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Post No.: 0790personality disorder


Furrywisepuppy says:


Our personality is reflected in our individual pattern of thoughts, feelings and behaviours. It can be influenced by the situations we find ourselves in, like the company we’re with. But if you experience and/or cause difficulties in how you relate to yourself and others, and have problems with coping with these difficulties on a daily basis – you may receive a diagnosis of ‘personality disorder (PD)’ by a mental health professional.


In more detail, you might be diagnosed with a personality disorder if the way you think, feel and behave causes you significant problems from day to day (e.g. feeling unable to trust others or feeling abandoned, which causes you or others distress in your everyday relationships); you experience these problems across multiple areas of your life (e.g. you struggle to start or maintain friendships or get on with others, to control your feelings and behaviours, or to manage your emotions to the extent that they feel overwhelming and frightening at times); these problems persist for a long time (perhaps since you were a child); and these problems aren’t solely caused by a substance or medical condition (e.g. drugs, or a head trauma).


We all have parts of our personalities that can cause us and/or others difficulties, but the intensity is greater for those with personality disorders. So having one doesn’t mean we’re broken – just neurodiverse and experience the world in a different way. Receiving a diagnosis may help one to understand how and why one behaves the way one does, and make one’s life make a little bit more sense. The difficulties can then be treated with self-care and support.


At present (so this could refine or change in the future), psychiatrists typically group diagnoses into 3 categories. In the suspicious category are paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder. In the emotional and impulsive category are antisocial personality disorder (ASPD), borderline personality disorder (BPD), histrionic personality disorder, and narcissistic personality disorder. And in the anxious category are avoidant personality disorder, dependent personality disorder, and obsessive compulsive personality disorder (OCPD).


Some no longer used, or not commonly used, personality disorder diagnoses or labels include Haltlose, immature, passive-aggressive, psychoneurotic, masochistic, sadistic, and psychopathic, personality disorders.


Each personality disorder involves its own set of diagnostic criteria. People don’t always fit into neat categories though so if you meet the criteria for more than one type then you may have what’s called a ‘mixed personality disorder’. It’s also possible to receive a diagnosis without fully meeting the criteria for a specific type. This is known as ‘personality disorder not otherwise specified (PD-NOS)’ or ‘personality disorder-trait specified (PD-TS)’.


Okay, so people with ‘paranoid personality disorder’ find it difficult to trust in and confide in others, including family and friends, for thinking that others are trying to exploit or take advantage of them. They too readily read threats and dangers in everyday situations, in innocent remarks or from casual looks from others. Consequently, they find it hard to relax.


Those with ‘schizoid personality disorder’ find it hard to form close relationships and prefer to be alone. They may have little interest in sex or intimacy, and may be emotionally cold towards others. They don’t tend to experience pleasure from many activities. People with this type are able to function fairly well however because, unlike those with schizophrenia or schizoaffective disorder, they don’t usually experience psychosis.


Those with ‘schizotypal personality disorder’ also don’t normally experience psychosis. But they might experience distorted perceptions or thoughts, and find forming close relationships quite difficult, in part because they express themselves in ways that others may find odd, eccentric or awkward (like believing that one has special powers and can read minds). This makes them hard to relate to. They are also usually anxious and paranoid in social situations, and tense with others who don’t share the same beliefs as them.


People with ‘antisocial personality disorder (ASPD)’ put themselves in risky, dangerous or illegal situations without thinking about the consequences towards themselves or towards others. They get bored easily and act impulsively, thus may find it hard to hold down a job for long. A diagnosis of conduct disorder before the age of 15 is a possible red flag. They can be unpleasant, aggressive and hurtful towards others, and get into fights easily. A lack of empathy, remorse or guilt, and frequently selfishly putting one’s own desires above any consideration for others, are also signs. This diagnosis includes psychopathy and sociopathy, which in some healthcare systems are terms that are no longer used, or were never used, as clinical diagnoses; although a ‘psychopathy checklist’ questionnaire is still often used during assessments for this personality disorder.


A person with ‘borderline personality disorder (BPD)’ or ‘emotionally unstable personality disorder (EUPD)’ may feel worried about others abandoning them and so they will either do everything to stop that from happening, or alternatively push them away themselves. They feel highly intense emotions with moods that can change rapidly (e.g. feeling chirpy in the afternoon to morose in the evening, or going from nothing to suddenly feeling extremely overwhelming emotions). Their sense of who they are and their aims in life can also be quite capricious depending on who they’re with. They’re impulsive, can do harmful things (e.g. binge eat, drive dangerously, abuse drugs) and can find it hard to make and keep stable relationships. Self-harm, suicidal thoughts, feeling empty, numb and lonely a lot of the time, and struggling to control one’s anger or to trust in others, are also possible signs. Common comorbidities include anxiety, depression, eating disorders and post-traumatic stress disorder (PTSD). When highly stressed, they might experience paranoia and have psychotic hallucinations, feel numb or ‘checked/spaced out’ (known as dissociation), and not remember things very well after they’ve happened.


BPD is currently the most commonly diagnosed personality disorder. We can all experience difficulties with our relationships, self-image and emotions but for those with BPD, these feel so consistently unstable and/or intense that it causes significant problems in their daily life.


Those with ‘histrionic personality disorder’ depend heavily on being noticed and receiving approval from others. So they feel like they must be the centre of attention, perhaps by dressing or behaving provocatively, and have to entertain people. They consequently have a reputation for being dramatic and over-emotional, as well as rash and easily influenced by others in order to seek their furry approval.


An individual with ‘narcissistic personality disorder’ will believe there are special reasons that make them different, better or more deserving than others. This is actually a symptom of a fragile self-esteem rather than high self-confidence because it requires others to recognise one’s worth. They selfishly put their own needs first and demand that others do too, while they’re unaware or dismissive of other people’s needs. They may feel upset if ignored and when not given what they feel they deserve, and may feel resentful about other people’s successes.


People with ‘avoidant personality disorder’ or ‘anxious personality disorder’ are sensitive to and may constantly expect disapproval and criticism. Feeling inferior to others, lonely and isolated is common to them. They persistently worry about being ‘found out’, being shamed, ridiculed or rejected. As a result, they avoid social or work activities where they must be with others, may avoid friendships, relationships and intimacy, and are reluctant to try new activities in case they embarrass themselves.


People with ‘dependent personality disorder’ feel needy and unable to make decisions or function day-to-day without help from others. They allow or want others to assume responsibility for many areas of their life, and may agree to things only because they don’t wish to be alone or lose someone’s support. They lack self-confidence, a belief in their own capabilities, and are thus very afraid of being left to fend for themselves. They can’t find that right balance between being able to depend on others while sometimes being independent from others.


Those with ‘obsessive compulsive personality disorder (OCPD)’ may feel the need to keep everything in order and in control, otherwise they’ll feel anxious if things aren’t ‘perfect’. Unrealistically high standards are set for oneself and others, one worries about mistakes being made by oneself or others, and one’s way is considered the best way of doing things. Note that this is separate from obsessive compulsive disorder (OCD), which describes a form of behaviour rather than a type of personality; although it similarly involves problems with perfectionism, the need for a sense of control, and inflexible thinking.


…As you may realise – we can all feel anxious at times, want to be reassured, want to be noticed, want others to know about our achievements, put ourselves first, and so forth. But it’s only a problem if these thoughts, feelings and behaviours become so extreme that it consistently negatively impacts our daily life and our relationships or interactions with others. That’s when they could become a personality disorder.


This also shows us how a trait that is adaptive when expressed to a certain extent can be maladaptive when expressed to a more extreme extent one way or the other.


Woof. We will learn about what we can do to help ourselves if we have a diagnosed personality disorder the next time we’re covering this area of mental health.


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