular, often co-occur. 

Gender and Personality Disorders

Some personality disorders are more common in women than in men. Examples of such personality disorders include borderline personality disorder (BPD) and histrionic personality disorder. However, antisocial personality disorder (ASPD) and obsessive-compulsive personality disorder (OCPD) are more common in men.

Personality Disorders and Substance Abuse

There have been a number of studies that suggest that personality disorders occur more often among those struggling with drug and alcohol addiction as compared to the general population. 

This may especially be the case for those suffering from antisocial, borderline, avoidant, and paranoid personality disorders. Unfortunately, the co-occurrence of personality disorders and substance abuse happens more commonly than many people may realize.

What Causes Personality Disorders?

Unfortunately, personality disorders are some of the least understood and recognized mental disorders. Professionals believe that both genetics and the environment play parts in the development of personality disorders. 

Some personality disorders appear to be linked to a family history of mental illness. For example, people with antisocial personality disorder are more likely to have family members who also suffer from personality disorders. Also, a family history of depression could be a risk factor for the development of borderline personality disorder or obsessive-compulsive personality disorder.

Even though research on personality disorders has been limited, no studies have shown that a person is born with a personality disorder. Similar to many other mental health disorders, the tendency to develop a personality disorder is inherited. Personality disorders appear when something interferes with the development of a healthy personality. 

The 10 Types and Symptoms of Personality Disorders

There are 10 distinct types of personality disorders. These types of personality disorders are broken down into 3 clusters of personality disorders. These include Cluster A, Cluster B, and Cluster C groups.

Schizoid Personality Disorder

Individuals twith schizoid personality disorder are detached from social ties and display little emotion. Individuals with schizoid personality disorder typically:
  • Prefer to be alone
  • Don’t seek close relationships
  • Seem not to care about praise or criticism from others

Schizotypal Personality Disorder

Individuals who suffer from schizotypal personality disorder display a pattern of being very uncomfortable in close relationships, having distorted thinking, and exhibiting bizarre behavior.  A person with schizotypal personality disorder may also do the following:
  • Have odd beliefs
  • Have extreme social anxiety
  • Engage in odd or peculiar behavior or speech

Paranoid Personality Disorder

People who suffer from paranoid personality disorder are overly suspicious of others. As a result, they often see others as being spiteful or mean. Individuals who suffer from paranoid personality disorder may also do the following:
  • Assume people will harm or deceive them
  • Avoid confiding in or becoming close to other people

People who suffer from Cluster B personality disorders tend to be dramatic and eccentric. Below are descriptions of the cluster B personality disorders.

Histrionic Personality Disorder

Individuals with this disorder display a pattern of excess emotion and attention-seeking. Individuals with this disorder may also:

  • Use physical appearance to get attention
  • Be uncomfortable when they’re not the center of attention
  • Have emotions that shift rapidly or are over-exaggerated

Borderline Personality Disorder (BPD)

People with this disorder show a pattern of instability in personal relationships, intense emotions, poor self-image, and recklessness. BPD is one of the cluster B personality disorders that most cause people to resort to drug or alcohol abuse to cope. 

Individuals who suffer from BPD may also do the following:

  • Have repeated suicide attempts
  • Go to extremes to avoid being abandoned
  • Demonstrate inappropriate, intense anger
  • Have continuous feelings of emptiness
BPD and Substance Abuse

Personality disorders and substance abuse are frequently co-occurring disorders. This is especially true when it comes to the personality disorder BPD. It’s common for people with borderline personality disorder to suffer from co-occurring substance use disorders.

BPD is a complex and serious mental health disorder, and it’s the only personality disorder that features suicide attempts or self-harming actions. Individuals who suffer from BPD and substance abuse should seek co-occurring disorder treatment immediately. 

A history of childhood trauma such as physical or sexual abuse, neglect, or an early loss of a parent is common in people with BPD. This is because many people with BPD developed its symptoms as a way to cope with childhood trauma. 

Not all people with BPD are coping with a history of childhood trauma though. So, it’s essential that individuals who suspect that they may be suffering from BPD receive a diagnosis from experienced medical professionals.

Challenges of Treating BPD and Substance Abuse

Individuals with BPD and co-occurring substance use disorders present some particular challenges when it comes to treatment. BPD is difficult to treat partly because of its far-reaching, destructive nature.

Using alcohol and drugs often worsen the impulsivity, suicidal tendencies, and self-harm risks that are associated with BPD. On the flip side, the presence of BPD can contribute to the severity of substance addiction symptoms. Thus, the course of substance abuse treatment can be made more complicated for people who suffer from BPD. 

When a person suffers from two co-occurring disorders at the same time, such as BPD and a substance addiction, it’s called dual diagnosis. Since co-occurring disorders often affect one another, individuals who suffer from dual diagnoses must treat their conditions simultaneously. 

Women and Borderline Personality Disorder

The criteria for personality disorders were standardized in 1980. Since then, all versions of the Diagnostic and Statistical Manual of Mental Disorders have indicated that BPD is positively more common in women than men. In fact, women were about 75% of people diagnosed with BPD in the U.S. 

Still, it isn’t known whether women are actually more likely to develop BPD or if there is just gender bias in the diagnosis of BPD. It’s possible that men with symptoms of BPD are more likely to be diagnosed with a different condition like post-traumatic stress disorder or major depressive disorder.

That being said, BPD affects mostly young women. People with BPD often suffer from other mental health issues though. Some common co-occurring mental health disorders to BPD include: 

  • Anxiety disorders
  • Eating disorders
  • Substance use disorders

A misdiagnosis can be a serious problem. For one, there are no medications approved by the Food and Drug Administration (FDA) for treating BPD. In addition, bipolar disorder medications are often not effective in treating BPD. Thus, misdiagnosed BPD patients may be accidentally exposed to the wrong prescription medications. This, in turn, may cause individuals to experience the dangerous side effects of personality disorders and substance abuse.

Although BPD and bipolar disorder share some similar symptoms, they are very different. While bipolar disorder can cause people to experience severe depression or mood swings, people with it can function normally between episodes. People with BPD might have a more chronic condition on the other hand that can cause self-harming behavior or suicidal tendencies.

Narcissistic Personality Disorder

Individuals who have narcissistic personality disorder display a pattern of need to be admired and a lack of empathy for others. As a result, narcissists may:

  • have an extravagant sense of self-importance
  • have a sense of entitlement
  • take advantage of others

Antisocial Personality Disorder (ASPD)

People who are living with ASPD typically display a pattern of not considering and possibly even violating the rights of others. An individual who suffers from ASPD may:

  • Not observe social norms
  • Lie repeatedly 
  • Deceives others
  • Act impulsively
  • Lack empathy

People who exhibit the traits that are associated with ASPD don’t develop them overnight. Instead, such individuals slowly develop antisocial personality disorder and its traits over time. When this happens, peers may likely begin to avoid these individuals. This only worsens the antisocial behavior of people who deal with this personality disorder. 

ASPD and Substance Abuse

ASPD and substance abuse often occur in people simultaneously. This is partly due to the fact that many people with antisocial personality disorder also tend to fail in school. As a result, people with ASPD seek out peers. 

By this time though, some of the only connections that people with ASPD can make are with people who use drugs or behave in deviant ways. This is not a good thing as drug addiction tends to introduce antisocial behavior in some people or worsen them in people that already suffer from ASPD.

People may seem like they’re immune to being affected by their peers, but if everyone around an individual who suffers from ASPD is behaving badly, the antisocial behaviors of that person may become even more extreme.

Furthermore, if the unhealthy behavior that a person who has ASPD exhibits starts to include substance abuse, that person could easily feel the need to abuse more and more substances to cope until he or she develops a co-occurring substance addiction. 

Treating ASPD and Substance Abuse

It’s tempting for people who suffer from personality disorders and substance abuse to just focus on the substance use problem. This is because that is probably the issue that is causing individuals with ASPD and substance abuse issues the most pain. 

However, it’s important to realize that antisocial behavior lies beneath substance use issues. Sometimes, even that behavior is rooted in a form of mental illness which must also be treated. 

Individuals who suspect that they may be suffering from ASPD need medical professionals to evaluate them with several mental health tests. Such mental health tests may reveal that a person that is suspected of suffering from ASPD is indeed suffering from that particular personality disorder. 

Mental health tests may also reveal that a person that is suspected to be suffering from ASPD may actually suffer from schizophrenia, depression, or some combination of mental health disorders. As long as any mental health disorder diagnosis is accurate, a treatment program can be put together to include all of an individual’s issues. 

Cluster C personality disorders often feel fearful and anxious. These fear and anxiety-ridden personality disorders include the following:

Avoidant Personality Disorder

People who suffer from avoidant personality disorder exhibit a pattern of extreme shyness, feelings of deficiency, and extreme sensitivity to criticism. As a result, people with this disorder may:

  • Be unwilling to get involved with others unless they are sure of being liked
  • Be preoccupied with being criticized or rejected
  • View themselves as not being good enough
  • Be socially incompetent

Dependent Personality Disorder

Individuals with dependent personality disorder are clingy and submissive. People who suffer from dependent personality disorder also usually need to be taken care of. 

As a result, these individuals may:

  • Have difficulty making decisions without reassurance
  • Feel uncomfortable or helpless when alone
  • Be unable to care for themselves

Obsessive-Compulsive Personality Disorder 

Obsessive-compulsive personality disorder (OCPD) isn’t to be confused with obsessive-compulsive disorder (OCD). OCPD disorder features a pattern of preoccupation with orderliness, perfection, and control. Thus, people who suffer from OCPD may:

  • Be overly focused on schedules and details
  • Work excessively and not allow time for leisure or friends
  • Be firm in their morality and values

Treatment for Personality Disorders and Substance Abuse

Some types of psychotherapy (talk therapy) help treat personality disorders. Certain forms of psychotherapy can also help treat personality disorders and substance abuse. 

During therapy sessions, an individual can get insight and knowledge about his or her personality disorder and what contributes to its symptoms. With the help of a therapist, individuals with personality disorders can also talk about their thoughts, feelings, and behaviors. 

Psychotherapy helps individuals with personality disorders do the following: 

  • understand the effects of their behaviors on others 
  • learn to manage and cope with symptoms
  • reduce behaviors causing problems with relationships

Commonly used types of psychotherapy include:

Also, family therapy can be helpful. Family members can be important in an individual’s recovery. They can work with the individual’s therapist on the best ways to help and support their loved one.

Having family members who have personality disorders and substance abuse can be very stressful. In that case, family members of the individual with personality disorders and substance abuse issues may also benefit from talking with a therapist who can help them cope. 


There are no medications that specifically treat personality disorders. However, medications such as antidepressants, anti-anxiety medications, or mood stabilizers may be helpful in treating some personality disorder symptoms. 

Likewise, these medications can be used in easing withdrawal symptoms from substance use. More severe or long-lasting withdrawal or personality disorder symptoms might call for a team treatment approach that involves a primary care doctor, a psychiatrist, a psychologist, a social worker, and family members.

Where Can You Get Dual Diagnosis Treatment?

Line drawing of a woman

Individuals can receive dual diagnosis treatment that’s both personalized and specialized at New Directions for Women. New Directions for Women is a female-only facility with over 40 years of providing support for women in addiction recovery along with their children and families. 

Here at New Directions for Women, we offer various levels of care that individuals that struggle with personality disorders and substance abuse can take advantage of. Our levels of care include everything from detox to inpatient treatment, to outpatient treatment, to aftercare treatment, and hopefully a dual diagnosis. Thus, women that need to receive addiction treatment or dual diagnosis treatment for co-occurring substance use and mental health disorders can receive the level of care that they need at our facility. 

New Directions is nationally known for serving women with children and pregnant women. We also serve more mature women. In doing so, we help older mothers and grandmothers not only achieve and maintain sobriety, but also enjoy their families as they do so. 

At New Directions, we understand that some women have a difficult time recovering from addiction and their possible co-occurring mental disorders in a co-ed facility. That’s why we specialize in treating women. If you or any other females that you care about need help overcoming co-occurring disorders that are made out of substance addiction and mental health disorders, please contact us now. We are here to answer your questions.

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Clinically Reviewed By:

Heather Black-Coyne, LMFT, CADC II, Chief Clinical Officer

Heather Black-Coyne, LMFT, CADC II, Chief Clinical Officer

Heather most recently served as the Clinical Director of a gender-specific treatment center in Huntington Beach. She is trained in both Dialectical Behavior Therapy (DBT) and Eye Movement Desensitization and Reprocessing (EMDR), which serve the needs of our clients, many of whom have experienced both complex trauma and substance use disorder.

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