Medical Article

Types of Personality disorders

Personality disorders are a group of mental illness that create unhealthy pattern of thinking, functioning and behaving. A person with a personality disorder cause significant problems with relationships, social activities and work. The affected people will have trouble in dealing with daily stress and problems. They may feel their thinking and behaving are quite natural and blame others for the challenges they face. The cause of this problem is unknown, may be genes, disruptions in attachments between parents and infants, have significant role in it. Usually the disorders begin in the teenage years or early adulthood. 

Category of personality disorders

There are many types of personality disorders. As per the latest version of DSM-5, personality disorders are grouped into three main clusters based on similar characteristics and symptoms. Patient with one personality disorder may show signs and symptoms of at least one additional type of personality disorder.  It is grouped as cluster A, Cluster B, and Cluster C.

Symptoms of Personality disorders

Each kind of personality disorder has a list of unique symptoms and behaviours. Hallmark of personality disorder is long term and pervasive thought pattern, emotions and behaviours, which cause distress and interfere with the ability to cope in different areas of life.  Patients show different types of personality disorders like this:

Cluster A:

Paranoid Personality disorder people will be often suspicious and mistrustful of others. Also interpret others will take advantage of them. Watch others closely, looking for signs of betrayal or hostility. In everyday situations, they will read threats and danger that others can’t see.

Schizoid personality disorder persons are uninterested in forming close relationships with other people, including own family members. They prefer to be alone with their thoughts. They are unemotional towards social interactions, and choose to live themselves without interference of others. 

Schizotypal Personality Disorder people have extreme difficulty in making close relationships. They may have peculiar dress, thinking, beliefs, speech or behaviour. Use unusual words or phrases and behave in ways that others find eccentric. They believe that they have special powers such as a ‘sixth sense’ and feel anxious and tense with others who do not share these beliefs.

Cluster B:

Antisocial personality disorder (ASPD), people put themselves in risky situations without considering the consequences and impact on others.  They show disregard for the law or behave in ways that are unpleasant for others. They will not hold down a job for long and behave aggressively and get into fights easily. Such people will hurt others and steal, without a feeling of guilty. 

Histrionic personality disorder persons are constant attention seekers, highly dramatic and emotional or sexually proactive for gaining attention. They speak dramatically with strong emotions, but lack facts and details to back up. Such people are easily influenced by others and excessively concerned about physical appearance.

Borderline personality disorder(BPD) People are very worried about people abandoning them, and would do anything to stop that happening.  Their emotions last from a few hours to a few days and can change quickly. They find it very hard to make and keep stable relationships, have suicidal thoughts or self-harming behaviour, feel empty and lonely a lot of the time and struggle hard to control their anger. 

Narcissistic personality disorder people believe that they are special and more important than others. They fail to recognise others feeling and need, always exaggerate their achievements or talents, resent other people’s successes. They are arrogant, often take advantage of others.

Cluster C:

Avoidant personality disorder people are too sensitive to criticism or rejection, feel inadequate, inferior or unattractive, and avoid work or social activities which require interpersonal contact. 

Obsessive compulsive personality disorder(OCPD)  persons demand to keep everything in order and under control. Neglect friends and enjoyable activities for excessive commitment to work or project, rigid and stubborn; be reluctant to spend money, inability to discard broken or worthless objects.

Dependent Personality Disorder is characterized by excessive dependence on others and feeling the need to be taken care of, weak and unable to make decisions or function properly without help or support. They feel difficulty in agreeing with others due to fear of disapproval, they will have low self-confidence and see other people as being much more capable than them. Feel urgent need of starting new relationship on end of close one.

Diagnosis of personality disorder

In the first step in diagnosis involves consulting a doctor or primary care professional or a mental health professional for mental health assessment. The doctor will take background information like past mental health issues, family relationships and background, medical history and the drug used.

Physical Exam: In this exam doctor do a physical exam and ask questions about health, because symptoms may be linked to an underlying physical health problem.

Psychiatric evaluation: In this session doctor discuss about your thoughts, feelings and behaviour and may include a questionnaire to help pinpoint a diagnosis. 

Lab tests: Usually lab tests include complete blood count, thyroid test, a screening test for alcohol and drugs.

After evaluations you may be referred to a psychiatrist or psychologist for further assessment. He/she may compare your symptoms to the criteria in Diagnostic and Statistical Manual of Mental Disorders(DSM-5), published by the American Psychiatric Association.

Treatment for Personality Disorder

The personality disorder can’t deal alone. Depending on your personality disorder and its severity you have to take support and treatment of doctor or mental health professional because personality disorders are long standing, treatment may require months or years. There are several treatments more often used to treat personality disorders, psychotherapy, medications and hospitalization are most common. 

Psychotherapy: It is the most effective long-term treatment option. Through this you can learn about your condition and talk about your moods, feelings, thoughts and behaviours. These insights help people to manage their symptoms, have satisfying relationships and make positive behavioural changes. Cognitive behaviour therapy, dialectical behaviour therapy, psychodynamic psychotherapy, psychoeducation are included in this method. 

Medication: There are no specific medications approved by the Food and Drug Administration to treat personality disorders. However, several psychiatric medicines that may be helpful to treat personality disorder symptoms which include the following:

Antidepressants: It is useful if you have a depressed mood, anger, impulsivity, irritability or hopelessness. 

Mood stabilizers: It can be helpful in tackling mood swings or reduce irritability, impulsivity and aggression. 

Antipsychotic medications: It is also known as neuroleptics, these may be helpful in symptoms that include losing touch with reality or in some cases of anxiety or anger problems.

Anti-anxiety medications: These may  be helpful if you have anxiety, agitation or insomnia. But in some cases, they can increase impulsiveness, so they’re avoided in certain types of personality disorders.

Hospitalization: If the personality disorder is so severe you need to be admitted to a hospital for psychiatric care. This is generally recommended only when you can’t take care of yourself properly or in immediate danger of harming yourself or someone else. After stabilization the doctor may recommend a day hospital program, residential program or outpatient treatment.


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