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Personality Disorder: Causes, Symptoms, and Treatment

What is Personality?

Delve into personality disorders: causes, symptoms, and treatments. Discover psychotherapy and self-care strategies for enhanced well-being.

A person’s personality is defined by their distinct ways of thinking, feeling and acting that distinguish them from others. It involves the individual’s unique patterns of thought, emotion and behaviour as well as the psychological mechanisms driving those patterns. Personality is the unique blend of psychological, emotional and behavioural traits that define an individual and influence their interactions with others.

It encompasses 3 core elements:

  • Temperament involves inborn attributes like introversion.
  • Character refers to acquired qualities like honesty.
  • Identity is how one sees oneself.

People have unique personalities made up of a complex combination of different traits. Personality traits affect how people understand and relate to the world around them, as well as how they see themselves.

What is Personality Disorder?

A personality disorder is a mental health condition where people have a lifelong pattern of seeing themselves and reacting to others in ways that cause problems. People with personality disorders often have a hard time understanding emotions and tolerating distress. And they act impulsively. This makes it hard for them to relate to others, causing serious issues, and affecting their family life, social activities, work and school performance, and overall quality of life. Personality disorders arise when an individual’s thinking, feeling, and behavior significantly deviate from societal norms, causing distress and impaired functioning over an extended period. 

Causes of Personality Disorder

Personality forms early in life. In the past, some believed that people with personality disorders were just lazy or even evil. But new research has begun to explore such potential causes as genetics, parenting and peer influences:

  • Genetics: – Researchers are beginning to identify some possible genetic factors behind personality disorders Your parents may pass down some personality traits to you. Sometimes these traits are called your temperament.
  • Childhood trauma: – Findings from one of the largest studies of personality disorders, the Collaborative Longitudinal Personality Disorders Study, offer clues about the role of childhood experiences. There is a link between the number and type of childhood traumas and the development of personality disorders. People with borderline personality disorder, for example, had especially high rates of childhood sexual trauma.  
  • Verbal abuse: – Even verbal abuse can have an impact. In a study of 793 mothers and children, researchers asked mothers if they had screamed at their children, told them they didn’t love them or threatened to send them away. Children who had experienced such verbal abuse were three times as likely as other children to have borderline, narcissistic, obsessive-compulsive or paranoid personality disorders in adulthood.
  • High reactivity: – Sensitivity to light, noise, texture and other stimuli may also play a role. Overly sensitive children, who have what researchers call “high reactivity,” are more likely to develop shy, timid or anxious personalities. However, high reactivity’s role is still far from clear-cut. Twenty percent of infants are highly reactive, but less than 10 percent go on to develop social phobias.
  • Peers: – Certain factors can help prevent children from developing personality disorders. Even a single strong relationship with a relative, teacher or friend can offset negative influences, say psychologists.
  • Brain changes: -Researchers have identified subtle brain differences in people with certain personality disorders. For example, findings in studies on paranoid personality disorder point to altered amygdala functioning. The amygdala is the part of your brain that’s involved with processing fearful and threatening stimuli. In a study on schizotypal personality disorder, researchers found a volumetric decrease in the frontal lobe of their brain.
  • Environment: – This includes your surroundings, events that have happened to you and around you, and relationships and patterns of interactions with family members and others. An individual’s personality evolves as they develop through life experiences and is shaped by various factors known as determinants of personality. Understanding these determinants helps explain why people behave differently in certain situations. It also helps in self-awareness and managing relationships.

Signs and Symptoms of PD

Each PD comes with its own set of symptoms, however there are known patterns of dysfunction across different personality disorders. They can have a broad range of symptoms including how people cope with life, manage emotions, and connect with others. Some common signs and symptoms of a personality disorder include: 

  • Behavior: Strange or unpredictable behavior, taking risks, impulsive actions
  • Emotions: Difficulty understanding emotions, being overwhelmed by negative feelings like distress, anxiety, worthlessness, or anger
  • Relationships: Difficulty making or maintaining relationships
  • Mood: Extreme mood swings or emotional outbursts
  • Instincts: Need for instant gratification, Suspicion or distrust, Chronic problems at school or work

Types of Personality Disorder: – This classification is outlined in the DSM-5-TR, which identifies ten distinct types of personality disorders.

  • Antisocial Personality Disorder:   Characterized by a pattern of disregarding or violating the rights of others. Behaviors may include non-conformity to social norms, repetitive deception, and impulsive actions.
  • Avoidant Personality Disorder:   Involves extreme shyness, feelings of inadequacy, and heightened sensitivity to criticism. Individuals may avoid social interactions unless certain of being liked and harbor concerns about criticism or rejection.
  • Borderline Personality Disorder: Manifests as instability in personal relationships, intense emotions, poor self-image, and impulsivity. Individuals may go to great lengths to avoid abandonment, engage in repeated suicide attempts, and exhibit inappropriate intense anger.
  • Dependent Personality Disorder: Features a pattern of needing to be taken care of, coupled with submissive and clingy behavior. Difficulty making daily decisions without reassurance and discomfort when alone due to fear of self-care incapability.
  • Histrionic Personality Disorder: Involves excessive emotion and attention-seeking behaviors. Individuals may feel uncomfortable when not the center of attention, use physical appearance for attention, and exhibit rapidly shifting or exaggerated emotions.
  • Narcissistic Personality Disorder: Characterized by a need for admiration and a lack of empathy for others. Individuals may possess a grandiose sense of self-importance, entitlement, and a tendency to take advantage of others.
  • Obsessive-Compulsive Personality Disorder: Involves a preoccupation with orderliness, perfection, and control. Individuals may focus excessively on details, work excessively without time for leisure, and demonstrate inflexibility in morality and values.
  • Paranoid Personality Disorder: Features a pattern of suspicion towards others, perceiving them as mean or spiteful. Individuals often assume harm or deception from others, avoiding close confidences.
  • Schizoid Personality Disorder: Involves being detached from social relationships and expressing little emotion. Individuals typically avoid close relationships, choose solitude, and seem indifferent to praise or criticism.
  • Schizotypal Personality Disorder: Manifests as discomfort in close relationships, distorted thinking, and eccentric behavior. Individuals may exhibit odd beliefs, peculiar behavior or speech, and excessive social anxiety.

While personality disorders are not typically diagnosed in individuals under 18 due to ongoing personality development, it’s noteworthy that some individuals may not recognize the issue, and co-occurrence of multiple personality disorders is possible. 

Treatment

Psychotherapy can help a person understand the effects their behavior may be having on others and learn to manage or cope with symptoms and to reduce behaviors causing problems with functioning and relationships. Certain types of psychotherapy have shown to be effective for treating personality disorders. Ideally, during psychotherapy, an individual can gain insight and knowledge about their disorder, what is contributing to symptoms, and get to talk about thoughts, feelings and behaviors.  The type of treatment will depend on the specific personality disorder, how severe it is, and the individual’s circumstances.

Commonly used types of psychotherapy include:

  • Psychoanalytic/psychodynamic/transference-focused therapy
  • Dialectical behavior therapy
  • Psychoeducation (teaching the individual and family members about the diagnosis, treatment and ways of coping)

There are no medications specifically used to treat personality disorders. However, in some cases, medication, such as antidepressants, anti-anxiety medication or mood-stabilizing medication, may be helpful in treating some symptoms.

More severe or long-lasting symptoms may require a team approach involving a primary care doctor, a psychiatrist, a psychologist, a social worker and family members.

In addition to actively participating in a treatment plan, some self-care and coping strategies can be helpful for people with personality disorders.

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