Specific personality disorders
Personality disorders refer to situations where long-term and unchanging models of behaviour, a way of experiencing things, observing the environment and yourself make everyday life and relationships difficult. However, a personality disorder can be treated and you can learn to live with it.
Personality disorder as an illness is distinguished from characteristics of personality in that, as an illness, it causes suffering to people – and often also to people close to them. Diagnosis is not easy and takes time.
Personality disorders usually already develop in childhood or adolescence. The underlying reasons may include hereditary factors, pregnancy, childhood experiences and trauma. Personality disorders are fairly common, as 5–15% of the population have a personality disorder. This means more than 800,000 Finns.
What are the symptoms of personality disorders?
A personality disorder may manifest itself, for example, as misinterpretation of another person’s emotions and thoughts or difficulties in social relationships or working life. Behaviour related to a personality disorder is like a permanent way of controlling interactions, anxiety or feelings of loneliness related to human relationships.
The emotional expression of a person with a personality disorder may be so strong that the people around them even find it frightening. The person’s behaviour and reactions may be perceived as strange and not as generally accepted ways of reacting to things. Lack of awareness of illness is possible. Personality disorders are often not recognised by the person; instead, treatment is sought because of something else, such as depression or substance abuse.
Sometimes the person’s environment has the effect of not activating the personality disorder. In some cases, the person’s age may also reduce the symptoms.
In stress situations, many of us can experience and behave momentarily in a way that suggests a personality disorder. Psychiatric illnesses may also be associated with behaviour similar to personality disorders, which, however, only occurs during the illness.
Three main groups of personality disorders
Personality disorders are classified based on dominant behaviours. Typically, personality disorders are divided into three main clusters:
Cluster A: Paranoid, schizoid (withdrawing) and schizotypal (psychotic traits) personality. This cluster is characterised by odd or eccentric behaviour. It’s difficult for an others to understand the behaviour or the flow of thought, but it’s not psychotic.
Paranoid
- Decreased sense of reality
- Holding grudges
- Paranoid ideation
- Suspicion towards other people
- May experience an unintentional or small comment or matter as targeted at them.
- Anger and counterattack
- Repeatedly suspects that their partner is unfaithful or that their subordinates or colleagues are systematically plotting against them.
Schizoid
- Withdrawal from relationships
- Limited expression of emotions
- Retreating to the world of imagination, self-reflection or hobbies
- Not many close friends
- Isolation, lack of interest in contact
Cluster B: Antisocial, borderline (unstable), histrionic (attention-seeking) and narcissistic personality. In this cluster, emotional instability or impulsiveness guides behaviour and capacity for empathy has deteriorated.
Antisocial
- Ignorance of norms, laws and morality
- Indifference, unwillingness and inability to take other people into account
- Impulsive, easily irritable
- Always finds the fault in others.
- Conflicts with society, friends and/or family
Borderline
- Instability of emotional states and self-image, volatility of emotional states and plans
- Instability in relationships
- Fear of abandonment, difficulty in controlling anger
- A volatile perception of oneself: excellent or failed and insignificant
- Difficulty regulating emotions
- Mood swings
- Black-and-white thinking
- Life often seems to be in chaos, difficulty committing to plans in the long term.
- Relationship turbulence
Histrionic (attention-seeking)
- Obsessive seeking of attention
- Need to be the focus
- Dressing, drama, flirting, excessive liveliness
- Close relations may become tired of the self-centred behaviour.
- Easily insulted, seeking satisfaction and excitement
- Conflicts in relationships: if not enough attention, may lead to depression
Narcissistic
- Ideas of grandeur, unrealistic ideas of their abilities
- Lack of empathy
- Strong need for admiration
- Feels entitled to special treatment.
- Envious, arrogant
- May use others.
- Longer-term self-esteem and self-respect regulation disorder
Cluster C: Avoidant, dependent and obsessive-compulsive personality. In this cluster, anxiety, fear and obsession restrict activities. Functional capacity is often better than in the other clusters.
Avoidant
- Strongly inhibited in relationships
- Insecurity, insufficiency, tension
- Sensitive to criticism and rejection
- Social situations are difficult: feels that others are critical of them.
- Needs approval.
- Avoids social contacts and discussing personal matters.
Dependent
- Emphasised need to be cared for: leads to adaptive, even submissive behaviour.
- Difficulties in making decisions
- Inability to trust their own coping or support being available from others
- Often symptoms of anxiety and depression
- Seeking approval from another
- Needs support even in small decisions.
Obsessive-compulsive
- Strong need for order, perfection and control
- Overly conscientious, perfectionist, pedantic, stubborn
- Inflexible in matters related to values and morality
- Details, rules, schedules
- Often devote themselves to their work at the expense of relationships.
- Often leads to burn-out.
How are personality disorders treated?
Even though it’s not easy to change behaviours related to personality disorders, it’s possible. Psychotherapy can be helpful if your behaviour and its consequences restrict your life and disrupt relationships. Therapy can help you find new behavioural models, find more self-knowledge and ways to live with it.
The family and friends of persons with a personality disorder may also need outside help and support.
