Personality Disorders refer to a group of mental illnesses that are grouped under an umbrella term. These involve a long-term pattern of thoughts that are unhealthy and inflexible. These behaviors tend to cause serious problems in an individual’s personal, social, and work life. People with personality disorders usually have problems dealing with day-to-day occurrences and stressors. Though the exact cause of the disorders is not known, personality disorders have been linked to genetics and childhood experiences. 

Symptoms of Personality Disorders

• Cluster A: Cluster A personality disorders are characterized by odd and eccentric thinking in social situations and interpersonal relationships.
• Cluster B: Cluster B Personality Disorders are characterized by symptoms of being overly emotional, erratic, and dramatic. This may cause issues in the way they maintain relationships.
• Cluster C: Cluster C personality disorders are marked by feelings of anxiousness and avoidance.

Causes of Personality Disorders

Research into the causes of personality disorders has not come to a conclusive decision. However, certain risk factors can indicate the occurrence of these disorders in individuals. The major factors linked to personality disorders include genetics, childhood trauma, intense verbal abuse, and interactions with peers.

Genetics

Research has slowly begun identifying the genetic factors behind the development of personality disorders. This includes the identification of a malfunctioning gene that is linked with the occurrence of OCPD (Obsessive Compulsive Personality Disorder). Genes related to anxiety, aggression, and fear also play a part in the occurrence of personality disorders.

Childhood Trauma

Findings from studies related to personality disorders have found links between childhood experiences and the incidence of personality disorders in people. Studies have also shown that the type and number of traumas faced by a child can indicate the occurrence of personality disorders within them. BPD has shown high relation with the occurrence of childhood sexual trauma.

Types of Personality Disorders - Symptoms

There are 10 types of personality disorders. They are characterized by different signs and symptoms. However, they share a common effect - they cause significant distress in the normal functioning of a person in their daily lives. Personality Disorders can widely be divided into 3 groups based on general symptoms:

Cluster A:

Cluster A personality disorders are characterized by odd and eccentric thinking in social situations and interpersonal relationships. The types of personality disorders under Cluster A include:

‍Paranoid Personality Disorder

This is a disorder characterized as an eccentric personality disorder. This indicates that their behavior will appear odd and unusual to others in society. An individual with the disorder is usually (as the name indicates) paranoid and very suspicious of other people. They mistrust easily and are always concerned that others are out to harm them. Some other signs of this disorder include an inability to confide with others, holding on to grudges for a long time, being callous in their interactions, and finding threatening implications in even the most innocent of interactions. They are also quick to anger and hostility. 

Treating PPD includes establishing trust with the patient, which is tough since the person has an intense mistrust of others. This is why treating PPD is challenging.‍

‍Schizoid Personality Disorder  

Individuals with schizoid personality disorder are usually socially withdrawn where they shy away from or completely avoid interacting with others. They may not be emotionally expressive and to other people, it may seem that they do not care for people or what happens around them. Some other symptoms of schizoid personality disorder include a lack of motivation, difficulty expressing emotions appropriately, disinterest in activities, and a preference for being alone. 

Schizoid Personality Disorder can be treated with the help of psychotherapies to change thought patterns and group therapy to find a platform to practice socializing with others. 

Schizotypal Personality Disorder 

Schizotypal Personality Disorder is marked by odd behaviors including strange beliefs, odd speech, problems in interpersonal relationships, paranoia, etc. Individuals with STPD may find it difficult to react appropriately in situations and face discomfort in social settings. They may experience ideas of reference, which is the misinterpretations of events that take place around them. 

Cognitive Behavioral Therapies can help to reframe patterns of thinking and behaving, while medication can also be used to treat symptoms. 

Cluster B:

Cluster B Personality Disorders are characterized by symptoms of being overly emotional, erratic, and dramatic. This may cause issues in the way they maintain relationships. The personality disorders under Cluster B include:

Antisocial Personality Disorder

Antisocial Personality Disorder, sometimes referred to as Sociopathy, is a disorder where the person consistently shows very little to no regard for the feelings of others and has no sense of right or wrong. They tend towards antagonizing people, manipulating people, treat people harshly or callously. More importantly, they show no guilt or remorse for their behaviors.

Other signs of the disorder include frequent violations of the law, a tendency to lie, violent behavior, impulsiveness, and problems with substance abuse. These symptoms indicate that people with Antisocial Personality Disorder have problems in their family, work, and educational lives.

Narcissistic Personality Disorder

Named after the legendary Greek hunter Narcissus, who fell in love with his reflection so much so that he refused all other romantic advances, this disorder is characterized by the individual’s need for constant admiration and a significant lack of empathy for the people around them. A person with a narcissistic personality disorder may have an inflated sense of self-importance, a sense of entitlement, and exploitative tendencies.  

Borderline Personality Disorder

Borderline Personality Disorder (BPD) impacts the way a person feels and understands themselves and the people around them. The disorientation is strong enough to cause significant problems in day-to-day functioning.

Some signs of BPD are self-image issues, difficulty in managing emotions, and a tendency to have unstable relationships. Further, people with BPD have an intense fear of abandonment, fear of being alone, sudden anger, impulsiveness, frequent mood swings, and a tendency towards reckless behavior. 

The signs of Borderline Personality Disorder become evident by early adolescence and progress from there. BPD is treatable and with appropriate help, people with BPD can live fulfilling and happy lives. 

Histrionic Personality Disorder

Individuals with histrionic personality disorder are usually attention-seeking and manipulative. They rely highly on the attention and validation they get from others and have no sense of self-worth derived from themselves. They may even feel uncomfortable if they are not the center of attention. Some common signs of a person having a histrionic personality are that they may act overly dramatic, be provocative, and have difficulty maintaining relationships. 

Fortunately, individuals with histrionic personality disorder can manage their symptoms with the help of psychotherapies that help them reshape their irrational beliefs into more positive ones. 

Cluster B:

Cluster C personality disorders are marked by feelings of anxiousness and avoidance. The personality disorders under Cluster C include:

Obsessive Compulsive Personality Disorder

Obsessive-Compulsive Personality Disorder (OCPD) is characterized by extreme perfectionism and neatness. Individuals with the disorder also have an extreme need to impose their own sense of neatness and preferences on the outside environment as well.

OCPD is characterized by various signs and symptoms. They find it difficult to express their emotions, form close relationships and maintain close relationships. People with OCPD work hard, but their tendency to want perfectionism in everything can make them inefficient. They often tend to exhibit righteousness and anger; this means they often face social isolation. They also face anxiety and depression.

It is important to note that OCPD is sometimes misidentified as OCD or anxiety disorder. 

Avoidant Personality Disorder 

Individuals with avoidant personality disorder are usually anxious in social situations and are sensitive to rejection. They may even avoid situations out of fear of being rejected. AVPD is also characterized by a lack of interest in everyday activities, difficulty maintaining relationships, a need for approval from others, and self-consciousness. 

Effective treatment can help individuals with AVPD find healthy coping mechanisms to deal with their anxieties and adopt more healthy behaviors. 

Dependent Personality Disorder 

Individuals with Dependent Personality Disorder feel overly dependent on others for their emotional and physical needs. This also impairs their decision-making skills, since they believe that they need help from others to reach a decision. They also need constant reassurance.

Psychotherapy can help in teaching people with ASPD ways to cope with their distress. Medication can also help to manage symptoms of the personality disorder.

Diagnosis of Personality Disorders

To reach a diagnosis of a personality disorder, several physical and psychological assessments are conducted by a mental health professional to get a better understanding of the individual’s symptoms. These assessments include:

Physical Examination: Your clinician might first conduct physical exams via blood tests and screenings for substance use. This helps to eliminate physical disorders as the cause of the symptoms.

Psychiatric Assessments: With the help of psychological assessments, a mental health professional might identify maladaptive thought patterns that are causing distress to the individual. The medical history of the individual is also used to understand if there may be a genetic basis for the disorder. These assessments further help understand stressful factors in the person’s environment, behaviour and mood patterns, cognitive and verbal abilities etc.

For personality disorders, the following behaviours and thought patterns are looked out for:

1. The way an individual perceives themselves and the people around them.
2. Interactions with others
3. Whether emotions are expressed appropriately or not
4. Impulsive behaviors, and impulse control 

The psychiatrist or psychologist then compares the symptoms of the individual to the diagnostic criteria as given in the DSM 5 or ICD 10. If the symptoms match, then the individual can be diagnosed with a personality disorder.

Treatment of Personality Disorders

The treatment plan for each personality disorder differs since every individual shows different symptoms. Some psychotherapies are also used specifically for certain personality disorders. Some of the common methods used for treatment are:

Psychotherapy:

• Individual Counselling
• Group Therapy - Group therapy provides a safe platform for individuals to express their feelings and difficulties they face during the duration of their disorder with individuals who are experiencing similar symptoms to theirs. This creates an environment of acceptance and open dialogue. 
• Cognitive Behavioural Therapy - CBT is a popular treatment method that helps individuals reframe their negative thinking patterns into more positive or healthy ones. This is especially helpful for personality disorders where much of the focus is on thought patterns and behaviors. 
• Dialectical Behavioural Therapy - DBT is a type of cognitive behavioral therapy that was made specifically to treat difficult-to-manage disorders. This therapy focuses on both acceptance and change and makes use of individual as well as group counseling. DBT is most often used with Borderline Personality Disorder in which the individual may experience intense emotional distress that may even cause suicidal behaviors. 
• Family Therapy - A large part of the road to recovery depends on the social support an individual gets from their loved ones and family members. Family therapy can help to recognize and find solutions to conflicts within the family system. It also helps family members to understand more about the condition their loved one is suffering from and support them appropriately. 
• Psychoeducation - Psychoeducation is a crucial part of personality disorder treatment. It helps to teach the individual to be more aware of their condition and create insight into their own symptoms. 

Medication:

While there are no specific medications to treat personality disorders, the following is typically used to treat individual symptoms that occur as a result of the disorder:

• Antidepressants - Can be used to manage depressive moods or feelings of hopelessness and anger. 
• Anti-anxiety Medication - Help to manage anxiety, agitation, or even insomnia. 
• Mood Stabilizers - Help to manage mood swings or irritability and irritation that some individuals may experience. 
• Antipsychotic Medication - These are specifically used if the individual starts losing touch with reality in the course of their condition.

These medications should only be taken after consulting a psychiatrist. In case you feel you are experiencing any side effects from the medicine, it is possible to change the dosage based on your psychiatrist’s suggestion. 

Cadabams has a team of multispecialty professionals who work together to provide you with personalized treatment plans made especially for you.