When you see people behave strangely, you begin to wonder why they behave like that. This is because they have a personality disorder. Not everyone who behaves oddly has a personality disorder.
Recently, there has been a surge in people self-diagnosing themselves with various personality disorders. They do not know whether have it or not, or which category they fit into in personality disorders.
This article is aimed at helping you understand what personality disorders are, the types of personality disorders, and how to identify them in people.
What are Personality Disorders?
Your personality is a sum of everything that makes you, you. It includes everything about the way you think, act, and feel.
A personality disorder is when the way you feel, think, and act causes intense distress, which deviates strongly from societal expectations, or makes it difficult for you to function effectively. Personality disorders can also be described as conditions in which individuals differ significantly from an average person in terms of how they perceive, think, feel, or relate to people.
Personality disorders are more than just having a bad day once in a while. It involves changes in a behavioural pattern that occurs over a long period of time. It involves changes in how a person feels about themselves and other people, which may lead to negative behaviour that can be distressing and upsetting.
Causes of Personality Disorders
The causes of personality disorders are yet to be fully understood. But certain factors can make it more likely for someone to develop one. They include:
- Some sorts of abuse or neglect during childhood.
- A family history of mental illnesses or personality disorders.
- Unstable or chaotic family life during childhood
- Being diagnosed with a childhood conduct disorder
- Loss of parents through death, traumatic divorce of parents during childhood
Types of Personality Disorders
According to the Diagnostic and Statistical manual of mental disorders (DSM-5), a reference publication for psychological and physical disorders, they recognize ten types of personality disorders divided into three main clusters. Each cluster has certain symptoms in common.
Cluster A personality disorders
Cluster A personality disorders have unusual and eccentric behaviour. These includes:
- Paranoid personality disorder: The main symptom of this type of personality disorder is paranoia, which includes a great mistrust and suspicion of others without adequate reason for suspicion. They often believe others are trying to demean, threaten or harm them.
- Schizoid personality disorder: This condition is marked by consistent dissociation and general disinterest in interpersonal relationships. People with this type of personality disorder have a limited range of emotions and difficulty communicating with others.
- Schizotypal personality disorder: People with this condition exhibit a consistent pattern of intense discomfort and very few interpersonal relationships. Superstitions, distorted views of reality and unusual behaviours may hinder relationships with others.
Cluster B personality disorders
Cluster B personality disorders involve people who exhibit dramatic and erratic behaviours. People with this condition display unstable, intense, and impulsive behaviours. Cluster B personality disorders include:
- Antisocial personality disorder (ASPD): They are unable to respect others and do not follow laid down norms or rules. They break laws and may cause emotional or physical harm to people around them.
- Borderline personality disorder (BPD): This condition is marked by difficulty with emotional regulation, resulting in low self-esteem, mood swings, and impulsive behaviours leading to problems in relationships.
- Histrionic personality disorder: This disorder is marked by an unstable, intense, and distorted self-image. Self-esteem depends on the approval of others and does not come from a true feeling of self-worth for people with this type of disorder. They have a great desire to be noticed by their peers, which doesn’t come from a true sense of self-worth.
- Narcissistic personality disorder: This condition is marked by a consistent pattern of perceived superiority and grandiosity. There is an excessive need for praise and admiration and a complete lack of empathy for others. Their behaviour and attitude often stem from low self-esteem and lack of self-confidence.
Cluster C personality disorders
Cluster C personality disorders involve severe fear and anxiety. They include:
- Avoidant personality disorder: People with this condition have a severe feeling of being inadequate and are very sensitive to being negatively judged by others. People with this personality disorder tend to avoid social interaction due to the intense fear of rejection.
- Dependent personality disorder: This condition involves a constant and intense need to be cared for by someone else. They are often very submissive, in need of constant reassurance and unable to make decisions. They tend to display passive, clinging behaviour and fear separation.
- Obsessive-compulsive personality disorder (OCPD): This condition is marked by a consistent and extreme need for perfectionism, orderliness, and control. This obsession leaves no room for flexibility. People with OCPD are slow in completing tasks which also interferes with their relationships with others.
OCPD is different from obsessive-compulsive disorder (OCD), which is not a personality disorder but an anxiety disorder. People with OCD usually have self-awareness and accept they need to change, while people with OCPD have little or no self-awareness of their behaviours.
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Who Do Personality Disorders Affect?
Personality disorders can affect anyone. But the various types of personality disorders affect people differently.
Many personality disorders begin in the late teen years when the personality develops and matures. As a result, almost everyone diagnosed with personality disorders is above the age of 18. An exception is an anti-social personality disorder, with approximately 80% of people affected by this disorder starting to show symptoms by age 11.
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How to Identify Someone With a Personality Disorder?
Personality disorders are not easy to diagnose unless via professional and medical personnel. Understanding the difference between personality types and personality disorders is important. A person may be shy or want to spend time alone, but this doesn’t necessarily mean the individual has a schizoid personality disorder.
The difference between personality style and a personality disorder can be determined by evaluating how one’s personality affects the various parts of their life, including:
- Awareness of reality
- Behaviour and impulse control
So, how do you identify personality disorders in people?
- They are often overwhelmed by negative feelings such as anxiety, distress, anger and worthlessness.
- They avoid other people and feel empty and emotionally disconnected.
- They present with odd behaviours.
- They avoid other people and feel emotionally disconnected and empty.
- They have difficulty handling negative feelings and often descend into self-harm, such as abuse of drugs, alcohol or overdosing and, in rare cases threatening other people.
- Sometimes they experience periods of loss of contact with reality.
- They have difficulty maintaining close and stable relationships with others, especially with partners, children, and professional careers.
- A need for instant gratification.
- Poor control of impulse.
- Lack of self-confidence.
- Excessive dependence on others.
- Constantly seeking attention
- Some fantasize about power, attractiveness, and success.
- Disregard for others’ feelings.
- Consistently irresponsible towards children or work.
- They have an excessive concern about their physical appearance.
- Inconsistent behaviour, which is often frustrating and confusing to people around them
- They are unaware of how their behaviour causes problems with themselves and/or others.
- They have difficulties understanding realistic and acceptable ways to treat others
It is important not to become alarmed if you see some of these personality traits in yourself. Everyone has different personality quirks, with most personality disorders not diagnosed until 18 years of age.
This is because our personality is constantly developed up too late adolescence. The only difference for people with personality disorders is that their behaviour is extreme, and they find it difficult to adapt to or change it.
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How are Personality Disorders Diagnosed?
Personality disorders are difficult to diagnose since they may be very similar to personality styles. Healthcare providers base the diagnosis of specific personality disorders on certain criteria provided in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.
Mental health professionals such as psychologists or psychiatrists are trained to diagnose personality disorders by asking broad, general questions which won’t create a defensive response or hostile environment. They as questions along the lines of:
- Past history
- Reality testing
- Previous work history
- Impulse control
Personality disorders are generally underdiagnosed because sometimes healthcare professionals focus on the symptoms of anxiety or depression, which occur more commonly than personality disorders.
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How are Personality Disorders Treated?
Personality disorders are most times challenging to treat. This is because people with personality disorders do not feel their behaviour is problematic, so they do not seek treatment.
Most times, when persons with personality disorders seek treatment, modern medicine still lack treatment options as there are no approved drugs to treat personality disorders. But various medications help with dealing with the symptoms of anxiety and depression, which are more common than a personality disorders.
Psychotherapy can be used to manage personality disorders. It involves various treatment techniques to help you identify and change troubling emotions, thoughts and behaviours.
Using psychotherapy for treating personality disorders is aimed at achieving the following goals:
- It helps reduce immediate distress, such as depression and anxiety.
- It decreases unhealthy and socially undesirable behaviour.
- Modifying the personality traits that are causing difficulties.
- It enables the person to understand the problems are internal and not caused by others.
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It is important to remember that personality disorders are mental health conditions. As with all mental health conditions, seeking help as soon as symptoms appear can help decrease the disruption to your life.
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- David Chiedozie Ndeokwelu is a graduate of Microbiology, who holds a Masters degree in public health. He is currently a medical student at the University of Ilorin and is passionate about fields of career, public health, entrepreneurship and career building.