Personality Disorder: key facts
Mental
Health: have you been affected by the recession? We
would welcome your views.
What is a personality disorder (PD)?
- Our 'personality' is the collection of ways that we think, feel
and behave that makes us all individuals
- A person's personality has different parts (or 'traits'), such
as openness, sociability, confidence, impulsivity, introversion
among many others. Most of these personality traits are present in
everyone to some degree. It is the unique variation in degrees and
combinations
of personality traits that make us who we
are.
- Our personality develops from both our inherited genes and our
life experiences, particularly in childhood.
- Most of the time, our personality allows us to get on
reasonably well with other people, but for some of us, this isn't
true.
- If you have a personality disorder. parts of your personality
make it hard for you to live with yourself and/or other
people.
You may have a personality disorder if you experience severe
difficulties over a long period of time in several of these
areas:
- making or keeping relationships and friendships
- getting on with people at work or with friends and family
- keeping out of trouble
- controlling your feelings or behaviour
You often feel unhappy or distressed and/or find that you upset
or harm other people.
How common is PD?
Probably about 1 in 10
people has a PD, but many will not be severe.
Personality disorders tend
to fall into three groups according to the aspect of personality
which seems to cause the main problems:
Cluster A: 'Suspicious' - includes
- You are suspicious of other people - you feel that they are
being nasty to you.
- You are sensitive to rejection and tend to hold grudges
Schizoid
- You don't have strong emotions, don't like contact with other
people and prefer your own company.
- You have a rich fantasy world.
Schizotypal
- You have odd ideas and difficulties with thinking. Other people
see you as eccentric.
- You may see or hear strange things.
Cluster B: 'Emotional and Impulsive' -
includes
Antisocial
- You don't care about the feelings of others, get easily
frustrated, fight, commit crimes and find it hard to have close
relationships.
- You do things on the spur of the moment, don't feel guilty and
don't learn from unpleasant experiences.
Borderline, or Emotionally
Unstable
- You do things without thinking, find it hard to control your
emotions, and feel empty.
- You feel bad about yourself and often self-harm.
- You make relationships quickly, but easily lose them.
- You often feel paranoid or depressed and, when, stressed, may
hear noises or voices,
Histrionic
- You over-dramatise events and tend to be self-centered.
- Your emotions are strong, but change quickly.
- You worry a lot about your appearance and crave
excitement.
Narcissistic
- You feel very important and dream of succes, power and
status
- You crave attention, tend to exploit others and ask for favours
that you don't return.
Cluster C: 'Anxious' - includes
Obsessive-Compulsive (aka
Anankastic)
- You are perfectonist, worry about detail and are perhaps
rigid.
- You are cautious and find it hard to make decisions.
- You have high moral standards, tend to judge other people and
worry about doing the wrong thing.
- You are sensitive to criticism and may have obessional thoughts
and behaviours.
Avoidant or Anxious
- You are very anxious and tense, you worry a lot, feel insecure
and inferior.
- You want to be liked and accepted, and are sensitive to
criticism.
Dependent
- You rely on others to make decisions for you and do what other
want you to do.
- You find it hard to cope with daily tasks, feel hopeless and
incompetent , and easily feel abandoned by others.
Professional help
Psychologists and psychiatrists can help. You
can learn to control aspects of your emotions and behaviour which
cause these problems.
Our personalities tend to stay constant over a long period of
time, so the treatment will often be long-term. The mainstay of
treatment are talking therapies, of which there are different
types, but drug treatments can also help.
Treatments
include:
Counselling and dynamic psychotherapy, cognitive and behavioural
therapy (CBT), cognitive analytical therapy (CAT),
mentalisation-based therapy (MBT) and dialectical behaviour therapy
(DBT).
- Treatment in a therapeutic community
A place where you can attend (or sometimes stay) for several
weeks or months, Most of the work is done in groups. You learn from
being with other people in a unit. It differs from 'real life' in
that any disagreements or upsets happen in a safe place. The staff
and other patients help you get through such problems and learn
from them.
It has been difficult to study the benefits of medications in
personality disorder, which means evidence for their effects is
limited. Most drug trials are based on borderline personality
disorder.
Antipsychotic
drugs can reduce the suspiciousness of the Cluster A
disorders. They can also help with borderline disorder if people
feel paranoid, or are hearing noises and voices.
Antidepressants can help
with the mood and emotional difficulties of people with Cluster B
disorders, for example in reducing aggressive, impulsive and
self-harming behaviours. They can also reduce anxiety in Cluster C
disorders.
Mood
stabilisers such as lithium, carbamazepine and sodium
valproate may also reduce impulsiveness and aggression.
How effective is treatment?
The evidence is weak because treatments are usually quite
complicated, so it is hard to know what part actually worked. The
studies are also usually small and rather too short, and the ways
of measuring improvement are poor. However, there is growing
evidence to show that symptoms of borderline personality disorder
can improve and even resolve over time.
Which approach is best for me?
This depends on what you prefer as well as the type of problem
that you have. However, a lot depends on what is available in your
area.
This is an abridged version our main leaflet on Personality
Disorder.
This leaflet is made available through the
generosity of the Charitable Monies Allocation Committee of the
mental health charity St Andrew's, Northampton
© November 2012.
Due for review: November 2014.Royal College of Psychiatrists. You
can link to, download, print, photocopy and distribute this leaflet
free of charge. But you must not change it or repost it on a
website.
Charity registration number (England and
Wales) 228936 and in Scotland SC038369
Please note that we are unable to offer advice on individual cases. Please see our
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advice on getting help.
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