Personality Disorders Treatment
Types of Behaviors
Diagnosis and Evaluation
Treatment for Personality Disorders
Personality disorders are defined by dysfunctional thought patterns and behaviors that cause patients to have difficulty interacting with others or functioning in the world. Handling the stress that comes with everyday responsibilities is usually too much for patients to bear, and maintaining a contented and functional relationship is near impossible. Negative and inflexible, patients diagnosed with a personality disorder exhibit behaviors that fall outside the “normal” range – not just for a day or a week but for years.
Who is most likely to suffer from a personality disorder? There are no boundaries. Men and women, young and old, all races and economic classes – depending upon the specific disorder, some are more likely than others to develop the issue but across the board, no one group is more likely to develop a personality disorder. Though signs and symptoms can become apparent during the teenage and young adult years, some patients may escape diagnosis until they are older. In fact, the American Geriatric Society says that up to 10 percent of older adults have a personality disorder and that number is even higher among older adults living in nursing homes.
Far from the average struggle that comes with staying on top of things at work, paying bills on time and raising a family, patients living with a personality disorder have traits that are classified as disabling; they are unable to make changes or stop these traits on their own. Though each disorder comes with its own set of symptoms, risk factors and treatments, they all have one thing in common – every personality disorder is treatable with medication and psychotherapy at a mental health treatment center equipped to provide comprehensive and effective care.
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Types of Behaviors
Depending upon the types of behaviors exhibited by patients, a specific type of personality disorder may be the diagnosis. Some of the most common types include:
- Antisocial. Though they understand the difference between right and wrong, antisocial personalities completely disregard the moral construct when making decisions. With no respect for law or basic tenets of the social contract, many with antisocial personality disorder often end up in jail. Unable to carry out rudimentary tasks like maintaining a legitimate job or caring for a family, many have issues with drug and alcohol addiction as well. They appear to have no remorse when their actions hurt others. A sociopath has the most severe form of antisocial disorder.
- Avoidant. According to the National Institute of Mental Health (NIMH), about 5.2 percent of the population is diagnosed with avoidant personality disorder. These patients are usually overly shy with strangers and take loss or rejection very hard. They are often obsessive about their own perceived failings and only get close to those who they believe will accept them without judgment. Many end up isolated with few relationships, preferring loneliness to rejection.
- Borderline. Those with borderline personality disorder (BPD) have a skewed self-image, which causes them to believe that they are worthless. They often have violent or angry outbursts that push others away even when they truly want to have a positive relationship. Their unstable emotions, outbursts and mood swings cause patients to have problems in every aspect of their lives, which in turn often causes a high degree of stress. BPD is more often diagnosed in women than in men.
- Dependent. Dependent personalities are characterized by relying almost totally on those around them to make even the simplest decisions. Dependent personality disorder is an anxious personality disorder defined by fear and nervousness, which makes patients clingy, helpless and consistently in search of reassurance. It is diagnosed equally in men and women. Symptoms may appear in early to middle adulthood.
- Depressive. Depressive personalities are often pessimistic, seeing only the negative side of a situation or focusing on the one thing that is out of place or imperfect. Patients with this disorder have no hope that things will get better in the future and often blame themselves for the imperfections and inability to better the situation. Depression is common among depressive personalities, especially later in life.
- Histrionic. Histrionic personality disorder is a dramatic personality disorder and characterized by the need to be the center of attention at all times. Overly emotional, uninhibited and disorganized, histrionic personalities will behave inappropriately in order to get attention – attention that they overwhelmingly desire in order to feel good about themselves. More often diagnosed in women than men, it is usually evident by early adulthood.
- Narcissistic. Narcissistic personalities believe that they are entitled to whatever they want. They are often arrogant and believe themselves to be smarter and more important than others. They show little feeling toward others and often appear to be hostile, depressed or paranoid. When criticized, they may lash out; their self-esteem is often delicate and they very easily take offense even when it is not intended.
- Obsessive-compulsive. Obsessive-compulsive disorder is an anxiety disorder that is based on a pattern of obsessive worrying that leads to repetitive compulsive actions. Both the thoughts and actions are highly stressful for patients, but they are unable to stop them or to find relief through the compulsive actions. Whatever the obsession (e.g., fear of germs, symmetry, fear of attack, perfectionism, etc.), the compulsive action usually causes more distress, does little to mitigate the fear, and causes the patient great stress because he or she recognizes that both the worries and the repetitive actions are dysfunctional.
- Paranoid. Paranoid personality disorder is characterized by suspicion of others as well as irritability and hostility. Paranoid personalities are often delusional, mistrusting others without provocation. More men than women are diagnosed with the disorder and signs often become apparent in early adulthood.
- Passive-aggressive. Passive-aggressive personalities often procrastinate on taking action and avoid putting themselves in the spotlight but heavily criticize those who take risks and are active, resenting them for their progress and reveling in their failures.
- Schizoid. Schizoid personalities usually go out of their way to avoid social relationships of any kind and are awkward in even the most basic interactions. They may appear emotionless and standoffish to others even though they are often overly sensitive and lonely.
- Schizotypal. Schizotypal personality disorder patients often believe things that are unusual and exhibit behaviors that are perceived as eccentric and inappropriate. Interpersonal relationships are often problematic and cause severe anxiety in the patient, which in turn causes them to isolate and avoid social situations.
According to the American Geriatric Society, personality disorders are divided into clusters to aid in the diagnostic and evaluation process prior to treatment. These clusters are defined as:
- Cluster A. Paranoid, schizotypal and schizoid personalities are classified as having a Cluster A disorder, also called eccentric personality disorders. Patients diagnosed with these disorders are often described as eccentric by others.
- Cluster B. Narcissistic, borderline, antisocial and histrionic personalities are all defined as having Cluster B disorders. To others, those with a Cluster B disorder are perceived as very erratic in their behavior, overly emotional and melodramatic.
- Cluster C. Avoidant, obsessive-compulsive and dependent personality disorders are included in the Cluster C classification. Patients in this category are overly anxious and scared of real and imagined harm.
For each personality disorder, there are a number of suspected causes, but no one knows exactly what causes any specific disorder. According to the National Institutes of Health (NIH), some of the possible causes of different personality disorders include:
- Genetics. With some disorders, a family history can be indicated and a specific disorder is often diagnosed repeatedly within the family bloodline.
- Early childhood experiences. Witnessing violence, abuse or trauma; being victim to violence, abuse or trauma; and problems at home or in the immediate environment are often cited in the history of patients seeking treatment for personality disorders.
- Poor parenting choices. When parents are neglectful, hurtful or abandon their children, it can be one of the contributing factors for a personality disorder.
- Trauma. When disorders become evident later in life, it can be triggered by a specific or overwhelming trauma, such as the loss of a loved one, medical illness or other issue. Without the coping skills to successfully handle the problem, some patients may develop a personality disorder, especially if they already have a tendency toward strong or eccentric personality traits.
Note: There is no guarantee that a personality disorder will develop simply because some of these traits exist in a person’s life. In some cases, none of the above causes are evident. In other cases, all may be present but a personality disorder does not result.
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In general, personality is created by a combination of both an inherited nature and environmental experiences and exposure. Possible risk factors that may contribute to the development of a personality disorder in combination include:
- Instability at home during childhood
- Sexual, verbal or physical abuse
- Hereditary predisposition for a specific disorder
- Neglect and abandonment during childhood
- Conduct disorder during childhood or teen years
- Loss of parent through divorce or death
Like the potential causes of personality disorders, risk factors do not indicate that a personality issue will definitely be a problem. Also, specific disorders have their own unique combination of possible risk factors. For example, those who are raised with an overindulgent parent may be more likely to develop a narcissistic personality disorder.
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Diagnosis and Evaluation
For many personality disorders, it can be extremely difficult to get an early and accurate diagnosis. In some cases, patients may not believe that their issues are problematic or require treatment. For example, many patients with borderline personality disorder will be uninterested in receiving real treatment due in part to the fact that one characteristic of their illness is to believe that anyone who contradicts their views is either inferior, wrong or attacking them. According to a study published in British Journal of Psychiatry Supplement, only a psychiatrist trained in the evaluation of those with personality disorders is qualified to diagnose these mental health issues. A detailed medical history, as well as a life history that explores different experiences, traumas and difficulties, is necessary for an informed diagnosis. In some cases, the patient may be unable to be completely truthful or forthcoming; the psychiatrist may need to enlist the help of family members and caregivers. Even then, it can be difficult if memories fail or anyone distorts past events by “cleaning up” motivations or actions for the medical professional. A long observation period may be necessary.
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Treatment for Personality Disorders
Personality disorder treatment can often be as difficult as diagnosing the problem. It can take a great deal of time to allow therapies and medications to do their work, to make adjustments to both aspects of the treatment program, and then to assess the outcome. If there is a co-occurring disorder like depression, addiction or another issue, this can further complicate the matter and require additional treatment.
The long-term goal of decreased symptoms and an ability to function well in the community, at work and at home is most often achieved through short-term goals. Personality disorder treatment plans should be personalized according to the experience of the patient and the specific disorder, making use of medications and therapy that are modified and upgraded as necessary.
For each personality disorder, different therapies and pharmacological solutions have been proven effective. For example, disorders that have a component of negativism or depression may be treated with antidepressants while disorders that are classified as anxiety disorders may be treated with benzodiazepines or anti-anxiety medications.
Different types of therapies, too, can be mixed and matched to aid patients in their recovery so they can learn the coping mechanisms necessary to function in day-to-day life. Personal therapy is an absolute necessity and required to maintain consistent monitoring of the patient. Cognitive Behavioral Therapy (CBT), family therapy, group therapy sessions, experiential therapies, exposure therapy and holistic treatments may also prove beneficial depending upon the specific symptoms experienced.
If you would like to learn more about the types of personality disorder treatment programs that are available to you and which would most benefit you or your loved one, contact us today for more information. We can help you locate the best mental health treatment program for your needs, no matter which personality disorder is the issue. Call now.