Personality disorders are a complex type of mental disorder that are usually unknown to most people. When they think of mental disorders, they may think of mood disorders (depression disorders, bipolar disorders), anxiety disorders, or disorders like schizophrenia; therefore, this basic post is for awareness and understanding purposes.
This is part of a very brief and basic project I did for a college psych/mental health course. I got over 100% on it! Many of you asked me to post it.
Note that this is a brief personality disorder awareness post. This is not a diagnostic tool.
Description: Personality broadly refers to the individual, characteristic differences in people, like within behaviors, emotions, mental processes, interpersonal patterns, and perceptions. These patterns are persistent across life and different contexts. In other words, we don’t suddenly start behaving, feeling, thinking, perceiving and reacting like another person. Although personality alters depending on age and the environment, we still clearly have individual differences and characteristics that remain the same about us. A personality disorder affects these areas of someone, causing internal and external symptoms within those core and baseline areas of personality functioning. This occurs in one’s every day life and disrupts the typical interacting and functioning of an individual.
Rather than mood disorders in which they occur as episodic mood changes, personality disorders occur as the individuals base of personality development and occurs across contexts, just as anyone’s typical personality does.
As a result, personality disorders surface more through development and become more apparent in young adulthood and can’t be diagnosed before age 18; however, there are certain exceptions to this (and rightfully so).
These disorders particularly, especially cluster B personality disorders and borderline PD, have an excessive amount of stigma attached to them. This has led to misrepresentation, mistreatment, and neglect in treatment and among society. The word “borderline” particularly has extreme stigma attached to it in the mental health field.
Causes: There is no single cause for personality disorders, as various factors contribute (and the interactions between them). There are some found specific causes for each personality disorder, which I will not go into as this is a basic post that includes all of them. Overall, some include:
-Studies have shown that there is a strong genetic correlation, as temperament and some features may be inherited.
-Neurobiological differences have been shown to play a major role as well (Functioning and make-up of the limbic system, lobes, etc).
-Environmental factors (abuse, neglect, harsh punishments etc) may reinforce the development.
Types:
The personality disorders are put in clusters based on these descriptive similarities:
Cluster A (Eccentric)
-Paranoid PD
-Schizoid PD
-Schizotypal PD
Cluster B (Erratic)
-Antisocial PD
-Borderline PD
-Histrionic PD
-Narcissistic PD
Cluster C (Anxious)
-Avoidant PD
-Dependent PD
-Obsessive Compulsive PD
Other
-General personality disorder
-Other specified personality disorder/unspecified personality disorder
-Personality change due to another medical condition
Symptoms and examples:
A. Paranoid Personality Disorder:
Characterized by pervasive, paranoid distortions and perceptions of others, such as extreme suspicions and distrust towards others’ motives and actions. People may usually be interpreted as malicious, persecutory, deceptive, dangerous.
-May withdraw or have unstable relationships and interactions due to such suspicions, distrust, and preoccupations
-May be reluctant to reveal information about oneself, including simple information
-May experience persistent, inner instabilities and external reactions to the paranoid perceptions (anger, anxiety, panic)
-May react externally to such suspicious, such as with outbursts and accusations
-May be persistently preoccupied by such paranoid thought patterns
-May read others’ words as having hidden, distrustful or dangerous, messages and codes
A. Schizoid Personality Disorder:
Characterized by detachment of social relationships and indifferent/withdrawn emotions, behaviors, and interactions.
-May withdraw from others and lack relationships due to an indifference towards others
-May not desire nor enjoy relationships with others, including family and partners
-May appear to lack reactions and responses towards others
-May appear indifferent to negative or positive feedback from others
-Emotions may be flat, seem withdrawn, or blank
-May lack pleasure, interest, and satisfaction in activities and hobbies
-May mainly choose solitary activities
A. Schizotypal Personality Disorder:
Characterized by limited social interactions and discomfort around others, in addition to unusual patterns of behavior and thinking.
-Has a spectrum relationship with schizophrenia
-May limit or cut off relationships and interactions due feeling uncomfortable around others
-May experience anxiety as a result of how uncomfortable, judged, and “watched,” they feel around others
-May experience ideas of reference
-May experience unusual and atypical beliefs, including magical thinking, superstitious, and constant fantasies
-May experience perceptual illusions
-May portray unusual behavioral disruptions influenced by such thinking patterns patterns
-May speak in unusual patterns (vague, stereotyped, metaphorical, etc)
B. Antisocial Personality Disorder:
Characterized by a disregard and violation towards the rights, feelings, and treatment of others.
-May have unstable relationships due to such disregard and behaviors
-May experience internal and express external aggression, anger, and irritability
-May engage in impulsive behavior and reckless activities
-May lack a concern for the safety of self and others, and put themselves and/or others in risky situations
-May express indifference and/or justification to have wronged, hurt, or violated others
-May engage in deceitful and conning behaviors
-May perform repetitive, law-breaking behavior
-May show persistent disregard for responsibilities, obligations, and commitments, such as within work, relationships, bills, etc.
B. Borderline Personality Disorder:
Characterized by emotional hypersensitivity plus an inability regulate the emotional extremities, resulting in unstable behaviors, relationships, and a sense of self/identity. (Specific detail here x).
-May have unstable relationships due to intense reactions
-May experience extreme reactions/bouts of anger, depression and anxiety
-May experience specific, intense reactions and extreme preoccupations to real or perceived abandonment, rejection, and criticism
-May engage in suicidal ideations and self-harm
-May experience severe identity based symptoms, such as a poor self esteem and self-direction (jobs, goals, values, plans,) and radical behavior and appearance changes
-May engage in impulsive behavior or reckless activities
-May react with thinking patterns of splitting, idealization, and devaluation
-May experience intense reactions that lead to dissociation and brief paranoia/psychotic symptoms (delusions, hallucinations).
B. Histrionic Personality Disorder:
Characterized by an unstable self-esteem and excessive, dramatic emotional expressions, appearing to be attention seeking and theatrical.
-May have unstable relationships due to inappropriate or excessive behaviors and expressions
-May consider relationships to be more intimate and dramatic than what they are
-Self-esteem and needs may be dependent on others’ approval and attention
-May be easily influenced by others
-May dress in a provocative or attention seeking manner
-May display exaggerated, easily altering emotions
-Emotions may appear to be shallow or superficial due to exaggeration
-May speak in an impressionistic or theatrical manner
B. Narcissistic Personality Disorder:
Characterized by an enlarged self-importance, grandiosity, and a lack of empathy towards others.
-May have unstable relationships due to preoccupations with oneself, a lack of empathy, or a need for control
-May necessitate for a high amount of admiration, control, or authority
-May experience internal and express external anger, demands, or depression when needs are not met
-May view talents, skills, and accomplishments to be superior and exaggerated
-May have an inflated self-importance with or without feelings of depression and a deflated self-esteem
-May believe to have specific rights and entitlements
-May have persistent preoccupations with power, success, and ideals
-May view self as always correct
C. Avoidant Personality Disorder:
Characterized by persistent and extreme feelings of inadequacy, insecurity, and fears of disapproval, resulting in extreme isolation and avoidance of others and situations.
-Has a spectrum relationship with social anxiety disorder
-May lack relationships due to fear causing unwillingness and reluctance to associate
-May isolate oneself and avoid communication
-May view oneself as inferior, incompetent, and lesser than others
-May experience persistent anxiety or distress
-May refrain from various activities due to fear of shame and embarrassment
-May appear to be tense or restless in social situations
-May entirely avoid and stay away from opportunities and involvements
C. Dependent Personality Disorder:
Characterized by severe self-doubt, uncertainty, and a continuous, extreme dependency on others for needs and care
-Has a spectrum relationship with separation anxiety disorder
-May have unstable relationships due to excessive, expressed needs
-May persistently seek out individuals to care for them
-May be markedly submissive, afraid to express disagreements, and passive
-May experience constant fear and preoccupations of being alone or left to care for oneself
-May struggle to make basic every day decisions and carry out responsibilities without the help, reassurance, or approval of another
-May engage in excessive behaviors to obtain such nurturance
-May agree to carrying out certain tasks, chores, or terms to obtain such nurturance, even if uncomfortable
C. Obsessive Compulsive Personality Disorder:
Characterized by persistent, extreme preoccupations in one’s every day life towards a need for order, rules, perfection, control, etc.
-May have disrupted or unstable relationships due to preoccupations and fixations
-May have reactions of frustration, anger, and anxiety when these demands on fixations and patterns are not meant
-May express an extreme need for order, rules, and regulations in typical, every day tasks
-Views such order and rules as the correct and the proper way
-May have fixations with minor details, lists, and organization within work, relationships, every day tasks, and so on
-May experience some difficulty to complete tasks due to high set perfectionisms, which may result in anxiety and low-self esteem
-May express rigid ideas and behaviors regarding morals, ethics, values, spending rights, and so on
-May appear to be stubborn or tense
Other: General Personality Disorder:
Consists of a basic, general set of a personality disorder criteria that applies to all 10 mentioned PD’s. Affected areas of these personality disorders include:
-Cognition (thought pattern, ways of perceiving the self, others, situations, etc)
-Affectivity (intensity of emotions, appropriateness of expressions, range of mood, etc)
-Interpersonal functioning (behaviors, reactions, empathy, etc).
-Impulse control
Other specified/unspecified personality disorder:
These PD’s are characterized by such impairments, but in which one does not meet the criteria for any of the 10 listed PD’s, such as having mixed cluster features or having a PD not listed in the DSM anymore (passive aggressive PD, etc).
-Specified personality disorder is when the doctor chooses to specify the reason (such as the ones listed above).
-Unspecified personality disorder is when the doctor chooses to not specify why no diagnosis of either of the 10 was given and provides an explanation of why there’s nothing specified.
Personality change due to medical condition:
This is a separate category diagnosed when an individual has a persistent personality change and disturbance that has been shown to be due to a specified medical condition (epilepsy, tumor, etc)
-Also affects the individuals daily functioning, interactions, and causes impairments in life
-Specified types and main features:
-Labile type (rapid emotions)
-Disinhibition type (impulse control)
-Apathetic type (apathy, indifference)
-Paranoid type (suspiciousness and distrust ideations)
-Other type
-Combined type
-Unspecified type
Treatments:
There are no FDA medications approved for personality disorders; however, certain types may benefit certain PD’s and symptoms (anti depressants, mood stabilizers, anti psychotics, etc).
Dialectical Behavior Therapy, a variation of Cognitive Behavioral Therapy revised specifically with borderline PD symptoms in mind, is very helpful in treating a variety of the other PD’s as well. DBT was created by Marsha Linehan to help patients engage in awareness and regulate emotions and impulses by applying coping skills and strategies.
Other beneficial psychotherapies include:
Cognitive Behavioral Therapy: focuses on how thoughts influences emotions and behavior. It aims to help patients recognize, alter, and cope with them.
Psychoanalytical Therapy: is related to the theories of how the unconscious mind and early events influences thoughts and behavior. It can help patients gain insight and cope.
Schema Therapy: is used to treat personality disorders by focusing on maladaptive patterns through assessment, awareness, and then implementing behavior and pattern changes.
Coping:
Apart from the mentioned treatments, other coping strategies and techniques may benefit. They could differ per individual preference, symptom, and PD type.
-Practicing self-validation
-Self workbooks
-Awareness and insight exercises and strategies
-Emotional intelligence practices
-Physical activity
-Healthy diet to prevent triggered symptoms and help one function
-Grounding techniques for dissociation, psychotic symptoms, and distorted perceptions
-Many BPD books state specifically that borderline PD may highly benefit from a pet and transitional object
-Writing, reading, music, arts, for expressions
-Self-harm alternatives
Prevention:
While there may not be a specific way to prevent a personality disorder due to the variety of causes, many factors have been shown to hinder the development:
-Early intervention and coping
-Validation
-Societal intervention to prevent abuse and neglect
-Healthy lifestyle
I hope many of you find this helpful for awareness, as these are very misunderstood conditions. (May edit some parts later).
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