Definition and Overview

Personality disorder refers to clusters or classes of characteristics or personality traits that are often characterized as deviation from cultural or social norm.

Every person has a personality that is defined by how he or she thinks, feels, and behaves. It is affected by several elements, including experiences, interactions with other people, and the person’s own perception of himself or herself and the rest of the world. Since every person is unique, no personality is also alike.

However, for an average person, personality can develop and even change depending on certain circumstances and as time passes. This is how he or she copes with stress and other people’s personality.

Personality disorders are classified into three clusters:

  • Cluster A are personality disorders characterized by the oddity or eccentricity of the person’s behavior. The main keyword is fantasy—that is, he or she tends to create a world or situation that is so far-fetched from reality. Some of the disorders that are under cluster A are paranoia, schizophrenia, and schizotypal. Because they already have their own set of beliefs and living in a world completely different from what’s real, they have a hard time forming relationships.

  • Cluster B refers to personality disorders characterized by difficulty in controlling one's own feelings. Their behavior therefore can be unpredictable, and the lack of power over their feelings can sometimes force them to respond more excessively than others in certain situations. Examples are those who are antisocial and narcissistic.

  • Cluster C refers to personality disorders characterized by enhanced feelings of fear and anxiety, which take control over their own emotions, thoughts, and behavior. Examples are those who are avoidant, obsessive-compulsive, and overly dependent.

Causes of Condition

It’s unclear how some people develop personality disorders, but there are theories.

First, they may have experienced an event in their lives that is life changing, traumatic, or influential. These events are typically experienced during the younger years since personality starts to develop at an early age. For instance, a person who has been left behind by a parent may eventually have an overly dependent personality disorder or the extreme need of others for love and care. They fear of being abandoned and thus would often do anything to keep the person around, including being overly submissive to their partners.

Another theory is that genetics may be playing a huge role. Many studies, for example, have established a link between symptoms of schizophrenia and genetics. People who have first-degree relatives diagnosed with the disorder have around 55% chance of developing the same than the general population. Meanwhile, at least half of the cases of clinical depression are attributed to heredity.

Genes can influence the way the brain’s function. It may prevent the proper transfer of information, which then results to convoluted ideas, thoughts, or behavior of a person.

However, having relatives with mental or personality disorders doesn’t have to mean the person will also develop them. But the possibility will remain high.

Key Symptoms

Symptoms of personality disorders can vary depending on the cluster or the specific mental problem. Some of the common ones include:

  • Feeling of extreme fear and anxiety
  • Obsession over a certain object, event, or person
  • Compulsion to do something repeatedly or even against own judgment
  • Feeling of worthlessness and guilt
  • High level of distress
  • Inability to cope with stress
  • Difficulty in understanding other people’s personality
  • Socially inept (solitary or withdrawn)
  • At risk of self-harm including cutting and suicide
  • Prone to uncontrolled or unreasonable anger
  • Over-reliance on other people
  • Difficulty in accepting criticism or advice
  • Eccentric behavior
  • Paranoia

Some people exhibit very mild symptoms of personality disorders, making it difficult for them to be diagnosed. Others, on the other hand, have extreme signs they can sometimes be a threat to themselves and others.

More often than not, stress can aggravate the symptoms. It’s also common for patients to develop complex mental disorders. For instance, a person with avoidant personality disorder can also be diagnosed with depression.

Who to See and Treatments Available

It’s hard to “cure” personality disorders since they are already innate in a person. However, symptoms can be controlled or managed to allow the person to establish better relationships with themselves and others.

A person who believes to have a personality disorder can approach psychologists and psychiatrists, who have received adequate training, education, and experience in dealing with behaviour, thoughts, and emotions of people.

Depending on the results of the consultation, the practitioner may recommend psychotherapies that include cognitive behavioral therapy (CBT). In CBT, a person with a personality disorder is believed to have a distorted negative perception that affects his own actions, feelings, and overall personality. For instance, a person who has failed in an exam may feel stupid, and thus, any mistake he or she makes at work or at home, he or she attributes to his “stupidity.” All the other events therefore only serve as a validation of his or her negative thoughts. Clinicians would use different techniques including journaling to explore the root cause and teach the person coping mechanisms to correct and improve the negative perception.

Other options include group therapy, which is more in depth, and reflective therapy, which deals with the negative experiences of the person that may have contributed greatly to the development of the personality disorder.

So far, there’s no known medication for personality disorders. Most of the drugs recommended are for controlling the symptoms of the disorder. SSRIs (selective serotonin uptake inhibitors), for example, can be given to patients who have significant depressive symptoms.

People with personality disorders can react differently with each of these options, so clinicians must be able to modify, adjust, and even completely change the programme whenever necessary.

References:

  • Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA. Personality and personality disorders. In: Stern TA, Rosenbaum JF, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, PA: Elsevier Mosby; 2008:chap 39.
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