Exploring the Link Between Schizotypal Personality Disorder (SPD) and Substance Use

Millions of people struggle with mental illness and addiction every day. They are two of the most common issues that people face both in the U.S. and around the globe. This includes people who struggle with schizotypal personality disorder (SPD) and excessive substance use or even substance use disorder (SUD). The good news is there are multiple means, methods, and modalities that can help one to recover from co-occurring addiction and mental illness at the cellular level.

Better Understanding Addiction

Addiction is one of the biggest medical issues that currently exists. Addiction negatively affects the lives of millions of people and their families, many of whom will sadly never receive the help that they so desperately need. 

So, what exactly is addiction? It is much more than simply drinking alcohol or using substances. According to the National Institute of Drug Abuse (NIDA), “Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences. It is considered a brain disorder because it involves functional changes to brain circuits involved in reward, stress, and self-control. Those changes may last a long time after a person has stopped taking drugs.” It is also very important to note that addiction is a disease. Most medical and recovery professionals agree that addiction is more like chronic diseases such as cancer and diabetes than it is some type of “choice.”

Yet, people still stigmatize addiction as a moral failing or “choice.” According to NIDA, “For much of the past century, scientists studying drugs and drug use labored in the shadows of powerful myths and misconceptions about the nature of addiction. When scientists began to study addictive behavior in the 1930s, people with an addiction were thought to be morally flawed and lacking in willpower. Those views shaped society’s responses to drug use, treating it as a moral failing rather than a health problem, which led to an emphasis on punishment rather than prevention and treatment.” Mental illness has faced similar stigmas over the years.

Better Understanding Mental Illness

Mental illness is often misunderstood and mistaken for something that is in someone’s control. This is simply not the case. Mental illness, like addiction, is a disease. Any other categorization leads to stigma. According to the Centers for Disease Control and Prevention (CDC), “Mental health conditions are common, and more treatments are available than ever to help people cope, recover, and thrive. However, stigma can prevent or delay people from seeking care or cause them to discontinue treatment. Stigma refers to negative attitudes, beliefs, and stereotypes people may hold toward those who experience mental health conditions.”

The number of people affected by mental illness is also much greater than many people may think. According to the National Institute of Mental Health (NIMH), “Mental illnesses are common in the United States and around the world. It is estimated that more than one in five U.S. adults live with a mental illness (59.3 million in 2022; 23.1% of the U.S. adult population). Mental illnesses include many different conditions that vary in degree of severity, ranging from mild to moderate to severe. Two broad categories can be used to describe these conditions: Any Mental Illness (AMI) and Serious Mental Illness (SMI).” Mental illness also commonly co-occurs with alcohol use disorder (AUD) and SUD.

Better Understanding Co-Occurring Disorders of Addiction and Mental Illness

Co-occurring disorders of addiction and mental illness (also known as comorbidities) occur more than people may think. According to NIDA, “Many individuals who develop substance use disorders (SUD) are also diagnosed with mental disorders, and vice versa. Multiple national population surveys have found that about half of those who experience a mental illness during their lives will also experience a substance use disorder and vice versa. Although there are fewer studies on comorbidity among youth, research suggests that adolescents with substance use disorders also have high rates of co-occurring mental illness; over 60 percent of adolescents in community-based substance use disorder treatment programs also meet the diagnostic criteria for another mental illness.” 

It is also important to understand that the entire family (and close friends) can be affected by mental illness and addiction. This is why these issues are referred to as family diseases. Mental illness and addiction act as tornados that rip through the family unit and destroy everyone and everything involved. 

However, there is some good news. While the family may be the most affected by addiction and mental illness, they also often have the greatest opportunity to get their loved one help. This is because they are in close proximity and can tell if something may be going on. Of course, they must be able to recognize the signs and symptoms of addiction if they are going to be of any service. 

The Signs and Symptoms of Addiction and Mental Illness

Now, of course, the signs and symptoms of mental illness and addiction are always going to vary based on the individual. However, one can look out for many universal signs and symptoms. The following are just a few of those signs and symptoms of mental illness and addiction:

• Feeling anxious, nervous, or overly “stressed out”
• Not being able to stop once starting drinking or using
• Experiencing trouble at work or school
• Issues with relationships at home
• Having trouble with sleep cycles, including sleeping too much and not sleeping enough (hypersomnia and insomnia)
• Losing interest in activities once enjoyed
• Isolating away from family and close friends
• Feeling overwhelming dread
• Loss of appetite and a lack of care regarding physical appearance and well-being
• Exhibiting excessive mood swings
• Experiencing physical ailments such as headaches, body aches, and gastrointestinal problems
• Having feelings of worthlessness, hopelessness, and helplessness
• Causing harm to oneself or others
• Having suicidal ideations

Yes, people often minimize addiction and/or mental illness or even falsely categorize it as that previously mentioned “choice.” However, as one can see, these signs and symptoms are significant and can even be deadly. This is why reaching out for professional help as soon as possible is critical. Doing so could mean the difference between short-term side effects and long-term consequences. It is also important to understand the specific types of mental illnesses that may be affecting a loved one. This includes personality disorders.

Better Understanding Personality Disorders

Personality disorders can be highly disruptive to everyday life. According to the peer-reviewed journal Personality Disorder, by Doctors Fariba, Gupta, Torrico, and Kass, “Personality disorders reflect an enduring pattern of inner experience and behavior that deviates markedly from the norms and expectations of the surrounding culture. Individuals with personality disorders may experience distorted perceptions of reality and abnormal affective responses… These disorders can adversely affect multiple aspects of life, including relationships, work, and overall functioning—underscoring the need for early intervention and interdisciplinary care. Early diagnosis and treatment are crucial in managing the symptoms and improving the quality of life for those affected.”

Personality disorders affect millions of people around the world. While some personality disorders are more prevalent than others, it is thought that roughly 9% of the world is affected by a personality disorder at any given time. These are not insignificant numbers and show how important it is to focus on effective treatments for personality disorders. This includes schizotypal personality disorder (SPD).

What Is Schizotypal Personality Disorder (SPD)?

So, what exactly is SPD? According to the peer-reviewed thesis “Schizotypal Personality Disorder,” by Doctors Francois and Torrico, “Schizotypal personality disorder, as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision (DSM-5-TR), is a psychiatric disorder characterized by deficits in social and interpersonal skills, highlighted by a reduced ability to form close relationships, occurring in the setting of eccentric behavior and cognitive or perceptual distortions. Although the DSM continues to categorize schizotypal personality disorder as a personality disorder, the World Health Organization reclassified schizotypal personality disorder as a form of schizophrenia in the International Classification of Diseases, 11th Revision (ICD-11). The estimated prevalence of schizotypal personality disorder is between 1% and 4%….”

There are also specific criteria that one must meet to be diagnosed with SPD. According to the peer-reviewed journal Current Psychiatry Reports, “The SPD diagnostic criteria for DSM-5 are essentially unchanged from DSM-IV-TR, and consist of: ideas of reference; odd beliefs or magical thinking; unusual perceptual experiences and bodily illusions; odd thinking and speech; suspiciousness or paranoid ideation; inappropriate or constricted affect; behavior or appearance that is odd, eccentric, or peculiar; lack of close friends or confidants, other than first-degree relatives; excessive social anxiety that doesn’t diminish with familiarity and tends to be associated with paranoid fears. Five of nine criteria are required for a diagnosis of SPD.”

Exploring the Link Between Schizotypal Personality Disorder (SPD) and Substance Use

As previously mentioned, there is a significant and direct link between addiction and mental illness. This includes addiction and SPD. However, there is another layer with addiction and SPD. Substance and alcohol use can actually increase the chances of someone with SPD becoming schizophrenic. This is especially true with cannabis and alcohol.

According to the peer-reviewed journal JAMA Psychiatry, “Substance use disorders are common in patients with schizotypal disorder, and cannabis has been shown to be a risk factor for developing schizotypal disorder.” Additionally, “cannabis has also been linked to an increased risk of schizophrenia. Other substance use disorders, in particular alcohol use disorder, may also increase risk of later schizophrenia.”

This is why it can be so critical to diagnose SPD as soon as possible. Doing so could stop the disorder from accelerating and getting worse. Also, stopping substance and alcohol use early can eliminate the chances of long-term addiction. The good news is that there is hope. There is a solution. There are many effective treatments for SPD and addiction.

How to Best Treat Schizotypal Personality Disorder (SPD)

The best way to treat SPD and addiction is with a multi-angled approach. This means utilizing as many means, methods, and modalities as possible for the most well-rounded treatment. It is important to note that many recovery centers only offer single-modality recovery plans. This takes the “individualized” out of the equation and can ultimately leave someone without the proper means for recovery.

Here at Exclusive Hawaii Rehab, we know that “one-note” recovery plans rarely work. That is why we focus on comprehensive and individualized recovery plans. This starts from our intensive and honest intake process to all of our aftercare options. We also make sure to focus on the underlying issues of mental illness and addiction. The key is to get to the root/core causes of the issue. Often, this relates to issues of trauma or post-traumatic stress syndrome (PTSD). This is certainly true with SPD. 

We also focus on modalities from all areas of recovery. We utilize holistic healing methods like yoga and mindfulness meditation to address emotional and spiritual issues. Also, we use experiential therapies to use nature and creativity as healing tools. However, all of our recovery plans begin with a foundation of evidence-based treatments like psychotherapy.

Traditional Treatments Involving Psychotherapy

Psychotherapy has long been the number one go-to for issues of mental illness and addiction recovery. There is a reason for this – it works! Also, there is a long history of efficacy that shows that it works. Two of the most effective and trusted forms of psychotherapy are dialectical behavior therapy (DBT) and cognitive-behavioral therapy (CBT).

CBT has been shown to be highly effective at treating many issues, including personality disorders like SPD. According to the peer-reviewed thesis, Cognitive Behavior Therapy, by Doctors Chand, Kuckel, and Huecker, “[CBT] has been extensively researched and found to be effective in a large number of outcome studies for some psychiatric disorders, including depression, anxiety disorders, eating disorders, substance abuse, and personality disorders. It also has been demonstrated to be effective as an adjunctive treatment to medication for serious mental disorders such as bipolar disorder and schizophrenia…. Its efficacy has also been established in the treatment of non-psychiatric disorders such as irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia, insomnia, migraines, and other chronic pain conditions.” 

DBT has also been shown to be highly effective. Many people have also reported that DBT has improved their relationships. According to the peer-reviewed journal Borderline Personality Disorder and Emotion Dysregulation, “Prior to DBT, participants reflected on how their relationships with others were impacted as a result of their difficulties, with some participants describing how they had lost touch with many of their friends. Participants spoke about how their relationships have improved as a result of DBT and how they have continued to improve in the years since completing the programme, where they now experience more positive and open relationships with others and have been able to reconnect with old friends….”

Utilizing Experiential Therapies, Group Therapy, and Holistic Healing Methods

There are also many other treatments that can be highly effective for treating SPD and SUD. These methods include experiential therapies like nature immersion therapy, surf therapy, and horticulture therapy. These are great ways to connect to the Earth while better connecting with oneself.

Then, there are holistic healing methods like acupuncture, massage therapy, yoga therapy, and mindfulness meditation that can offer a myriad of benefits. These benefits include improved breathing, mental clarity, better balance and centering, and reduced anxiety and depression. They also often help one better connect to a spiritual program of recovery, which many people describe as the cornerstone of their treatment plan.

Healing at the Cellular Level With Exclusive Hawaii Rehab

Here at Exclusive Hawaii Rehab, we believe in long-term success over short-term “fixes.” That is why all of our recovery plans are individualized and comprehensive, with a focus on the future.

SPD and substance use do not need to be the end. It is time for a new beginning. You got this! We can help.

Schizotypal personality disorder (SPD) is characterized by eccentric thoughts and behaviors, which can complicate relationships and coping strategies. There are also many correlations between SPD and substance use. For example, individuals may turn to drugs or alcohol as a means of managing their symptoms or finding relief from social anxiety. If you feel like you or a loved one is struggling with issues of addiction, mental illness, or both, we can help get you on the positive path toward recovery right away. You don’t have to go through this process alone. For more information about treatment options for schizotypal personality disorder (SPD), please reach out to Exclusive Hawaii Rehab today at (808) 775-0200.