‘Addictive Personality Disorder’ is a term many Americans search for online. It is also often used to describe the personality traits of people who suffer from substance abuse. But contrary to popular belief, there is no such thing as an “addictive personality.”
Despite many studies, scientists have been unable to come up with unified diagnosis criteria for ‘Addictive Personality Disorder’.
However, the DSM V, the current Diagnostic Manual for all psychiatrists in the US, does list ‘substance abuse disorder’, where the patient abuses drugs, and ‘substance induced disorder’ where a drug causes psychiatric symptoms.
Diagnostic Criteria – when is substance abuse disorder present?
The DSM defines 11 criteria for substance use disorder. The main ones are:
- You feel cravings and a ‘need’ to use the substance.
- Attempts to stop using the substance never succeed.
- You use the substance in high doses, for long time periods.
- Your substance use prevents you from normal functioning.
- Substance use severely impacts your social life and relationships.
- Increased tolerance to the substance, so that you need increasing amounts.
- Development of so-called withdrawal symptoms when you stop taking the substance.
- Substance use may put you in danger due to reckless behavior or resulting physical or psychological harm.
The clinician uses a questionnaire and personal interview to determine how severe your disorder is. Four or five of the eleven criteria suggest a more extreme form of substance use disorder.
Addictive Personality Disorder Traits
Although ‘addictive personality disorder’ is not a scientific term, substance addicts do share some common personality traits.
Patients who are vulnerable to addictions often lack impulse control, find it difficult to regulate their emotions, seek thrills and sensations, and suffer from a low sense of self-worth.
These traits are also very common in other personality disorders as well. Some of these other personality disorders often occur simultaneously with addictions (co-morbidity).
Personality disorders and addiction
The psychiatric disorder most closely linked to the concept of ‘addictive personality disorder’ is Borderline Personality Disorder.
BPD often succumb to substance addictions because they cannot regulate their emotions. Like patients suffering from narcissistic personality disorder, their exaggerated self-image clashes with reality. That can lead to seeking comfort in substance addiction. Major Depressive Disorder also often occurs together with addictions. Patients use the drug to escape from their symptoms.
But alcohol, for example, is a depressant, and therefore makes the symptoms of your depression worse, not better.
What causes substance use disorder?
The DSM V acknowledges that some people are more likely to be affected by substance use. The brain produces ‘feel-good’ and ‘oblivion’ chemicals naturally. Addictive substances flood the brain with similar chemicals, often in much higher doses.
A history of trauma and unresolved developmental issues may also factor in. Childhood abuse and recurring traumatic events often plays a role.
What are the treatments for ‘addictive personality disorder’?
Addictions can be treated with a combination of medication and therapy.
Treatment happens through out-patient appointments or residential care in rehabilitation centers. Recent studies also show a lot of potential for the development of medication to treat alcohol addiction on a biological level.
However, by far, the most popular treatment for addiction in the US is participation in the programs run by Alcoholics Anonymous (AA). This organization, now at 2 million members, is not run by mental health professionals. Instead, it works through peer groups with a flat hierarchy, where people struggling with addiction meet anonymously and process their substance abuse experience.
The AA program has existed since 1934. The main principle is the so-called 12 Step Program, a tool for self-reflection and behavior modification.
AA also provides a mentoring system where members get support from another addict who has been in recovery for at least two years. That mentor is available 24/7 to help prevent relapse.
Part of the AA program is to frame addiction as a disease, and to move away from blaming the addict for their addiction, while putting emphasis on personal transformation and 100% sobriety.
AA has expanded into programs that apply the 12 Step Program to other substance addictions, such as NA (Narcotics Anonymous), addiction based behaviors such as OA (Overeaters Anonymous) and so-called non-substance addictions such as SAA (Sex Addicts Anonymous).
Non-substance addictions remain controversial as a concept, since there is no scientific foundation for ‘Addictive Personality Disorder’. However, unwanted behaviors also seem to respond very well to AA methods.
Research is still ongoing regarding the exact causes of specific addictions, as well as the general mental health conditions of those who succumb to substance abuse.
So far, AA and AA-related programs offer the best recovery options.