Personality Disorders

A class of mental disorders characterized by enduring, inflexible patterns of thought and behavior, personality disorders can cause serious issues and difficulties for people with these disorders, their family members and, at times, co-workers. They can affect about ten percent of the population.

People diagnosed with a personality disorder experience ongoing patterns of thought, emotion and behaviors that are in sharp contrast to normal social expectations of behavior and thinking. They may experience difficulties with impulse control, emotiveness, cognition and interpersonal functioning. Rigidity in behavior and thought are a common feature of these disorders, which seem to have their origins in early adulthood.

One of the central issues with any personality disorder is that the person, despite ample evidence to the contrary, believes that their thinking and behavior is correct, consistent and appropriate. This can result in difficulties in relationships and poor coping skills that can lead to distress, anxiety, depression and self-harming.

Types of personality disorders

Personality disorders can be grouped under three main headings:

Odd Disorders

Schizoid personality disorder — characterized by detachment from and disinterest in social relationships

Schizotypal personality disorder — finds interacting socially extremely uncomfortable and has distorted thinking and perceptions.

Paranoid personality disorder — shows a tendency to mistrust and suspect the motives of others.

Emotional, Erratic or Dramatic Disorders

Narcissistic personality disorder — need for admiration and grandiosity, lack of empathy.

Borderline personality disorder — a persistent instability of identity, behavior and relationships, which often lead to impulsivity and self-harm.

Antisocial personality disorder — a lack of empathy, manipulative and impulsive behavior, complete disregard for others’ rights and boundaries.

Histrionic personality disorder — exhibits ongoing excessive emotions and attention-seeking behavior.

Anxious or Fearful Disorders

Avoidant personality disorder — experiences ongoing feelings of being inadequate and socially inhibited, overly sensitive to negative evaluation.

Dependent personality disorder — has a psychological need to be cared for by other people.

Obsessive-compulsive personality disorder — characterized by perfectionism, control and conformity to rules, to the exclusion of social and leisure activities (distinct from obsessive-compulsive disorder).

Diagnosis

For someone to be clinically diagnosed with a personality disorder, their behavioral patterns must cause themselves or others significant distress or constraint in their daily personal, work or social situations. Diagnoses often don’t occur until someone is in their 20s or 30s, and only tend to occur when they are seeking advice or treatment while under heightened pressure or stress. In general, 40 to 60 percent of psychiatric patients are diagnosed with a personality disorder, the most frequent of all psychiatric diagnoses.

Treatment

As personality disorders tend to be a fundamental part of a person, they are difficult to treat or “cure.” People with personality disorders are notoriously difficult to get along with, often don’t seek treatment, and have a high drop-out rate from treatment.

A promising treatment for Borderline Personality Disorder (BPD) puts emphasis on the patient developing ways to manage and control their frequently overwhelming, extreme and confusing emotions. An example is having a therapist teach a client how to practice mindfulness, which allows the client to observe, but not react to, or act out their emotions, or turn to self-harming to seek instant relief from their emotions.

Cognitive Therapy (CT) focuses BPD clients’ efforts on recognizing and changing core beliefs about themselves, others and the world through revisiting, examining and re-interpreting early childhood experiences. One of the key factors is altering clients’ views of their therapists, so that a trusting and productive therapist-client relationship can be formed. Work can then proceed with addressing the client’s core beliefs about themselves and others.

While these treatments are showing promising result for patients diagnosed with Borderline Personality Disorder, trial therapies for other personality disorders are still emerging. As each of the personality disorders have unique causes and characteristics, it will take considerable empirical research, trials and evaluations of promising interventions before reliable treatments can be publicized.

Personality Disorders
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Jana Evans

Janet Evans is our resident Health Nut and aspiring chef. She can shop at Whole Foods and Trader Joe's with her eyes closed.