A Personality Disorder is a condition which involves an individual thinking, behaving, feeling or relating in a very different way from the average person.
There are ten different personality disorders, split into three clusters. The clusters are ‘odd and eccentric’, ‘dramatic, emotional and erratic’, and ‘anxious and fearful’.
The different disorders vary considerably, and thus the symptoms of each differ too. There is nothing wrong at all with being different, and there is little to suggest that there is a ‘normal’ personality type.
However, an individual with a personality disorder may find their symptoms cause them distress, and results in them not living their life how they want to.
In many cases, with the right treatment, support and lifestyle, a recovery is possible. At the least, symptoms should be able to be controlled more.
Types of Personality Disorders
There are ten different personality disorders. The ten disorders can be split into three clusters:
Cluster A – “Odd and Eccentric”
Paranoid Personality Disorder: Paranoid Personality disorder is characterised by feelings of paranoia – especially towards others – hypervigilance and a general mistrust of others. An individual with this disorder may find their paranoia has a marked effect on their life. In the vast majority of cases, their suspicions are irrational. They often find it difficult to form meaningful friendships.
Schizoid Personality Disorder: This disorder is characterised by a lack of interest and detachment from social relationships. A Schizoid individual will often be seen as a “loner”. Other symptoms include a lack of drive or motivation in life, and a lack of emotion throughout multiple contexts. They commonly exhibit a rich fantasy world.
Schizotypal Personality Disorder: Someone with Schizotypal Personality Disorder will exhibit a range of eccentric and bizarre behaviours, such as peculiar mannerisms, abnormal beliefs, and will struggle to interact socially. They may be seen as being unusual or strange. Someone with this disorder may lose touch with reality, or later go on to develop Schizophrenia.
Cluster B – “Dramatic, Emotional and Erratic”
Antisocial Personality Disorder: Antisocial Personality Disorder is a condition that involves an overall disregard for others. Someone with this disorder may be manipulative, violate the rights of others, showcase an alarming lack of empathy, and will normally act without thinking of potential consequences. Those around them may merely be seen as pawns.
Borderline Personality Disorder (Emotionally Unstable Personality Disorder): This is the most well-known personality disorder – being characterised by intense mood swings, unstable relationships and unpredictable behaviour. Someone with this disorder will often fluctuate rapidly between loving or hating someone, or even themselves. They may feel paranoid or depressed. An individual may self-harm due to their impulsive behaviour.
Histrionic Personality Disorder: Histrionic Personality Disorder is characterised by a pattern of attention-seeking behaviour. Someone with this disorder may see the world as their stage, and showcase excessive emotions. They may take particular care in how they look. They may dress in a promiscuous fashion, and act overtly seductive. They may struggle with relationships due to their symptoms.
Narcissistic Personality Disorder: Someone with this disorder will normally see themselves as superior to others, and believe they should receive special treatment. They will require admiration and acceptance from others. They will lack empathy, and have little regard for the feelings of others. They will often manipulate or take advantage of others for their personal gain.
Cluster C – “Anxious and Fearful”
Obsessive-Compulsive Personality Disorder (Anankastic Personality Disorder): An individual with Obsessive-Compulsive Personality Disorder will show a rigid conformity to rules, an innate need for perfectionism, and a need to control circumstances and events. The person will always try to follow set rules. Their preoccupation with rules and perfectionism will often lead to significant impairment in social activities. In instances where they lack control, they will exhibit considerable anxiety. They may also be judgemental, while also being sensitive to criticism.
Avoidant Personality Disorder: Avoidant Personality Disorder is a condition characterised by overwhelming feelings of anxiety, a fear of rejection from others, and poor self-esteem. A person with this condition may also be very sensitive to criticism from others – owing to their pervasive need for acceptance from others.
Dependent Personality Disorder: Someone with Dependent Personality Disorder will have a pervasive need to be cared for by other people. Typical symptoms include not making decisions, an overriding fear of abandonment, need for reassurance and immaturity. The person may have poor self-esteem – seeing themselves as a weak individual.
These disorders cover a broad range of areas. But most importantly, a person’s personality will cause them distress – in order for a disorder to be present.
Read More: What Are The Types of Personality Disorders? [Construction]
Symptoms of Personality Disorders
The symptoms of each personality disorder differ, from disorder to disorder. These symptoms will typically lead to impairment in social and work-based environments
Below, we outline just a couple of symptoms for each personality disorder. For a more thorough analysis, you can view the article for each single type of disorder [construction].
Paranoid Personality Disorder:
- Feelings of paranoia – especially towards others
Schizoid Personality Disorder:
- Lack of interest and detachment from social relationships
- Lack of emotion throughout multiple contexts
Schizotypal Personality Disorder:
- Will exhibit a range of eccentric and bizarre behaviours.
- Show peculiar mannerisms and abnormal beliefs
Antisocial Personality Disorder:
- Exhibits an overall disregard for others.
- Show a lack of empathy to others, and may violate their rights
Borderline Personality Disorder:
- Intense mood swings
- Unstable relationships with others – either love or hate someone, no in between
Histrionic Personality Disorder:
- Long-term pattern of attention-seeking behaviour.
- Showcase excessive emotions.
Narcissistic Personality Disorder:
- Normally see themselves as superior to others, and believe they should receive special treatment.
- Lack empathy, and have little regard for the feelings of others.
Obsessive-Compulsive Personality Disorder (Anankastic Personality Disorder):
- Rigid conformity to rules.
- Exhibit anxiety when there is a lack of control over situations.
Avoidant Personality Disorder:
- Overwhelming feelings of anxiety
- Fear of rejection from others, and need for acceptance
Dependent Personality Disorder:
- Pervasive need to be cared for by other people.
- Making others make decisions for them
As seen, there are a vast array of differing symptoms. But importantly, distress from symptoms is a crucial prerequisite for a Personality Disorder.
Read More: What Are The Symptoms of Personality Disorders? [Construction]
Causes of Personality Disorders
Personality Disorders are very complicated conditions that arise based on personality traits. These traits typically take years to form, and as such become ingrained in an individual’s thoughts, feelings and behaviour. While the speculated causes of each personality disorder differs, some possible factors that may trigger a personality disorder include:
- Genetics: A family history of personality disorders or mental illness may lead an individual to be more susceptible to developing the condition. Certain personality traits – such as a low self-esteem or oversensitivity – may make someone more vulnerable to developing a disorder. Some of these traits could be inherited.
- Childhood and Upbringing: As the childhood years are when a personality is formed, an individual’s experiences in their formative years may impact them. For someone who has had a difficult experience – such as having an absent parent or alcoholic parent, they may have had their development stunted. Any instability throughout childhood too can have an impact. A lack of bonding between child and parent too could have an impact. Neglect, or a general lack of support too may have an effect.
- Abuse: Physical, sexual or emotional abuse can lead to any mental health condition developing. Abuse in childhood may particularly have an effect.
- Bereavement: A sudden death, especially of a parent when younger, can be a very difficult experience to go through – and lead to a disorder eventually developing.
- Major Life Event: Major life events, such as unemployment, divorce or even having a baby can have a big effect on someone – potentially altering their personality to the extent where they develop a disorder.
- Substance Abuse: Those that suffer from substance abuse problems may often have a personality disorder concomitantly.
Often, a range of events or factors contribute to the development of a Personality disorder.
Read More: What Are The Causes of Personality Disorders? [Construction]
Diagnosis of Personality Disorders
Personality Disorders cannot be diagnosed through a laboratory test or other medical examination. Instead, an individual who suspects they may have a personality disorder should see a Doctor.
A doctor will ask them a range of questions based on their symptoms. If they believe a personality disorder may indeed be present, then they should refer the individual to a Community Mental Health Team (CMHT). This is a team made up of mental health professionals.
A member of the CMHT will carry out a full assessment of symptoms, and aim to make a diagnosis. They will ask further questions, and aim to generate a full picture of how an individual’s personality traits are causing them distress, and see if a diagnosis can be made. It is important that an individual answers all questions truthfully – as this will ensure an accurate diagnosis can be made.
In terms of the actual symptoms, each personality disorder will have certain criteria that needs to be fulfilled. For instance, symptoms associated with Borderline Personality Disorder are markedly different than those for Schizotypal Personality Disorder.
However, for a diagnosis to be made, as a starting point, there are some basic requirements that need to be met for an individual to be considered to have a personality disorder:
- The individual’s personality strays significantly from the norm in someone’s culture
- This may include how an individual interprets experiences, their emotional response to experiences, the way an individual acts around others, or their ability to control urges and impulses (at least two of these areas)
- The personality of an individual remains the same in many different contexts
- The personality of an individual causes them significant distress and/or impairment in multiple areas of functioning
- The personality in question is long-standing, and can be dated back to adolescence or early adulthood
- The symptoms displayed cannot be better explained by an alternate mental health condition
- The symptoms displayed haven’t been caused by substance abuse
Sometimes, an alternative condition may be diagnosed, if the symptoms of an individual are better-suited to a different condition.
Seeking help for a Personality Disorder is important. The symptoms typically won’t clear up on their own, and therefore the earlier help is sought, the sooner treatment can begin.
Read More: How is Personality Disorders Diagnosed? [Construction]
Treatment of Personality Disorders
Personality Disorders typically cause significant functional impairment in both social and work environments. The good news is though, that with the right treatment and support, it is possible for quality of life to improve significantly.
Each different personality disorder has a different treatment plan. However, in general, treatment will involve:
- Talking Therapy: There are a wide range of talking therapies that can be used to treat personality disorders. Certain therapies are effective in certain disorders. Therapy can help treat the possible causes, challenges, traumatic events, unhelpful thoughts, unhelpful feelings, and behaviours that may have contributed to the onset of the disorder. These therapies help an individual understand their symptoms more, and may lead them to changing unhelpful traits – in theory leading to an improvement in quality life.
Cognitive Behavioural Therapy (CBT): CBT is a type of therapy that is used to treat a range of mental health conditions. CBT involves an individual talking face-to-face with a therapist, although sometimes CBT can be conducted in a group setting. CBT attempts to improve an individual’s wellbeing and mood. The therapy focuses on the link between thoughts, feelings and actions. This can be useful for those with low self-esteem, anxiety, unhelpful personality traits or intrusive thoughts. CBT can help an individual understand their feelings more, and in the long run should lead to an improvement in quality of life.
Psychoanalytical Psychotherapy: Psychoanalytical Psychotherapy is a talking therapy that aims to help uncover and resolve unconscious beliefs that cause psychiatric conditions. Traumatic experiences that may or may not be buried in the unconscious mind can be highlighted and processed. Psychoanalytical psychotherapy involves talking to a trained therapist. The therapist can show the individual how early memories and past traumas have affected their thinking, behaviour and attitude in the modern day. Psychoanalytical psychotherapy is especially useful for any condition that involves past trauma. Renowned neurologist Sigmund Freud developed this therapy, which is typically completed over a long-term basis.
Dialectical Behavioural Therapy (DBT): DBT is a type of therapy that is tailor-made for Borderline Personality Disorder, though can also be useful for many other conditions. The therapy runs on the basis that an individual is emotionally vulnerable, and that the individual grew up in an environment where emotions were dismissed and not treated. These factors cause an individual to feel guilty or ashamed for having upsetting emotions, which leads to more upset. DBT aims to change this system, using a range of techniques to help, with a focus on acceptance and problem-solving.
- Medication: There aren’t any medicines licensed to specifically treat a personality disorder. However, sometimes medication can be prescribed to help with some symptoms, like anxiety, low mood, paranoia, delusions or anything else that is causing distress. The exact medication will depend on which personality disorder is present. Antidepressants can help with low mood, impulsive behaviour, energy, and anxiety problems. Antipsychotics are believed to work best with Cluster A (odd and eccentric) personality disorders. This is especially the case when suspiciousness and paranoia are traits. Mood Stabilisers are rarely prescribed, though can provide support for someone with Borderline Personality Disorder or other disorder who has an unstable mood.
Antidepressants: Antidepressants can help to improve and regulate mood. They should improve motivation and restore energy. SSRI Antidepressants are the most commonly prescribed. They act on the brain chemical serotonin – which is thought to help in regulating mood and emotion. They may include side-effects such as a dry mouth, sexual problems and nausea, though these should hopefully be short-term. Other classes of antidepressants are available in the event of an inadequate reaction.
Antipsychotics: Antipsychotics (also known as neuroleptics) block the effect of dopamine – a chemical in the brain that is heavily linked to psychotic symptoms like hallucinations. They can also be useful for stabilising mood, and treating anxiety. They are not suitable for everyone however, and are often associated with many side effects like weight gain, dizziness and dry mouth.
Mood Stabilisers: Mood stabilisers can help level out moods, meaning fewer lows, and fewer euphoric highs are felt. Lithium Carbonate is the best-known mood stabiliser. Valproate is a well-known anticonvulsant which is often used as a stabiliser for people who cannot take Lithium Carbonate.
As a reminder, each personality disorder features different treatment plans.
Personality Disorders are very hard conditions to deal with. But, due to the many treatment options that are available, symptoms should improve in time, and a better quality of life can be attained.
Read More: How Can Personality Disorders Be Treated? [Construction]
Living with a Personality Disorder
A personality disorder can cause an individual great discomfort. In some cases however, it won’t negatively affect a person’s life, they’ll just like a diagnosis.
But in many cases, a personality disorder can not only negatively impact a person, but also anyone in their surroundings.
It is important to give people with a personality disorder space, but also to listen to and acknowledge their thoughts and feelings.
Read More: 10 Tips on Living With a Personality Disorder [Construction]
The prognosis of a Personality Disorder depends on a huge range of factors. First of all, the actual condition involved is important. Some disorders have a better prognosis than others.
Long-term treatment is very important for Personality Disorders, as so many factors accumulate to build an individual’s personality. How an individual responds to therapy and/or medication is also an important consideration.
Increased suicide risks, an ongoing stigma of personality disorders, and risks of poor quality of life, are all issues too that contribute to the overall poor prognosis for these disorders. But help is available, and recovery is possible.
Read More: What is the Prognosis For Personality Disorders [Construction]
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