Personality Disorders: Types, Symptoms, Causes, Treatment

Since ancient times, we have recognized a large variation in the way people think, feel, and behave. We call this “personality.” Your personality is a combination of your thoughts, emotions, and behaviors that makes you unique. 

According to the American Psychiatric Association, a personality disorder is “a way of thinking, feeling and behaving that deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time.”

Generally, this condition begins in childhood or adolescence. It is associated with a poor quality of life and a risk of early death. One World Health Organization (WHO) study concluded that 6.1% of the world’s population suffered from a personality disorder. Unfortunately, the US National Institute of Mental Health found that less than half of people with this disorder receive mental health treatment in any given year.

In this article, we will cover the types, symptoms, causes, diagnosis, and treatments of this umbrella of mental illnesses.

Types and Symptoms of Personality Disorders

The Diagnostic and Statistical Manual of Mental Disorders, version 5, or DSM-5 recognizes ten different types of personality disorders. Specifically, they are organized into three clusters based on their symptoms as follows.

Cluster A (Odd, Bizarre, Eccentric)

• Paranoid Personality Disorder: Characterized by a distrust of others, even friends, family, and partners. Those with this condition easily feel shame and humiliation and bear grudges. They also often blame their unacceptable feelings on others.
• Schizoid Personality Disorder: Those with this condition seem detached and aloof, and are prone to fantastical thinking. They also may be indifferent to others and lack appropriate emotional responses.
• Schizotypal Personality Disorder: Symptoms include odd appearance, behavior, and speech. People with this condition have no desire to interact with others and believe that everything going on is related to them.

Cluster B (Dramatic, Erratic)

• Antisocial Personality Disorder: People with this personality disorder have no concern for the feelings of others and no regard for normal social behavior and obligations. They may seem irritable and aggressive, failing to learn from their previous experiences. Additionally, they may have a higher chance of having a prison record.
• Borderline Personality Disorder (BPD): Also called emotionally unstable personality disorder. People with BPD may experience feelings of emptiness and fear of abandonment. They may also undergo outbursts of anger and violence, suicidal threats, and acts of self-harm.
• Histrionic Personality Disorder: Those with this disorder may lack self-worth and depend on the attention and approval of others for a sense of well-being. They may also feel sensitive to criticism or rejection and react badly to disappointment or failure.
• Narcissistic Personality Disorder: People with this disorder feel very self-important, with a strong sense of entitlement, and a need to be admired. They may show fits of anger and revenge called a “narcissistic rage” that can have serious consequences for all those involved.

Cluster C (Anxious, Fearful)

• Avoidant Personality Disorder: People with this personality disorder believe that they are socially awkward, unappealing, or inferior, and constantly fear being embarrassed, criticized, or rejected. They may also have strong feelings of anxiety, often associated with a sense of rejection by parents or peers during childhood.
• Dependent Personality Disorder: Characterized by a lack of self–confidence and a need to be looked after by others. They may also have feelings of inadequacy and helplessness, as well as a fear of abandonment.
• Obsessive-Compulsive Personality Disorder (OCD): People with OCD have an excessive preoccupation with details, rules, lists, order, organization, or schedules. Perfectionism can become so extreme that it prevents a task from being completed. They may also feel anxious about things over which there is no control.

Unfortunately, all forms of personality disorders put you at extra risk of depression and thoughts of suicide.

Causes of Personality Disorders

The causes behind most personality disorders are complicated. In fact, genetic and environmental factors seem to work together to cause this illness. Genetic abnormalities in brain chemistry and environmental factors such as child abuse, predict antisocial behavior and the development of this illness. Additionally, exposure to childhood difficulties can predict an increased risk of this mental health condition.

Diagnosis of Personality Disorders

A mental health professional such as a psychologist or psychiatrist will use an overall analysis of your problem and the DSM-5 to make a diagnosis of a personality disorder. They make take the following steps to establish a diagnosis:

• History and medical examination, including laboratory tests for alcohol and drugs. People with personality disorders often also have physical complaints, which can confuse the diagnosis.
• A detailed interview with a doctor or mental health professional that includes an assessment of your thoughts, feelings, and behavior.
• A psychological evaluation which may include questionnaires.
• Discussion of your symptoms.

Treatment of Personality Disorders

The main goals of treatment include fewer symptoms, improved well-being, better interpersonal relationships, and a greater understanding of self. Therefore, a joint set of treatment goals between you and your therapist is important. In particular, this approach will ensure that treatments are personalized and meaningful to you as an individual. 

Psychotherapy

One of the main treatments for personality disorders is a variety of types of psychotherapy or so-called “talk therapy.” These include, for example:

• Cognitive behavioral therapy as a way to change to a better pattern of thought and behavior
• Dialectical behavioral therapy as a way to spot and control your emotions and behavior
• Interpersonal therapy to improve social functioning and relationships with other people
• Family-focused therapy to improve communication and problem solving between family members and other close relationships
• Mentalization-based therapy as a way to use your mental powers to change your thinking and behavior

Psychotherapy works to improve your understanding of your mental state. Without that understanding, successful treatment is unlikely.

More important than the type of psychotherapy, however, is the relationship between you and your therapist. This relationship is the most important predictor of the success or failure of your treatment.

Medications

There are currently no medications that are approved to treat personality disorders. In some cases, however, your doctor may use some of the following medications along with psychotherapy:

• Antidepressants like Selective Serotonin Reuptake Inhibitors (SSRIs)
• Anti–psychotics, such as Clozaril (Clozapine)
• Mood stabilizers such as Lithium  
• Anti–anxiety medications such as benzodiazepines such as Xanax (Alprazolam)

The treatment of personality disorders is typically a prolonged process that may require inpatient treatment when symptoms such as severe depression or suicidal thoughts are present. Inpatient treatment programs allow the development of a strong therapeutic relationship between you and your therapist, which might be more difficult to establish in an outpatient program. Following inpatient treatment, a prolonged course of outpatient treatment may be necessary to keep your symptoms under control.

Reach Out for Help

Port St. Lucie Hospital specializes in mental health services and is located on 20 acres near the beautiful Savannas Preserve. If you or one of your loved ones struggles with a mental health disorder, we are here to help.

Our 24-hour mental health services are provided by licensed professionals in various disciplines. We tailor our programs to our patient’s needs and will help you every step of the way.

We welcome you to our facility. From support groups to individual therapy treatment options, we are here to fight the battle with you. Reach out to us online today and take our free mental health screening. You can also call us at 772-335-0400 to begin your journey toward recovery.