Personality Disorders In A Nutshell

By Avion Anderson

Each and every individual has a unique personality that patterns their thoughts, feelings and behaviours and makes each person different from another, and trying to understand another person’s personality and traits is sometimes difficult.

There are those who are more extroverted – they prefer the company of others and enjoy socializing and networking a great deal – which is okay with me, but there are others, like me, who are introverted and enjoy being alone. It’s not that we find anything wrong with being around others such as our family, friends and co-workers, but we love and cherish our me-time.

There are those persons who are more emotional while others are calm, and those who enjoy new experiences while others prefer to stick to familiar things. All these differences are part of normal diversity and help to make human relations interesting.

What is Personality Disorder?

The term ‘Personality Disorder’ implies there is something not-quite-right about someone’s personality, and it refers to a diagnostic category of psychiatric disorders characterized by a chronic, inflexible, and maladaptive pattern of relating to the world. This maladaptive pattern is evident in the way a person thinks, feels, and behaves.

The most noticeable and significant feature of these disorders is their negative effect on interpersonal relationships. A person with an untreated personality disorder is rarely able to enjoy sustained, meaningful, and rewarding relationships with others, and any relationships they do form are often fraught with problems and difficulties.

Types of Personality Disorders

There are about 10 known personality disorders, such as:

Schizoid Personality Disorder

A defining feature of individuals with Schizoid Personality Disorder is a preference for solitary activities and isolation, reflected by a pattern of detachment and withdrawal, and an indifference to social relationships, including those with family. This preference is not due to anxiety about being in social situations, or paranoia, but rather stems from an inner emptiness and apathy towards social situations. One generally lacks strong emotional experiences, and displays a restricted range of emotions.

In addition to one’s own lack of emotionalizing, one tends to lack an awareness of other people’s feelings, and to struggle to empathize. There’s limited involvement in relationships with others, which precludes the development of friendships, and when interacting with others one may exhibit significant social skills deficits, demonstrating long silences and minimal verbal exchanges. I have been diagnosed with this, and overcoming it is not without its challenges.

Schizotypal Personality Disorder

Individuals with Schizotypal Personality Disorder present with odd or peculiar beliefs (e.g., ideas of reference or magical thinking), appearance, and behavior. One tends to report unusual perceptual experiences that do not meet the threshold for psychosis. Those eccentric beliefs may manifest in unusual speech that is over-elaborate or vague.

Additionally, they exhibit considerable social anxiety, resulting from paranoid fears and suspiciousness rather than negative self-appraisals. Their tendency to experience interpersonal discomfort and paranoia often leads them to withdraw, which subsequently limits opportunities for them to develop social skills or experience interactions that may disconfirm their paranoid beliefs; as a result, they lack close friends other than close relatives. When they do interact with others, they may display constricted or inappropriate emotions and poor psycho-social functioning in general.

Narcissistic Personality Disorder

Individuals with Narcissistic Personality Disorder exhibit a grandiose sense of self-importance, a need for excessive admiration, and a lack of empathy. They may display a sense of entitlement, believe they are exceptionally unique and can only be understood by or associated with an elite few, and/or be preoccupied with fantasies of unlimited success, power, beauty, intellect or ideal love.

Nonetheless, the appearance of superiority and arrogance actually masks a thin-skinned sensitivity to rejection, criticism or defeat. Their arrogant attitudes, behaviors and interpersonal exchanges primarily serve to enhance and maintain self-esteem. This maintenance of self-esteem is often dependent on relationships with others, and individuals with Narcissistic Personality Disorder are often interpersonally exploitative and will try eliciting admiration from others in service of themselves. Limited empathic responses are characteristic of these individuals, and the motive behind any seemingly altruistic behavior is to enhance self-esteem.

Antisocial Personality Disorder

Individuals with Antisocial Personality Disorder exhibit a pattern of disregard for or violation of other people’s rights, since adolescence. They exhibit a tendency to violate social norms, and may engage in behaviors that lead to run-ins with the law. They may deceive, trick and con people, for personal gain or pleasure. Impulsiveness and aggression, leading to physical altercations, often feature.

They may have little awareness of personal or others’ safety. They lack a sense of responsibility, leading to failure to meet work demands or financial obligations. Furthermore, individuals with Antisocial Personality Disorder lack remorse and may rationalize negative consequences that they have inflicted on others.

Avoidant Personality Disorder

The lives of people with Avoidant Personality Disorder are marked by a pattern of social inhibition and hypersensitivity to perceived criticism, which is associated with chronic feelings of personal inadequacy, beginning by early adulthood. People with this disorder believe that they are socially inept or otherwise inferior to others. They typically avoid activities involving significant interpersonal contact because they fear that people will negatively evaluate or reject them. They are commonly inhibited about initiating relationships or openly expressing themselves within relationships, and may be highly reluctant to take risks due to fear of embarrassment.

Histrionic Personality Disorder

Individuals with Histrionic Personality Disorder often display dramatic and fluctuating emotions. They tend to enjoy being the center of attention and may become uncomfortable otherwise. They may use their appearance, impressionistic speech, or provocative/sexually seductive behaviors to draw attention to themselves. People with Histrionic Personality Disorder tend to be easily influenced by others. Furthermore, they may deem relationships to be more intimate than generally perceived by others.

Dependent Personality Disorder

Individuals with dependent personality disorder feel incapable of caring for themselves. They have difficulty making decisions or assuming responsibility without relying on others for advice and reassurance. They may be reluctant to take on projects due to lack of self-confidence. In order to avoid disapproval or being left alone, they may avoid expressing disagreement and may subject themselves to unpleasant activities or abusive relationships. Furthermore, they may be preoccupied with unrealistic fears of being left alone, and may pursue close relationships urgently after one has ended.

Obsessive-Compulsive Personality Disorder (OCPD)

Beginning by early adulthood, people with Obsessive-Compulsive Personality Disorder (OCPD) display a persistent preoccupation with themes of order and control. Their perfectionism and focus on organization frequently interferes with their ability to complete tasks effectively or enjoy leisure pursuits. Peers might describe individuals with this disorder as inflexible, stubborn or closed-minded.

Other common features may include workaholic tendencies, hoarding, and unwillingness to delegate responsibility to others. OCPD differs from Obsessive-Compulsive Disorder (OCD) because it reflects a general personality style and does not involve specific obsessions or compulsions.

Paranoid Personality Disorder

The primary feature of Paranoid Personality Disorder is a tendency, apparent in multiple contexts, to distrust others and suspect them of malicious intentions even when there is little evidence to support these suspicions. Because of this attitude, which develops by early adulthood, people with this disorder are frequently reluctant to confide in others, and worry constantly about the potential disloyalty of romantic partners, friends and associates. Such individuals are also likely to misinterpret many remarks as threats or insults, and to respond to perceived insults with immediate anger and long-term grudges.

Borderline Personality Disorder (BPD)

This is a disorder characterized by chronic patterns of emotional instability and distress, mainly relating to concerns about self-identity and relationships with others. People with BPD report feeling extremely emotional yet empty and cannot bear the thought of being abandoned. Behaviorally, BPD is often accompanied by impulsive behaviors such as risky sex, substance abuse, shoplifting and self-injurious cutting or overdosing. Living with someone who has BPD can be difficult since relational dysfunction is a primary symptom of the disorder.

Causes of Personality Disorders

Personality is the combination of thoughts, emotions and behaviors that makes one unique, and the way one views, understands and relates to the outside world and oneself.

Personality forms during childhood and shapes our lives, through:

– Our genes: Certain personality traits may be passed on to us by our parents through inherited genes. These traits are sometimes called our temperament.

– Our environment: This involves the surroundings we 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. One’s genes may make one vulnerable to developing a personality disorder, and a life situation may trigger its 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

– A childhood conduct disorder history

– 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 and alcohol and drug abuse.

Diagnosis

Once 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 relate 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: Your doctor may also compare your symptoms to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), to assess for a diagnosis of a personality disorder that involves long-term marked deviation from cultural expectations and 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.

The treatment team

There are certain types of treatments that a doctor may advise a patient to undergo. This all depends on their particular personality disorder, its severity and their life situation. Patients often need a team approach to meet all of their psychiatric, medical and social needs. 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, well-controlled symptoms, you may only need treatment from your primary doctor, a psychiatrist or other therapist. If possible, find a mental health professional with experience in treating personality disorders.

Treatments for personality disorders

Psychotherapy

Psychotherapy – or talk therapy – is the main way to treat personality disorders. 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.

Therapy may also include 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 specific medications to treat personality disorders. However, several types of psychiatric medications may help with various personality disorder symptoms.

– Antidepressants: Antidepressants may help if you have a depressed mood, anger, impulsivity, irritability or hopelessness, all of which may correlate 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 doctors avoid prescribing them for patients with certain types of personality disorders.

Hospital and residential treatment programs

In some cases a personality disorder may affect you so severely that you need to go to a hospital for psychiatric care. Doctors generally only recommend this 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.

Lifestyle and home remedies

Along with your professional treatment plan, consider these lifestyle and self-care strategies:

– Be an active participant in your care. This can help your efforts to manage your personality disorder. Don’t skip therapy sessions, even if you don’t feel like going. Think about your goals for treatment and work toward achieving them.

– Take your medications as directed. Even if you’re feeling well, don’t skip your medications. If you stop, symptoms may come back. You could also experience withdrawal symptoms from stopping a medication too suddenly.

– Learn about your condition. Education about your condition can empower you and motivate you to stick to your treatment plan.

– Get active. Physical activity can help manage many symptoms, such as depression, stress and anxiety. Activity can also counteract the effects of some psychiatric medications that cause weight gain. Consider walking, jogging, swimming, gardening or taking up another form of physical activity that you enjoy.

– Avoid drugs and alcohol. Alcohol and street drugs can worsen personality disorder symptoms and interact with medications.

– Get routine medical care. Don’t neglect checkups or skip visits to your primary care professional, especially if you aren’t feeling well. You may have a new health problem that needs addressing, or your medication might be giving you side effects.

An early diagnosis is totally important, rather than waiting until later on in life, which might be too late for some of you all out there. When you get older, living with a personality disorder interferes with, and may ruin, your entire life. One may look upon it as a curse, although there are those that see it as a blessing.

Keep on Fighting – Never Give Up

For me, it has been both a blessing and a curse upon my life. A curse, because I am at war each and every minute and second of the day with my mind, thoughts, words and actions. It keeps me isolated from everyone around 90% of the time, fearful of interacting with the outside world. And if I do communicate with others, it’s just for a brief second: that’s the other 10% of the time.

It’s also a blessing, because it pushes me and motivates me to become stronger than I am, to share my story, and to allow others to open up about their own mental problems by raising awareness.

Share Your Story. Raise Awareness. End The Stigma.

Reproduced with permission, originally posted on avionneslegacy

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