Personality Disorders, Chicken or Egg?
 

Do you guys agree alcoholism/addiction is a symptom of a personality disorder in most cases? I know my XABF was BPD/NPD, and on a few occasions completely ASPD. Basically, all the cluster B's.

I read a study once that suggested over 90% of alcoholics/addicts observed in a controlled psychiatric environment were found to suffer from an underlying personality disorder. In most cases several overlapping (co-morbid) personality disorders. Hence, the concept of the "dry drunk," and persisting problems and instability after eliminating the addictive substance, is attributed 100% to these preexisting disorders.

The other school of thought seems to be that alcoholism mimics the traits of cluster B personality disorders in particular (isn't it even in the big book that alcoholism/addiction leads to sociopath/psychopath behaviors and though processes?). As in, the disordered behavior is caused by the substance abuse, and any problems persisting after recovery are attributed to behaviors learned while in active addiction.

I started researching mainly to understand what was happening to ME as a result of being involved with this disordered person...

In relationships with personality disordered people/addicts we are brainwashed, abused, idealized and devalued, blamed, used, and worst of all trauma-bonded to our abusers, codependent, obsessed, and addicted ourselves. We become isolated in the cycle of abuse, our foundation and reality blown out from under us. We lose control of ourselves, of our lives completely. We lose faith and trust in our sanity and capabilities. Who we were before the A becomes a memory. We become ugly, as ugly as them. Yet, we do not know how to exist without our A's and we perpetuate the magical thinking, the fantasy, which by now requires an abandon of all logic and core values to maintain, until...when?

If you read the experiences of people who have had relationships with sociopaths, narcissists, bpds, are they any different than ours? It's really some serious s*@! we put ourselves through with them, knocked my socks off like I never would have imagined anything could. PTSD, probably adrenal fatigue, permanent damage to our chemical neurotransmitters or something...you know? I still have flashbacks, still doubt my sanity and worth as a person, still break NC and want this person in some sick way knowing he is emotionally 4 years-old and incapable of truly reciprocating love at the very least, and at the very most is dangerously abusive.

Sorry so long and to ramble, but was wondering what you guys thought about this connection and any personal experiences with PDs.

This was posted by a member on another section of SR. I found it helpful:

"Originally Posted by cynical one

The Brain Chemistry of Being a Loved One
~Lori Pate
B.A Psychology
University of Texas at Austin

Many people who have loved an addict have felt like they were going insane from all the chaos, worry, regret, fear, anger, confusion and more that comes with caring for someone who is in active drug addiction.

It seems reasonable that if the addict would just stop using, everything would return to normal and a happy life would resume. There is usually more going on though. There are chemical changes happening not just in the brain of the addict, but also in the brain of the loved one.

"What? I'm not the crazy one! The addict in my life is the only one going crazy, not me!"

That isn't always true. The chemical changes in the brain of a loved one should be understood to help speed recovery. Chemical changes in the brain of someone who is constantly in a state of stress, fear, anxiety and anger are not insignificant and are accompanied by withdrawal symptoms just like an addict who stops using.

The brain uses chemical messengers, called neurotransmitters, to allow us to feel feelings. Hunger, thirst, desire, satisfaction, frustration, fear and every human emotion are felt by the activity of chemical messengers in the brain. The most important messenger in this situation is norepinephrine (also known as adrenaline).

Norepinephrine is known as the "fight or flight" chemical messenger. This chemical is what causes us to feel a rush of energy when faced with a dangerous situation. Proper activity and levels of this messenger help humans get and keep themselves safe from harm. This chemical gives us the super-human abilities to outrun an attacker or think quickly in an emergency.

When a dangerous situation is perceived, norepinephrine is released in the brain. Receptors in the brain have "parking spaces" for the chemical to "park" in, which deliver the message. Once the chemical is plugged in, we feel a burst of energy, and a drive to get ourselves safe, take action, run or fight.

After the event is over, the messenger is released from the parking spot, and recycled to use again later. We begin to feel calmer and safer. The rush subsides. Heart rates return to normal. The feelings of fear and anxiety subside.

This happens all the time in all healthy humans.

But the human brain does not like constant stimulation. As soon as we are excited from a chemical message, the brain goes to work to return levels to normal. There are several mechanisms that work to do this. First, the chemicals are picked up by "reuptake" chemicals. Think of them like a tow truck. They are constantly floating around, looking for a chemical to tow back home. Recycling the chemicals restores levels to normal.

If constant stimulation occurs, causing constant chemical messages, recycling isn't enough. So the brain, in its effort to regain a normal balance, will begin destroying the chemicals permanently. If we are constantly in fight or flight mode, the brain determines that we have too many "fight or flight" messengers, so destroys them.

For someone who actually has too much adrenaline in their brain, this is helpful. But for someone who is constantly in a situation where they really are put under stress, and are triggered to respond to fear over and over, the destruction of their chemical messengers begins to cause a brain chemistry imbalance.

There is a third mechanism that the brain uses to restore balance. After recycling and destroying the messenger chemicals, if the brain is still being over-stimulated, it will destroy the parking spaces that the chemicals plug into. These are called dendrites. Once a dendrite is destroyed,it can not be repaired. It will never again receive the chemical message it was designed to receive. It is like yanking out the phone cord of a phone that won't stop ringing. It will never ring again.

When a loved one is in a constant state of worry and fear, the brain first experiences stimulation. It feels imperative for the loved one to take action, sometimes desperate action, in an attempt to remedy the fearful situation. If this stimulation continues day after day, the brain can not tolerate the constant stimulation and starts taking action to regain balance. Adrenaline is destroyed. Receptors are destroyed.

This is when the insanity of being a loved one really takes off. The loved one is no longer chemically balanced. Several things happen at this point:

****Things that used to signal danger no longer feel so dangerous. There simply aren't enough "danger" chemicals or receptors to accurately convey the appropriate feelings. At this point loved ones may begin accepting very dangerous situations as OK. For example they may feel it is a good idea to track down a loved one at a dealer's house, or accept a loved one who is violent and abusive in their home. They may make a choice to allow a dangerous person to be around their children. This is not because the loved one just isn't making good choices. More accurately it is because their brain chemistry has been altered by the constant chaos, and they no longer have the right feelings that would initiate safe choices. Unacceptable behavior doesn't feel as truly dangerous as it is. ****

Still, some loved ones are aware enough to know they should stop being in a dangerous situation. When the loved one stops contact with the addict in their life, that is when withdrawal sets in.

Withdrawal occurs when the brain is accustomed to a particular level of chemical activity, and that level is suddenly reduced.

A loved one who has become accustomed to constant stimulation from fear and concern, who then suddenly finds themselves in a safe, calm environment, will feel withdrawal because their brains have adjusted to a high level of adrenaline.

Withdrawal symptoms cause the loved one to feel quite uncomfortable. They will feel sad, have sleep problems, and feel that something is missing or just not quite right. This will cause the loved one to feel a desire to reach back out to the chaos they were accustomed to. The chaos will cause a hit of adrenaline to occur. This is the exact same cycle that an active drug addict goes through: stimulation followed by withdrawal. Withdrawal feelings cause a desire to be stimulated again, because the brain does not like extremes.

Because the loved one who has undergone chemical changes has lower than normal adrenaline activity in the brain, they will crave stimulation. They will feel an overwhelming desire to "check on" the addict, or to take a phone call even though they know it will not have the end result of a pleasant conversation. They will engage in arguments that they know have no possibility of being resolved while the addict in their life is still in active addiction. The will feel drawn back to the fear and worry they just escaped.

An extreme example of this is seen when a battered spouse continues to return to their abuser despite having other options.

This is the brain chemistry side of the chaos cycle of being a loved one.

So does it ever get better?

Yes! It absolutely can get better.

The human body can make more adrenaline, to replace what was destroyed when under constant stress. Not quickly, but slowly, it can replenish the levels of adrenaline so that the person feels normal, without needing chaos in their life to achieve a balance.

The human body makes neurochemicals from our food intake. A healthy, protein rich diet gives the body the building blocks it needs to make more adrenaline. Regular light exercise, a normal sleep pattern, a safe environment, and a healthy diet will help the brain recover."

Here is a link to the original post if you want to read the feedback:

http://www.soberrecovery.com/forums/...loved-one.html

wow..this SO needs to be a sticky!!!

To answer your question: No, I do not. I believe that alcoholism/addiction is a disease in and of itself. Most people I know who are alcoholics or addicts have not also had symptoms of a PD. Although I think the nature of alcoholism makes people very irrational, self-centered, and seemingly narcissistic. So, if anything, from my perspective it would be the other way around, that the PD would be a symptom of the alcoholism. Google Dr Lloyd Garrett's articles on alcoholism and addiction; VERY informative.

It's truly amazing, so informative. This is one of the most helpful things I've read about this ever. Thanks so much, Pelican!

I've struggled with the whole alcoholism is a "disease" too...My RAH has an addictive brain...when he was drinking..he played cards or darts and just fixated on them. then when the drinking stopped..it was playstation for hours at a time...or AA 2x a day every day..then it was hunting and the gun club.. He's either all in or all out..he can't do anything in moderation..and balance.

Yeah...balance is a good term. It's been 3 yrs..and he still is the same..he just doesn't drink. Honestly..when he drunk he was much nicer to me than he is now 3 yrs sober.

So I guess my thinking is..is this a disease...or is he chemically off balanced (is that the same as disease)...or is he just a self-centered jerk..plain and simple. The last 3 yrs i thought it was a disease..but now..i'm really think his behavior is his choice.

It would be easier to think it was a disease..then I could justify his actions and think...well maybe he does love me..and even though he won't hardly hold my hand or talk to me..its just the disease. But now in my heart..i really don't believe that...i just think hes mean..and he has to have his way 24/7. It's exhausting.

No. Because like L2L said, I believe alcoholism/addiction is a disease is and of itself.

I'm not alcoholic because I'm bipolar any more than I'm alcoholic because I'm diabetic, have kidney disease or have a potential cancerous protein in my blood.

Now I may chose to drink as a way to cope with one of those other diseases but that does not mean that they caused my alcoholism.

I am simply an alcoholic and they are all seperate diseases that I happen to have.

Blue
sober in AA since 1992

Done stickied under "Classic Reading"

Mike :)

I am not sure I'd call it a "personality disorder" as one that would be found in the DSM IV or a billable code on an insurance form.

But I have seen common threads in the many AA speaker meetings I've been to or listened to over the internet. Lack of self confidence, lack of knowledge on boundaries, compulsiveness, etc. I put it in the "emotional sobriety" category.

So then we get involved in the roller-coaster of a relationship and have a lot of similar "symptoms" as listed above. We just get caught up in the chaos of it all, and often we aren't even aware its happening until it's all-encompassing. That's why we need "recovery" too, in whatever form that may take. I do consider it finding my "emotional sobriety" again.

I don't know about the statistics, but I've read that the majority of alcoholics also suffer from a mental illness (depression and bipolar are most common). Frequently drinking/using is a way of self-medicating. Remember, alcoholism itself is a mental illness.

The problem is that we pick someone like this, we're attracted to them. I learned I was responsible because I pick someone who has major problems and stay with him. If I let someone -- anyone -- abuse me then it's really my fault.

My XABF kicked an 8-year Rx drug addiction and picked up booze, porn, coke, and other women 6 months later (and no, his emotional instability and problem behavior did NOT stop when he quit drugs). He now claims he was never really an addict (this, coming from a man who wanted to get a Sober4Life tattoo on his arm while in early recovery). He is still doing coke and binge drinking daily despite a trip to the doctor that revealed he was a week out from a stroke with fatty liver AND triglycerides in the 700's at 29 years-old. But guess what?: The doctor is wrong and a quack, and XABF is wonderful and doesn't need to change a thing.

In my heart I too think XABF is just a mean, heartless, sociopath phony, addiction and PDs or not. A self-centered, narcissistic jerk who feels entitled and superior and lacks empathy and a moral compass. A manipulative emotional child who is always testing boundaries and dodging responsibility. Why should he have yet another excuse for all the lying, cheating, stealing, manipulating, raging, etc.? I don't think all alcoholics/addicts are jerks at the core, but many seem to be judging from these boards. How many times have we heard, "he was nicer before he got sober..."?

The abusive A's do cause so much damage to us though, and it's so nice to find anything that explains what is happening to us and why we don't run for the hills immediately! This one really helped me understand what was happening to me too: Ambient Abuse and Gaslighting

I've heard alcoholism and addiction in general referred to as a severe Obsession.

I have no doubt personally that alcoholism is a disease. And that it runs in families. Because I've got it and I know what I physically feel like as soon as even a sip of anything alcohol passes my lips. How out of control the urge to keep drinking is.

As for whether or not some behavior is a diagnosable Personality Disorder, and what might cause it, If you stick around on this board long enough, you will begin to see the same story written over and over by different people. It is weird how alcoholics even say the exact same words as other alcoholics.

I do think that there are many things at play like Debi4Vols was pointing out. One thing I'm reminded of is that everyone does have their own personalities, but I believe the alcoholism takes over the person's personality after a certain point. It is a progressive disease. To me, the Choice lies not in how I act or treat others while drunk necessarily, but in not taking that first drink.

Thanks everybody for sharing. This is a great thread for me; really has me thinking.

You know... I've spent a lot of time trying to understand and analyze my AXH and whatever disorders he may or may not suffer from in addition to the alcoholism.

I tried getting him to get evaluated for the different disorders and mental illnesses I amateur-diagnosed in him. He was furious and accused me of not accepting him the way he was, etc. When I finally left and he was facing criminal charges, he agreed. He got some diagnosis. He said he wouldn't get any treatment because I was forcing him to pay too much child support.

The bottom line for me is this: It doesn't matter. If you're still with your alcoholic, and your alcoholic is willing to pursue not only recovery but also treatment for underlying mental health problems -- find the best professional you can find and run with it.

For me? The only thing that matters is that my life became unmanageable because of the alcohol that ran his life. Other than that, I'll quote LaTeeDa again: "Unacceptable behavior is unacceptable." Whether you can find a mental health professional who's willing to slap a label on it and call it some fancy name or not doesn't matter. I refuse it in my life.

lillamy said, "I tried getting him to get evaluated for the different disorders and mental illnesses I amateur-diagnosed in him. He was furious and accused me of not accepting him the way he was, etc. When I finally left and he was facing criminal charges, he agreed. He got some diagnosis. He said he wouldn't get any treatment because I was forcing him to pay too much child support."

That's classic. I agree, it doesn't matter. Treatment is optional, insanity is optional. My exH chooses to act the way he acts, and that includes taking me to court. Then he sent me an e-mail that says it wasn't his decision to take me to court, it was the court's decision. He no longer has physical custody of the kids because he was verbally, emotionally, and physically aggressive toward them. He isn't paying the support he's supposed to pay, and claims that I'm stressing him out and he should not be accountable because what I want is unreasonable.

And he doesn't even drink much, at least, not last I knew. When we were married I definitely didn't think he had a "drinking problem", it was a "dry drunk problem." Both of us have lots of alcoholism in our family trees.

So I don't think diagnosis matters...that only helps in the sense that I know I'm not alone when I read the diagnostic criteria, but then again I can just as easily find out that I'm not alone by coming here or attending an Alanon meeting. If I let myself get too wrapped up in the "chicken or egg" dilemma I feel like I'm lending too much energy to something I don't want.

posie

Nicam, somehow I missed this in your original post
but wanted to tell you I know what you are talking about here and I agree. I think maybe it is the "psychic" trauma we experience when confronted with what these sick people do that does the damage, and that the damage changes a person. For good. I have had symptoms of PTSD since my "awakening" from being in a relationship with an alcoholic addict. Whether or not it really is PTSD, who knows?

Thanks for sharing.

I would be more likely to believe mental illness is a causal factor than personality disorders. Except I'm pretty sure the research has shown that the relationship between the two is that people with mental illnesses are simply more vulnerable to abuse alcohol. But then that puts us right back to the question of whether or not alcoholism is a disease.

Wow what a description. I can relate, with a couple people I had in my life in the past. Makes me wonder what in the hell would make us want to BE with or around them in the first place? Over the years I've found quite a few reasons why I did, including being an ACOA, co-dependent tendencies, my own drinking, feeling sorry for other people, and my "need" to "help." It's been a lot of pain realizing these things about myself, but worth it!

I 100% agree with the study cited in your post Nicam.

Getting back to your specific question...chicken/egg. I spent the best part of 20 years drinking. I always had some degree of anxiety as far back as I can remember and once I discovered rum and coke at University, my anxiety dissipated. Hmmmmm.

Having spent a few years in AA, I would be hard pressed to think of anyone who did not drink because of depression and or anxiety. Perhaps the "chicken" end of things. Then there was the contingent of bi polar and some with diagnosed PD's. Let's face it, no emotionally healthy individuals abuse alcohol.

Once I decided to place my low ball glasses on the top shelf, I sought therapy and was prescribed anti depressants. Anxiety dissipated. Too bad I didn't go that route before I medicated with alcohol.

Looking around at the rooms of AA I hear that many people, once sober, finally become diagnosed for other ailments: chronic depression is a big one, eating disorders, self harming, bipolar are also things I've heard recovered alcoholics discuss. The AA book "Living Sober" highly recommends that we seek help for these outside issues.

I don't think that alcoholism is a symptom of personality disorders, but that alcoholism and personality disorders can exist side by side, giving the person a "double diagnosis". I have a brother who is diagnosed with paranoid schizophrenia. His mental illness presented itself during adolescence long before he developed chronic alcoholism. And yes, I think that if a person has an underlying disorder, they will try to self medicate.

If we try to see mental disorders as the cause of alcoholism I think we run into a problem: what about all the people with the same mental disorders who don't develop alcoholism?