Personality disorders

What is it?

Personality disorder is a complex disorder. It involves thoughts, feelings and behaviour patterns that tend to be different to other people's and may be considered unusual, unexpected or even offensive.

People with personality disorder are said to resort to a variety of desperate impulsive behaviours as a quick fix for painful emotions, such as loneliness, fear and anger. It could mean loving someone intensely one moment and despising them the next. It could mean feeling you're special one moment and self-loathing the next.

It usually becomes noticeable in adolescence or early adulthood. It can make it difficult to form friendships and close relationships. This can lead to feelings of isolation and alienation, which increases the risk of suicide.

What are the different types?

The disorder has been described as having two main forms. The impulsive type, where the predominant characteristics are emotional instability and acting impulsively. Outbursts of violence or threatening behaviour are also common, particularly in response to criticism from others.

The other main form is Borderline Personality Disorder. People with this diagnosis may display degrees of emotional instability and their own self-image, aims and preferences(including sexual) may be unclear. Many of these people lead chaotic and emotionally empty lives. They may have a tendency to become involved in intense and unstable relationships, experience repeated emotional crises and often engage in suicidal threats or acts of self-harm.

The American Psychiatric Association DSM-IV-TR lists ten types of personality disorder each with a different set of emotions, attitudes or behaviours.

Visit the Mind website to find out more about these.

What causes Personality Disorder?

The causes of personality disorder are unclear and may be influenced by many factors: genetics, quality of relationships when growing up, family circumstances, experience of trauma.

Some studies have also identified changes in brain chemistry. Whether or not this is a cause many people will have suffered emotional, sexual or physical abuse in childhood . Sadly people with personality disorder have often lived very difficult lives and in this respect their behaviour needs to be viewed as a consequence of those earlier life experiences.

Treatment

Whether or not people with personality disorders are treatable has long been a topic of controversy. Although described as a mental illness, personality disorders are not considered treatable by many psychiatrists . This is beacuse the range of behavioural disturbances and characteristics of the condition can make it difficult to diagnose. Patterns of thoughts, feelings and ways of relating are so deeply entrenched they make it difficult to treat.

There is evidence though that people with milder personality disorders can be helped, although it can be a lengthy process taking years. Some talking treatments can be helpful, cognitive behaviour therapy in particular. Medication can't cure a personality disorder but it may be used to alleviate symptoms such as depression.

What can others do to help?

You can help by emphasizing the positive aspects of a person's personality and encouraging them to change any negative behaviour. Good information about their illness and possible treatments is also important.

Caring for someone with a personality disorder can be very difficult. Often sufferers may need specialist care and treatment which is not available locally.