Personality disorders are a group of mental health conditions that are characterized by inflexible and atypical patterns of thinking, feeling, and behaving. These inner experiences and behaviors often differ from the expectations of the culture in which someone lives. If you have a personality disorder, you may have a difficult time relating to others and dealing with everyday problems in the ways that are expected by your cultural group. You may not be fully aware of this discrepancy between your thoughts and behaviors and those accepted by society. You may have a view of the world that’s quite different than that of others. As a result, you could find it difficult to participate in social, educational, and family activities. These behaviors and attitudes often cause problems and limitations in relationships, social encounters, and work or school settings. They may also make people you feel isolated, which can contribute to depression and anxiety. Personality disorders are treatable, however. Often a combination of talk therapy and medication can go a long way in helping you live with one of these conditions. The cause of personality disorders isn’t known. However, it’s believed that they may be triggered by genetic and environmental influences, most prominently childhood trauma. Personality disorders tend to emerge in the teenage years or early adulthood. The symptoms vary depending on the specific type of personality disorder. For all of them, treatment typically includes talk therapy and medication. There are numerous types of personality disorders. They’re grouped into three clusters based on similar characteristics and symptoms. Some people may have signs and symptoms of multiple personality disorders. Cluster A: Suspicious
Cluster B: Emotional and impulsive
Cluster C: Anxious
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is a reference that doctors and mental health professionals use to help diagnose mental health conditions. Each personality disorder has criteria that must be met for a diagnosis. A primary care doctor or mental health professional will ask you questions based on these criteria to determine the type of personality disorder. In order for a diagnosis to be made, the behaviors and feelings must be consistent across many life circumstances. They should also cause significant distress and impairment in at least two of the following areas:
In some cases, your primary care doctor or mental health professional may perform blood tests to determine whether a medical problem is causing your symptoms. In some cases, they may order a screening test for alcohol or drugs if they think substances are causing your symptoms. Treatment can vary depending on the type and severity of your personality disorder. It may include psychotherapy and medications. PsychotherapyPsychotherapy, or talk therapy, may help in managing personality disorders. During psychotherapy, you and a therapist can discuss your condition, as well as your feelings and thoughts. This can provide you with insight on how to manage your symptoms and behaviors that interfere with your daily life. There are many types of psychotherapy. Dialectical behavior therapy can include group and individual sessions where people learn how to tolerate stress and improve relationships. Cognitive behavioral therapy aims to teach people how to change negative thinking patterns so they can better cope with everyday challenges. MedicationThere aren’t any medications approved for the treatment of personality disorders. However, certain types of prescription medications might be helpful in reducing various personality disorder symptoms, such as: If you think someone may have symptoms of a personality disorder, or if they tell you that they think they do, encourage them to talk with a mental health professional. While voicing your concerns may cause tension, emphasize that your first priority is their well-being. Call 911 or local emergency services if you ever feel that the other person intends to cause harm to themselves or others. You can also provide your loved one with a list of crisis resources for when they need immediate support. Below are some hotlines and text lines that they can reach 24/7. The most important aspect of treating a personality disorder is determining the condition in the first place. When you recognize that you have a mental health condition, it will be easier for you to seek and stick with treatment. Once you find a treatment that works for you, you should see an improvement in your symptoms. You may have to try a few different types of treatment to find what works best. That’s OK. What matters is that you find a good fit.
Current research shows that treatment can decrease the symptoms and suffering of people with BPD. Talk therapy is usually the first choice of treatment (unlike some other illnesses where medication is often first.) Generally, treatment involves one to two sessions a week with a mental health counselor. For therapy to be effective, people must feel comfortable with and trust their therapist. Some BPD symptoms are easier to treat than others. Fears that others might leave, intense, unstable relationships or feelings of emptiness are often hardest to change. Research shows that treatment is more effective in decreasing anger, suicide attempts and self- harm, as well as helping to improve over-all functioning and social adjustment People whose symptoms improve may still have issues related to co-occurring disorders, such as depression, substance abuse, eating disorders, or post-traumatic stress disorder. However, research suggests that full-blown BPD symptoms rarely coming back after remission.
Dialectical behavior therapy (DBT) focuses on the concept of mindfulness, or paying attention to the present emotion. DBT teaches skills to control intense emotions, reduce self-destructive behavior, manage distress, and improve relationships. It seeks a balance between accepting and changing behaviors. This proactive, problem-solving approach was designed specifically to treat BPD. Treatment includes individual therapy sessions, skills training in a group setting, and phone coaching as needed. DBT is the most studied treatment for BPD and the one shown to be most effective. Mentalization-based therapy (MBT) is a talk therapy that helps people identify and understand what others might be thinking and feeling. Transference-focused therapy (TFP) is designed to help patients understand their emotions and interpersonal problems through the relationship between the patient and therapist. Patients then apply the insights they learn to other situations. Good Psychiatric Management: GPM provides mental health professionals an easy-to-adopt “tool box” for patients with severe personality disorders. Medications cannot cure BPD but can help treat other conditions that often accompany BPD such as depression, impulsivity, and anxiety. Often patients are treated with several medications, but there is little evidence that this approach is necessary or effective. People with BPD are encouraged to talk with their prescribing doctor about what to expect from each medication and its side effects. 1 Self-Care activities include: regular exercise, good sleep habits, a nutritious diet, taking medications as prescribed, and healthy stress management. Good self-care can help to reduce common symptoms of BPD such as mood changes, impulsive behavior, and irritability. 1. Zanarini MC, Frankenburg FR. omega-3 Fatty acid treatment of women with borderline personality disorder: a double-blind, placebo-controlled pilot study. Am J Psychiatry. 2003 Jan;160(1):167–9. |