A Comprehensive Guide to Understanding Personality Disorders

A personality is made up by a way of behaving, feeling and thinking that distinguishes one from others. Environment, experiences, and genetics all shape a personality together. The notion is that people’s personalities are shaped in childhood and remain fixed; however, research suggests that personalities evolve throughout people’s lives.  

A personality disorder involves disruptive patterns of mood, thinking, and behaviour that can be long-lasting – causing distress and impairing daily functioning. They are usually treatable using the right combination of therapy and psychiatric treatment.

What is a Personality disorder?

To be classified as a personality disorder, one's way of thinking, feeling and behaving deviates from social norms, leads to distress, hampers normal functioning, and lasts for a significant time period. This pattern emerges by late adolescence or early adulthood.

The DSM-5-TR identifies 10 specific types of personality disorders which affect at least two of the following areas:

• Perception about self and others

• Pattern of emotional responses

• Pattern of relating to other people

• Pattern of managing one’s own behaviour

The 10 types of personality disorders are further classified into three main clusters:

Cluster A personality disorders

Cluster A involves personality disorders that are characterized by eccentric behaviours or thinking patterns. These include:

• Paranoid personality disorder: This is marked by paranoia that can be defined as persistent mistrust and suspicion of others without sufficient reason. Those with paranoid personality disorder often hold the belief that others are trying to demean them or cause harm.   

Also read: Reassuring a Loved One Diagnosed With Paranoid Personality Disorder

• Schizoid personality disorder: Marked by a continued pattern of a general disinterest and detachment in interpersonal relationships. People with this disorder showcase a minimal range of emotions in personal or social interactions.

• Schizotypal personality disorder: Marked by a regular pattern of severe discomfort with and restricted need for interpersonal relationships. Distorted perceptions of reality and odd behaviour might strain personal connections.

Cluster B personality disorders

These include severely unstable as well as impulsive behaviours. Cluster B personality disorders include:

• Antisocial personality disorder (ASPD): Characterized by a lack of respect toward others and inability to conform to social norms. People diagnosed with ASPD may indulge in physical or emotional violence and break the law. There is a general disregard for taking accountability for their actions.

Also read: Understanding Antisocial Personality Disorder

• Borderline personality disorder (BPD): Marked by the inability for emotional regulation, leading to mood swings, low self-esteem, impulsive behaviours and consistent relationship issues.

• Histrionic personality disorder: Marked by extreme, unstable emotional state and a distorted self-image. Self-esteem depends on external validation and doesn’t stem from a personal sense of self-worth. There is an overwhelming desire for attention, and may display dramatic and/or inappropriate behaviours to get attention.

Also read: Understanding Treatments for Histrionic Personality Disorder

• Narcissistic personality disorder: This condition involves a consistent pattern of perceived superiority and grandiosity, an excessive need for praise and admiration and a lack of empathy for others. These thoughts and behaviours often stem from low self-esteem and a lack of self-confidence.

Also read: Narcissistic Personality Disorder - Symptoms, Causes, and Treatments

Cluster C personality disorders

Cluster C personality disorders involve severe anxiety and fear. They include:

• Avoidant personality disorder: This is marked by chronic feelings of inadequacy and intense fear of being negatively judged by others. Although there is willingness for social interaction, people with this disorder avoid it due to fear of rejection.

• Dependent personality disorder: Marked by an excessive, chronic need to be cared for by others. People with this condition are submissive, needing reassurance constantly and unable to make decisions for themselves.

• Obsessive-compulsive personality disorder (OCPD): Marked by a constant and severe need for perfectionism, control, and orderliness (leaving no room for flexibility) that ultimately interferes with task completion.

Some general signs and symptoms of personality disorders:

• Their loved ones perceive their behaviour as inconsistent, confusing, and often times frustrating.

• They may have trouble understanding practical and acceptable ways to behave around others.

• They may be unmindful of how their behaviours affect others and create problems.

• If they have kids, their parenting style may be emotionally unstable, irresponsible, or abusive, leading to mental health problems in their kids.

Treatment

Personality disorders can be some of the most difficult disorders to treat and diagnose, because those affected don’t usually believe their behaviour is problematic.

There isn’t a wide range of treatment options available for Personality disorders, but typically medications of anxiety and depression are prescribed that help with Personality Disorder symptoms.

DBT and CBT have been shown to be effective treatment options for personality disorders, especially for BPD and Histrionic Personality Disorder, respectively. Therapy and Psychiatric medicines can help with efficient symptom management,

 Psychotherapy can effectively help manage symptoms by focusing on the following:

·       Reducing immediate discomfort

·       Expanding emotional awareness

·       Reducing socially unacceptable behaviour

·       Modifying personality traits leading to dysfunctional behaviour

Also read: The Significance of Self-Care for Individuals Living with a Personality Disorder

Final Word

Personality disorders are distortions in one’s personality manifested through behaviour and patterns of thinking that are often out of alignment with social norms. These disorders frequently showcase symptoms of odd and eccentric behaviour. A combination of psychiatric medicines and therapy can help with efficient symptom management.