Understanding Personality Disorders

Personality refers to the way an individual may think, feel and behave that makes them different and unique from other people. This is largely influenced by the individual’s experiences, surroundings, life situations and inherited characteristics.

A personality disorder is a mental health problem, where these thoughts, feelings and behaviors, deviate significantly from the expectations of the culture and society and begins to create distress or problems functionally “normally” in society. These also tend to last a relatively long period of time and victims often find it very difficult to change these unwanted patterns.

Almost all personality disorders feature some form of long term pattern of behavior and inner experience that differs greatly from what is expected. These usually manifest by late adolescence or by early adulthood and causes problems with functioning. There are about 10 specific types of personality disorders but in order to be considered one, the difference in behavior must be present in at least two of the following areas:

  • Emotional response. 
  • The way of thinking about oneself and others. 
  • Relating to other people. 
  • Controlling one’s behavior. 

What are the risk factors?

Like many mental health problems, the precise cause of personality disorders are not know, but the following factors seem to increase the risk of developing or triggering a personality disorder:

  • Family history of mental illness, especially personality disorders.
  • Being diagnosed with a childhood conduct disorder.
  • Abusive, unstable or chaotic family life during childhood.
  • Variations in brain chemistry and structure.

Personality disorders are thought to be caused by a combination of these genetic and environmental influences. So generally speaking, your genes make you susceptible to a personality disorder, and a life situation may trigger its actual development.

Signs and symptoms

The types of personality disorders are generally grouped into three categories called “clusters”. These are based on similar characteristics and symptoms. It is important to note that many people with one personality disorder also, more often than not, have signs and symptoms of at least one other personality disorder. It is also not necessary to display all the symptoms of a listed disorder in order to be diagnosed.

Understanding the different types of personality disorders

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There are different types of personality disorders and all these different types need to be clearly understood so that you can be able to pick up their distinct signs and symptoms and seek appropriate treatment. Personality disorders have been categorized in three clusters and they are as follows:

Cluster A Disorders

These are characterized by odd, eccentric thinking or heavier. The disorders and symptoms are listed below:

Paranoid personality disorder

  • Suspicion and distrust of others and their motives. 
  • Hesitancy to confide in others due to the unreasonable fear that they will use the information against you.
  • Perceiving innocent remarks or situations as personal insults and attacks.
  • Tendency to hold grudges. 
  • Angry or hostile reaction to perceived slights or insults. 
  • Unjustified suspicion that a significant other partner is unfaithful. 

Schizoid Personality disorder

  • Limited range of emotional expression. 
  • Appearance of being cold or indifferent towards others. 
  • Lack of interest in social or personal relationships, always wanting to be alone.
  • Inability to take pleasure in most activities.
  • Limited or no sexual drive. 
  • Inability to pick up on social cues.

Schizotypal personality disorder

  • Odd perceptual experiences, such as hearing voices. 
  • Inappropriate emotional responses or flat emotions. 
  • Peculiar dressing, thinking, beliefs, speech or behavior. 
  • Inappropriate or indifferent or suspicious response to others. 
  • Believing you can influence people and events with your thoughts. 
  • Believing casual events have hidden messages or meanings for the individual. 

Cluster B Disorders

Cluster B disorders are characterized by dramatic overly emotional or unpredictable thinking or behavior. The various disorders and their symptoms are listed below:

Antisocial Personality disorder

  • Persistent lying, stealing or conning of others. 
  • Impulsive behavior. 
  • Disregard for others needs or feelings. 
  • Aggressive and violent behavior. 
  • Consistently irresponsible. 
  • Lack of remorse or regret for behavior. 
  • Disregard for one’s own safety.

Borderline Personality disorder

  • Fragile self image. 
  • Unstable and intense relationships. 
  • Ongoing feelings of emptiness. 
  • Frequent and intense displays of anger. 
  • Paranoia that’s often stress related and inconsistent. 
  • Intense fear of abandonment and loneliness. 
  • Impulsive and risky behavior. 
  • Suicidal behavior such as self injury. 

Histrionic personality disorder

  • Shallow and rapidly changing emotions. 
  • Excessive concern with ones’ physical appearance. 
  • Constant attention seeking. 
  • Thinks relationships are closer than they actually are. 
  • Easily influenced by others. 
  • Has dramatic and strong opinions with few supporting facts 

Narcissistic personality disorder

  • Arrogance. 
  • Fantasies about power, attractiveness and success. 
  • Exaggeration of achievements or talents. 
  • Constantly expects praise and admiration. 
  • Belief that you’re more special or important than others. 
  • Failure to recognize others needs and feelings. 
  • Taking advantage of others and unreasonable expectation of favors.
  • Belief that others envy you. 

Cluster C Disorders

These are characterized by anxious, fearful thinking or behavior. They include the following disorders:

Avoidant Personality disorder

  • Extreme sensitivity to criticism and rejection. 
  • Fear of disapproval embarrassment or ridicule. 
  • Extreme shyness in social situations and personal relationships. 
  • Socially inhibited, timid and isolated.
  • Feeling inadequate, inferior or unattractive. 
  • Avoidance of work activities that require interpersonal contact. 

Dependent personality disorder

  • Submissive or clingy behavior toward others. 
  • Difficulty disagreeing with others, fearing disapproval. 
  • Lack of self confidence, requiring excessive advice and reassurance from others to make even small decisions. 
  • Fear of having to fend for yourself if left alone. 
  • Excessive dependence on others and feeling the need to be taken care of. 
  • Constant need to always be in a relationship. 
  • Tolerance of poor and abusive treatment, even when options are available. 

Obsessive Compulsive personality disorder

  • Rigid and stubborn. 
  • Preoccupation with details, orderliness and rules. 
  • Inability to discard broken or worthless objects. 
  • Desire to control people, tasks and situations.
  • Inability to delegate tasks. 
  • Extreme perfectionism resulting in dysfunction and distress when things are not done right. 
  • Tight over budgeting and spending of money. 
  • Inflexible about morality, ethics or values. 

Diagnosis of personality disorders

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Diagnosing a personality disorder can take a lengthy period of time as a mental health professional would have to look at the long term patterns of an individuals functioning and symptoms. For a minor (individual under 18) to be diagnosed, the symptoms need to have been present for at least a year. Some people with these personality disorders may not even recognize that they have a problem. In addition to this most people often have more than one kind of personality disorder.  

Your doctor may perform the following tests to determine a diagnosis:

  • Physical exam – This is done in order to eliminate the chance that your symptoms may be linked to an underlying physical health problem. This may include lab tests in addition to screening tests for alcohol and drugs.
  • Psychiatric evaluation – This usually includes discussion about your thoughts feelings and behavior. It usually takes the form of a therapy session but may also include questionnaires to help pinpoint a diagnosis.
  • Diagnostic criteria in the DSM-5 – Your mental health professional may compare your symptoms to the criteria in the Diagnostic and Statistical Manual of Mental disorders published by the American Psychiatric Association.

How personality disorders are treated

Certain types of psychotherapy have been found to be effective for treating personality disorders. During psychotherapy an individual can gain insight and knowledge about the disorder and what is contributing to symptoms and can talk about thoughts feelings and behaviors. Common types of psychotherapy used include but are not limited to:

  • Group therapy
  • Cognitive behavioral therapy
  • Psychoanalytic/psycho-dynamic therapy
  • Dialectical behavior therapy
  • Psycho-education

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