Personality Issues & Disorders

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Some people feel that they have difficulties because of who they are, what they think, how they react to different situations and the way they find themselves behaving. Some people are told that this is the reason they have difficulties and are given a diagnosis of a personality disorder.

What is a Personality Disorder?

For some people it seems that parts of their personality develops in a way that sometimes makes it difficult to get on with other people or even to feel as though they can live with themselves.

Some people don’t seem to be able to learn from the things that happen to them, and that they can’t change the parts of themselves that seem to cause the problems.

Other people may have noticed this since the person’s childhood or early teens.

People who have been diagnosed with a Personality Disorder may have difficulties with:

  • making or keeping close relationships
  • getting on with people at work
  • getting on with friends and family
  • keeping out of trouble
  • controlling feelings or behaviour
  • listening to other people

This can lead them to feel unhappy or distressed and/or often upset or harm other people. It can lead to other mental health problems such as depression, anxiety, eating disorders or drug and alcohol problems.

How common are personality disorders?

The difficulties in clearly defining personality disorders have meant that previous research studies have suggested that up to 1 in 5 people might have a personality disorder. However, a larger and more rigorous UK study in 2006 suggested that, at any given time, about 1 in 20 people will have personality disorder.

Other studies indicate a prevalence of >10-13% of the adult population in the community, and show that personality disorders are more common in younger age groups (25-44 years) and equally distributed between males and females.

Types of Personality Disorder

Three main groups of personality disorders have been identified by studying the patterns of personality traits, or characteristics, shared by a number of people.

Most people will recognise aspects of their own personality when they read through the descriptions of each type. This doesn’t necessarily mean that they have a personality disorder. Some of these characteristics can be helpful in some areas of life. For people who do have a personality disorder, some of these traits will be spoiling life for them – and often the lives of those around them.

A person can have the characteristics of more than one personality disorder.

The three groups have been broadly distinguished from each other according to their emotional ‘flavour’:

 

  • Cluster A: ‘Odd or Eccentric’
  • Cluster B: ‘Dramatic, Emotional, or Erratic’
  • Cluster C: ‘Anxious and Fearful’

The general characteristics associated with different diagnostic labels for personality disorders are summarised below.

Cluster A: ‘Odd or Eccentric’

 

  • Paranoid
  • Feeling suspicious
  • feeling that other people are being nasty to you (even when evidence shows this isn’t true)
  • feeling easily rejected
  • tending to hold grudges

Schizoid

  • being described by self or others as emotionally ‘cold’
  • disliking contact with other people, preferring your own company
  • having a rich fantasy world

Schizotypal

  • displaying eccentric behaviour
  • having ‘odd’ ideas
  • experiencing difficulties with thinking
  • showing lack of emotion, or inappropriate emotional reactions
  • seeing or hearing strange things

Cluster B: ‘Dramatic, Emotional or Erratic’

 

  • Antisocial, or Dissocial
  • not caring much about the feelings of others
  • easily getting frustrated
  • tending to be aggressive
  • committing crimes
  • finding it difficult to make close relationships
  • being impulsive – doing things on the spur of the moment without thinking about them
  • not feeling guilty about things you’ve done
  • not learning from unpleasant experiences

Borderline, or Emotionally Unstable

  • being impulsive – doing things on the spur of the moment
  • finding it hard to control your emotions
  • feeling bad about yourself
  • often self-harming, e.g. cutting yourself or making suicide attempts
  • feeling ’empty’
  • making relationships quickly, but easily losing them
  • possibly feeling paranoid or depressed
  • when stressed, possibly hearing noises or voices

Histrionic

  • over-dramatising events
  • being self-centred
  • having strong emotions which change quickly and don’t last long
  • possibly being suggestible
  • worrying a lot about your appearance
  • craving new things and excitement
  • sometimes being seductive

Narcissistic

  • having a strong sense of your own self-importance
  • dreaming of unlimited success, power and intellectual brilliance
  • craving attention from other people, but showing few warm feelings in return
  • taking advantage of other people
  • asking for favours that you do not then return

Cluster C: ‘Anxious and Fearful’

 

Obsessive-Compulsive

  • worrying and doubting a lot
  • being a perfectionist – always checking things
  • being rigid in what you do, sticking to routines
  • being cautious, preoccupied with detail
  • worrying about doing the wrong thing
  • finding it hard to adapt to new situations
  • often having high moral standards
  • being judgemental
  • being sensitive to criticism
  • sometimes having obsessional thoughts and images (although these are not as bad as those in obsessive-compulsive disorder)

Avoidant

  • feeling very anxious and tense
  • worrying a lot
  • feeling insecure and inferior
  • having to be liked and accepted
  • being extremely sensitive to criticism

Dependent

  • passive
  • relying on others to make decisions
  • doing what other people want you to do
  • finding it hard to cope with daily chores
  • feeling hopeless and incompetent
  • easily feeling abandoned by others

Unclear Diagnosis?

Your symptoms and difficulties may not fit exactly into any one of these categories.

You may see aspects of yourself in more than one category.

Professionals, too, may find it hard to give you a single diagnosis.

This is not unusual. It is pretty hard to describe any personality clearly, and so it can be difficult to make a clear diagnosis of personality disorder. It may be more helpful to think of these as exaggerations of normal, overlapping personality types instead of as diagnoses or categories.

What causes personality disorder?

The answer is not clear, but it seems likely that a number of factors can play a part.

Early Environment

Sometimes, but not always, people with personality disorder have experienced

  • physical or sexual abuse in childhood
  • violence in the family
  • parents who drink too much

If children are taken out of this sort of difficult environment, they are less likely to develop a personality disorder. For these children their early experiences can make it difficult to develop a good understanding of themselves and how their emotions work in relation to other people.

Brain problems

Some people with antisocial personality disorder have very slight differences in the structure of their brains, and in the way some chemicals work in their brains. However, there is no brain scan or blood test for a personality disorder.

Potential triggers

  • using a lot of drugs or alcohol
  • problems getting on with your family or partner
  • money problems
  • anxiety, depression or other mental health problems
  • important events
  • stressful situations

Treatment

With help, many people with personality disorder can start to lead a normal and fulfilling life. Most can, at least, cope more effectively with their difficulties.

Different treatments can help, including medication in some instances, and psychological therapies in others.

Psychological therapies based around recognising and changing unhelpful patterns in relationships or thinking patterns can help people with personality disorders find more comfortable and safe ways of managing what can be disruptive emotions and behaviours. They can also help address any other associated mental health problems, such as depression or anxiety.

Self-help

There are a number of things you can do in order to help yourself feel better at times that feel difficult:

  • Try to unwind when stressed – have a hot bath or go for a walk. You may find yoga, massage or aromatherapy useful.
  • Make sure you get a good night’s sleep – but don’t get too upset if you can’t sleep.
  • Look after your physical health and what you eat. You’ll feel better on a balanced diet, with lots of fruit and vegetables.
  • Avoid drinking too much alcohol or using street drugs.
  • Take some regular exercise. This doesn’t have to be extreme. Even getting off the bus one stop early, and walking the rest of the way can make a difference.
  • Give yourself a treat (although not drugs or alcohol!) when things are difficult or you have coped at a stressful time.
  • Take up an interest or hobby. This is a good way to meet others and take your mind off the day-to-day stresses that we all face.
  • Talk to someone about how you are feeling. This could be a friend or relative or, if preferred, a therapist or counsellor. If you don’t have access to a counsellor or therapist, then try your GP.
  • The internet is a good resource of information.
  • If things get really tough, try phoning a helpline such as the Samaritans

Living with someone who has a personality disorder

If you are living with someone who has been diagnosed with a personality disorder this can also be very difficult. You may worry about the effects the personality disorder is having on them, and perhaps on your life too. How would they react if you talked to them about it?

If he or she is happy to talk about it, get some more information. Even if they don’t see a problem at the present time, they may do in the future.

Day-to-day living with someone who has a personality disorder can be difficult – but it isn’t always. Giving people their own space, listening to and acknowledging their concerns, and involving others (friends, relatives and, at times, mental health professionals – nurses, therapists or doctors) can all be useful. It is also important to look after your own physical and mental health.

If you are becoming stressed, depressed or are suffering with your own mental health problem then it is important that you pay attention to this and get any help that you might also need.

Resources

 

Emergence: This is a service user-led organisation supporting all people affected by a diagnosis of personality disorder, whether you are a service user, carer (which is a family member or friend of a service user) or a professional in the field.

Mind: a leading mental health charity in England and Wales which has extensive information on personality and personality disorder.

Personality disorder: no longer a diagnosis of exclusion: This provides information, resources and learning opportunities for those with a personality disorder and their carers.

Samaritans: Helpline: 08457 90 90 90. Samaritans is available 24 hours a day to provide confidential emotional support for people who are experiencing feelings of distress or despair, including those which may lead to suicide. The website has helpful information about stress and self-harm.

Rethink Mental Illness: Rethink is a leading national mental health membership charity and works to help everyone affected by severe mental illness recover a better quality of life. This has information on personality and personality disorder.

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