Personality disorders are a category of mental health conditions marked by disruptive patterns of thinking, feeling, and behaving, affecting how a person perceives both themselves and the world. This leads to serious challenges in their relationships and daily life.
Co-occurring personality disorders and substance use disorders (SUD) are common and, importantly, treatable. Lasting recovery and stability require addressing both conditions at the same time through an integrated approach known as dual diagnosis treatment. At our drug and alcohol rehab in Atlanta, we provide comprehensive care designed to treat the underlying personality disorder while also helping clients overcome substance misuse, giving them the best chance for long-term success.
What are Personality Disorders?
Personality disorders are a group of mental health conditions involving long-lasting, disruptive patterns of thinking, behavior, mood, and relating to others. These patterns of thought and behavior differ from what is considered normal in mainstream culture and are often inflexible once they emerge in adolescence or early adulthood.
In addition to acting impulsively, people with personality disorders often experience difficulty understanding their own emotions and tolerating distress. Often, people with personality disorders don’t realize their thoughts and behaviors are problematic. This makes it hard for them to relate to others, which can cause serious interpersonal issues that negatively affect their family life, social activities, and work and school performance.1
There are 10 distinct types of personality disorders, each with important differences. These disorders are organized into three distinct groups, or clusters, of A, B, and C.
Cluster A Personality Disorders
Cluster A personality disorders have a consistently dysfunctional pattern of thinking and behavior that reflects suspicion or lack of interest in others. They often involve unusual or odd thoughts and behaviors. Cluster A personality disorders include:1,2
- Paranoid personality disorder, characterized by the patient’s extreme fear and distrust of others and harboring the idea that people are trying to harm them.
- Schizoid personality disorder, characterized by a preference to be alone and a disinterest in having relationships with others.
- Schizotypal personality disorder, characterized by unusual thoughts and ways of behaving and speaking. People with schizotypal personality disorder are uncomfortable in close relationships with others.
Cluster B Personality Disorders
Cluster B personality disorders are defined by a consistently dysfunctional pattern of dramatic, overly emotional thinking or unpredictable behavior. This group of disorders includes:1,2
- Antisocial personality disorder, in which the person maintains a long-term pattern of manipulating, exploiting, or violating the rights of people around them. Antisocial personality disorder is further characterized by aggressive, reckless, or impulsive behaviors.
- Borderline personality disorder, characterized by difficulty managing emotions, leading to impulsivity and feelings of weakness, uncertainty, and emptiness.
- Histrionic personality disorder, in which a person has overly dramatic emotions and impulses and craves attention.
- Narcissistic personality disorder, in which the person lacks empathy and seeks the admiration of others. People with narcissistic personality disorder believe they are better than others and deserve special treatment.
Cluster C Personality Disorders
Cluster C personality disorders have a consistently dysfunctional pattern of anxious thinking or behavior. People in this group tend to have anxious or fearful thoughts. Cluster C personality disorders include:1,2
- Avoidant personality disorder, in which a person is very shy and feels that they are not as good as others. People with this disorder are highly sensitive to criticism and often avoid people because they fear rejection.
- Dependent personality disorder, in which a person depends too much on others and feels they need to be cared for or tended to.
- Obsessive-compulsive personality disorder involves the need for control and order. People living with this personality disorder are often highly inflexible. Obsessive-compulsive personality disorder differs from obsessive-compulsive disorder (OCD), though many of their symptoms are similar.
Symptoms of Personality Disorders
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a reference text that medical professionals consult to diagnose mental health disorders, lists the symptoms of personality disorders as including:3
- An enduring pattern of thinking and behaviors that differs from the expectation of the larger culture
- The pattern of thinking and behavior is enduring, inflexible, and pervasive across a range of social and personal situations
- This pattern is associated with significant distress or impairment across various aspects of life, including social, occupational, and other important areas of functioning
- The pattern is stable and enduring, and can be traced back to adolescence or early adulthood
- The pattern is not better explained by another mental disorder
- The pattern cannot be explained by the psychological effects of substance use or a medical condition such as traumatic brain injury
While the symptoms of each personality disorder differ, every disorder involves problems and uncertainty with how people see themselves.2
The Connection Between Personality Disorders & Addiction
Yes, there does seem to be a connection between co-occurring personality disorders and SUDs.3 There appears to be many possible causes for this connection, including certain biological pathways and factors, both genetic and environmental.
One possible cause for this connection involves the isolation that accompanies many personality disorders. The loneliness that develops can lead to the increased substance use characteristic of SUD. Another possible cause is the impulsivity and poor decision-making characteristic of various types of personality disorders, sowing the seeds for the frequent substance abuse that can lead to SUD.3
Another common explanation for the prevalence of so many mental health disorders co-occurring with SUD involves self-medication, that is, people living with a personality disorder will turn to drugs and alcohol as a means of finding relief from the more distressing symptoms of their disorder. While substance use may provide temporary relief, personality disorder symptoms will return, inciting more frequent substance use and, eventually, addiction.
Can You Treat Personality Disorders & Addiction Together?
Personality disorders and addiction can be treated together. In fact, many treatment programs offer what is known as dual diagnosis treatment, which addresses the SUD and co-occurring mental health disorder simultaneously. This approach takes into account the ways in which personality disorders and addiction can influence and impact each other by providing coordinated care that targets both disorders.
Dual diagnosis treatment is recommended for those with co-occurring disorders, since focusing on just one disorder while leaving the other untreated increases the risk of relapse or worsening mental health symptoms.4
How are Personality Disorders & Addiction Treated?
Dual-diagnosis treatment of a personality disorder and an SUD can take place in a variety of settings, though treatment almost always starts with medical detox, the multi-day process of ridding illicit substances from the body while managing the patient’s most uncomfortable withdrawal symptoms.
Following detox, the dual-diagnosis patient undergoes one or more therapeutic treatments to treat their personality disorder and help them maintain their sobriety. These treatments include residential treatment, partial hospitalization (PHP) treatment, intensive outpatient (IOP), outpatient (OP), and aftercare. Treatments range from the more immersive to the less immersive; the exact treatment plan depends on the patient and their individual needs.
Dual diagnosis treatment can also include the use of prescription medications to manage the patient’s short- and long-term substance withdrawal symptoms. This is known as medication-assisted treatment, or MAT for short.
In treatment, patients typically receive therapy, counseling, and group support to help them avoid relapse by defining and working through their individual triggers. Empowered Recovery Center in Atlanta also employs specific holistic therapies like art therapy, meditation and mindfulness, and breathwork to help patients further engage in their recovery.
Do Medications Treat Personality Disorders?
Currently, there are no medications for specific personality disorders that have been approved by the U.S. Food and Drug Administration.3,5 However, several kinds of medications can help with specific symptoms of a personality disorder. Among them are Selective Serotonin Reuptake Inhibitors (SSRIs), a class of antidepressants that increase serotonin in the brain.
Medications that can be used to treat specific symptoms of personality disorders include:5
- Antidepressants like Prozac® (fluoxetine), Zoloft® (sertraline), Wellbutrin® (bupropion hydrochloride), and Paxil® (paroxetine) can help people with personality disorders whose symptoms include depression, anger, irritability, or hopelessness.
- Mood stabilizers like Lamictal® (lamotrigine), and Eskalith® (lithium) are medications used to ease the mood swings symptomatic of certain personality disorders. They have also been found to reduce impulsivity and aggression.
- Also called neuroleptics, antipsychotic medications can help those whose symptoms include psychosis, or losing touch with reality. They can also help in the management of anxiety or anger. Brand names of neuroleptics include Thorazine® (chlorpromazine) and Haldol® (haloperidol).
- Anti-anxiety medications such as Klonopin® (clonazepam), and Horizant® (gabapentin) can ease patients’ anxiety or trouble sleeping. Some anti-anxiety medications can increase impulsivity in the user, which is why they are not used with some types of personality disorders.
Treating Personality Disorders & Addiction in Atlanta
At Empowered Recovery Center in Atlanta, we help our clients develop the skills they need to create positive changes in their lives. Our addiction and mental health treatments can assist you in working toward long-term recovery and wellness.
We accept many insurance plans and can work with out-of-network insurance plans to get you the help you need. Our rehab admissions team is happy to verify your insurance coverage either over the phone or online so that you’ve got all the details of paying for rehab and using insurance for rehab.
We offer a wide range of rehab programs in Atlanta to suit your needs, including partial hospitalization programs (PHP), intensive outpatient programs (IOP), and outpatient care. We also include one year of free recovery coaching to provide support once you’ve completed your program.
If you’re ready to learn more about our comprehensive treatment offerings, call us today or fill out our contact form to take that first step towards a healthier you.
References
- Mayo Clinic (2023). Personality disorders: Symptoms & Causes. Mayo Foundation for Medical Education and Research. Retrieved July 19, 2025, from https://www.mayoclinic.org/diseases-conditions/personality-disorders/symptoms-causes/syc-20354463
- MedLine Plus (2024). Personality Disorders. National Library of Medicine. Retrieved July 20, 2025, from https://medlineplus.gov/personalitydisorders.html
- U.S. National Library of Medicine (2024). Personality Disorder. National Institutes of Health. Retrieved July 21, 2025, from https://www.ncbi.nlm.nih.gov/books/NBK556058/
- Cleveland Clinic (2022). Dual Diagnosis. Cleveland Clinic’s Health Library. Retrieved July 21, 2025, from https://my.clevelandclinic.org/health/diseases/24426-dual-diagnosis
- Mayo Clinic (2023). Personality disorders: Diagnosis & Treatment. Mayo Foundation for Medical Education and Research. Retrieved July 22, 2025, from https://www.mayoclinic.org/diseases-conditions/personality-disorders/diagnosis-treatment/drc-20354468
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