A personality disorder is a type of mental disorder in which you have a rigid and unhealthy pattern of thinking, functioning and behaving. A person with a personality disorder has trouble perceiving and relating to situations and people. This causes significant problems and limitations in relationships, social activities, work and school.
In some cases, you may not realize that you have a personality disorder because your way of thinking and behaving seems natural to you. And you may blame others for the challenges you face.
Personality disorders usually begin in the teenage years or early adulthood. There are many types of personality disorders. Some types may become less obvious throughout middle age.
Types of personality disorders include:
- Antisocial personality disorder is characterized by a long-standing disregard for rules, social norms, and the rights of others. People with this disorder typically begin displaying symptoms during childhood, have difficulty feeling empathy for others, and lack remorse for their destructive behaviours.
- Avoidant personality disorder involves severe social inhibition and sensitivity to rejection. Such feelings of insecurity lead to significant problems with the individual’s daily life and functioning.
- Borderline personality disorder is associated with symptoms including emotional instability, unstable and intense interpersonal relationships, unstable self-image, and impulsive behaviours.
- Dependent personality disorder involves a chronic pattern of fearing separation and an excessive need to be taken care of. People with this disorder will often engage in behaviours that are designed to produce care-giving actions in others.
- Histrionic personality disorder is associated with patterns of extreme emotionality and attention-seeking behaviours. People with this condition feel uncomfortable in settings where they are not the centre of attention, have rapidly changing emotions, and may engage in socially inappropriate behaviours designed to attract attention from others.
- Narcissistic personality disorder is associated with a lasting pattern of exaggerated self-image, self-centeredness, and low empathy. People with this condition tend to be more interested in themselves than with others.
- Obsessive-compulsive personality disorder is a pervasive pattern of preoccupation with orderliness, perfectionism, inflexibility, and mental and interpersonal control. This is a different condition than obsessive compulsive disorder (OCD).
- Paranoid personality disorder is characterized by a distrust of others, even family, friends, and romantic partners. People with this disorder perceive others intentions as malevolent, even without any evidence or justification.
- Schizoid personality disorder involves symptoms that include being detached from social relationships. People with this disorder are directed toward their inner lives and are often indifferent to relationships. They generally display a lack of emotional expression and can appear cold and aloof.
- Schizotypal personality disorder features eccentricities in speech, behaviours, appearance, and thought. People with this condition may experience odd beliefs or “magical thinking” and difficulty forming relationships.
Diagnosis of a personality disorder requires a mental health professional looking at long-term patterns of functioning and symptoms. Diagnosis is typically made in individuals 18 years or older. People under 18 years of age, are typically not diagnosed with personality disorders because their personalities are still developing. Also, people may have more than one personality disorder.
Treatment for personality disorders
A personality disorder is hard to deal with alone. Talking to a doctor or mental health professional is the first step towards getting support and treatment.
It can be difficult for someone with a personality disorder to learn to trust a doctor or therapist. However, establishing a positive relationship with a healthcare provider is an important step towards recovery. The treatment may vary, based on the type of personality disorder and any other conditions that might be present.
Psychotherapy is the most effective long-term treatment option for personality disorders. Psychotherapy is when a psychologist or psychiatrist helps people to understand their thoughts, motivations and feelings. These insights can help people to manage their symptoms, and make positive behaviour changes.
- Cognitive Behaviour Therapy (CBT) – is a psycho-social intervention that aims to improve mental health. CBT focuses on challenging and changing unhelpful cognitive distortions and behaviours, improving emotional regulation, and the development of personal coping strategies that target solving current problems.
- Dialectical Behaviour Therapy (DBT) – is a type of cognitive behavioural therapy. Its main goals are to teach people how to live in the moment, cope healthily with stress, regulate emotions, and improve relationships with others.
- Psychodynamic Psychotherapy – or psychoanalytic psychotherapy is a form of depth psychology, the primary focus of which is to reveal the unconscious content of a client’s psyche in an effort to alleviate psychic tension.
- Psychoeducation – is an evidence-based therapeutic intervention for patients and their loved ones that provides information and support to better understand and cope with illness
Medicine and personality disorders
There is no specific medicine to treat personality disorders. However, antidepressant medication may be used to treat associated conditions such as anxiety and depression, or to help the individual to cope with their symptoms. Less frequently, other types of medicines such as antipsychotics or mood stabilisers may be prescribed.
Medicine works most effectively in combination with psychotherapy.
Some people with personality disorders may have trouble coping with stressful events (like large crowds at an event, stress at work or at home), and may need emotional support in a crisis. They may develop suicidal tendencies/thoughts and require emergency assistance.
If you or a loved one may be suffering with a personality disorder, I encourage you to seek help through your local mental health organisation.
In South Africa, you can contact SADAG (South Africa Depression and Anxiety Group) on 011 234 4837.