Personality Disorders

Personality disorders are not related to a time limited episode or a single behavior or event, but are a constant personality pattern. The traits of a patient with personality disorders are a constant source of suffering and difficulties in functioning in society. Personality disorders are difficult to diagnose and even more difficult to treat. What are the causes of personality disorders and how to treat them?

Personality disorders are not a typical psychiatric problem that may go away. They concern a disturbed structure of the human personality that affects many areas of life.

Personality disorders should be understood as the presence of permanent characterological features and established patterns of behavior and behavior, as well as relationships with other people and functioning in society. This applies to the attitude towards oneself and the environment, but also to the way of experiencing oneself and others. People with personality disorders can feel constant suffering.

Genetic, biological and psychosocial factors can lead to personality disorder. The first symptoms of personality disorders appear most often in late childhood or adolescence. The close environment of the person they relate to is not always aware of it, therefore personality disorders are usually diagnosed only in adulthood.

According to the international psychiatric classification (ICD-10 International Classification of Diseases and Health Problems), the following personality disorders are distinguished:

• paranoid personality – lack of trust in other people, tendency to experience pain for a long time, suspiciousness towards the environment,
• schizoid personality – withdrawal or shallowing of emotions, emotional coldness, limited ability to experience feelings, loneliness, poor interest in sexual experiences,
• dissocial personality – aggressiveness, emotional coldness, tendency to use violence, low empathy and a negligible level of compassion,
• histrionic personality – excessive expression of emotions, theatricality, dramatization, ease of being influenced, shallow and unstable emotionality,
• emotionally unstable personality – impulsiveness, quick entering into relationships and equally quick rejection of them, constant feeling of emptiness, tendency to depression, difficulty in functioning in society,
• anankastic personality – obsessive thinking revolving around order and rules, over-control, perfectionism,
• dependent personality – inability to make independent decisions, avoiding responsibility, strong fear of abandonment, a sense of failure and helplessness in the event of failure,
• fearful (avoidant) personality – constant feeling of tension and anxiety, feeling of unattractiveness and inferiority, excessive concentration on being criticized or rejected.

There are some common characteristics to people who suffer from personality disorders, which are:

• durable and deeply entrenched,
• manifested in the way of perceiving reality, thinking and feeling emotions towards oneself and other people,
• inflexible, the person usually behaves in an identical (or at least similar), disedaptive way,
• extremely exaggerated compared to the features of people without personality disorders,
• significant in contacts with other people (they limit or hinder contacts with other people, sometimes they even destroy relationships).

The traits of people with personality disorders are not individual behaviors but form a holistic pattern.

The basis for a correct diagnosis is a detailed psychiatric interview, both with the patient and with people from his / her close environment. Sometimes psychological tests are additionally carried out to remove any doubts regarding the diagnosis. In addition, it is important to exclude the presence of other abnormalities that may cause adverse behavior, such as brain damage or mental disorders.

Most personality disorders are treated with long-term psychodynamic psychotherapy. There are many studies confirming the effectiveness of such a procedure. Psychotherapists and psychiatrists often also decide to use elements of cognitive-behavioral therapy. The key to success is establishing a therapeutic relationship that will be based on the patient’s trust and full commitment.

Some patients require pharmacotherapy. Medicines help to better manage episodes of feeling worse or even depressed.

However, it cannot be denied that treatment of personality disorders is very difficult, and complete treatment is sometimes impossible. However, it is necessary to undertake it, because without appropriate therapy, a person with personality disorders may not be able to find himself in society and break relationships with loved ones. Moreover, her condition may lead to a deterioration of professional functioning, and in extreme cases even to suicide.