Everyone has a unique personality which has developed over many years and consists of various beliefs and ways of thinking, feeling and behaving. While the vast majority of Americans will not develop signs or symptoms of a personality disorder, over nine percent will on an annual basis. Significant problems in social, academic, employment and personal relationships can last for long periods of time, taking a serious toll on one’s quality of life. Thankfully, there are self-help methods and psychiatric services which can help individuals with personality disorders to live better and fuller lives.
What is a Personality Disorder?
A personality disorder is “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture” per the Diagnostic and Statistical Manual on Mental Disorders, Fifth Edition (DSM-5)1. Such experiences and behaviors can cause problems across all spheres of life and may be complicated by co-occurring psychological conditions including anxiety, depression, impulse control and substance use disorders.
Categories & Types of Personality Disorders
Understanding and being able to differentiate personality disorders can be challenging. Ten personality disorders are categorized into three separate groups – suspicious, emotional and impulsive and anxious. An additional type which may be diagnosed when the individual exhibits criteria for more than one type is called mixed personality disorder. The following categories and the specific types of disorders that belong to them are:
- Suspicious
- Paranoid Personality Disorder
- Schizoid Personality Disorder
- Schizotypal Personality Disorder
- Emotional and Impulsive
- Antisocial Personality Disorder
- Borderline Personality Disorder
- Histrionic Personality Disorder
- Narcissistic Personality Disorder
- Anxious
- Avoidant Personality Disorder
- Dependent Personality Disorder
- Obsessive-Compulsive Personality Disorder
Paranoid Personality Disorder is characterized by a lack of trust and confiding in others as well as feelings of being used, difficulty in relaxing and over-reading threats and dangers in everyday life. Symptoms of Schizoid Personality Disorder, on the other hand, are less troublesome and include difficulty forming close relationships, inability to experience pleasure, lack of interest in sex, and being mostly alone. The last disorder in the suspicious category is Schizotypal Personality Disorder. It involves distorted thoughts or perceptions, odd or eccentric behaviors, feelings of anxiousness or paranoia, all which make forming relationships very difficult.
Among the emotional and impulsive disorders, hallmarks of Antisocial Personality Disorder include acting impulsively or out of anger without consideration for others, putting oneself in harm’s way, acting illegally at times, being aggressive and getting into fights. The diagnosis usually occurs before the age of 15. One disorder that has gained a lot of attention is Borderline Personality Disorder. It is characterized by unstable emotions, feelings of abandonment, intense emotions, and impulsivity. People with this disorder may harm themselves, experience suicidal thoughts or attempts, struggle to trust others and lack a strong sense of who they are.
Two other disorders within this category are Histrionic and Narcissistic Personality Disorders. Histrionic Personality Disorder involves continually being the center of attention and feeling uncomfortable when not, being overly dramatic and emotional, feeling responsible for entertaining others and being easily influenced by others. People diagnosed with Narcissistic Personality Disorder feel special, better than others, become upset and resentful at other people’s success, are selfish and have very fragile self-esteem.
Within the anxious category, there is Avoidant Personality Disorder where feelings of anxiety cause avoidance of work and social activities, great sensitivity to criticism, worry about being shamed, and feelings of loneliness and inferiority. Dependent Personality Disorder is characterized by feeling needy and weak, afraid to care for one’s self, allowing others to assume responsibility for them and low self-confidence. And finally, not to be confused with Obsessive-Compulsive Disorder (OCD), which is more of a behavioral disorder, Obsessive Compulsive Personality Disorder describes those who are driven by perfection, a drive to keep everything in order and under control, and become anxious is everything is not perfect.
Possible Causes of Personality Disorders
Without getting overly specific about each type of personality disorder, most are caused by a combination of risk factors associated with one’s environment, social circumstances, early life experiences and genetics. In terms of the environment and social circumstances, living in an unstable and chaotic family whose members have mental health or substance use problems, lack of support from loved ones, and experiencing poverty, discrimination or dislocation may form the perfect storm for a disorder to develop.
Most psychological issues are usually associated with one’s past, especially their younger, childhood and adolescent years. The same holds true for personality disorders. Experiencing trauma, abuse or neglect are risk factors involved in the formation of personality disorders. And lastly, genetics do play a role in personality disorders. Certain genes linked to various conditions may lay dormant until they become activated by severe stress and trauma or growing up in undesirable conditions.
Self-Help
While living with a personality disorder can range from challenging to debilitating, there are a number of self-help methods and lifestyle modifications that can help. Learning various ways to cope with symptoms is important and can be achieved through learning more about the condition, becoming more self-aware of one’s thoughts, feelings and behaviors, and avoiding triggers if possible.
Management of anger, depression and anxiety can be achieved through breathing exercises, meditation, keeping a journal, or doing something creative. Exercising or distracting oneself with work or a hobby can be ways to channel negative emotions into something positive. If one is experiencing dissociation, it can be helpful to be more aware of environmental sounds and sights, wrapping oneself in a blanket, walking barefoot or aromatherapy to bring one’s self back to reality. And, if self-harm is an issue, some experts recommend drawing lines on the arm with a red pen, snapping the wrist with a rubber band, holding ice cubes or taking a cold shower.
Other ways to better manage troublesome symptoms include creating a healthy support network of people to talk to, planning for especially difficult times, finding an advocate, using relaxation techniques, mindfulness, and taking care of one’s physical health.
Professional Help
Beyond self-help methods, some individuals will need the care and treatment of specialists in mental and behavioral health. While there are no psychiatric medications specifically prescribed for personality disorders, certain drugs can help manage anxiety, depression and sleep problems. Some professionals may recommend a combination of medication and therapy or counseling. Medications can help with biological symptoms like serotonin-related mood imbalance and therapy can help one to develop coping skills.
In terms of psychotherapy, specific modalities may be recommended including dialectical behavior therapy to help in managing emotions, mentalization-based therapy to better recognize and understand one’s and other people’s mental states, cognitive behavioral therapy to see how thoughts and feelings are connected to behaviors, and cognitive analytic therapy, which focuses on trust in the therapeutic relationship and finding better ways to cope with difficulties.
Final Thoughts on Personality Disorders
While personality disorders affect a smaller percentage of Americans compared to classic anxiety or depressive disorders, they do tend to be chronic and sometimes devastating to those living with them. Personality disorders also are very complex, with roots beginning in childhood and developing over many years. They may also still carry a stigma, since they are based on a person’s “personality” which can be viewed as deviant, dysfunctional, or unpredictable. Through both self-help methods and the help of experts in mental and behavioral health, there is hope for living a fuller, more satisfying life and remaining in careers and important relationships that mean a great deal to the individual.
1 American Psychiatric Association. 2013. Diagnostic and Statistical Manual of Mental Disorders, Fifth Ed. Washington, DC: American Psychiatric Publishing.