Our personalities include the way we think, feel and behave and so personality disorders include a range of conditions that affect the proper functioning of these facets of our being. They can be a little hard to wrap your head around at first, and while there can be overlap between certain disorders, each one has its own specific set of definable characteristics necessitating its own individual approach in terms of treatment.
What are Personality Disorders?
Personality disorders include ten diagnosable types of psychiatric condition that have been recognised in the DSM-5. Each one is its own distinct mental health condition. These aren’t generalised complaints that people can mistakenly believe they’re suffering from, such as depression or anxiety. These are long-term mental health issues that result in patterns of behaviour and inner experience, making it exceedingly difficult for the sufferer to live as a functioning adult. These patterns of experience tend to begin by late adolescence and cause progressive dysfunction in a person’s social capacities. The good news is personality disorders are very treatable. But if left untended, they will worsen over time. People with personality disorders tend to struggle in at least two of the following areas:
- The way they think about themselves and others
- The way they respond and/or react emotionally
- The way they relate to other people
- The way they control their behaviour
Personality Disorder Types
At present, the ten types of personality disorder are grouped into three groups or clusters, depending on their shared set of symptoms.
This particular subset of personality disorder is characterised by odd or eccentric behaviour, which can and often does lead to issues with maintaining social relationships.
Cluster A personality disorders include:
Paranoid Personality Disorder: This disorder affects around 2.3% – 4.4% of adults with symptoms that include a persistent distrust of others, suspicions of being deceived or exploited by others even by close family and friends.
Schizoid Personality Disorder: This is best characterised by intense social isolation and almost complete indifference to other people. It actually tends to affect slightly more men than it does women. Those who suffer from this disorder are often described as being cold and withdrawn with them seldom having any close relationships with others.
Schizotypal Personality Disorder: People with this disorder are often described as having ‘unusual’ personalities, which are best characterised by odd speech patterns. They, too, also tend to have very few close relationships, displaying regular distrust and experiencing social anxiety.
The B cluster of personality disorders are characterised by dramatic and/or erratic behaviour. People who suffer from one of these disorders tend to experience intense bouts of emotional instability and are prone to impulsivity, theatrical and often-times law-breaking behaviours.
Anti-Social Personality Disorder: This particular condition tends to show up mostly in childhood. Someone who fits this archetype will usually display a complete disregard for the personal space and rights of others. They will be deceitful and manipulate those around them for their own personal gain.
Borderline Personality Disorder: This is best characterised by a lack of self-esteem and poor body image, which results in a persistent state of fearing abandonment by those around them. Sufferers of this disorder do have close relationships, being fairly co-dependent, but often experience great instability.
Histrionic Personality Disorder: The hallmark of this condition is persistent heightened emotions and attention-seeking behaviour, which can lead to inappropriate behaviour in public that can be equal parts provocative, theatrical and imply a false sense of intimacy.
Narcissistic Personality Disorder: This disorder is centred on a profound sense of self-centredness, which can cause the sufferer to have a hugely exaggerated self-image and lack of empathy for others. However, at their core, most narcissists are actually quite emotionally fragile.
The C cluster of personality disorders is characterised predominantly by a predisposition towards anxiety. People who suffer from this type of disorder tend to experience chronic anxiety and/or fearfulness.
Avoidant Personality Disorder: People with this disorder often experience extreme shyness and unjustified fears of rejection by others. This pattern is fuelled by intense feelings of inadequacy and criticism they may experience from others if they allow themselves to open up.
Dependent Personality Disorder: Dependents operate on the opposite side of the spectrum to those with avoidant personality disorder and have an intense dislike of being alone. This will often cause them to display behaviours to elicit symptoms to get people to take care of them.
Obsessive-Compulsive Personality Disorder: Although it shares a similar name to obsessive-compulsive disorder, this variant is actually a separate condition that is predicated on maintaining a strict observance order and control over everything they do in their life from work to scheduling everything down to the minute detail.
In comparison to mood disorders such as depression and bipolar disorder, there hasn’t been a great deal of research that be drawn upon that can be used as a reference for how to go about treating personality disorders. It’s widely believed by leading experts that personality disorders are so difficult to treat, because, they are, by their very nature, long-standing – and deeply entrenched – patterns of behaviour. There have, however, been a rise in the number of evidence-based treatments that have been shown to be effective at treating personality disorders.
At present, there are multiple types of psychotherapy that may be useful in treating personality disorders. The following list details the most common approaches but is by no means exclusive:
Dialectal Behaviour Therapy (DBT): Teaches coping skills and strategies to help you deal with urges relating to self-harm, suicide, regulating emotions, and improving relationships.
Cognitive Behavioural Therapy (CBT): The aim of this therapy is to recognise the negative thoughts that are serving as the mental programming keeping you locked in cyclical patterns of behaviour. So then, you can unpick them and replace them with more positive responses.
Mentalisation-based Therapy (MBT): This therapy teaches you how to notice and reflect on your internal state mind and encourages you also to become more aware of those of others around you.
Psychodynamic Therapy: This a traditional form of talk therapy, which places a large emphasis on exploring the unconscious mind. This is predominantly where feelings of upset, negative urges and thoughts that are too painful to deal with are stored.
While medication should never be the first and only port of call in treating mental health conditions, they can be a useful aid and complementary treatment to assist in gaining some much-needed quality of life improvements to enable you to explore more long-lasting therapeutic methods. In the course of a recommendation by your therapist or psychiatrist, you may be offered one of the following as part of your treatment plan:
- Anti-anxiety medication
- Mood stabiliser