Personality disorders (PDs) are disorders that manifest through a way of thinking, feeling, behaving, and relating to others in a different way than would be considered within the range of an average person. This deviation from the norm, or what is socially and culturally accepted as normal, is the central tendency of all personality disorders.
According to the American Psychiatric Association, PDs are described as “a pervasive pattern of thought, feeling, and behavior that characterize an individual’s unique lifestyle and mode of adaptation, which deviates markedly from the expectations of the individual’s culture.”
It is not to say that there is a particular type of personality that is “normal”, so the vast individual differences are recognized and accounted for when assessing for PDs, as well as different socio-cultural background, experiences, and economic factors.
An important distinction here is made between normal individual thought and behavior variability, when these thoughts, feelings, relation to others are so severe, that it affects the functioning of an individual and impairs the everyday life.
This means that exhibiting or observing an odd behavior or feelings alone is not enough for a clinical diagnosis, unless it can be attributed to psychological distress or negative effects on everyday functioning, life.
Personality disorder causes
Unfortunately, there is no single known cause for developing a PD. This partly stems from a broad variety of personality disorders as well as individual circumstances, i.e., life experiences, genetics, and development.
Currently, the research on PDs, also called pathological personalities, is primarily focused on four different perspectives, that allow for in-depth assessment and understanding of characteristics of pathological personality:
- Clinical symptomatology (observed or reported symptoms).
- Dysfunctional personality traits (determining traits that introduce limitations on capacity and functionality in cognitive, emotional, and impulse control systems).
- Neurological/neuroscientific (biological systems in the brain characteristic to pathological personality, using neuroimaging).
- Genetics (whole-genome association studies, genetic contribution to pathological personality).
Research from these suggests that genetics do increase the likelihood of developing a personality disorder, therefore the dedicated physician would be interested in family history. In addition, childhood trauma, especially abuse or neglect has been shown to increase the risk of developing a PD later in life.
Academic literature indicates both functional and structural brain differences between individuals that exhibit pathological personalities and healthy individuals. It is highly unlikely to be diagnosed with a PD before 18 years of age, given that the personality is considered to be yet developing.
Types, categories, and severity of personality disorders
Personality disorders, based on the nature of feelings, behaviors and thoughts are divided into 10 distinct personality disorders. Each of the distinct PDs are then assigned to one of three clusters:
- Cluster A contains odd and eccentric personalities, which includes:
- Cluster B includes dramatic, impulsive, emotional personalities, which includes:
- Cluster C of fearful and anxious personalities, which includes:
All of the PDs are serious conditions, and can’t be self-diagnosed, it is more common than not for an individual not to be aware of his or her own thoughts and behaviors as being problematic.
It is therefore required to see a healthcare professional, who would assess the long-term patterns, functioning, and symptoms. The dedicated clinician, in addition to assessing the particular PD or cluster will determine the severity of the disorder.
All PDs, based on the extent of symptoms, effects on functioning and ability to maintain healthy interpersonal relationships will be classified as mild, moderate, or severe.
Unfortunately, the PDs do not “go away” and in essence can get much more severe if they are left untreated. It is suggested that PDs that fall under the cluster A of odd and eccentric personalities tend to be the most severe and disruptive to an individual's life.
Help and treatment
Given that usually people suffering from PD are not aware of how harmful, and extreme their thoughts, beliefs, and behaviors are, it is common for close others or family members to express concern before the clinical diagnosis. People with PD will have difficulty maintaining and initiating interpersonal relationships.
In addition, they are likely to exhibit some of the following behaviors:
- Frequent and extreme mood swings.
- An unhealthy level of dependability on other people.
- Extreme vanity (narcissism).
- Social isolation.
- Frequent emotional outbursts (anger).
- Unreasonable suspicion of others.
- Delusional mistrust towards others (both individuals, groups of people, even institutions e.g. university, government).
- Poor impulse control.
- Need for gratification (either instant pleasures or gratification, reassurance from others).
- Substance abuse (is a frequent means of “self-medication”).
If you believe that you meet some or one of the above-described behaviors, the first step is seeking out help and support. You should contact your dedicated general practitioner and explain the concerns you have. Alternatively, talk to a close friend or family member, who might help and support you in contacting health services.
If you believe that a close one is suffering from a PD, try talking to them calmly and encourage seeking out help. It could be useful to think about the possible triggers that precede negative emotions or outbursts. Do not try to “fix” them or “correct” them if you find yourself in an argumentative situation, rather listen and appreciate their feelings, which can help to build trust and closer relationships. However, at all times, it should be encouraged to seek professional help.
Treatment for PDs usually starts with therapy and counseling. Even though there are no specialized medications for PDs, antidepressants, antipsychotics, and anti-anxiety medications are often prescribed to treat the severe symptoms of PDs. Family and friend support has been shown to play an important role in managing the PD and remaining in therapy, which can help to live a fully functional life.