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  • Writer's pictureSTEM Medley

Personality disorders

I'm Suhani, a 16 year old with an interest in psychiatry.


What are personality disorders?


Personality is the way of thinking, feeling and behaving that makes a person different from other people. An individual’s personality is influenced by experiences, environment (surroundings and life situations) and inherited characteristics.


A person’s personality typically stays the same over time. A ‘personality disorder’ is a way of thinking, feeling and behaving that deviates from the expectations of the culture and causes distress or problems functioning, lasting over time.



Types and Symptoms


Personality disorders can be of many types. They are mainly divided into three ‘clusters’ based on similar characteristics and symptoms. Many people who show signs and symptoms of one personality disorder also usually show signs of at least one other personality disorder. For a person to be diagnosed with a personality disorder, it is not necessary for all signs and symptoms of that disorder to be present.


The three clusters with their symptoms are given below-


Cluster A (odd thinking and eccentric behaviour) consists of three types of personality disorders, namely


1. 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


2. 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


2. Schizotypal personality disorder

  • Peculiar dressing, thinking, beliefs, speech or behaviour

  • 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 (dramatic and erratic behaviour) contains four types, they are


1. 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 behaviour

  • Disregard for the safety of self or others

  • Impulsive behaviour

  • Consistently irresponsible

  • Lack of remorse for behaviour


2. Borderline personality disorder

  • Impulsive and risky behaviour, 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 behaviour 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


3. 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


4. 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 favours and advantages, often taking advantage of others

  • Envy of others or belief that others envy you


 


Cluster C (severe anxiety and fear) consists of 3 types of personality disorders, which are


1. 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


2. Dependent personality disorder

  • Excessive dependence on others and feeling the need to be taken care of

  • Submissive or clingy behaviour 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


3. Obsessive compulsive 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


Causes


There can be various reasons for an individual to develop one or more personality disorders at different stages in life. The main causes for having personality disorders are:


Genetics. Researchers have now begun to identify certain genetic factors that may lead to the development of certain personality disorders.

Childhood trauma. Findings from one of the largest studies on personality disorders offer clues about the links between childhood trauma and the prevalence of personality disorders. For instance, it was found that individuals diagnosed with Borderline personality disorders had high rates of childhood sexual trauma.


Verbal Abuse. Verbal abuse can also be linked to the appearance of personality disorders. Children who were abused verbally were found to be three times as likely to have borderline, paranoid, narcissistic and obsessive-compulsive personality disorders.


Treatment


Best treatment for an individual having personality disorders depends not only on the type and severity of the disorder but also on the life situation of the individual. Often, a team approach is required to make sure the patient’s medical, psychological and social needs are met. Due to the long standing nature of personality disorders, treatment may often take months or even years.


Psychotherapy, also called talk therapy is the main way to treat personality disorders. During psychotherapy with a mental health professional, the affected person may learn about their condition and talk freely about their moods, feelings, thoughts and behaviours. The individual can learn to cope with stress and manage their disorder. Along with psychotherapy, certain psychiatric medications may help in managing personality disorders. Usually the medications given are:

  • Antidepressants

  • Mood stabilizers

  • Antipsychotic medications, and

  • Anti-anxiety medications


In some cases, the personality disorder may be so severe that the individual may require to be admitted to a hospital for Psychiatric care. However, this is only recommended when the individual cannot care for themselves or is in danger of direct harm to themselves or others.


If you suspect that you or someone you know may be having a personality disorder then do reach out to a mental health professional at the earliest.









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