Personality Disorders
Overview
A personality
disorder is a type of mental disorder in which you have a rigid and unhealthy
pattern of thinking, functioning and behaving. A person with a personality
disorder has trouble perceiving and relating to situations and people. This
causes significant problems and limitations in relationships, social
activities, work and school.
In some cases,
you may not realize that you have a personality disorder because your way of
thinking and behaving seems natural to you. And you may blame others for the
challenges you face. Personality disorders usually begin in the teenage years
or early adulthood. There are many types of personality disorders. Some types
may become less obvious throughout middle age.
Symptoms
Types of
personality disorders are grouped into three clusters, based on similar
characteristics and symptoms. Many people with one personality disorder also
have signs and symptoms of at least one additional personality disorder. It’s
not necessary to exhibit all the signs and symptoms listed for a disorder to be
diagnosed.
Cluster A
personality disorders
Cluster A
personality disorders are characterized by odd, eccentric thinking or behavior.
They include paranoid personality disorder, schizoid personality disorder and
schizotypal personality disorder.
Paranoid
personality disorder
- Pervasive distrust and suspicion of
others and their motives
- Unjustified belief that others are
trying to harm or deceive you
- Unjustified suspicion of the loyalty
or trustworthiness of others
- Hesitancy to confide in others due
to unreasonable fear that others will use the information against you
- Perception of innocent remarks or
nonthreatening situations as personal insults or attacks
- Angry or hostile reaction to
perceived slights or insults
- Tendency to hold grudges
- Unjustified, recurrent suspicion
that spouse or sexual partner is unfaithful
- Schizoid personality disorder
- Lack of interest in social or
personal relationships, preferring to be alone
- Limited range of emotional
expression
- Inability to take pleasure in most
activities
- Inability to pick up normal social
cues
- Appearance of being cold or
indifferent to others
- Little or no interest in having sex
with another person
Schizotypal
personality disorder
- Peculiar dress, thinking, beliefs,
speech or behavior
- Odd perceptual experiences, such as
hearing a voice whisper your name
- Flat emotions or inappropriate
emotional responses
- Social anxiety and a lack of or discomfort
with close relationships
- Indifferent, inappropriate or
suspicious response to others
- “Magical thinking” —
believing you can influence people and events with your thoughts
- Belief that certain casual incidents
or events have hidden messages meant only for you
Cluster B
personality disorders
Cluster B
personality disorders are characterized by dramatic, overly emotional or
unpredictable thinking or behavior. They include antisocial personality
disorder, borderline personality disorder, histrionic personality disorder and
narcissistic personality disorder.
Antisocial
personality disorder
- Disregard for others’ needs or
feelings
- Persistent lying, stealing, using
aliases, conning others
- Recurring problems with the law
- Repeated violation of the rights of
others
- Aggressive, often violent behavior
- Disregard for the safety of self or
others
- Impulsive behavior
- Consistently irresponsible
- Lack of remorse for behavior
Borderline
personality disorder
- Impulsive and risky behavior, such
as having unsafe sex, gambling or binge eating
- Unstable or fragile self-image
- Unstable and intense relationships
- Up and down moods, often as a
reaction to interpersonal stress
- Suicidal behavior or threats of
self-injury
- Intense fear of being alone or
abandoned
- Ongoing feelings of emptiness
- Frequent, intense displays of anger
- Stress-related paranoia that comes
and goes
Histrionic
personality disorder
- Constantly seeking attention
- Excessively emotional, dramatic or
sexually provocative to gain attention
- Speaks dramatically with strong
opinions, but few facts or details to back them up
- Easily influenced by others
- Shallow, rapidly changing emotions
- Excessive concern with physical
appearance
- Thinks relationships with others are
closer than they really are
Narcissistic
personality disorder
- Belief that you’re special and more
important than others
- Fantasies about power, success and
attractiveness
- Failure to recognize others’ needs
and feelings
- Exaggeration of achievements or
talents
- Expectation of constant praise and
admiration
- Arrogance
- Unreasonable expectations of favors
and advantages, often taking advantage of others
- Envy of others or belief that others
envy you
Cluster C
personality disorders
Cluster C
personality disorders are characterized by anxious, fearful thinking or
behavior. They include avoidant personality disorder, dependent personality
disorder and obsessive-compulsive personality disorder.
Avoidant
personality disorder
- Too sensitive to criticism or
rejection
- Feeling inadequate, inferior or
unattractive
- Avoidance of work activities that
require interpersonal contact
- Socially inhibited, timid and
isolated, avoiding new activities or meeting strangers
- Extreme shyness in social situations
and personal relationships
- Fear of disapproval, embarrassment
or ridicule
Dependent
personality disorder
- Excessive dependence on others and
feeling the need to be taken care of
- Submissive or clingy behavior toward
others
- Fear of having to provide self-care
or fend for yourself if left alone
- Lack of self-confidence, requiring
excessive advice and reassurance from others to make even small decisions
- Difficulty starting or doing
projects on your own due to lack of self-confidence
- Difficulty disagreeing with others,
fearing disapproval
- Tolerance of poor or abusive
treatment, even when other options are available
- Urgent need to start a new
relationship when a close one has ended
Obsessive-compulsive
personality disorder
- Preoccupation with details,
orderliness and rules
- Extreme perfectionism, resulting in
dysfunction and distress when perfection is not achieved, such as feeling
unable to finish a project because you don’t meet your own strict standards
- Desire to be in control of people,
tasks and situations, and inability to delegate tasks
- Neglect of friends and enjoyable
activities because of excessive commitment to work or a project
- Inability to discard broken or
worthless objects
- Rigid and stubborn
- Inflexible about morality, ethics or
values
- Tight, miserly control over
budgeting and spending money
- Obsessive-compulsive personality
disorder is not the same as obsessive-compulsive disorder, a type of anxiety
disorder.
When to see a
doctor
If you have any
signs or symptoms of a personality disorder, see your doctor or other primary
care professional or a mental health professional. Untreated, personality
disorders can cause significant problems in your life that may get worse
without treatment.
Causes
Personality is
the combination of thoughts, emotions and behaviors that makes you unique. It’s
the way you view, understand and relate to the outside world, as well as how
you see yourself. Personality forms during childhood, shaped through an
interaction of:
- Your genes. Certain personality
traits may be passed on to you by your parents through inherited genes. These
traits are sometimes called your temperament.
- Your environment. This involves the
surroundings you grew up in, events that occurred, and relationships with
family members and others.
- Personality disorders are thought to
be caused by a combination of these genetic and environmental influences. Your
genes may make you vulnerable to developing a personality disorder, and a life
situation may trigger the actual development.
Risk factors
Although the
precise cause of personality disorders is not known, certain factors seem to
increase the risk of developing or triggering personality disorders, including:
- Family history of personality
disorders or other mental illness
- Abusive, unstable or chaotic family
life during childhood
- Being diagnosed with childhood
conduct disorder
- Variations in brain chemistry and
structure
- Complications
- Personality disorders can
significantly disrupt the lives of both the affected person and those who care
about that person. Personality disorders may cause problems with relationships,
work or school, and can lead to social isolation or alcohol or drug abuse.
Diagnosis
If your doctor
suspects you have a personality disorder, a diagnosis may be determined by:
- Physical exam. The doctor may do a
physical exam and ask in-depth questions about your health. In some cases, your
symptoms may be linked to an underlying physical health problem. Your
evaluation may include lab tests and a screening test for alcohol and drugs.
- Psychiatric evaluation. This
includes a discussion about your thoughts, feelings and behavior and may
include a questionnaire to help pinpoint a diagnosis. With your permission,
information from family members or others may be helpful.
- Diagnostic criteria in the DSM-5.
Your doctor may compare your symptoms to the criteria in the Diagnostic and
Statistical Manual of Mental Disorders (DSM-5), published by the American
Psychiatric Association.
Diagnostic
criteria
Each
personality disorder has its own set of diagnostic criteria. However, according
to the DSM-5, generally the diagnosis of a personality disorder includes
long-term marked deviation from cultural expectations that leads to significant
distress or impairment in at least two of these areas:
- The way you perceive and interpret
yourself, other people and events
- The appropriateness of your
emotional responses
- How well you function when dealing
with other people and in relationships
- Whether you can control your
impulses
Sometimes it
can be difficult to determine the type of personality disorder, as some personality
disorders share similar symptoms and more than one type may be present. Other
disorders such as depression, anxiety or substance abuse may further complicate
diagnosis. But it’s worth the time and effort to get an accurate diagnosis so
that you get appropriate treatment.
Treatment
The treatment
that’s best for you depends on your particular personality disorder, its
severity and your life situation. Often, a team approach is needed to make sure
all of your psychiatric, medical and social needs are met. Because personality
disorders are long-standing, treatment may require months or years.
Your treatment
team may include your primary doctor or other primary care provider as well as
a:
- Psychiatrist
- Psychologist or other therapist
- Psychiatric nurse
- Pharmacist
- Social worker
If you have
mild symptoms that are well-controlled, you may need treatment from only your
primary doctor, a psychiatrist or other therapist. If possible, find a mental
health professional with experience in treating personality disorders.
Psychotherapy,
also called talk therapy, is the main way to treat personality disorders.
Psychotherapy
During
psychotherapy with a mental health professional, you can learn about your
condition and talk about your moods, feelings, thoughts and behaviors. You can
learn to cope with stress and manage your disorder.
Psychotherapy
may be provided in individual sessions, group therapy, or sessions that include
family or even friends. There are several types of psychotherapy — your mental
health professional can determine which one is best for you.
You may also
receive social skills training. During this training you can use the insight
and knowledge you gain to learn healthy ways to manage your symptoms and reduce
behaviors that interfere with your functioning and relationships.
Family therapy
provides support and education to families dealing with a family member who has
a personality disorder.
Medications
There are no
medications specifically approved by the Food and Drug Administration (FDA) to
treat personality disorders. However, several types of psychiatric medications
may help with various personality disorder symptoms.
- Antidepressants. Antidepressants may
be useful if you have a depressed mood, anger, impulsivity, irritability or hopelessness,
which may be associated with personality disorders.
- Mood stabilizers. As their name
suggests, mood stabilizers can help even out mood swings or reduce
irritability, impulsivity and aggression.
- Antipsychotic medications. Also
called neuroleptics, these may be helpful if your symptoms include losing touch
with reality (psychosis) or in some cases if you have anxiety or anger
problems.
- Anti-anxiety medications. These may
help if you have anxiety, agitation or insomnia. But in some cases, they can
increase impulsive behavior, so they’re avoided in certain types of personality
disorders.
- Hospital and residential treatment
programs
- In some cases, a personality
disorder may be so severe that you need to be admitted to a hospital for
psychiatric care. This is generally recommended only when you can’t care for
yourself properly or when you’re in immediate danger of harming yourself or
someone else.
After you
become stable in the hospital, your doctor may recommend a day hospital
program, residential program or outpatient treatment.
P.S. If you or someone you know in the community needs help for any of the symptoms stated above and would like to speak with a professional call us now at 021-34546364-66 or 021 38896858