What is personality?
Personality refers to the way we think, feel, behave, perceive the world around us and interact with others.
It is a collection of characteristics that a person develops as they grow up and make each person an individual.
Personality develops during childhood and teenage years and by early 20s, each individual has their own personality having their own ways of thinking, feeling and behaving.
What is personality
It is defined as:
a deeply ingrained pattern of behaviour of a specified kind that deviates markedly from the norms of generally accepted behaviour, typically apparent by the time of adolescence, and causing long-term difficulties in personal relationships or in functioning in society.
People with personality disorder usually find it difficult to make or keep close relationships, get on with people at work, get on with friends and family and control their feelings and behaviour.
They are more likely to have other mental health issues like depression, anxiety or drug and alcohol problems.
Some symptoms of personality disorders tend to improve slowly with age. Antisocial behaviour and impulsiveness, in particular, seem to reduce by ageing.
Different types of personality disorders:
personality disorders are divided to three groups:
Cluster A: ‘Odd or Eccentric
Cluster B: ‘Dramatic, Emotional, or Erratic’
Cluster C: ‘Anxious and Fearful’
A person might have some of the symptoms of a personality disorder but it doesn’t necessarily mean that they have a personality disorder.
Some people have the characteristics of more than one personality disorder.
Cluster A: ‘Odd and Eccentric’
Signs and symptoms of Paranoid personality disorder:
feel that other people are being nasty to them (even when evidence shows this isn’t true)
feel easily rejected
tend to hold grudges
Signs and symptoms of Schizoid personality disorder:
don’t like contact with other people, prefer their own company
have a rich fantasy world
Signs and symptoms of Schizotypal personality disorder:
difficulties with thinking
lack of emotion, or inappropriate emotional reactions
see or hear strange things
Cluster B: ‘Dramatic, Emotional and Erratic’
Signs and symptoms of Antisocial, or Dissocial personality disorder:
don’t care much about the feelings of others
easily get frustrated
tend to be aggressive
find it difficult to make close relationships
impulsive – do things on the spur of the moment without thinking about them
don’t feel guilty about things they have done
don’t learn from unpleasant experiences
Signs and symptoms of Borderline, or Emotionally Unstable
impulsive – do things on the spur of the moment
find it hard to control their emotions
feel bad about self
often self-harm, e.g. cutting self or making suicide attempts
make relationships quickly, but easily lose them
can feel paranoid or depressed
when stressed, may hear noises or voices
Signs and symptoms of Histrionic personality disorder:
have strong emotions which change quickly and don’t last long
can be suggestible
worry a lot about own appearance
crave new things and excitement
can be seductive
Signs and symptoms of Narcissistic personality disorder:
have a strong sense of own self-importance
dream of unlimited success, power and intellectual brilliance
crave attention from other people, but show few warm feelings in return
take advantage of other people
ask for favours that they do not then return
Cluster C: ‘Anxious and Fearful’
Signs and symptoms of Obsessive-Compulsive (aka Anankastic)
worry and doubt a lot
perfectionist – always check things
rigid in what they do, stick to routines
cautious, preoccupied with detail
worry about doing the wrong thing
find it hard to adapt to new situations
often have high moral standards
sensitive to criticism
can have obsessional thoughts and images (although these are not as bad as those in obsessive-compulsive disorder)
Signs and symptoms of Avoidant (aka Anxious/Avoidant)
very anxious and tense
worry a lot
feel insecure and inferior
have to be liked and accepted
extremely sensitive to criticism
Signs and symptoms of Dependent personality disorder:
rely on others to make decisions for them
do what other people want you to do
find it hard to cope with daily chores
feel hopeless and incompetent
easily feel abandoned by others
What causes personality disorder?
Like other mental disorders, childhood experience especially early childhood and genes can play a part. Sometimes, but not always, people with personality disorder have experienced physical or sexual abuse in childhood.
Some brain abnormalities can also lead to developing personality disorder, especially antisocial personality disorder.
What is the treatment for personality disorders?
Treatment for people with personality disorders can be talking therapies and/or medication.
Talking therapies include:
Mentalisation Btherapyased Therapy (MBT): it aims to help the patient to better understand themselves and others by being more aware of what’s going on in their own head and in the minds of others. It is helpful in borderline personality disorder.
Dialectical Behaviour Therapy (DBT) – this uses a combination of cognitive and behavioural therapies, it is helpful in borderline personality disorder.
Cognitive Behavioural Therapy (CBT) – a way to change unhelpful patterns of thinking.
Schema Focused Therapy – a cognitive therapy that explores and changes collections of deep unhelpful beliefs. Again, it seems to be effective in borderline personality disorder.
Transference Focused Therapy – a structured treatment in which the therapist explores and changes unconscious processes. It seems to be effective in borderline personality disorder.
Dynamic Psychotherapy – looks at how past experiences affect present behaviour. It is similar to Transference Focused Therapy, but less structured.
Cognitive Analytical Therapy – a way to recognise and change unhelpful patterns in relationships and behaviour.
Treatment in a therapeutic community – this is a place where people with long-standing emotional problems can go to (or sometimes stay) for several weeks or months.
People with personality disorders are more likely to have another mental health difficulties, like depression and anxiety.
Medication can be very effective in treating those conditions. However it is not clear whether medication can help with symptoms of personality disorder.
Antipsychotic drugs usually at a low dose can reduce the suspiciousness in paranoid, schizoid and schizotypal personality disorders. It can help if people feel paranoid, or are hearing noises or voices, usually in patients with borderline personality disorder.
Antidepressants can help with the mood and emotional difficulties that people with antisocial, emotionally unstable, histrionic, and narcissistic personality disorders experience.
Some of the antidepressants can help with impulsive and aggressive behaviour in people with borderline and antisocial personality disorders. They can also reduce anxiety in patients with obsessive compulsive disorder and anxious avoidant/ dependant personality disorders.
Mood stabilisers can help with unstable mood and impulsivity that people with borderline personality disorder may experience.
The short-term use of sedative medications can be useful during a crisis