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.

Personality disorder

What is personality
disorder?

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.
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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:

suspiciousness

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:

emotionally ‘cold’

don’t like contact with other people, prefer their own company

have a rich fantasy world

Signs and symptoms of Schizotypal personality disorder:

eccentric behaviour

odd ideas

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

commit crimes

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

feel ’empty’

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:

over-dramatise events

self-centered

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

judgemental

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:

passive

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

Reference : amir hashemi tari

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