This information will help anyone who has been given a diagnosis of personality disorder .Also to create awareness among friends or relatives.
What is personality?
It’s very difficult to say, what do you mean exactly by the word ‘personality’. It seems very obvious but extremely hard to explain.
It is difficult because the way you behave , and appear to other people , it can become different in different situations. You can know a person well at work, but he may behave totally opposite in his private life.
The word ‘personality’ refers to specific set of traits that a person has developed as growing up and which make each of us an distinct individual. These include the ways that ;
- How do you think
- How do you feel
- How do you behave
By late teenage or early 20s, everyone has developed hisbown personality. We have our own ways of thinking, feeling and behaving.
These stay qualities most of times , stay same for rest of our life.
What is a personality disorder?
In this case, for whatever the reason may be , parts of your personality can develop in certain ways that make it so difficult for you to live with yourself or with other people.
You don’t care or seem to be able to learn from the bad experience or things that happen to you. You may find that you can’t change the even bits of your personality (traits) that cause the problems.
These traits just go on making life more and more difficult for you and often for people dealing with it.
2. Often people have noticed specific traits from your childhood and early teens. For example, you may find it difficult to.
- making or maintaining close relationships ( with spouse ,children, friends )
- getting along with people at work/job
- keeping out of trouble
- controlling your feelings or behaviour
- listening to other people or criticism
If this makes you
- distressed or unhappy about yourself or others
and/or
- often as a result you become very emotional or physical abusive to others
then you may have a personality disorder.
Life seems more difficult if you have a personality disorder, as result you are more likely to have other mental health issues such as depression or drugs or alcohol problems.
How common are personality disorders?
Studies shows upto 1 in 20 people might have a personality disorder which may have been diagnosed or remain undiagnosed .
Is personality disorder treatable?
Mental health professionals help people with personality disorders. Yes, they are treatable but bid hard to treat .Main reason of treatment to become unsuccessful is that firstly people don’t admit or even when they admit finally, they are suffering from a personality disorder. They don’t adhere to treatment prescribed by psychiatrist.
This includes medications as well as regular psychotherapy sessions .
Does personality disorder changes over time?
Yes. There is a evidence that they tend to change slowly with age. Aggression and impulsiveness seems to reduce in your 30s and 40s.
It can also, sometimes , work in the opposite direction.
For example, schizotypal personality disorder can have more chances of development into the mental illness schizophrenia.
What causes personality disorder?
The answer is not very simple , it seems like other mental disorders, upbringing, brain problems and genes can play an integral part.
Upbringing
Sometimes people with personality disorder may not or may have experienced
- physical or sexual abuse in childhood
- violence and criticism in the family
- parents who drink too much
- children of Broken families (Divorced/Single parents)
If children are brought up in this sort of difficult environment, they are likely to develop a personality disorder but some children remain normal too.
Early life problems
Aggression resulting in physical or optional abuse , disobedience, and repeated temper tantrums in childhood.
Brain problems
People with antisocial personality disorder have slight differences in the structure of their brains .
However, there is no brain scan or blood test that can diagnose it.
Triggers
- using a lot of drugs or alcohol
- having problems getting on with your family or partner
- having money problems
- comorbid anxiety, depression or other mental health problems
- important distressful events, death of loved ones eg; parents ,siblings etc
Personality disorders have been categorized into three groups, according to their emotional ‘flavour’:
- Cluster A: ‘Odd or Eccentric
- Cluster B: ‘Dramatic, Emotional, or Erratic’
- Cluster C: ‘Anxious and Fearful’
As you read the descriptions of each type, you may bit recognise some aspects of your own personality.
This doesn’t mean that you have a personality disorder. Some of these traits may even be helpful in some areas of your life.
If you do have a personality disorder then these traits will be making your life hard .
A person can also have the characteristics of more than one personality disorder.
Cluster A: ‘Odd and Eccentric’
Paranoid
- always suspicious about others or surroundings /events
- feel that other people are being nasty to you (even when evidence shows they are not true)
- most of the times feels easily rejected
- tend to hold grudges
Schizoid
- Emotionally ‘cold’
- They don’t like contact with other people, prefer your own company
- Have a rich and detailed fantasy world, most of times absorbed in it
Schizotypal
- Eccentric behaviour
- Clinging to odd ideas
- Having difficulty with thinking pattern
- Lack of emotion, or high emotional reactions
- Seeing or hearing strange things
Cluster B: ‘Dramatic, Emotional and Erratic’
Antisocial, or Dissocial
- They don’t care much about the feelings of others
- They get frustrated
- Becoming aggressive over trivial matters
- Committing crimes
- Finding it difficult to make close relationships
- Impulsive tendency – do things in the fringe of moment without thinking about them
- They don’t feel guilt about things even very wrong they have done
- Don’t learn from unpleasant or painful experiences
Borderline, or Emotionally Unstable
- Impulsivity – doing things on the spur of the moment
- Find it hard to control emotions
- Feeling bad about yourself all the times
- Often involving self centered aggression like self-harm, e.g. cutting yourself or making suicide attempts
- Having Chronic feeling ’emptiness “
- making relationships quickly, but easily losing them
- Can feel being paranoid or depressed most of the times
Histrionic
- Self over-dramatization of events
- Always self-centered
- Having strong emotions which can change quickly and don’t last long
- Suggestible
- Worrying a lot about your appearance
- Crave new things and excitement
- Seductive in appearance or actions
Narcissistic
- Having Strong sense of own self-importance
- Dream of unlimited success, power and intellectual brilliance
- Crave attention from other people
- They take advantage of others or asking favors that they do not return
Cluster C: ‘Anxious and Fearful’
Obsessive-Compulsive (aka Anankastic)
- Worrying most of the time and doubt a lot
- Perfectionist – always want perfection and repeatedly check things to make them look more elegant or precise
- Rigid in what they do, stick to routines
- Cautious, preoccupied with detail
- Worrying about doing the wrong thing
- Finding it hard to adapt to new situations
- Often have very high moral standards
- Being judgmental
- Sensitive to criticism
- Can have obsessional thoughts and images or even rituals
Avoidant (aka Anxious/Avoidant)
- Always being anxious and tense
- Worrying a lot about future or even present situations
- Feeling insecure and having inferiority complex
- Trying to be liked and accepted
- Tend to be extremely sensitive to criticism
Dependent
- Tend to be passive in actions or relationships
- Relying on others to make important decisions of their life
- Do what other people want them to do
- Always finding it hard to cope with daily chores
- Feeling hopeless and incompetent
- Feeling abandoned by others
With focused help and treatment, many people with personality disorder can start living a normal and fulfilling life.
Treatment for people with personality disorders can be either psychological (talking therapies) and/or physical (medication) or in worst cases both.
The type of therapy/ treatments offered depends on:
- what patient wants or prefer
- the type of difficulties they have
- what is available locally
1. Psychological: talking therapies
A lot of psychotherapies seem to work well, especially for cluster B personality disorders (‘Dramatic, Emotional and Erratic’). They all have a clear structure , how they work which has to be explained well to the patient.
Longer-term therapies can last for years, and may have to be engaged more than once a week.
They include:
- Mentalisation Based Therapy (MBT) :
- It combines both group and individual therapy. It aims to help patient better understand problems of himself and others by being more aware of what’s going on in his own head and in the minds of others. It is useful helpful in borderline personality disorder.
- Dialectical Behaviour Therapy (DBT):
This therapy uses a combination of both cognitive and behavioural therapies. It also involves individual
- therapy and group therapy, and is quite helpful in borderline personality disorder.
- Cognitive Behavioural Therapy (CBT) -:
- It is a way to change , problematic and unhelpful patterns of thinking.
Schema-Focused Therapy :
- Cognitive therapy which explores and changes deep unhelpful beliefs. Again, it is quite effective in borderline personality disorder.
Transference-Focused Therapy:
- A structured treatment in which the therapist explores thought process and changes pattern of unconscious processes. It seems to be more effective in borderline personality disorder.
Dynamic Psychotherapy :
- It helps patients to look at how past experiences affect present behaviour.
Cognitive Analytical Therapy :
- It is a Therapy to recognise and change unhelpful cognitive (thoughts process) patterns having effect on relationships and behaviour.
Treatment in a therapeutic community :
- This is a place where people , with long-standing emotional problems can for several weeks or months. Most of the work is done in groups. People learn from other oatient who are also struggling or have came out of problems of their personalities.
2. Physical: medication
Majority of people with personality disorders seems to have another mental health difficulties, like depression and anxiety. Or Alcohol/drug abuse . Medications are often prescribed to people with personality disorders to treat these underlying conditions or disorders.
Antipsychotic
Drugs (usually at a very low dose)
- It can reduce the suspiciousness present in three cluster A personality disorders (paranoid, schizoid and schizotypal).
- It can help with borderline personality disorder if people feeling paranoid ( hearing noises or voices).
Antidepressants
- It can help with mood and emotional difficulties that mostly people suffer with cluster B personality disorders (antisocial , borderline , histrionic, and narcissistic) .
- Slective serotonin reuptake inhibitors (SSRIs) can help people being impulsive and aggressive in borderline and antisocial personality disorders.
- It can reduce anxiety in cluster C personality disorders (obsessive-compulsive, avoidant or dependent).
Mood stabilizers
- It can help with unstable mood and impulsivity that people with borderline personality disorder have .
Sedatives
- The short-term use of sedative medication is a part of a larger care plan which can be used in crisis situations.
FAQ’s
Personality Disorder is just a problem with Erratic behaviours ,don’t need any therapy:
Its true that personality disorder is a disorder involving most of the behaviours are erratic or learned through bad experiences .But it doesn’t mean it can get better by just venting out with a friend or reading self help books. You need to be engaged with a psychiatrist on regular follow ups ,depending upon the level of severity.
I am too old or too young to get a treatment for personality disorder:
Mostly people hesitate or even deliberately live in denial , they have a personality related issues.When confronted by family or friends, they still argue we are too young or too old to get treatment for personality .You can engage in therapy,from age less 20 years to even more than 50 years.
Can I live a normal life with personality disorder:
Yes , of course. If someone sticks to the treatment advised and follows the regular psychotherapy sessions. It’s quite normal to start living a new life with less amount of problems and stress mainly arising because of personality related issues.
