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Personality Disorders & Substance Use: Signs, Symptoms, and Treatment Options in Maryland
Personality disorders are long-term mental health conditions that affect the way a person thinks, feels, and relates to others. [1] When traits like impulsivity, emotional volatility, or chronic emptiness are present, the risk of turning to drugs or alcohol as a coping mechanism increases.
Unfortunately, traditional addiction treatment often overlooks these underlying personality patterns, making relapse more likely without the right kind of care. That’s why personality disorders and addiction treatment centers in Maryland, such as The Freedom Center, offer specialized dual diagnosis programs that address both issues at the same time for lasting recovery.
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Key Points
- Personality disorders and substance use often fuel each other and need to be treated at the same time.
- Traits like borderline instability or narcissistic defensiveness are common in people struggling with addiction.
- Dual diagnosis programs in Maryland offer therapy, psychiatric care, and relapse prevention for both conditions.
- The Freedom Center provides personalized, trauma-informed care to foster lasting healing and emotional well-being.
What Are Personality Disorders?
Personality disorders are complex, long-standing mental health conditions that shape the way someone experiences emotions, thinks about themselves, and interacts with others. [2]
These deeply rooted patterns can make it difficult to maintain stable relationships, hold a job, or navigate everyday situations. Many individuals with personality disorders face ongoing challenges with self-esteem, emotional control, and trust in personal or social settings.
Some of the most common types include:[3]
- Borderline Personality Disorder (BPD): Marked by intense emotions, fear of abandonment, impulsivity, and unstable relationships.
- Narcissistic Personality Disorder (NPD): Characterized by a need for admiration, low empathy, and fragile self-esteem beneath a confident exterior.
- Antisocial Personality Disorder (ASPD): Often linked to disregard for others’ rights, manipulation, and impulsive behavior.
These disorders often require long-term, structured treatment. Without support, symptoms can lead to self-destructive choices, including substance use.
That’s why personality disorders and addiction treatment centers in Maryland, such as The Freedom Center, offer specialized care that addresses both challenges at once. These personality disorder treatment centers utilize a combination of therapy, medication, and personalized support to help clients achieve real, lasting change.
Addiction and Personality Disorders
Personality disorders and addiction often overlap in ways that create a complicated and painful cycle.[4] Traits like impulsivity, emotional instability, or chronic emptiness can lead to using drugs or alcohol in an attempt to self-soothe or escape. Substance use rarely helps in the long run—it usually deepens emotional distress and makes the symptoms of the personality disorder harder to manage.
Take Borderline Personality Disorder (BPD), for example. Intense mood swings, fear of abandonment, and overwhelming emotions can drive a person to seek relief through substances.[5] Unfortunately, this often results in more chaos—more emotional crashes, more risky behavior, and more broken connections.
For those with Narcissistic Personality Disorder (NPD), addiction can look different.[6] Substances might be used to maintain a sense of control, boost self-image, or numb uncomfortable feelings like shame or insecurity. As addiction takes hold, denial, defensiveness, and manipulation can increase, complicating both recovery and relationships.
In the end, drug addiction and personality disorders tend to feed off one another. Without addressing both at the same time, sustaining recovery is difficult. That’s why dual diagnosis care, like the programs offered at The Freedom Center in Maryland, is so important. Treating both conditions together provides a path toward real stability and healing.
Signs Someone May Need Dual Diagnosis Treatment
When personality disorders and addiction go hand in hand, it can be hard to tell where one issue ends and the other begins. Certain signs indicate that both conditions may require treatment in a dual diagnosis program.
They might notice patterns like unstable or chaotic relationships, emotional outbursts, or behaviors like self-harm and impulsive decisions. If someone frequently turns to drugs or alcohol to cope with these feelings—or if their mood swings, identity struggles, or reactions feel extreme—it could point to a deeper, underlying condition.
Many people with co-occurring disorders find it nearly impossible to stay sober without addressing their mental health treatment needs.[7] That’s why personality disorders and addiction treatment centers in Maryland, like The Freedom Center, offer integrated care that treats the whole picture.
If emotional volatility, manipulative tendencies, or antisocial behavior are part of someone’s struggle, dual diagnosis treatment could be a crucial next step.
What to Expect at a Dual Diagnosis Program in Maryland
When someone enters a dual diagnosis program in Maryland, the first step is a full evaluation.
At The Freedom Center, this includes a comprehensive psychiatric assessment with clinicians to understand personality traits, emotional patterns, and mental health history, alongside a detailed look at substance use.
This provides the care team with the insight they need to create a personalized treatment plan and identify the levels of care that work best for each person, not just their symptoms.
From there, treatment is highly individualized. Patients and clients participate in therapy designed to help them understand their behaviors, improve emotional regulation, and work through long-standing patterns that may be tied to a personality disorder.
At the same time, they’ll receive addiction support—this might include medication-assisted treatment, relapse prevention strategies, and coping skills for cravings and stress.
The Freedom Center offers a structured and compassionate environment that promotes holistic wellness by addressing both the mind and body. Whether someone is dealing with BPD and substance abuse, narcissism and addiction, or another complex diagnosis, their integrated care model is built to help them stabilize, grow, and move forward.
Evidence-Based Therapies for Personality Disorders and Addiction
Effective treatment for personality disorders and addiction requires more than talk therapy—it takes targeted, research-backed approaches that address the full complexity of each condition.[8]
At The Freedom Center and other personality disorders and addiction treatment centers in Maryland, clients receive personalized care that blends multiple therapeutic modalities for long-term healing.
Dialectical Behavior Therapy (DBT)
Originally for Borderline Personality Disorder (BPD), DBT is one of the most effective therapies for individuals dealing with emotional instability, self-harm, and intense interpersonal conflict.
It teaches core skills for dealing with mental health issues like emotion regulation, distress tolerance, and mindfulness—tools that are critical in managing both addiction and impulsive behaviors.
Cognitive Behavioral Therapy (CBT)
CBT helps clients uncover and challenge the negative thought patterns that fuel substance use and unhealthy coping mechanisms. For those with narcissistic traits or antisocial tendencies, it also supports building insight and restructuring behaviors that interfere with recovery. [9]
Trauma-Informed Care
Many individuals living with personality disorders have a history of trauma that influences how they see the world, respond to stress, and relate to others.
Rather than focusing just on symptoms, trauma-informed care looks at the “why” behind those behaviors.
This type of therapy emphasizes emotional safety, trust, and empowerment, which builds a sense of security and well-being. It helps people feel supported, not judged, as they work through painful experiences.
Medication Management
When needed, medications such as SSRIs, mood stabilizers, or antipsychotics can help regulate mood, reduce anxiety, and stabilize mood swings. [10]
At The Freedom Center, psychiatric providers work closely with each client to ensure that any medications prescribed are tailored to their symptoms and adjusted as needed throughout treatment.
The Freedom Center’s Dual Diagnosis Treatment Programs
As one of the leading personality disorders and addiction treatment centers in Maryland, The Freedom Center offers a full continuum of care designed for those with both mental health and substance use disorders. Every program is built to support healing on both fronts—emotionally, behaviorally, and physically.
Inpatient Dual Diagnosis Program
For clients experiencing intense emotional distress, frequent relapse, or unsafe behaviors, inpatient treatment in Buckeystown provides 24/7 clinical care.
This level of support is ideal for stabilizing acute symptoms, managing medication safely, and beginning the deep work of healing from both addiction and personality disorder traits.
Partial Hospitalization & Intensive Outpatient Programs (PHP/IOP)
Our PHP and IOP programs in Gaithersburg offer structured daytime therapy while allowing clients to live at home or in supportive housing.
These programs include individual therapy, group sessions, psychiatric care, and DBT/CBT work tailored to personality disorders. They’re ideal for those transitioning from inpatient care or requiring ongoing support without full-time residential treatment.
Outpatient Treatment and Aftercare Services
Long-term recovery is about consistency. Our outpatient services provide continued therapy, psychiatric check-ins, relapse prevention planning, and peer support groups.
We also help clients transition into aftercare plans that may include sober living, alumni support, and vocational or academic assistance, ensuring the support doesn’t stop when formal treatment ends.
If you or a loved one is ready to get help but finances are holding you back, give us a call. We can work with your health insurance provider.
If you or a loved one is ready to get help but finances are holding you back, give us a call. We can work with your health insurance provider.
Dual Diagnosis Program at The Freedom Center
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All content produced by The Freedom Center undergoes a detailed evaluation process to ensure accuracy and quality. We only work with medical professionals and individuals with extensive experience in the field, and all content produced undergoes a review process to ensure accuracy. Our goal is to be a reliable resource the recovery community can turn to for information they can trust.
Frequently Asked Questions About Personality Disorders and Addiction
Powder cocaine is a hydrochloride salt that’s usually snorted or dissolved and injected.
Crack cocaine is a crystalized form that’s smoked. Crack produces a faster, more intense high, but also wears off quickly, leading to more frequent use. [11]
Both forms are highly addictive, but crack is often associated with a quicker path to dependence due to how rapidly it enters the bloodstream and affects the brain.
Finishing rehab doesn’t mean the journey ends.
At The Freedom Center, the team will help each person develop a personalized recovery plan that lasts. That might include alumni support, sober living connections, and continued therapy.
The goal is that everyone leaves with a roadmap—and a support system—to stay sober and thrive in real life after their time at The Freedom Center.
People with personality disorders tend to experience intense emotions, difficulty with impulse control, and a deep sense of emptiness or instability. [11] To try to manage these overwhelming feelings, many turn to drugs or alcohol for relief. Substances can temporarily dull emotional pain, boost confidence, or offer an escape, but that relief is short-lived. This can be the case with other mental health disorders as well.
Over time, substance use usually worsens the very symptoms it was meant to soothe, leading to a cycle of emotional distress and addiction. Without integrated care that treats both the personality disorder and the addiction, it can be difficult to break that cycle for good.
Sources
[1][2][3][10][11] What are Personality Disorders? (n.d.). https://www.psychiatry.org/patients-families/personality-disorders/what-are-personality-disorders
[4]Parmar, A., & Kaloiya, G. (2018). Comorbidity of Personality Disorder among Substance Use Disorder Patients: A Narrative Review. Indian Journal of Psychological Medicine, 40(6), 517–527. https://doi.org/10.4103/ijpsym.ijpsym_164_18
[5] Kienast, T., Stoffers, J., Bermpohl, F., & Lieb, K. (2014). Borderline personality disorder and comorbid addiction. Deutsches Ärzteblatt International. https://doi.org/10.3238/arztebl.2014.0280
[6] Jauk, E., & Dieterich, R. (2019). Addiction and the dark triad of personality. Frontiers in Psychiatry, 10. https://doi.org/10.3389/fpsyt.2019.00662
[7][12] Co-Occurring disorders and health conditions. (2024, September 30). National Institute on Drug Abuse. https://nida.nih.gov/research-topics/co-occurring-disorders-health-conditions
[8][9][13] Help for personality disorders. (n.d.). American Psychological Association. https://www.apa.org/topics/personality-disorders/help
