Personality disorder

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at March 23, 2016
StartDiseasesPersonality disorder

Personality disorder is a broad category of mental disorders encompassing a group of mental health conditions characterized by unhealthy patterns of behaving, thinking, and functioning. Nearly 31 million Americans suffer from some form of personality disorder.

Depending on the severity, a person with a personality disorder may have difficulty coping with everyday situations, which can cause problems with work and professional relationships and limit the individual’s ability to function in society.

Contents

Definition & Facts

A personality disorder is an enduring, pervasive, rigid pattern of thinking, functioning, and behaving that deviates significantly from the expected norms of the individual’s culture. In most cases, personality disorders first surface during adolescence or early adulthood. The Diagnostic and Statistical Manual of Mental Disorders V, which is used by clinicians to diagnose psychiatric conditions, lists 10 different personality disorders divided into three clusters according to the similarity of symptoms and characteristics:

Cluster A disorders:

Cluster B disorders:

Cluster C disorders:

Symptoms & Complaints

Personality disorders cover a broad range of symptoms. A person does not have to exhibit all of the symptoms of a particular disorder to be diagnosed. Many individuals with a personality disorder show signs and symptoms of additional disorders.

Individuals with paranoid personality disorder are highly distrustful of the actions and motives of others. They may also have overly angry or hostile reactions to perceived insults and tend to hold a grudge.

Individuals with schizoid personality disorder are often uninterested in personal relationships. They may exhibit a limited emotional range and be unable to pick up on social cues, which can make them seem cold and distant.

Schizotypal personality disorder is characterized by peculiar speech, behavior, and dress. The person may report hearing voices and believe they have the ability to control other people and events with their thoughts.

Individuals with antisocial personality disorder often engage in behavior that is impulsive, irresponsible, and lacks regard for the safety or feelings of others. These individuals may be aggressive and often have ongoing problems with the law.

People with borderline personality disorder often suffer from a fragile self-image, a fear of abandonment, and feelings of emptiness, which may lead them to engage in risky behaviors like unsafe sex, binge eating, or gambling.

A person with histrionic personality disorder craves attention. They may speak, act, or dress in overly dramatic or provocative ways to gain attention. Narcissistic personality disorder is characterized by a sense of self-importance. They may act arrogantly by exaggerating their accomplishments and expect praise, admiration, and envy from others.

Individuals with avoidant personality disorder may feel inferior and inadequate and fear ridicule and disappointment. These individuals are often shy and inhibited in social situations. Dependent personality disorder is characterized by a lack of self-confidence and the need for reassurance from others when making even small decisions. These individuals may be overly clingy and submissive in relationships and may be reluctant to leave an abusive situation even when there are options.

A person with obsessive-compulsive disorder is typically preoccupied with rules, order, and details. They often take perfectionism to the extreme and like to be in total control of tasks and situations.

Causes

Personality is the unique combination of emotions, thoughts, and behaviors that shape how a person relates and understands the world around them. The factors influencing a person’s personality are a combination of their genes and the events, places, and people that make up their life.

Genetic factors may make a particular person susceptible to a personality disorder while environmental factors may trigger the development of the condition. Factors that increase an individual's risk of developing a personality disorder include:

  • Variations in brain structure or chemistry.
  • Family history.
  • Low levels of education and poverty
  • Unstable and chaotic family life during childhood.
  • Abuse or neglect during childhood.
  • Being diagnosed with a conduct disorder during childhood.

Diagnosis & Tests

A primary care physician will perform a physical examination and lab tests to rule out the possibility that a medical condition is causing the symptoms. They may also conduct screenings for drugs and alcohol. The individual may then be referred to a mental health professional for a mental evaluation. A person is diagnosed with a personality disorder if their pattern of thinking and behavior are pervasive across multiple life circumstances and cause impairment or distress in at least two of the following:

  • The way the person perceives and interprets himself and others.
  • The way the person deals and acts with others.
  • The appropriateness of the individual’s emotional responses.
  • How well the person controls impulses.

Treatment & Therapy

Treatment of personality disorders depends on the severity and type of disorder as well as the individual’s life circumstances. Treatment is often life-long and may require a team of professionals, including primary physicians, therapists and psychiatrists, pharmacists, social workers, and family members.

The primary form of treatment is psychotherapy. This involves the individual working with a mental health practitioner to gain insight into their thoughts and behaviors. The goal is to develop healthy ways to manage symptoms and control behaviors that interfere with daily life.

Medications, such as antidepressants, antipsychotics, and anti-anxiety drugs, may help relieve the symptoms associated with various personality disorders. Individuals with personality disorders may require hospitalization if their symptoms become so severe that they are a danger to themselves or others.

Prevention & Prophylaxis

There is no way to predict or prevent a person from developing a personality disorder. Individuals with a personality disorder often do not realize they have a problem since they consider their behaviors normal. Anyone who suspects their loved one is suffering from a mental health condition should encourage them to seek professional help as soon as possible.

Individuals diagnosed with a personality disorder should educate themselves regarding their condition, take their medication as prescribed, follow-up with the doctor as recommended, and avoid drugs and alcohol.