20
personality + substance use

Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

  • Upload
    others

  • View
    0

  • Download
    0

Embed Size (px)

Citation preview

Page 1: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

personality +

substance use

Page 2: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

Contents:What are personality traits? 1

What is a personality disorder? 1

hoW common are personality disorders? 4

What causes personality disorders? 4

personality disorders and substance use 4

When should i seek help? 5

hoW are personality disorders treated? 5

tips for staying Well 6

techniques for staying Well 9

Where to get help 15

About this booklet:this booklet is part of a series on mental health and substance use funded by the australian government department of health and ageing.

substance use in this booklet refers to the use of alcohol, tobacco and other drugs.

Other booklets in this series include:

• TraumaandSubstanceUse• MoodandSubstanceUse• PsychosisandSubstanceUse• AnxietyandSubstanceUseAvailable at www.ndarc.med.unsw.edu.au

Page 3: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

>> 1

WhAt Are personAlity trAits?• Personalitytraitsrefertoaperson’sindividualpatternsofthinking,feeling,andbehaving.• Thesepatternsofthinkingandbehavingusuallybegininchildhoodandcontinuethrough

toadulthood.• Ourpersonalitytraitsmakeuswhoweare—theyarewhatmakeeachofusunique.• However,personalitytraitscanbeaproblemwhentheycauseproblemswith

relationships,educationoremployment,andsometimeswiththelaw.• Ifpatternsofthinking,feeling,orbehavingarecreatinglotsofproblemsinmanyareas

ofaperson’slife,theymayhaveapersonalitydisorder.

WhAt is A personAlity disorder?• Thereisawiderangeofpersonalitydisorders(see

Table1).Alloftheminvolvepervasivepatternsofthinkingandbehaving,whichmeansthatthepatternsexistineveryareaofaperson’slife(thatis,work,study,home,leisureandsoon).

• Themostsignificantfeatureofpersonalitydisordersistheirnegativeeffectonpersonalrelationships.Apersonwithanuntreatedpersonalitydisorderoftenhasdifficultyforminglong-term,meaningful,andrewardingrelationshipswithothers.

• Individualswithapersonalitydisorderaregenerallynotupsetbytheirownthoughtsandbehaviours,butmaybecomedistressedbytheconsequencesoftheirbehaviours.

>> 1

Page 4: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

2  •  personality  + substAnCe use

table 1. Types of personality disorders

paranoid personality

Apersonwithparanoidpersonalitydisorderisdistrustfulandsuspiciousofothers,andbelievesthatothers’motivesarehostile.

schizoid personality

Apersonwithschizoidpersonalitydisorderisdetachedfromsocialrelationships,andhasalimitedabilitytoexpressemotionsaroundothers.

schizotypal personality

Apersonwithschizotypalpersonalitydisorderhasdifficultyformingcloserelationships,andisveryuncomfortablearoundothers.Thispersonmightalsohavejumbledthoughtsandbehaveoddly.

Antisocial personality

Apersonwithantisocialpersonalitydisorderdisregardsandviolatestherightsofothers,withalackofremorsefortheimpactoftheirbehaviouronothers.

histrionic personality

Apersonwithhistrionicpersonalitydisorderisoverlyemotional,andexcessivelyseekstheattentionofothers.

narcissistic personality

Apersonwithnarcissisticpersonalitydisorderstronglybelievesintheirowngreatness,andmaybehaveinwaysthatshowthis.Theymayalsoseekadmirationfromothers,andhavetroubleunderstandingthethoughts,feelingsandneedsofothers.

Avoidant personality

Apersonwithavoidantpersonalitydisorderavoidssocialinteractionwithothersforfearofcriticism,disapprovalorrejection.

dependent personality

Apersonwithdependentpersonalitydisorderfeelsanextremeneedtobetakencareof.Thismayleadtoapersongivinginveryeasily,beingoverlyclingyandafraidofseparation.

obsessive-compulsive personality

Apersonwithobsessivecompulsivepersonalitydisorderisextremelycontrolled,orderly,andperfectionistic.Theirrigidattentiontodetail,rulesandproceduresmayinterferewiththeirabilitytofunctioneffectively.

Page 5: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

>> 3

borderline personality

Apersonwithborderlinepersonalitydisorderisemotionallysupersensitivetoeventsintheirlife,resultinginextrememoodswingswithintenseanger,panic,despairandfeelingsofchronicemptiness.Relationshipsareunstableandintense,oftenwithanextremefearofabandonment.Impulsiveandrecklessbehaviours(includingsuicideattemptsandself-harm)arecommon.Theremayalsobebriefepisodesofparanoiaandlossoftouchwithreality.

do you have any pervasive patterns of thinking and behaving that are a problem for you or those who are close to you?

Page 6: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

4  •  personality  + substAnCe use

hoW Common Are personAlity disorders?• Personalitydisordersarecommon.Approximatelyoneintenpeoplehavea

personalitydisorder.• Personalitydisordersareevenmorecommonamongpeoplewithalcohol,tobaccoor

otherdrugproblems.Abouthalfofallpeoplewithalcoholorotherdrugproblemsalsohaveapersonalitydisorder.

• Themostcommonpersonalitydisordersseenamongpeoplewithalcoholorotherdrugproblemsareantisocialandborderlinepersonalitydisorders.

• Ifyouhaveapersonalitydisorder,youarenotalone.

WhAt CAuses personAlity disorders?• Personalitydisordersdevelopinchildhoodandthepatternsofthinkingandbehaving

becomemoreingrainedasapersongetsolder.• Thereisnosinglecauseofpersonalitydisorders.However,thereareseveralfactorsthat

maycontributetothedevelopmentofpersonalitydisorders,suchas:—Familyhistory—Chemicalimbalancesinthebrain—Lifeexperiences(e.g.,childhoodabuse,neglectorseparationfromcaregivers,

growingupwithparentswhowereover-involvedorunder-involved)

personAlity disorders And substAnCe use• Sometimespeopleusealcohol,tobaccoorotherdrugstocopewithnegativeemotions.

Thisisoftencalled‘self-medication’.• Otheraspectsofaperson’spersonalitymayalsoaffecttheiralcohol,tobaccoorother

druguse.Forexample,peoplewhohaveantisocialtraitsmayusesubstancesbecauseitisa‘deviant’behaviour,andpeoplewhoare‘avoidant’mayusesubstancestohelpthemcopewithanxietyinsocialsituations.

• Regardlessofthereasonswhypeopleuse,somefindthattheydevelopalcohol,tobaccoorotherdrugproblemsbecausetheyneedtodrink,smokeorusegreateramountsmorefrequentlytogettheeffecttheywant.

• Somepeoplealsofindthatalcohol,tobaccoorotherdrugusemakessomeoftheirproblematicpersonalitytraitsworseandcanmakedifficultrelationshipsevenmorecomplicated.

Page 7: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

>> 5

When should i seek help?• Ifyoubelieveyourbehavioursareaproblemorifyouansweryestoanyofthefollowing

questions,youshouldseekprofessionalassistance(seepages15–16): Doyouhavepervasivepersonalitytraitsthatcauseyouorothersdistress? Doyourpersonalitytraitsorsubstanceuseinterferewithyourhome,work,study,

relationshipsorsociallife? Doyouusealcohol,tobaccoorotherdrugstocope? Haveyouthoughtaboutharmingyourselforothers?

hoW Are personAlity disorders treAted?• Effectivetreatmentsareavailable.Bothpsychologicaltherapyandmedicationcanhelp

peoplewithpersonalitydisorders.• Thetypeoftreatmentdependsonthetypeofpersonalitydisorder.

psychological therapy• Psychologicaltreatmentsusuallyinvolvetherapythatisfocusedoncopingwithnegative

emotions,learninghowtointeractwithpeopleindifferentsituations,understandingandchangingunderlyingbeliefsthatmaycontributetosomemaladaptivepersonalitytraits,andmanagingself-harmandsuicidalbehavior.

• Someofthemostcommonpsychologicaltreatmentsarecognitivebehaviourtherapy(CBT)anddialecticalbehaviourtherapy(DBT).

• Ifyou’reinterestedinseeingapsychologist,yourGPcanhelpyoubypreparingamentalhealthplan,andreferringyoutoanappropriatepsychologist.

Cognitive behaviour therapy (Cbt)• CBTisapsychologicaltreatmentwhereaperson

workswithatherapisttolookattheirpatternsofthinking(cognition)andacting(behaviour).Oncenegativethinkingpatternscanbeidentified,apersoncanmakechangestoreplacethemwithonesthatpromotegoodmoods,morerealisticthoughts,andbettercopingskills.Thistypeoftherapyalsoencouragesapersontoparticipateinactivitiestheypreviouslyenjoyed,andincreaseactivitiesthatgivethempleasureorasenseofachievement.

Page 8: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

dialectical behaviour therapy (dbt)• DBTisatypeofpsychologicaltherapythatfocusesonchangingbehaviour.DBThelpsa

persondevelopskillswhichcanhelpthemremaingrounded,incontroloftheirbodyandmind,copewithinterpersonalconflict,dealwithstressfulsituationsandretaincontroloftheiremotions.Inthisway,DBTisatypeoftherapythatteachesskillsforcopingwithfeelings,whichcanthenaffectaperson’sbehaviours.

medication• Medicationmayalsobehelpfulalongsidepsychologicaltherapy.Thetypeof

medicationdependsonthepersonalitydisorder,butmightincludeanti-depressants,mood-stabilisers,oranti-psychoticmedications.

• Medicationscanbehelpfulinmanagingyouremotions;however,somepeopleexperienceunpleasantanddistressingsideeffects.Inmostinstancesthereisachoiceofmedication,butitmaytaketimetoestablishwhichmedicationisbestsuitedtoyourneeds.Tellyourdoctoraboutanysideeffectsthataredistressingyou.

interactions with alcohol, tobacco or other drugs

• Itisveryimportantthatyoufollowyourdoctor’sinstructionswhentakinganymedicationthathasbeenprescribedtoyou.

• Beforebeingprescribedmedicationitisimportanttotellyourdoctoraboutyouralcohol,tobaccoorotherdrugusesothattheymaygiveyouthebestpossiblecare.Alcohol,tobaccoandotherdrugscaninteractwithsomeprescriptionmedications,andthisinteractionmayaltertheeffectivenessofthemedication.Mixingprescribedmedicationswithalcoholorotherdrugscanalsohavedangerousconsequencesincludingoverdoseandpossiblydeath.

• Ifyouusealcohol,tobaccoorotherdrugsandareonmedication,letyourdoctorknowifyouareplanningtostopusingalcohol,tobaccoorotherdrugs.Whenyoustopdrinking,smokingorusing,thebloodconcentrationsofothermedicationscanalsobeaffected,sothedoctormayneedtoadjustthedoseofyourmedication.

tips for stAying WellThereareanumberofthingsyoucandotolookafteryourself:• Take care of yourself.Makesureyoueathealthilyandgetregularexercise.Exercise

providesanoutletforthestressthathasbuiltupinyourbody.• Plan to do something you enjoy each day.Thisdoesn’thavetobesomethingbigor

expensiveaslongasitisenjoyableandprovidessomethingtolookforwardtothatwilltakeyourmindoffyourworries.

6  •  personality  + substAnCe use

Page 9: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

What are some things that you like to do that are pleasant or enjoyable?

• Make time for rest and relaxation. Stressandanxietycanmakeanyproblemsseemworse.Itisimportanttotryandreducestressandanxietybygivingyourselftimetorestandrelax.Youcanusetechniquessuchascontrolled breathing,progressive muscle relaxation,ormindfulness(thesetechniquesaredescribedonpages9–12),oranyotheractivityyoufindrelaxing(e.g.,reading,listeningtomusic,goingforawalk).Thesetechniquescanalsohelpyoumanageyourcravingsorurgestousealcohol,tobaccoorotherdrugs.

• Avoid or limit your use of alcohol, tobacco or other drugs.Alcohol,tobaccoandotherdrugscanintensifysomeproblematicpersonalitytraits.Itisrecommendedthatnomorethantwostandarddrinksshouldbeconsumedeachday(forfurtherinformationrefertotheAustralianDrinkingGuidelines).Avoidhighdosesofsubstances,andriskydrugtakingbehaviour,suchasinjectingdruguse.Takeregularbreaksfromdrinkingorusing,andavoidusingmultipledifferenttypesofdrugs.Ifyouhavebeendrinking,smokingorusingregularlyitcanbedifficulttocutdown.Theactivitieslistedonpages9–14ofthisbookletmayhelpyoucopewithyourcravingsandurgestouse.

>> 7

Page 10: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

8  •  personality  + substAnCe use

• Take medication as prescribed. Avoidmixingprescribedmedicationwithalcohol,tobaccoorotherdrugs,asthiscouldhavedangerousconsequences,suchasmakingprescribedmedicationineffectiveorincreasingtheeffectsofalcoholorotherdrugs.

• Seek support. Everybodyneedssupport.Talktofamilymembersorfriendsthatyoutrustaboutyourfeelings,orwritethemdowninadiary.Theserviceslistedattheendofthisbookletmayalsobeuseful.

• Plan to do something each day that brings a sense of achievement. Theseactivitiesareoftentheonesthatpileupwhenapersonisgoingthroughahardtime,butcanbearealsourceofstressifleftalone.Activitieslikethisincludehouseholdchores(cleaning,vacuuming,floors,washingclothes),payingbills,returningphonecalls,andsoon.Byjustchoosingoneoftheseactivitiestodoeachday,youcanpreventthingspilingup,whichcanhelpyoufeelabitmoreincontrolofyourlife.Theflow-oneffectcanbearealsenseofachievement(orrelief)thatthisactivityhasbeencompleted.

• Monitor your emotions.Trykeepingtrackofyouremotionsinadiary.Writedownhowyouhavefeltatdifferenttimesoftheday.Whenwereyourmoodslowest,whenyoufelttheworst?Whenwereyourmoodshighest,whenyoufeltbest?Whatwereyoudoingandwhatwereyouthinkingatthosetimes?Whendidyouhavecravingstousealcohol,tobaccoorothersubstances?Howmuchsleepdidyouhaveeachnight?Keepingadiaryofyouremotionscanhelpyoulearnthepatternsbetweenthewayyoufeel,thethingsyoudoandthewayyouthink.

What strategies do you find help manage your emotions and your alcohol, tobacco or other drug use?

Page 11: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

>> 9

teChniques for stAying Well Theactivitiesandtechniquesonthefollowingpagescanbeusedtohelpyoumanageyourpersonalitysymptomsandaswellasanycravingstousealcohol,tobaccoandotherdrugs.Youcanalsousethemeverydayaspartofageneralplantostaywell.Whilemanypeoplefindthetechniquesonthefollowingpagesuseful,theydon’tworkforeveryone.Donotusethemifyoufindthemdistressingorunpleasant—itisimportanttofindwhatworksbestforyou.

Controlled breathing exerciseHaveyounoticedsometimesthatyou’rebreathingtoofast?Stresscanaffectyourheartrateandbreathingpatterns.

Arelaxedbreathingrateisusually10to12breathsperminute.

Practisethisexercisethreetofourtimesadaywhenyou’refeelingstressedoranxioussothatyoucanusethisasashort-termcopingstrategy.

1 Timethenumberofbreathsyoutakeinoneminute.Breathingin,thenoutiscountedasonebreath.

2 Breathein,holdyourbreathandcounttofive.Thenbreatheoutandsaytheword‘relax’toyourselfinacalm,soothingmanner.

3 Startbreathinginthroughyournoseandoutslowlythroughyourmouth,inasix-secondcycle.Breatheinforthreesecondsandoutforthreeseconds.Thiswillproduceabreathingrateof10breathsperminute.Inthebeginning,itcanbehelpfultotimeyourbreathingusingthesecondhandofawatchorclock.

4 Counttoyourself.

5 Continuebreathinginasix-secondcycleforatleastfiveminutesoruntilthesymptomsofoverbreathinghavesettled.

6 Afterpractisingthisexercise,timethenumberofbreathsyoutakeinoneminute.Practisethecontrolledbreathingexerciseeachdaybeforebreakfast,lunch,dinnerandbedtime.Usethetechniquewheneveryoufeelanxious.Gradually,you’llbefamiliarenoughwiththeexercisetostoptimingyourself.

Source: beyondblueFactsheet6–Reducingstress2010

Page 12: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

10  •  personality  + substAnCe use

mindfulnessMindfulnessisatechniquethathelpsyoufocusonyourinternalorexternalenvironment,withoutbeingdistractedorconcernedbywhatsurroundsyou.Mindfulnesscanbeappliedtoanytaskthatyoudo,suchasdoingthewashingup,orbrushingyourteethforexample.Thisparticularactivityistoshowyouhowtousemindfulnessskillstopayparticularattentiontoaroutineactivity(walking).Thistechniquemightseemdifficulttostartwith,butifyoupractise,itwillbecomeeasier.

1 First,findaplacewhereyoucanwalkupanddownwithoutworryingaboutwhomightseeyou.Itdoesn’tmatterwhereyouare,aslongasyoucantakeabout10steps.

2 Standinarelaxedposturewithyourfeetpointingstraightaheadandyourarmshanginglooselybyyoursides.Lookstraightahead.

3 Youwillpractisewalkinglikeitisthefirsttimeyouhaveeverwalked.Startwalkingandwhileyouarewalking,practisepayingattentiontoallthephysicalandothersensationsthatoccur—sensationsthatyouprobablywouldnotnormallybeawareof.Startbybringingyourfocustothebottomsofyourfeet,noticingwhatitfeelslikewhereyourfeetcontacttheground.Feeltheweightofyourbodytransmittedthroughyourlegsandfeettotheground.Youmayliketoflexyourkneesslightlyacoupleoftimestofeelthedifferentsensationsinyourfeetandlegs.

4 Next,transferyourweightontotherightfoot,noticingthechangeinphysicalsensationsandyourlegsandfeetasyourleftleg‘empties’ofweightandpressureandyourrightlegtakesoverassupportforyourbody.

5 Withtheleftleg‘empty’,allowyourleftheeltoriseslowlyfromthefloor,noticingthechangeinsensationsinyourcalfmusclesasthishappens.Allowtheentireleftfoottoliftgentlyofftheflooruntilonlyyourtoesarestillincontactwiththeground.Slowlyliftyourleftfootcompletelyoffthefloorandmoveyourleftlegforward,noticingthephysicalsensationsinyourfeet,legsandbodychangeasyourlegmovesthroughtheair.

6 Placeyourleftheelonthegroundinfrontofyouandallowtherestofyourleftfoottomakecontactwiththefloor.Asthishappens,noticethechangesinphysicalsensationsthatoccurasyoutransfertheweightofyourbodyontoyourleftfootfromyourrightfoot.Allowyourrightfootto‘empty’ofweight.

Page 13: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

>> 11

7 Repeatthisprocesswiththerightfoot.Firstliftyourrightheelofftheground,thentherestofyourfoot,andmoveitslowlyforward,noticingthechangesinphysicalsensationsthatoccurthroughoutthismotion.

8 Keeprepeatingthisprocessasyouslowlymovefromoneendofyourwalktotheother,beingawareoftheparticularsensationsinthebottomsofyourfeetandheelsastheymakecontactwiththefloor,andthemusclesinyourlegsastheyswingforward.

9 Continuethisprocessupanddownthelengthofyourwalkforabout10minutes,beingawareasbestyoucan.

10 Yourmindwillwanderawayfromthisactivityduringyour10minutesofpractice.Thisisnormal—it’swhatmindsdo.Whenyounoticethishashappened,gentlyguidethefocusofyourattentionbacktothesensationsinyourfeetandlegs,payingparticularattentiontothecontactyourfeethavewiththefloor.Thiswillhelpyoustayinthepresentmoment,concentratingonwhatishappeningnow,ratherthanworryingaboutthepastorthefuture.

11 Tobeginwith,walkmoreslowlythanusual,togiveyouabetteropportunitytopractisethisexercise.Onceyoufeelcomfortablewiththeexercise,youmayliketoexperimentwithdifferentspeedsofwalking.Ifyouarefeelingagitated,youmayliketostartoffwalkingfast,withawarenessthatthisiswhatyouaredoing,andthenslowdownnaturallyasyoubegintosettle.

12 Trytoworkthisactivityintoyourdailyroutine—practisewhenyouarewalkingtothebus,ortotheshops,oraroundthehouse.

Page 14: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

12  •  personality  + substAnCe use

progressive muscle relaxationProgressivemusclerelaxationinvolvestensingandrelaxingdifferentmusclegroupsoneaftertheother.Ithelpstoreducephysicalandmentaltension.Afullsessionofrelaxationtakesabout15to20minutes.

1 Sitinacomfortablechairinaquietroom.

2 Putyourfeetflatonthefloorandrestyourhandsinyourlap.

3 Closeyoureyes.

4 Dothecontrolledbreathingexerciseforthreeminutes.

5 Afterthreeminutesofcontrolledbreathing,startthemusclerelaxationexercisebelow.

6 Tenseeachofyourmusclegroupsfor10seconds,thenrelaxfor10seconds,inthefollowingorder:» Hands:clenchyourhandsintofists,thenrelax» Lower arms:bendyourhandsupatthewrists,thenrelax» Upper arms:bendyourarmsupattheelbow,thenrelax» Shoulders:liftyourshouldersup,thenrelax» Neck:stretchyourneckgentlytotheleft,thenforward,thentotheright,

thenbackwardsinaslowrollingmotion,thenrelax» Forehead and scalp:raiseyoureyebrows,thenrelax» Eyes:closeyoureyestightly,thenrelax» Jaw:clenchyourteeth,thenrelax» Chest:breatheindeeply,thenbreatheoutandrelax» Stomach:pullyourtummyin,thenrelax» Upper back:pullyourshouldersforward,thenrelax» Lower back:whilesitting,rollyourbackintoasmootharc,thenrelax» Buttocks:tightenyourbuttocks,thenrelax» Thighs:pushyourfeetfirmlyintothefloor,thenrelax» Calves:liftyourtoesofftheground,thenrelaxand» Feet:gentlycurlyourtoesdown,thenrelax

7 Continuecontrolledbreathingforfivemoreminutes,enjoyingthefeelingofrelaxation.

Source: beyondblueFactsheet6–Reducingstress2010

Page 15: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

>> 13

Coping with CravingsTheeasiestwaytocopewithcravingsorurgestousealcohol,tobaccoorotherdrugsistotry to avoid theminthefirstplace.Thiscanbedonebyreducingyourexposuretocravingtriggers(e.g.,gettingridofdrugsandfits/pipesinthehouse,notgoingtopartiesorbars,reducingcontactwithfriendswhouse,andsoon).Sometimescravingscan’tbeavoided,andyouneedtofindwaystocopewiththem.

Cravingsaretime-limited,thatis,theyusuallylastonlyafewminutesandatmostafewhours.Ratherthanincreasingsteadilyuntiltheybecomeunbearable,theyusuallypeakafterafewminutesandthendiedown,likeawave.Everywave/cravingstartssmall,andbuildsuptoitshighestpoint,beforebreakingandflowingaway.

Cravingswilloccurlessoftenandfeellessstrongasyoulearnhowtocopewiththem.Eachtimeapersondoessomethingotherthanuseinresponsetoacraving,thecravingwilllosesomeofitspower.Thepeakofthecravingwavewillbecomesmaller,andthewaveswillbefurtherapart.

Below are some things for you to try out, to cope with the symptoms of cravings. Put a tick (4) in the box next to those things you think you could do.

Eat regularly,evenwhenyoudon’tfeellikeit.

Drink plenty of water—especiallywhenyougetacraving.

Insteadofdrinking,smokingorusing,drink water or chew gum.

Use‘Delaying’and‘Distraction’whenyourcravingissetoff.Whenyouexperienceacraving,putoffthedecisiontodrinkorusefor15minutes.Goanddosomethingelselikegoforawalk,read,listentomusic,ordothedishesetc.Thiswillhelpyoutobreakthehabitofimmediatelyreachingforalcohol,tobaccoorotherdrugswhenacravinghits.Youwillfindthatonceyouareinterestedinsomethingelse,thecravingwillgoaway.

What are some things you could do to distract yourself?

Page 16: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

14  •  personality  + substAnCe use

Usetherelaxationanddeep breathingtechniquesdescribedearliertocopewithacravingonceitissetoff.Ifacravingdevelopsinresponsetostressfulsituations,relaxationtechniquesanddeepbreathingexercisesarereallyuseful.

Ride out the craving by ‘urge surfing’.Formapictureinyourmindofawaveatthebeach.Thisisacravingwave,andrememberthatthecravingwavewillbuilduptoitshighestpoint,andthenfallawayasitrollsintoshore.Picturethecravingwavebuildingup,gettingreadytobreak,seeitbreak,seethefoamform,andseethewavefadeawayasitrollsintoshore.Now,pictureyourselfridingthewave,surfingthecravingwaveintoshore.Youdon’tfalloff,youdon’tgetdumpedandchurnedaround,justpictureyourselfcalmlysurfingthecravingwaveintoshore.

Talk to someone,perhapsafriendorfamilymember,aboutcravingwhenitoccurs.

Use positive self-talk.Tellyourselfthatcravingsonlylastabout10minutes.Tellyourself‘thisfeelingwillpass’.Youwillfindthattheurgesandcravingsthemselveswillbeeasiertodealwith.Saytoyourself,‘yes,thisfeelsprettybad,butIknowitwillbeoversoon’.

Challenge and change your thoughts.Whenexperiencingacraving,manypeoplehaveatendencytorememberonlythepositiveeffectsofusingdrugsandoftenforgetthenegativeconsequencesofusing.Remindyourselfofthebenefitsofnotusingandthenegativeconsequencesofusing.Thisway,youcanremindyourselfthatyoureallydon’tfeelbetterifyouhave‘justonedrink’andthatyoustandtolosealotbydrinking,smokingorusing.Are there other things you do that help you cope with cravings?

Coping with Cravings continued

Page 17: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

>> 15

Where to get helpThebestplacetostartistosee a doctor.Theycanprovideyouwithfurtherinformationandareferraltoanappropriatehealthprofessional.Theorganisationsbelowmayalsobeuseful.

Talkingwithtrustedfamily members or friendscanalsobeveryhelpful.Yoursupportnetworkcanassistyouinmakingdecisions,helpyouaccessservices,andgiveyouvitalsupportthroughyourrecovery.

national

Lifeline: 13 11 14Quitline: 13 78 48SANEHelpline: 1800 187 263FamilyDrugSupport: 1300 368 186ACt:

Alcohol&DrugInformationService: (02) 6207 9977CanberraAllianceforHarmMinimisationandAdvocacy: (02) 6279 1670nsW:

Alcohol&DrugInformationService: (02) 9361 8000 or 1800 442 599NSWUsersandAIDSAssociation: (02) 8354 7300 or 1800 644 413nt:

Alcohol&DrugInformationService: (08) 8922 8399 or 1800 131 350CrisisLine: 1800 019 116NorthernTerritoryAIDS&HepatitisCouncil: (08) 8953 3172qld:

Alcohol&DrugInformationService: (07) 3837 5989or1800 177 833QLDInjectorsHealthNetwork: (07) 3620 8111or1800 172 076QueenslandIntravenousAIDSAssociation: (07) 3620 8111sA:

Alcohol&DrugInformationService: 1300 131 340SouthAustralianVoiceinIVEducation: (08) 8334 1699tAs:

Alcohol&DrugInformationService: (03) 6230 7901or1800 811 994TasmanianCouncilonAIDS,Hepatitis&RelatedDiseases: (03) 6234 1242

Page 18: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

ViC:

Alcohol&DrugInformationService: (03) 9416 1818or1800 888 236HarmReductionVictoria: (03) 9329 1500VictorianDrugUsersGroup: (03) 9329 1500WA:

Alcohol&DrugInformationService: (08) 9442 5000or1800 198 024WesternAustraliaSubstanceUsersAssociation: (08) 9321 2877

Therearealsosomehelpful websiteswhichgiveinformationandguidance.Herearesome:

AnxietyOnline: www.anxietyonline.org.auAustralianCentreforPosttraumaticMentalHealth: www.acpmh.unimelb.edu.auAustralianDrinkingGuidelines: www.alcohol.gov.auAustralianDrugInformationNetwork: www.adin.com.auBeyondblue: www.beyondblue.org.auBlackDogInstitute: www.blackdoginstitute.org.auClinicalResearchUnitforAnxietyandDepression: www.crufad.unsw.edu.auDruginformationandadvice: www.saveamate.org.auDruginformationandresearch: www.druginfo.adf.org.auDruginformation,services,informationandsharedstories: www.somazone.com.auDualDiagnosis:AustraliaandNewZealand: www.dualdiagnosis.org.auFamilyDrugSupport: www.fds.org.auHeadspace: www.headspace.org.auHIV,sexualheathanddruginformationforlesbian,gay,bisexualandtransgendercommunities: www.acon.com.auMentalIllnessFellowship: www.mifa.org.auQuitnow: www.quitnow.info.auReachOut!: www.reachout.com.auSANE: www.sane.org

16  •  personality  + substAnCe use

Page 19: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

©NationalDrugandAlcoholResearchCentre2011

ThisbookletwasproducedbytheNationalDrugandAlcoholResearchCentre.ItwaswrittenbyKatherineMills,ChristinaMarel,AmandaBaker,MareeTeesson,GlenysDore,FrancesKay-Lambkin,LeonieMannsandTonyTrimingham.Thankyoutoeveryonewhowasinvolvedindevelopingthisbooklet.

DesignedandtypesetbyPetaNugent

ISBN978-0-7334-3045-9

Page 20: Personality disorder and substance use · of a person’s life, they may have a personality disorder. WhAt is A personAlity disorder? • There is a wide range of personality disorders

ThisbookletispartofaseriesonmentalhealthandsubstanceusefundedbytheAustralianGovernmentDepartmentofHealthandAgeing.

Personalitytraitsrefertoaperson’sindividualpatternsofthinking,feeling,andbehaving.Ourpersonalitytraitsarewhatmakeusunique.

Personalitytraitscanbecomeproblematicwhentheycauseproblemswithrelationships,educationoremployment,substanceuseandsometimeswiththelaw.Thisbookletaimstohelpyoumanagedifficultiesyoumaybehavingintheseareas.

Otherbookletsinthisseriesandfurtherinformationonmentalhealthandsubstanceuseareavailableatwww.ndarc.med.unsw.edu.au