Dundee Association for Mental Health

 ‘Personality’ is the characteristics or qualities that form an individual’s character. For example the way they feel, behave and their pattern of thoughts all make up someone’s personality and this is what makes each person the individual they are.  Generally speaking someone’s personality does not normally change very much, but it can develop as people go through different experiences in life, and as their circumstances change.  People are usually flexible enough to learn from past experiences and change their behaviour to cope with life more effectively, but if someone has a personality disorder they are likely to find this more difficult. 

The term personality disorder describes various clusters of symptoms and slots different groups into separate categories of disorder.  There are many different types and it is not uncommon for someone with one type of personality disorder to have other types of personality disorder as well. 

Personality Disorders usually become noticeable in adolescence or early adulthood, but sometimes starts in childhood.  It can make it hard for people with a personality disorder to start and keep friendships or other relationships and may find it hard to work effectively with other people.

People with mild personality disorders usually manage to live normal lives but in times of increased stress the symptoms of the personality disorder are likely to impact seriously on how they think and feel and they can find it hard to cope. 

There are 10 different types of personality disorder.  Each one is linked with a different set of attitudes, emotions and behaviours.  To make them easier to understand some psychiatrists have grouped them into three clusters.  These are:

Cluster A which features odd or eccentric behaviour, the personality disorders in this cluster includes:

§      Paranoid Personality Disorder where people with this disorder can be cold and detached and find it hard to form relationships, they are often suspicious in their surroundings and can act angrily towards other people.

§        Schizoid Personality Disorder where people diagnosed with this disorder can be cold, distant and reclusive, shying away from closeness or intimacy.  They can get caught up in their own thoughts and hold back from getting involved with other people.

§       Schizotypal Personality Disorder has the same traits as the Schizoid Personality Disorder but in addition to the above they can have chaotic thoughts and views and are poor communicators.

Cluster B which features dramatic, emotional or erratic behaviour, the personality disorders in this cluster includes:

§        Borderline Personality Disorder where people with this disorder have a shaky, unsure view of themselves and have problems with relationships.  They can be moody and see things in black and white.  They feel they lost out on nurturing as children and can become very needy and clingy as adults.  When their needs are not met, they feel empty, angry and abandoned and may react in a desperate and impulsive way.

§        Antisocial Personality Disorder -  People diagnosed with this disorder disregard the feelings, property and authority of others, they often become have violent and aggressive behaviour and tend to show a lack of remorse.

§        People diagnosed with Narcissistic Personality Disorder they display an abnormally high opinion of themselves, are oversensitive to criticism and resent those people who do not admire them.

§         People diagnosed with Historic Personality Disorder are obsessive about their appearance and constantly demand attention.  Their behaviour is often seen as over the top and they may be referred to as being ‘shallow’.

Cluster C features anxious or fearful behaviour, the personality disorders in this cluster includes:

§        Dependant Personality Disorder where people depend on their opinion and judgement.  Their insecurity, indecision and lack of self esteem can make it difficult for them to take care of themselves.

§        Avoidant Personality Disorder causes people diagnosed to avoid situations which can cause conflict because they cannot face the possibility of being rejected.  By doing so, however, they make their own situation worse by isolating themselves and avoid forming any relationships.

§        People diagnosed with Obsessive Compulsive Personality Disorder are so inflexible in their approach to things that they become anxious and indecisive and normally end up not completing any tasks they have started.  They like to be in control and have difficulty in sustaining healthy relationships.

There is no single cause of personality disorder.  It is thought that a combination of factors may contribute to people being vulnerable to the development of a personality of disorder due to genetic factors although it is thought it may be related more to the fact people affected have not had the opportunity to learn at an early age how to act or react and manage their feelings.

A personality disorder may also relate to incidents or traumas in childhood like physical or sexual abuse or where there have been difficulties in parenting.  Figures show that around 80% of those diagnosed with borderline personality disorder have been diagnosed as having a childhood trauma.

Dissociative Identity Disorder (previously referred to as multiple personality disorder) and other dissociative disorders are now understood to be fairly common side effects of severe traumas in childhood. 

Personality Disorders are more common when stress levels are high so treatment tends to focus on coping and learning how to relate to others.  This is because people diagnosed with personality disorders have often missed the opportunity in childhood to learn how to cope and manage their feelings.

Many people do not even know they have a personality disorder.  They may just think that they are miserable and that their lives are pointless.  Part of the problem is they are not able to think about their feelings, so they may even resort to drugs and alcohol, self harm or even overdoses, which make things worse.

There are various kinds of help available; your doctor may be a good start as he/she will be to refer you to someone who knows how to offer the best help.  Psychological and drug therapies provide some benefit for people with personality disorders.  Counselling and Psychotherapy give people the chance to talk about their difficulties.  Therapy aims at helping people bring their true feelings to the surface, so that they can experience and understand them better.  Other forms of help available include Cognitive Behavioural Therapy (CBT) which is a combination of cognitive therapy and behavioural therapy.  It helps to weaken the links between upsetting situations and your normal reaction to them, teaching you how to calm your mind and body and feel good.  It also helps you to recognise patterns that make you angry, anxious or depressed. 

Medical Treatment and Support Groups are also other forms of help available for people suffering from Personality Disorders.