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PERSONALITY DISORDERS

The term 'personality' refers to the group characteristics that we all develop as we grow up. This includes ways that we think ,feel and behave. Our personality traits usually stay very similar throughout our lives. 

Someone with a personality disorder thinks, feels, behaves and relates to others very differently from the average person and their personality does not necessarily remain consistent and stable. 

Because the symptoms of personality disorders can have such an impact on day-to-day life, people may find that they develop other mental health problems such as depression, anxiety or substance misuse. 

Personality disorders can be divided into three main clusters according to the psychological characteristics. Someone can have the characteristics of more than one personality disorder. 

Cluster A: Odd or eccentric

  • Paranoid - irrational suspicion, tend to hold grudges, interpret other people's motivations as malicious. 

  • Schizoid - lack of interest in things, social isolation, prefers own company, restricted emotional expression. 

  • Schizotypal - discomfort interacting with others, distorted thoughts and perceptions, eccentric behaviour. 

Cluster B: Dramatic, emotional and erratic

  • Antisocial or dissocial - easily frustrated, impulsive, irresponsible, disregard for other people's rights, no guilt.

  • Borderline - unpredictable, difficulty controlling emotions, fears of abandonment and isolation, fluctuating moods. 

  • Histrionic - dramatic, over-reactions, changing emotions, self-centred, attention seeking, easily influenced by others.

  • Narcissistic - self-importance, superior to others, arrogant, dreams of success, crave attention, envious of others. 

Cluster C: Anxious and fearful

  • Obsessive-compulsive - perfectionist, rule-bound lifestyle, sticks to routines, restrained and rigid, desire to be in control, sensitive to criticism, conscientious. 

  • Avoidant or anxious - very anxious and tense, hesitant, self-conscious, insecure, have to be liked or accepted, extremely sensitive to what others think about them. 

  • Dependent - seek constant reassurance from others, submissive, a need to be taken care of by others, lack of self-confidence, fear of being abandoned. 

It is not clear exactly what causes personality disorders, but inherited genes, other mental health conditions and environmental influences in childhood play a part.

Genes may include:

  • Genes inherited from parents

  • Problems with brain development

  • The environment a person grows up in

  • Neglect, physical abuse or sexual abuse

Triggers may include:

  • Mental health problems including drug missus 

  • Significant live events

  • Relationship problems

  • The death of a loved one

  • Problems with brain development

  • The environment a person grows up in

  • Neglect, physical abuse or sexual abuse

Treatments available for Personality Disorders

People often assume that our personalities cannot be changed or rehabilitated, but that is not true. With professional support and the appropriate treatment plan, it is possible for things to change and improve for people with personality disorders.  

Professional treatment plans will vary depending on the specific diagnosis of personality disorder. Usually the person is assigned to a community mental health team (CMHT) to provide day-to-day support and treatment, while ensuring the person has as much independence as possible. 

  • Dialectical Behavioural Therapy, better known as DBT uses a combination of cognitive and behavioural therapy, with the aim of breaking the vicious cycle of experiencing intense and upsetting emotions, yet feeling guilty and worthless for having these emotions. DBT is based on teamwork with the person expected to work with their therapist and the other people in the group sessions to help combat their strong and distressing emotions collectively. 

  • Therapeutic communities offer structured environments where people with a range of complex psychological conditions come together to interact and take part in group and individual therapy, as well as other activities designed to improve their social skills and self-confidence.

  • Mentalisation-based Therapy consists of the person examining their own thoughts and beliefs and assessing whether they're useful, realistic and based on reality. The person learns to hold back from their thoughts about themselves and to examine others to see if their thoughts are valid. 

  • Arts therapies aim to help people who find it hard to express their thoughts and feelings verbally. The therapy focuses on creating something as a way of expressing their feelings. 

  • Medication such as Antipsychotics and mood stabilisers are sometimes prescribed to alleviate psychotic symptoms and to reduce impulsive behaviours. Currently but there is no medication approved to treat BPD. 

Aiding another with Personality Disorders

 

  • If a person is experiencing a crisis because of their personality disorder, maintain a calm and non-threatening attitude. 

  • Listen to what they say carefully, make eye contract, provide reassurance and be patient. 

  • Accept what they say without judging them and try to show your understanding of their points of view. 

  • Remind them of the positives you see in them. 

  • You may find that simply talking to them and showing you care can help bring them out of the current crisis. 

  • You may not be aware the person has a personality disorder. In this situation, follow the first aid action plan for mental health - C.A.R.E and seek support accordingly. 

  • If they have already been given a diagnosis, they should have a telephone number to call, such as a local crisis resolution team (CRT) who will be able to help them.