Guest Post: How Addiction Leads to Personality Disorders

How Addiction Leads to Personality Disorders
By Sharon Torres

Personality disorders such as narcissism and sociopathy are often blamed upon the nature vs. nurture model. When people’s brains are wired to have these kinds of problems and it is coupled with childhood trauma, these are possible causes of having a psychological disorder.

However, there is another side of the story where personality disorders don’t just come from childhood trauma nor a natural brain wiring–it comes with the development of an addiction. I hope that my experience with being in a relationship with someone who is suffering from both addiction and a personality disorder will provide you with insight into how one caused the other and vice versa.

My story of narcissistic abuse

I was a naive girl in college back in my home country. I always dreamed of having a perfect relationship so I kept myself free from exclusively dating unless I was certain. My cousin then invited me to a social ball at this college, and this is where I met my dashing, charming, ex-boyfriend.

My ex was a senior of my cousin, so he was required to introduce me as his partner in the social ball. This young and handsome bachelor was known among his batch mates and he was known as the heartthrob of his class. This is where it began–after the party, he added me on Facebook which was to my surprise! I wasn’t even able to take a hint that he noticed me.

After hours and days of talking, the friendship quickly grew to something romantic. Looking back, I believe it was the love bombing phase in our relationship. Since he knew that I took the bait, he was eager to win me.

This romantic phase turned sour when we eventually became a couple after 3 months. I started to feel neglected, and I discovered something he had hidden from me throughout that getting-to-know-you phase–he had a drinking problem! Still, my rose-colored glasses stayed on. I was determined to “change” him and make our relationship better.

Little did I know that those hopes were just that–mere hopes. He was deep in denial of his drinking problem, and when he had fits of rage he would say things that he didn’t mean. He would threaten to break up with me, curse me, suddenly stop responding to my calls, blaming me as being too “controlling.” He would even talk to other girls just to show that I was easily dispensable. Being naive as I was, I thought that these were normal relationship conflicts. I took the verbal and emotional abuse as though it was something that I should work on. When he was sober, he would lure me in again through his sweet words and coaxing. The pattern repeated itself again and again, which ultimately tore my self-esteem.

My relationship with my ex was full of heartache and pain, until one day, I chose to free myself from this vicious cycle. It took me one whole year to finally get away from this narcissistic abuse after months of hoovering and questioning my decision. Needless to say, I do not regret my decision. I am happily married now to another man, and the difference was clear as day. Looking back, I realized how one’s personality can change due to having an addiction problem.

Why is addiction linked to personality disorders?

Addiction of any kind, whether it is drugs, alcohol, or other substances, can affect a person’s physical, mental, and emotional state. The addictive component found in these substances changes the brain’s wiring through continued use. In the case of alcoholism, the brain is led to the release of endorphins, which are the natural feel-good hormones of the brain.

The problem with continued, increasing use of these substances is that it quickly escalates from tolerance into dependence. When the brain and body are dependent on drugs and alcohol, functioning without it becomes a disaster–this causes the multitudes of withdrawal symptoms, anxiety, distress, and the dreaded changes in personality.

According to several Colorado addiction resources, a person who is addicted to substances may show one or more of the following traits:

Impatience. When a person suffers from substance use, it is their source of comfort and gratification. Without it, they may often find themselves having an attitude of impatience. They are impatient towards their partners, become unreasonably demanding towards others, or may show fits of rage because of their inability to wait.

Easily aggravated. Anger is another issue that may often appear due to substance use. When the body is largely dependent on drugs or alcohol, it may easily suffer from physical symptoms such as nausea, vomiting, cramping, or fevers. Additionally, it can also affect the person’s mood because of the many discomforts without the substance.

Impulsive. When combined with being easily aggravated, people who suffer from substance abuse and personality disorders tend to say or do things that they may regret later. They are prone to getting in physical fights, reckless driving, having multiple partners, or doing other dangerous acts that could affect them or their loved ones.

Manipulative
Manipulation is one of the hallmarks of personality disorders such as sociopathy and psychopathy. People who are highly manipulative will do anything to get what they want–without a sense of morality of their means to get there. In the same way, people with addictions can use other people and situations to their advantage, and this is because they need the immediate pleasure of consuming the substances they need.

Abusive. Abuse is not just through physical means. They can also involve verbal and emotional abuse, which are hard to determine especially if you are blindsided in your relationships. Most people who suffer from personality disorders along with substance abuse will use rudeness, cursing, and other forms of hurtful words at their peak of anger. A steady, loving relationship ensues respect from one another–and although conflicts are bound to happen, it does not involve hurting each other physically or through words. If you are a victim of abuse, seek help right away.

It is important to understand that people suffer from personality disorders due to their genetic or familial predisposition to them, from an abusive or neglectful early childhood, or from other early trauma. They learn that using substances make them feel “in control” of their disorder. In the same way, people also develop personality disorders due to continued substance use. It is a two-way cycle that exacerbates and increases the risk for both.

If you feel like a loved one is suffering from a personality disorder coupled with substance abuse, there are addiction resources to help them out. They offer medical treatment, counseling, and lifestyle rehabilitation to help them take a shot at recovery and to manage their personality disorders.

*****
Sharon Torres is a freelance writer who is chronicling her experiences through this thing called life. She believes that if you always move forward in life then there is no need to look back. Her favorite writer is Phillip K. Dick.

Visit Sharon’s blog at: http://sharontorreswriter.blogspot.com/

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Going insane: how I got diagnosed with BPD

going_insane

I thought I should explain how I got diagnosed with BPD. Although my out of control behaviors in 1995-1996 were due to prolonged emotional and mental (and some physical) abuse at the hands of my ex (on top of having been a victim of narcissistic abuse growing up), the focus of this article isn’t on narcissistic abuse or the way my ex behaved, but rather on my reactions and how out of touch with reality I actually became.

My memory of this time is sketchy and fragmented, almost dreamlike, so what I’m about to write may not flow together well. I believe my fuzzy memories of these two years were due to 3 things: (1) intermittent substance abuse, including alcohol; (2) being so out of touch with reality; and (3) I may have blocked out some of these incidents or partially blocked them out so they seem sort of grey when I think about them now, like a dream.

In 1995 my ex’s mother could no longer live alone so she came to live with us. At first things went smoothly, but she had Alzheimers and was deteriorating fast, and soon her care was left entirely to me. At the same time I was the stay at home mom to a 2 and 4 year old. My ex had started drinking a lot during this time, and said it was because he hated his mother (a malignant narcissist herself) and his behavior toward her was very abusive. He justified his abuse by saying she deserved it because of the way she had treated him. My children saw this behavior but in my emotionally weakened state due to his constant gaslighting, projecting and triangulating (he had turned most of our friends against me) as well as isolating me from those who could help me, I began to collude in his abusive behavior toward his mother. I didn’t physically attack her (he did) but in my frustration with things like her wetting the bed I would yell at her whenever he did and sometimes even when he wasn’t there. I also didn’t try to stop him when he used to spank her like a naughty child.

My ex was drinking heavily and smoking a lot of pot, and I joined him. At night, after the kids were asleep, we would often both be drunk and high. Sometimes his friends came over, who were all younger than we were (my ex’s friends were always younger than him). Sometimes things got wild. I was no longer attracted to my ex by this time due to his constant emotional abuse, so when I was drunk I openly flirted with his friends. I was unfaithful too, but so was he (I am definitely not proud of any of this, especially because I had young children at the time).

We fought constantly. One night, drunk, he threatened me with a gun. I ran down the street screaming and went and hid in a grove of trees for hours in the freezing cold. On several occasions I called the police and they would show up to fund us both drunk and didn’t know who to believe so they would leave and tell us to sober up. At this time I had no control over my reactions or my emotions. I acted more immature than my own kids sometimes.

I used to sleep during the day and wasn’t as good a mother as I could have been. I was testy, impatient and neglectful. I loved my kids dearly, but just didn’t have the emotional stamina or energy to deal with them more effectively or lovingly. (I tried to make up for that later).

Soon the dissociative episodes began. Sometimes things looked weird. People looked like they weren’t real and they seemed demonic. I began to have delusions of reference. I had the weird sensation of unrelated events or conversations somehow referencing exactly what I was thinking. I felt like I was outside my body a lot, as if I was watching the events of my life unfold instead of being in them. This began to happen when I started distancing myself from my emotions into a “comfortable numbness.” (This is common in PTSD and BPD). But it wasn’t comfortable–it was horrifying. I think I was unconsciously protecting myself from feeling too much emotional pain. The abnormal had become normal, the insane had become sane, the evil had become good. I walked through my days in a sort of fog, but not all the time. Occasionally, when triggered, I would come back into myself and “go off” on my ex and experience a tidal wave of unbelievably painful and intense emotions. Instead of spending my evenings doing quiet things with my family, I spent that time on the computer in chat rooms, talking to men. I imagined I fell in love with one or two of them. My emotional reactions to these online entities I had never met were as intense as if they were actual relationships, but all of it was fantasy. To me it felt real.

I couldn’t sleep at night, but would sleep most of the day away. I didn’t take care of the house and only did the rudimentary necessities for the kids, in between taking care of my ex’s mother’s almost constant needs. I lost patience with both her and the kids easily. We ate cereal and yogurt most nights for dinner because I didn’t have the energy or wherewithal to cook anything.

I started a job after awhile at a hotel. I had a short affair with the disc jockey/maintenance man there. I wasn’t in love with him but I enjoyed the kindness he showed me, that my husband wasn’t giving me. One night he confronted me about it and I confessed everything. He didn’t seem upset but admitted he was having an affair too. Strangely, we did not fight about this. I really didn’t care whether he loved me anymore; I was convinced he hated my guts.

I quit my job on a whim even though we needed the extra income, because my ex had squandered over $100K we got from the sale of his mother’s house. One day I just decided not to go in anymore. I didn’t even bother to call, which normally is out of character for me. I started doing really crazy things. One night after a really bad fight I went into the closet in the master bedroom and sat on the floor crying for what seemed like hours. My ex didn’t seem concerned and went out instead. I don’t know why I was doing this; I felt like I had lost my mind and there was no reason for doing this. I had no idea what I was doing; I was just reacting to my pain like a wounded animal. The episodes of dissociation and delusions of reference became worse. I imagined everything–even voices on TV or songs on the radio–were coded messages that referenced something in my life. This is impossible to explain if you haven’t experienced it but it was very strange and disorienting.

delusions_reference

One day shortly after the closet incident, I left the kids in the house with him and decided to go driving. I had no idea where I was going or what I was doing, but I suddenly thought it would be a good idea to drive at 90 mph (the speed limit was 65 mph). Normally I’m a very cautious driver but during this time I had thrown all caution to the wind. I wasn’t suicidal in the sense of making a conscious effort to kill myself and I didn’t even contemplate suicide, but I was taking huge risks with my life. Miraculously, nothing happened, not even a pullover by police. I returned home feeling exhilarated from my crazy drive, but immediately that feeling disappeared and I was hit with the horror of my reality and started screaming irrationally and throwing things against the wall just to hear them break. I don’t even know what set this tantrum off–probably nothing at all, but I had this overwhelming desire to act out my excruciating emotional pain. I had no control over myself at all. When I thought about my behavior later on, I was horrified. I wasn’t even drinking anymore by now, so I wasn’t drunk. I was just insane.

My ex told me I was crazy. He always did anyway. But I really was crazy. He told me I should commit myself to a mental institution–or he would. To his surprise (and mine) I agreed. In that moment of clarity, I realized how crazy I had become (due to his emotional abuse of me, but that didn’t make me any less crazy). I allowed him to drive me to the mental hospital, which turned out to have an excellent program and engaging activities. I felt relief in entering that hospital and spent the next three months there. My Axis 1 diagnosis was Major Depression and anxiety, and my Axis 2 diagnosis was BPD, as well as substance abuse. I was also diagnosed with PTSD. I received daily therapy–both individual and group, as well as DBT classes–and I was put on Depakote (a mood stabilizer), Prozac (for the depression) and Klonopin (for anxiety). I stabilized during my stay but I wasn’t as committed to using the DBT tools I learned there as I became later on. I remember calling my mother from the hospital and telling her what was wrong with me, and her attitude was like, “so what? You need to be a mother to your children.” She didn’t even know I was in the hospital. So much for maternal support.

I had mixed feelings about returning home. I was overjoyed to see my children, but wasn’t too happy to see my husband at all. I really just wanted to stay in that hospital for the rest of my life. I didn’t want to face reality.

Fortunately, my mental state never got that bad again, but his abuse was to get much worse. He used my descent into the madness of severe BPD and major depression as an excuse to punish me for “having gone batshit insane” when I should have been a better mother and wife to him.

I still have a lot of guilt and shame over the way I neglected my children when they were so young and helpless. I wonder sometimes how much my not being there for them may have damaged them.

When I look back even earlier at my life, I can remember similar incidents of being totally unable to control my emotional reactions to stressors and triggers, with periods of almost robotic numbness and dissociative episodes in between outbursts. It was a pattern I was familiar with, but it reached its pinnacle in 1995-1996. I had a relapse in 1997 and spent a week in the psych ward at the regular hospital, and got the same exact diagnosis as the year before. Over the next several years, while I was still married to my ex, I spent most of my time in a state of emotional numbness, living on “automatic pilot.” It wasn’t until I finally got the POS out of my life that I felt safe enough to begin to let myself feel emotions again–but this time with mindfulness and acceptance instead of allowing my emotions to control me. I still have a long way to go.

Narcissists with Aspergers?

lonely_guy

There’s been much written about the relationship between Aspergers syndrome and narcissism, mostly about the way they are often confused with each other (or misdiagnosed as the other disorder) due to the belief that people with Aspergers lack empathy (which is not true). I wrote about this false belief in my article, “People with Autism Do Not Lack Empathy!”

People with Aspergers may SEEM unempathic, because they are not always very good at expressing emotions or knowing how to react when other people share their emotions with them. But an Aspie’s lack of appropriate social reaction to the emotions of others doesn’t mean they can’t FEEL the emotions around them. In fact, some may feel other’s emotions MORE keenly than neurotypicals, and they can be easily overwhelmed, which may cause them to withdraw from the situation and partly account for why they may seem less engaged emotionally or uncaring about the feelings of others.

aspie_misdiagnosis

Narcissism as an Autism Spectrum Disorder?

question2

Psychology Today had an interesting article comparing narcissism to high functioning autism (Aspergers) and at least one psychologist thinks they may be the same disorder!:

Khalid A. Mansour (the British Arab psychiatrist), has proposed in an article in the Pan Arab Journal of Psychiatry (link is external) that narcissistic personality may merit classification as an autistic spectrum disorder.

Dr. Mansour writes, “There is now significant level of agreement that emotional processing problems like: lack of empathy, poor self-awareness, self-centredness, poor reciprocation of emotion, poor ability to maintain emotional relationships, anxiety and anger outbursts are more or less central features of autism (10, 50,51).”

Interesting. When I first read the above paragraph, I though Dr. Mansour was writing about severe narcissism. His description fits both narcissism and autistic spectrum disorders. Hmmm.

Dr. Mansour similarly quotes from the ICM-10 listing these features of autism:

–Self-centeredness; inappropriate to developmental level and cultural expectations
–Poor self-awareness, poor ability to develop remorse or learn from mistakes
–Poor empathy or appreciation of others feelings
–Poor ability to reciprocate emotions.
–Hostile dependency on safe relations.
–Failure to develop emotional relationships appropriate to developmental level and social norms
–Treating people as objects or preferring objects over them
Again, this list certainly sounds a lot like narcissism.

Dr. Monsour concludes: “… it is noticeable that people with NPD, do not show a major degree of functioning problems in stress free environment or when they are supported (except that they are perceived as “not pleasant characters” to deal with). However under stress and without support they can become quite dysfunctional in a way not far from what we usually see in Asperger’s syndrome. “

I don’t buy it. This is the opinion of one psychiatrist. While it’s true that on the surface these two disorders may appear similar, the mechanism behind the behaviors are vastly different–in fact, almost the opposite. For the narcissist, their lack of empathy and failure to engage the emotions of others is due to their inability to feel the emotions of those around them, but they can FAKE empathy fairly well, even if they choose not to. If they are trying to obtain supply, they can be pretty good at it. Their social skills are not the problem–their inability to feel other’s emotions are. They are like actors in a play. In contrast, a person with Aspergers or high functioning autism DOES feel the emotions of others around them strongly, but lacks the social skills necessary to be able to convey this to others effectively. Unlike the narcissist, people with Aspergers are very bad actors.

But the question was, can Aspergers and narcissism occur together?

aspie_narcissist

But we’re talking here about comorbidity. The question I’ve raised is whether Aspergers and Narcissism can be comorbid with each other–that is, can someone have BOTH disorders?

The answer appears to be yes. I found this on Yahoo Answers, from a man who claims to be both a high functioning autistic AND a sociopath:

[…] people with Asperger’s can be sociopaths and or narcissists as well. “CO-MORBID” is the medical term used to describe a disability or group of disabilities that exist another disability in a single individual at the same time. It is possible to be autistic and have cerebral palsy or have aspergers and diabetes. Likewise it is also possible to have both Aspergers and mental disorders including sociopath and narcissism. Asperger’s does not exist in a bubble that protects it from co-morbid disabilities and mental defects.

I have High Functioning Autism and I also have antisocial tendencies I must always keep properly managed. I see my psychiatrist regularly. I take my medications as needed and I have trained myself to always be mindful of my darker instincts to insure they do not express themselves in disastrous ways. I have high functioniong autism but; thanks to early intervention by family, doctors and others I was made keenly aware of my antisocial ways and taught how to manage them in ways that kept everyone safe. It is the single most difficult thing I do in life to keep my antisocial ways well managed but; having seen the monster I become when enraged is motivation enough to keep me always vigilant.

There’s no reason why the disorders couldn’t exist together. Personally, I’ve never known anyone with both disorders, but that doesn’t mean they don’t exist. Using a fictional example, I’m going to speculate here what the behavior of a narcissist with Aspergers might be like.

The Case of Mark F.

Depressed Forty Year Old Man Drinking Alone

Mark F. always had trouble making friends. In grammar school he was bullied due to his inability to fit in with others or show empathy. He was socially awkward and never seemed to know the right thing to do or say. Mark not only was unable to show appropriate reactions in social situations, but rather than suffer in silence and wonder why others didn’t understand or like him (as most Aspies do), he didn’t care about the feelings of those around him. He was easily hurt by the bullying, but reacted in rage due to these narcissistic injuries to himself. He’d lash out at those who injured him and didn’t care if he hurt someone else.

As Mark grew older, he had difficulty keeping a job, not only because of his inappropriate, almost schizoid affect that was very offputting to those around him, but also because he deliberately caused pain to others with his frequent insensitive insults. Due to his Aspergers, Mark lacked the social skills to be able to effectively use the more subtle narcissistic “tools” such as gaslighting or triangulation against others, but he was very good at blame-shifting and projecting his character defects onto those around him. Lacking the social skills to know what behaviors were appropriate, he’d “go off” on those in authority, and was frequently fired from his jobs for insubordination, gossiping openly about his coworkers, missing work due to debilitating hangovers (more about this in the next paragraph), and starting fights.

Mark never married. Though good looking, due to his poor social skills and openly hostile attitude (he was unable to mask his anger, resentment and envy of others), his dates never developed into relationships. No woman would stay with him longer than a few weeks. He had no friends and resorted to frequent drinking to cope with his loneliness.

As you might imagine, Mark was miserable. He constantly felt victimized. He was frequently depressed and wondered why he couldn’t get others to cooperate with his need to use them for supply. In his frustration and envy of all those around him for their “better social skills,” Mark tried to self-medicate by drinking heavily and his frequent drunkenness only served to exacerbate his rages and cause his work attendance to be poor.

Having both disorders would be a recipe for extreme misery. Mark’s behavior is just one way narcissism comorbid with Aspergers could manifest itself. An effective narcissist must possess good social skills to be able to charm others into trusting them and to use their “bag of tricks” in an effective way, and therefore an Aspie with narcissism wouldn’t be particularly dangerous, just very unlikeable. Therefore, I don’t think it would be probable that an Aspie could be a “malignant narcissist” but they certainly could be suffering from NPD. A person with both disorders would have zero charm and therefore not have many opportunities to use others the way a narcissist with good social skills could. My feeling is substance abuse would be a huge problem for such a person, in their attempt to make life more bearable. For those not resorting to substance abuse or alcoholism, severe depression or even suicidal ideation could result.

“Coming out” about my BPD

Hand of a child opening a cupboard door

On November 22, 2014, I wrote an article about my daughter Molly (not her real name), who I suspected of having NPD due to having been used as a flying monkey by her father for many years. I prayed it was “just” BPD.

Last month she was evaluated and her Axis II diagnosis was Borderline Personality Disorder (BPD). While BPD is a Cluster B disorder and shares a number of traits with narcissism, it’s more amenable to treatment because a Borderline does have a conscience and the ability to feel empathy–but their tendency to fly off the handle, their insecurity/neediness, and propensity to engage in self destructive activities that sometimes hurt others masks the fact they really aren’t bad people. My daughter actually has a huge heart and cries when she sees someone suffering or in pain, so it fits that NPD wasn’t her diagnosis. Still, I’m relieved she’s been officially cleared of it.

I was diagnosed with BPD myself in 1996. I have been hesitant to call attention to it on this blog or talk about it much, because of its close association with NPD and other “character disorders” like ASPD. At the time I was diagnosed I was in an inpatient psychiatric setting, where I was also diagnosed with Bipolar I (major depression with fewer or no manic episodes), generalized anxiety, PTSD, Avoidant PD (I didn’t know you could have two PD’s at once back then), and substance/alcohol abuse. At the time I was not diagnosed with Aspergers (that was much later, and I was self diagnosed at first).

I definitely had all the traits of a borderline, but in the hospital and in outpatient therapy following my stay, I learned ways to control my BPD traits, such as my tendency to fly off the handle easily, act impulsively without thinking how it would harm others, idealize/devalue people (black or white thinking), abuse drugs and alcohol, and generally coming off as being very self centered and oblivious to the needs of others.

DSM_borderline
Click to enlarge.

For a time back in the early 1980s I even test drove narcissism, but as an essentially empathic person who suffers from a lot of guilt and shame, and has no desire to hurt others, narcissism didn’t work for me, and I am so grateful for that (even though I became a codependent doormat instead).

In therapy, I remember a method we were taught called “turtling”–which basically means to imagine yourself as a turtle when you feel yourself about to act/react in Borderline, impulsive, or self destructive ways. Turtling calls for enough insight to recognize your feelings prior to acting on them. You imagine going inside your shell to think about things before you act. I remember in the hospital we made “turtle” totems to keep as reminders to always think before we acted and ask ourselves why we felt the way we did. I still have the little clay turtle I made. I remember also being given a workbook for people with BPD with many helpful exercises and activities to help us recognize and control our behavior. It did help me a lot.

clay_turtle

Today I don’t think I display many BPD traits, but I don’t think I’m cured either. When I’m very depressed, frightened or angry, those BPD traits pop back up like unwanted pimples. I still remember the lessons from my therapy and still look at my little turtle or a picture of a turtle to remind myself to go inside myself and not react until I think things through and process my feelings.

Because this is a blog for survivors of narcissistic abuse and many (if not most) survivors think of narcissists as demons or monsters, I was hesitant to talk about my BPD much, because it’s a Cluster B disorder and is so close to NPD in many ways. The disorders are easily confused with each other. A person with full blown BPD can seem very much like one with NPD, but for the Borderline, the motive behind their unpredictable and sometimes destructive behavior is fear of abandonment and insecurity. For the narc, it’s for obtaining supply. Some people seem to think of people with BPD as almost as bad as narcissists. Some of them are.

So that’s why I’ve been reluctant to talk about this. But again, from Day One I committed to honesty and I hope I won’t be judged too harshly for “coming out” as a person with BPD.

borderline
Borderline personality disorder.

My daughter, I’m happy to say, knows almost as much about narcissism as I do now, and has been reading my blog. She came across the above article where I speculated she might have NPD and she was so worried about that it made her cry. We had a long discussion about that. Since then, she has been improving a lot and says my blog has helped HER! She says she’s proud of me for having the courage to start this blog. And I have to say, I’m just as proud of her. Here’s my article describing how healing and emotional that talk we had was. I think we will both be just fine.

My next article, which I will write later today, will be about how malignant narcissists can transform a good person into an evil one. They can infect you with their illness. That’s another reason why they’re so dangerous.