It can damage lives and relationships if left undiagnosed and untreated.
Personality disorders are mental health problems in which your attitudes, beliefs and behaviours cause you or others distress, as well as long-standing problems in your life. The word ‘personality’ refers to the pattern of thoughts, feelings and behaviour that makes each of us the individuals that we are. There are many different types and potential causes of personality disorders, and the signs and symptoms are diverse. Someone with a personality disorder experiences thoughts and feelings so intensely, they have trouble coping with daily life. They act in ways they can’t control, struggle to relate to situations and people, experience difficulties in how they think about themselves and others and may find it difficult to change these unwanted patterns.
As a result of these challenges, they often experience significant problems and limitations in their relationships, work and school environments. The symptoms of the illness usually first appear in mid to late teens or in early adulthood, with women three times more likely to be diagnosed with BPD than men.
Although researchers can’t exactly pinpoint the causes of personality disorders, certain factors can make it more likely that someone develops one. The environment people grow up in and the quality of care received can affect the way personality develops. People are more prone to develop personality disorder if they have experienced:
- a family history of personality disorders or other mental illnesses
- abuse or neglect during childhood
- unstable or chaotic family life during childhood
- being diagnosed with childhood conduct disorder
- the loss of parents through death, or a traumatic divorce, during childhood
- other significant traumas.
Not everyone who experiences a traumatic situation will develop these problems. The way people reacted to it, alongside the support and care received to help cope, will have made a lot of difference. Similarly, not everyone who develops a personality disorder will have had a traumatic experience.
Types of personality disorders
Personality disorder can show itself in different ways, and specialists take varying approaches to diagnose and understand personality disorders. Some of the different types of personality disorders are:
- Antisocial personality disorder: a tendency of not caring about others to the point of being aggressive and violent
- Avoidant personality disorder: hypersensitivity to criticism or rejection, therefore experiencing extreme shyness
- Borderline personality disorder: disorder which causes people to act impulsively, take huge risks, experience significant distress, and have an unstable moods
- Narcissistic personality disorder: belief that you’re better than everyone else
- Obsessive-compulsive personality disorder: a tendency of being extremely controlling, preoccupied with perfection, rules and orderliness; unable to throw away old or broken stuff.
- Schizotypal personality disorder: a tendency of not caring about others while having unusual thoughts, such as ‘magical thinking’.
Treatments for personality disorders
There is varied use of cognitive, behavioural and interpersonal methods that address issues associated with personality disorders. While some treatments for certain types of personality disorders have shown to be effective in reducing unhelpful behaviour, there are no generic treatments appropriate for all types of personality disorders.
Psychosocial strategies including education, counselling and support for the person, and his or her family can help with understanding, stress management and compliance with medication.
The types of psychotherapy that have been found to be most effective include:
- Dialectical behaviour therapy (DBT): specifically designed to treat borderline personality disorder. It uses a skills-based approach to teach how to manage emotions, tolerates distress and improves relationships.
- Schema-focused therapy: helps identify unmet needs that have led to negative life patterns. Therapy focuses on helping meet those needs in a healthy manner to promote positive life patterns.
- Mentalization-based therapy (MBT): talk therapy that helps identify thoughts and feelings at any given moment and create an alternate perspective on the situation. MBT promotes thinking before reacting.
- Systems training for emotional predictability and problem-solving (STEPPS): a 20-week treatment that involves working in groups that incorporate family members, caregivers, friends or significant others into treatment.
- Transference-focused psychotherapy (TFP): also known as psychodynamic psychotherapy, it aims to help understand emotions and interpersonal difficulties through the developing relationship between person and therapist.
- Good psychiatric management: focuses on making sense of emotionally difficult moments by considering the interpersonal context for feelings. It may integrate medications, groups, family education and individual therapy.
Personality disorder is a complex diagnosis that not everyone understands well, so you might find that people hold misconceptions about you or have a negative image of personality disorder.