Personality Disorders

Personality Disorder 

"Today is the day I have dreamed of since I was diagnosed with borderline personality disorder seven years ago. The day when I can finally say I’ve beaten my demons and come through as a better and stronger person

I never dared to imagine that one day I would be free of the thoughts that have haunted my nights and invaded my waking thoughts everyday of my life since I was five years old. The crushing fear of abandonment and emptiness that has caused me to kill off everything that was ever precious to me.

My illness has caused me so much heartache and has stolen over twenty years of my life.." Katie- a patient treated for borderline personality disorder as an inpatient. To read her entire story, please click here.

Personality refers to the collection of characteristics or traits that we develop as we grow up and which make each of us an individual, with regard to our thoughts, feelings and actions. One is said to have a personality disorder when the way they feel, think and behave, hinder them from adapting well to their environment such that, they cannot live well by themselves, and in relation to others. Personality disorders are conditions in which an individual differs significantly from an average person, in terms of how they think, perceive, feel or relate to others.

Types of Personality Disorders and their Signs/ Symptoms

The following are the basic types of personality disorders and their signs/ symptoms:

 

1. Paranoid personality disorder

You are likely to:
• find it very difficult to trust other people, believing they will use you, or take advantage of you
• find it hard to confide in people, even your friends
• watch others closely, looking for signs of betrayal or hostility
• suspect that your partner is being unfaithful, with no evidence
• read threats and danger – which others don’t see – into everyday situations.

2. Schizoid personality disorder

You are likely to:
• be uninterested in forming close relationships with other people including your family
• feel that relationships interfere with your freedom and tend to cause problems
• prefer to be alone with your own thoughts
• choose to live your life without interference from others
• get little pleasure from life
• have little interest in sex or intimacy
• be emotionally cold towards others.

3. Schizotypal personality disorder

You are likely to:
• find making close relationships extremely difficult
• think and express yourself in ways that others find ‘odd’, using unusual words or phrases
• behave in ways that others find eccentric
• believe that you can read minds or that you have special powers such as a ‘sixth sense’
• feel anxious and tense with others who do not share these beliefs
• feel very anxious and paranoid in social situations.

4. Antisocial personality disorder (ASPD)

You are likely to:
• act impulsively and recklessly, often without considering the consequences for yourself or for other people
• behave dangerously and sometimes illegally
• behave in ways that are unpleasant for others
• do things – even though they may hurt people – to get what you want, putting your needs above theirs
• feel no sense of guilt if you have mistreated others
• be irritable and aggressive and get into fights easily
• be very easily bored and you may find it difficult to hold down a job for long
• believe that only the strongest survive and that you must do whatever it takes to lead a successful life, because if you don’t grab opportunities, others will
• have a criminal record
• have had a diagnosis of conduct disorder before the age of 15.

5. Borderline personality disorder (BPD)

You are likely to:
• feel that you don’t have a strong sense of who you really are, and others may describe you as very changeable
• suffer from mood swings, switching from one intense emotion to another very quickly, often with angry outbursts
• have brief psychotic episodes, hearing voices or seeing things that others don’t
• do things on impulse, which you later regret
• have episodes of harming yourself, and think about taking your own life
• have a history of stormy or broken relationships
• have a tendency to cling on to very damaging relationships, because you are terrified of being alone.

6. Histrionic personality disorder

You are likely to:
• feel very uncomfortable if you are not the centre of attention
• feel much more at ease as the ‘life and soul of the party’
• feel that you have to entertain people
• flirt or behave provocatively to ensure that you remain the centre of attention
• get a reputation for being dramatic and overemotional
• feel dependent on the approval of others
• be easily influenced by others.

7. Narcissistic personality disorder

You are likely to:
• believe that there are special reasons that make you different, better or more deserving than others
• have fragile self-esteem, so that you rely on others to recognise your worth and your needs
• feel upset if others ignore you and don’t give you what you feel you deserve
• resent other people’s successes
• put your own needs above other people’s, and demand they do too
• be seen as selfish and ‘above yourself’
• take advantage of other people.

8. Avoidant (or anxious) personality disorder

You are likely to:
• avoid work or social activities that mean you must be with others
• expect disapproval and criticism and be very sensitive to it
• worry constantly about being ‘found out’ and rejected
• worry about being ridiculed or shamed by others
• avoid relationships, friendships and intimacy because you fear rejection
• feel lonely and isolated, and inferior to others
• be reluctant to try new activities in case you embarrass yourself.

9. Dependent personality disorder

You are likely to:
• feel needy, weak and unable to make decisions or function properly without help or support
• allow others to assume responsibility for many areas of your life
• agree to things you feel are wrong or you dislike to avoid being alone or losing someone's support
• be afraid of being left to fend for yourself
• have low self-confidence
• see other people as being much more capable than you are
• be seen by others as much too submissive and passive.

10. Obsessive-compulsive personality disorder (OCPD)

You are likely to:
• need to keep everything in order and under control
• set unrealistically high standards for yourself and others
• think yours is the best way of making things happen
• worry when you or others might make mistakes
• expect catastrophes if things aren’t perfect
• be reluctant to spend money on yourself or others
• have a tendency to hang on to items with no obvious value.
OCPD is separate from obsessive compulsive disorder (OCD), which describes a form of behaviour rather than a type of personality.

Causes of Personality Disorder

Research suggests that a combination of the following factors may lead to the development of personality disorder:

Family circumstances

Individuals who had difficult childhood are more prone to develop personality disorders. These difficulties include: changes in the family such that children have several different parent figures, with different demands and expectations, or spending time in foster care. Many people who experience physical, sexual or emotional neglect or abuse are more vulnerable to develop some personality disorders like borderline personality disorder
Antisocial personality disorder (ASPD) has been linked to antisocial behaviour in childhood, which could be the result of high levels of stress and family problems. These might include parents not giving children enough warmth, intimacy, consistency or appropriate discipline and supervision. Children whose parents have ASPD or abusing drugs or alcohol may also be factors.

Trauma

Repeated childhood traumas (unrelated to abuse), such as being involved in major incidents or accidents, or sudden bereavement, may lead to personality disorder. It’s been suggested that early and severe trauma, in particular, can cause personality difficulties.

Genetics and inheritance

Some elements of our personality are inherited. People are born with different temperaments; for example, babies vary in how sociable they are, in the intensity of their reactions, and in the length of their attention span. Some experts believe that inheritance may play a relatively big part in the development of OCPD (obsessive compulsive) and ASPD (antisocial).

Triggers to a Personality Disorder

• using a lot of drugs or alcohol
• problems getting on with your family or partner
• money problems
  
• anxiety, depression or other mental health problems
• important events
• stressful situations
• loss, such as death of a loved one

Living with personality disorder

People with a personality disorder, just like anyone who has mental health difficulties, can be stigmatised because of their diagnosis. They can attract fear, anger and disapproval rather than compassion, support and understanding. This is both unfair and unhelpful. Personality disorder is a real problem that demands real help. We can all help by being friendly, supportive and understanding, rather than being judgemental.

How to help yourself if you have a personality disorder

• Try to unwind when stressed - have a hot bath or go for a walk.
• Make sure you get a good night’s sleep.
• Look after your physical health and what you eat. You'll feel better on a balanced diet, with lots of fruit and vegetables.
• Avoid drinking too much alcohol or using street drugs.
• Take some regular exercise. This can be as easy as getting off the bus one stop early, and walking the rest of the way can make a difference.
• Give yourself a treat (although not drugs or alcohol!) when things are difficult or you have coped at a stressful time.
• Take up an interest or hobby. This is a good way to meet others and take your mind off the day-to-day stresses that we all face.
• Talk to someone about how you are feeling.
• Learn more about the disorder. You may do this by asking professionals as many questions about the disorder as you may have and doing your own research over the internet or from relevant books.

What you can do as a friend or relative.

As a relative, friend or companion to someone who suffers from a personality disorder, you very much get to feel the effects of the disorder especially when it takes a toll on your loved one. Many a times you might wonder what you can do to help the situation. Well, here are some ways that you can help a loved one suffering from a personality disorder:
• Emphasize the positive: a diagnosis of personality disorder doesn’t stop someone being likeable, intelligent, highly motivated or creative. Make the most of their strengths and abilities.
• Good information is crucial. If your friend or relative would find it helpful, you could be involved in discussions with mental health professionals, when they are explaining diagnoses and treatment approaches to them. You could act as their advocate and speak up and support them, making sure they get the answers they need from professional services.
• They may need your encouragement to change their behaviour. For instance, alcohol, drugs or staying in an abusive relationship can only add to their problems.
• Try not to stop them from doing things just because you think they may be unhelpful. Unless it’s something dangerous, it may be better to let them experience the consequences of their actions, so that they can learn from them.
• Telling them they are ‘immature’ or ‘inadequate’, or ‘attention-seeking’ or ‘making bad choices’ may sometimes feel justified, but it’s usually more helpful to focus on their good points and things that have gone well for them. Remember that it can be very hard to change, so try not to expect too much too soon.
• If their behaviour is difficult for you, let them know how it makes you feel, and ask them to think about how they would feel if they were treated in a similar way.
• If you treat them as if they are unable to cope, they will not learn how to make their own decisions or do things for themselves.
• Encourage them to reflect on their experiences and learn from them, rather than saying ‘I told you so’.
• Try to help identify situations that bring out the best or worst in them and follow up on this. For example, even if they are uncomfortable being close to people or in company, they may be much more relaxed and lose their inhibitions when they are discussing a subject that really interests them. So encouraging them to joining a particular society, club or class may be a way they can learn to enjoy company.

References

http://www.nhs.uk/Conditions/Personality-disorder/Pages/Definition.aspx   
http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/personalitydisorder.aspx 
http://www.mind.org.uk/information-support/types-of-mental-health-problems/personality-disorders/useful-contacts/#.VYOnP6g3bIU

http://www.mentalhealth.org.uk/get-involved/your-stories/kaylas-story/