Personality Disorders and Their Treatment Options

As human beings, we each have our own unique ways of thinking, feeling and behaving. For example, some people are shy and reserved, while others are more lively and outgoing.

Yet, while we may change our behaviour to meet the requirements of different social situations (we may act very differently in front of our friends than in the presence of our manager) we generally tend to behave in fairly predictable patterns.

What are Personality Disorders?

These patterns are generally referred to as our “personality”, and while our personalities do not tend to change dramatically, they can over time subtly develop in light of our experiences to help us cope with the challenges of daily life more effectively.

However, for some of us, parts of our personality develop in such a way that makes it difficult for us to live with ourselves and other people, resulting in a diagnosis of personality disorder.

These disorders are some of the most controversial of all psychiatric diagnoses due to many arguing that human personalities are far too complex to neatly categorise into separated disorders. Ongoing debate aside, these disorders can be highly distressing for both the individual and their loved ones who may find the subsequent behaviour unusual, and perhaps even offensive.

Consequently, as someone with a personality disorder you may find it difficult to make or keep relationships, control your behaviour or keep out of trouble. So having a personality disorder can make life incredibly difficult and isolating. They also tend to come hand-in-hand with mental health problems such as depression, anxiety or drug and alcohol problems, which can make your daily existence even more of a challenge.

Personality Disorders: Types and Symptoms

Personality disorders are generally grouped into ten types under three different categories -Suspicious, Emotional/Impulsive, and Anxious.

When reading the descriptions of these disorders it can be easy to identify some aspects of your own personality. But these personality aspects in someone with a personality disorder will be extreme and contain the power to cause significant destruction to the life of the individual and those around them.

It is possible to have elements of two or more personality disorders.

Cluster A: ‘Suspicious’

Paranoid: Suspicious, hostile, sensitive to rejection, tend to hold grudges, concerned with the hidden motives of those around you.

Schizoid: emotionally cold, do not desire close relationships, little interest in sexual activity with another person, avoids social activities, has a rich fantasy world.

Schizotypal: Eccentric appearance & behaviour, odd beliefs, difficulty thinking and speaking, suspicion & paranoia, excessive social anxiety.

Cluster B: ‘Emotional and impulsive’

Antisocial or Dissocial: aggressive, don’t care about the feelings of others, engage in criminal activity, lack of remorse, difficulty keeping long-term commitments such as relationships and employment, impulsive.

Borderline or Emotionally Unstable: Mood swings, find it hard to control emotions, impulsive, make relationships quickly but then lose them, often self harm and have suicidal thoughts, boredom and emptiness, intense anger, terrified of being alone.

Histrionic: Over-dramatise events, self-centred, easily influenced, crave excitement, extreme concern over physical appearance, seductive, rapidly shifting emotional states.

Narcissistic: Self-importance, self-centred. Dream of unlimited success, power and intellectual brilliance. Craves attention and admiration, lacks empathy, manipulative.

Cluster C: ‘Anxious’

Obsessive-Compulsive (aka Anankastic): perfectionist, sensitive to criticism, inflexible, overly cautious and conscientious, preoccupation with details, lists, schedules.

Avoidant (aka Anxious/Avoidant): Extremely anxious, insecure, extremely sensitive to criticism, desire to be liked and accepted, inhibited.

Dependent: passive, rely on others to make decisions, feel hopeless and incompetent, fears abandonment, avoid responsibility, do what other people want you to do, easily hurt by criticism.

Treatment for Personality Disorders

There are a wide variety of treatment options available for personality disorders, including both psychological therapy and medication. Your GP will have all the information you need concerning what medication and therapy is best for your symptoms and the availability of different therapies in your area. As a quick overview here are some of the main treatments available:

Talking Therapies

There are a good number of psychological therapies that have been shown to help people with personality disorders, especially those less severe. It is of course important to get the right therapy and it is essential that is delivered by a trained therapist.

Counselling: When things in your life are not going well, it can sometimes be extremely hard to talk about your true feelings to your friends and family. But talking about negative feelings can be extremely beneficial, and may be easier to talk through with a trained counsellor or therapist.

Cognitive Behavioural Therapy (CBT): Cognitive behavioural therapy helps to identify and change how you think and what you do by breaking down overwhelmingly negative problems into smaller manageable parts. This allows you and the therapist to see how these parts are connected and how they are affecting you.

Dialectical Behaviour Therapy (DBT): Uses a combination of cognitive and behavioural therapies, with some techniques from Zen Buddhism. It involves both individual and group therapy and teaches new skills to help you manage emotions, and improve the way you interact with others. This therapy can be particularly effective for borderline personality disorder.

Therapeutic Communities: This is a place where people with long-standing emotional problems can attend or stay for several weeks or months and undergo mostly social and group therapies such as art therapy and psychodrama. The staff and other residents encourage each other to discuss their problems and then provide feedback to help each other overcome their interpersonal issues.

Medication

There are no specific drugs that can “cure” a personality disorder, but doctors can prescribe them to target particular symptoms. For example, antidepressants can be used to target emotional and mood difficulties, while antipsychotics (at a low dose) can reduce the suspiciousness of the three cluster A personality disorders. It can take some time to find a drug that works and often medication is most effective when combined with a talking treatment.

Self Help

While talking therapies and medication can be very effective for personality disorders, you can also help manage your symptoms yourself. As with the majority of both psychological and physiological illness, healthy living can be fantastic factor in the day-to-day management of symptoms. This includes:

• Plenty of good quality sleep
• Eating healthy
• Exercise
• Relaxation
• Reduction in alcohol and street drugs

Do you recognise yourself in the above descriptions? Harley Therapy’s team of Counselling Psychologists and Psychiatrists are available for personality disorder treatment. Call 0845 474 1724.