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Personality Disorder
Personality disorders are a type of mental health problem where attitudes, beliefs and behaviours can cause longstanding difficulties in living.
Someone with a personality disorder may often experience difficulties in how they think about themselves and others, and may find it difficult to change these unwanted patterns.
A diagnosis of personality disorder may be given if all three of these apply: The way in which someone thinks, feels and behaves causes themselves or others significant problems in daily life. For example, feeling unable to trust others. The way in which someone thinks, feels and behaves causes significant problems across different aspects of their life. For example, struggling to start or keep friendships or get on with people at work. These problems continue for a long time, often starting in adolescents and continuing into adult life.
Diagnosis:
Psychiatrists tend to use a system of diagnosis which identifies 10 types of personality disorder. The types are grouped into three categories: Suspicious – paranoid, schizoid, schizotypal and antisocial. Emotional and impulsive – borderline, histrionic and narcissistic. Anxious – avoidant, dependent and obsessive compulsive. For each type, a diagnosis will not be made if someone only has one or two of the characteristics.
Paranoid personality disorder find it hard to confide in people, even friends find it very difficult to trust other people, believing they will be used and take advantage of watch others closely, looking for signs of betrayal or hostility read threats and danger – which others don’t see – into everyday situations.
Schizoid personality disorder be uninterested in forming close relationships with other people, including family feel that relationships interfere with freedom and tend to cause problems prefer to be alone in own thoughts choose to live life without interference from others get little pleasure from life have little interest in sex or intimacy
be emotionally cold towards others
Schizotypal personality disorder find making close relationships extremely difficult think and express themselves in ways that others find ‘odd’, using unusual words or phrases behave in ways that others find eccentric believe that they can read minds or that have special powers such as a ‘sixth sense’ feel anxious and tense with others who do not share these beliefs feel very anxious and paranoid in social situations.
Antisocial personality disorder (ASPD) put themeslves in dangerous or risky situations, often without considering the consequences for themselves or for other people behave dangerously and sometimes illegally behave in ways that are unpleasant for others feel very easily bored and act on impulse – may find it difficult to hold down a job for long behave aggressively and get into fights easily do things – even though they may hurt people – to get what they want, putting their own needs above others have a criminal record feel no sense of guilt if they have mistreated others believe that only the strongest survive and that they must do whatever it takes to lead a successful life because if they don’t grab opportunities, others will have had a diagnosis of conduct disorder before the age of 15. This diagnosis includes ‘psychopathy’. This term is no longer used in the Mental Health Act but a ‘psychopathy checklist’ questionnaire may be used in assessment.
Borderline personality disorder (BPD) feel very worried about people abandoning them, and would do anything to stop that happening have very intense emotions that last from a few hours to a few days and can change quickly (for example, from feeling very happy and confident in the morning to feeling low and sad in the afternoon) poor sense of self, and it can change depending on who they’re with find it very hard to make and keep stable relationships act impulsively and do things that could cause harm (such as binge eating, using drugs or driving dangerously) have suicidal thoughts or self-harming behaviour feel empty and lonely a lot of the time get very angry, and struggle to control anger.
be seen by others as much too submissive and passive.
Obsessive compulsive personality disorder (OCPD) need to keep everything in order and under control set unrealistically high standards for themselves and others think their way is the best way of making things happen worry when they or others might make mistakes expect catastrophes if things aren’t perfect be reluctant to spend money on themselves or others have a tendency to hang onto items with no obvious value.
“I have narcissistic borderline personality disorder. At first it was difficult to accept that the problem was essentially me, my personality. But then being able to put it into perspective as a developmental flaw was much easier to accept – that it was simply the way I'd developed in response to my environment and the situations I'd experienced”.
Causes:
There's no clear reason why some people develop a personality disorder and others don't. Most researchers think that a complex mix of factors is involved, such as: the environment in which they grow up. early childhood and teenage experiences genetic factors
Treatment:
There are a range of treatments that can help someone who experiences a personality disorder: Talking treatments (Cognitive Analytic Therapy CAT, Dialectical Behaviour Therapy DBT) Mentalisation Based Therapy (MBT), Schema Therapy Medication (antidepressants, antipsychotics, mood stabilisers) Therapeutic Communities
For family and friends:
Someone with personality disorder may feel especially anxious about their relationships. Sometimes people feel as though it can be hard to know the 'right' thing to say or how to help. But there are lots of positive things that can be done to be supportive:
Try to be patient – if someone is struggling to deal with their emotions, try not to get involved in an argument in the heat of the moment. It could be better to wait until everyone feels calmer to talk things through. Talk to them compassionately and calmly – when someone is experiencing difficult thoughts and feelings, their behaviour may be unexpected or upsetting. Try to understand what they're experiencing and what's affecting their thoughts, feelings and behaviour – this can help you to stay calm. Don't judge – try to listen. You may not understand why someone feels the way they do, but it can mean a lot to acknowledge and value how they're feeling. Remind them of their positives – a diagnosis of personality disorder doesn't stop someone being likeable, intelligent, kind, highly motivated or creative. Remind someone of the positives you see in them. Try to both set clear boundaries and expectations – it can be helpful to make sure everyone knows where the boundaries of the relationship are, and what you can expect from each other. This can help you both manage difficult feelings and situations. Think about how you could help keep them safe – it can be scary if you're worried someone you care about is hurting themselves, or is struggling with suicidal thoughts, but being prepared can help you cope. Learn more about personality disorder, and help to challenge stigma – personality disorder is a broad and complex diagnosis. It is often misunderstood and stigmatised, it is difficult to deal with these misconceptions on top of the mental health difficulty..
