What Is a Personality Disorder? - Psych Central 10 Mar 2021

You are unique. And this, no doubt, is mostly to your merit — but it’s also a result of where you’ve been, what you’ve experienced, and who you’ve experienced it with.

This unique character — which comes from a combination of external factors, behaviors, thoughts, and emotions — makes up your personality. It embraces how you, as an individual, see and relate to yourself and others.

Sometimes, some of these behaviors, thoughts, and emotions can cause you a great deal of distress that negatively impacts the way you function in the world. When this happens for a long time — and repeatedly — mental health professionals call it a personality disorder.

What are personality disorders? Your personality helps you function in life, with all the challenges that might usually come up. This means that even if you go through painful or stressful situations, you’ll have a strong chance to overcome them and move on.

How you cope with hardship may be different from how somebody else does. We all have our own ways of getting through, and that depends greatly on our dominant personality traits.

For example, you may be, among other things, patient, resilient, and persistent. These personality traits may help you overcome losing a job and become motivated to find a new and better one.

They’ll help you bounce back from your initial feelings of disappointment and devote time to finding another position. Even if you know it might not happen overnight, you stay motivated.

You may also reflect on the circumstances that led you here, assume responsibility (if any), and take note of the lessons learned.

If you have a personality disorder, though, this isn’t the case.

With a personality disorder, you typically experience emotions and thoughts that diminish your ability to:

-face and adapt to stress

-connect and bond with other people

-effectively solve problems

For example, if you have a personality disorder, your reaction to losing a job might be blaming your co-workers for the dismissal and getting into a fight with your boss. You might not realize how some of your behaviors might have led you to face these difficulties.

Now, it’s true that people who aren’t living with a personality disorder could have this same reaction. We all may feel angry, emotional, and paranoid at times.

But if you cope with stress in a similar way every time, and these traits are causing ongoing problems in your life, a mental health professional may reach the diagnosis of a personality disorder.

In other words, most people might recognize in themselves a few traits from a personality disorder.

But to actually receive the diagnosis, you would have to show all or almost all of the traits that characterize that disorder. Also, these traits would cause you a great deal of distress and problems in your life.

Not all personality disorders have the same symptoms and dominant traits. Something they all have in common, though, is that people with the disorder experience difficulties responding to the demands of life.

These difficulties affect:

-relationships

-work performance

-views of the world

-inner experiences

This isn’t a personal choice. Personality disorders are the result of many factors that have influenced your life, including:

-genetic inheritance

-biological processes

-learning development

-cultural experiences

-traumatic situations

-childhood relationships

There’s no one cause for personality disorders. And it’s not clear why not everyone reacts the same way to the same external and internal factors.

This is why experts believe the cause might be a specific combination of all of the above.

How are personality disorders diagnosed? Personality disorders are mental health conditions. That means only a trained mental health professional can make a proper diagnosis.

To do this, they’ll follow established guidelines for mental health.

The guidelines to diagnose a personality disorder typically come from the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. This handbook contains definitions, symptoms, and diagnostic criteria for most mental health conditions.

To make a diagnosis, a mental health professional will want to learn about your personal and medical history and assess your thoughts, emotions, and behaviors. Then, they will compare these observations to the criteria established by the latest edition of the DSM — currently the fifth edition (DSM-5).

Specifically, the five criteria that must be met to make a personality disorder diagnosis are:

1. Impairments These are difficulties you experience in how you see and relate to yourself (identity and self-esteem) and how you connect to other people (intimacy).

In other words, this refers to recurrent thoughts, emotions, and behaviors that might be hurtful to yourself and others.

2. Pathological personality traits To make a diagnosis, a mental health professional will look for a long-standing pattern of pathological traits.

These are traits that once and again make it difficult for you to interact with others or adapt to change. Or they may be traits that are not expected or accepted in your culture.

3. Duration and flexibility To be considered a personality disorder, these impairments and pathological personality traits must be stable, inflexible, and consistent throughout your life.

In other words, you’ve experienced these difficulties and responses for a long time and repeatedly across different situations.

4. Independent of culture or developmental stage This means that the specific behaviors and thoughts your therapist is looking at can’t be explained by your cultural customs or by the capabilities and needs of your age.

For example, an impulsivity trait in an adolescent is almost expected in some circumstances. But if you’re in your 40s, this same impulsivity might be assessed differently.

5. Not related to external factors A mental health professional will want to make sure that these behaviors, emotions, and thoughts aren’t a result of a substance you may be taking or a general medical condition or injury you’ve sustained.

In sum, if these five requirements are met, a mental health professional will move to diagnose you with a personality disorder.

Since there are 10 of them, that diagnosis will not be the same for everyone. It’ll depend on the specific impairments and personality traits that may be impacting your life the most.

Types of personality disorders The 10 personality disorders are classified into three groups, or clusters. These are based on the most representative emotional responses and behaviors:

-Cluster A: odd and eccentric

-Cluster B: dramatic, emotional, and erratic

-Cluster C: fearful and anxious

This is just an overview of all the types of personality disorders. Much more that goes into making a diagnosis than just observing a few behaviors.

Cluster A personality disorders Those with cluster A personality disorders have difficulty relating to other people and often behave in a way that others might consider odd or eccentric.

Paranoid personality disorder People diagnosed with paranoid personality disorder usually interpret other people’s behaviors as menacing or judgmental, even when this is not the case.

If you have this personality disorder, you’ll tend to perceive others around you as being deceitful, patronizing, or mean toward you. This might make you feel untrusting and angry all the time, leading you to have destructive outbursts and avoid developing close relationships.

Others may also perceive you as emotionally detached.

Schizotypal personality disorder A schizotypal personality disorder may lead you to feel very anxious in social situations and uncomfortable and awkward in close relationships. It may also be that you have an eccentric way of dressing and speaking, and others find you very peculiar.

People with this personality disorder may also have:

-paranoid ideas

-odd beliefs

-distorted thinking

For example, you may feel you can read other people’s minds, see into the future, or have close relationships with beings from another planet.

You may also dislike talking with other people and often talk to yourself.

Schizoid personality disorder Those diagnosed with schizoid personality disorder are usually shy, withdrawn, distant, and not socially responsive. They’re also usually very disinterested in others.

If you’ve been diagnosed with this personality disorder, you may find yourself absorbed in daydreaming and fantasizing a lot. These fantasies might be more interesting to you than what’s actually happening around you.

You may also actively withdraw from and lack interest in intimacy with other people, including close relatives. This might lead others to describe you as cold and detached.

Cluster B personality disorders Cluster B personality disorders usually evidence difficulty in controlling your own emotions and a tendency to act unpredictably.

Narcissistic personality disorder The most typical symptoms of narcissistic personality disorder (NPD) are:

-an inflated sense of self-importance

-a constant need for attention and praise

-a lack of empathy toward others

With NPD, you may feel superior to everyone else and often fantasize about unlimited beauty, power, money, and success. To earn these, you may feel it’s necessary to get other people out of the way by any means, without acknowledging their needs or feelings.

You might also be extremely sensitive to criticism and failure and experience intense variations in your mood.

Antisocial personality disorder Mental health professionals diagnose someone with antisocial personality disorder when there’s a persistent display of impulsive, reckless, and aggressive behaviors and no remorse about them.

These recurrent actions might come from:

-not realizing how your actions affect other people

-blaming others for what happens in your life

-constantly feeling overwhelmed and frustrated

-You may have a history of violent relationships, legal challenges, and even substance abuse if you have this personality disorder.

Borderline personality disorder You may experience constant and intense fluctuations in your mood if you have a borderline personality disorder (BPD). These changes in how you feel may also impact the way you think and feel about yourself.

You may also tend to think of others in black-and-white terms. You might think someone is perfect today, then not want to associate with them at all tomorrow.

This tendency to constantly feel disappointed in people might also lead you to experience feelings of emptiness and despair.

If you’ve developed BPD, you may also hate being alone and fear abandonment — which could lead you to use manipulation tactics such as self-mutilation, silent treatment, or suicidal warnings.

The term “borderline” is considered controversial because it has been misused to judge or discriminate against groups of people. We refer to this term here as a clinical diagnosis established by the DSM-5 and not as a judgment.

Histrionic personality disorder Someone with histrionic personality disorder (HPD) feels they need to be the center of attention in all situations. This may lead to overdramatic behaviors that others might perceive as odd and inappropriate.

If you live with HPD, you may feel anxious and frustrated if others ignore you or give more attention to someone else over you. You may also place a lot of importance on your physical appearance and modify it in a way that you feel will call more attention to you.

Cluster C personality disorders People with cluster C personality disorders usually live with strong feelings of anxiety, doubt, and fear.

Obsessive-compulsive personality disorder Obsessive-compulsive personality disorder is not the same as pbsessive-compulsive disorder (OCD). Someone with the personality disorder is likely not aware of their behavior, while someone with OCD realizes their obsessions and compulsions aren’t rational.

If you live with an obsessive-compulsive personality disorder, you may strive for perfection in all aspects of your life. To accomplish that, you might find yourself taking on way more than you can deal with, and you might feel no achievement is ever enough.

Other people might regard you as very reliable, tidy, and dependable, but also inflexible, stubborn, and strict. This may be because you usually have a hard time adapting to change or changing opinions.

You may also take a long time making any decision and completing tasks daily because you want everything to be perfect. When you can’t control the situation or things change around you, you might feel extremely anxious and vulnerable.

Dependent personality disorder Someone with a dependent personality disorder is usually submissive, letting other people assume control over their lives and decisions. There might also be a strong need for others to take care of you.

If you live with this personality disorder, you might have a hard time making decisions on your own. You’d rather ask for other people’s opinions or go with what they decide in every situation.

You may also find yourself extremely hurt if someone criticizes or rejects you.

You may be perceived as a “people pleaser” and could feel very anxious when you’re alone. You might not feel comfortable doing anything on your own.

You may also rely on your relationships and become depressed if one of them ends.

Avoidant personality disorder A diagnosis of avoidant personality disorder may mean you’re extremely fearful of rejection and abandonment. This could lead you to avoid almost all social activities and events, even when internally you wish you’d go.

With this personality disorder, you may also feel insecure around other people, worrying that you may say something silly or inappropriate. Sometimes, if placed in a situation where you have to interact with others, you may end up blushing, crying, and trembling.

People with this personality disorder feel the need to connect to others and establish close relationships, but they don’t because of their insecurities. This, in turn, makes them very upset.

TREATMENT FOR PERSONALITY DISORDERS Research shows that long-term psychotherapy is the most effective treatment for personality disorders. It may help you explore your thoughts and emotions and how these affect you and other people.

Therapy can also help you manage some of your symptoms so that you can cope with some situations more effectively.

In some instances, some symptoms might be treated with medications such as antidepressants. But this isn’t true for every personality disorder or every individual case.

Sometimes, your doctor might recommend including other health professionals in your treatment. They may also suggest your close relatives join you in a few therapy sessions, if you approve.

Because personality disorders all have different symptoms and triggers, they’re not all treated in the same way. The type of approach your doctor chooses will depend on your symptoms, their intensity, and your personal and medical history.

In general, psychotherapy for personality disorders will aim to:

-increase your ability to adapt to stress

-decrease or manage behaviors that might be causing you problems at work or in your relationships

-increase your ability to manage your moods

-reduce your distress

-help you understand your responsibility in stressful situations

These are just general objectives. When talking with your therapist, you’ll have the opportunity to participate in your treatment and set your own goals.

These are some of the most commonly used types of psychotherapy for personality disorders:

-cognitive behavioral therapy

-psychoanalytic therapy

-dialectical behavioral therapy

-schema therapy

Treatment for personality disorders is typically long term. It requires a strong commitment and persistence on your part. But you may experience relief and learn how to manage some emotions if you continue your treatment.

NEXT STEPS Even though there are five universal criteria to diagnose personality disorders, not all of them have the same symptoms.

More importantly, personality disorders are complex mental health conditions beyond a given set of behaviors and emotions. This is why only a trained professional is equipped to make a proper diagnosis.

Link

Share