Personality disorder

The term Personality disorder encompasses a multitude of different mental disorders in which the person affected can deviate greatly from "normal" behavioral patterns. Often, the actions and thoughts of patients appear inappropriate to the situation and inappropriate to healthy people. Typical forms of personality disorder are paranoid personality disorder and schizophrenia. However, the latter is classified as a psychotic disorder.

What is a personality disorder?

In psychology and medicine, the term personality disorder denotes a group of mental illnesses that begin in childhood or adolescence and are characterized by deviating experience and behavior patterns, which are described as rigid and inflexible, especially in situations that are conflicting for the person.

As a result, the functionality and performance of the person concerned is always impaired in the personal and social, sometimes also in the professional area, sometimes considerably. In clinical psychology and psychiatry, personality disorders are subdivided into subtypes defined by characteristic features according to the diagnostic systems ICD-10 and DSM-IV. However, overlaps and thus combined personality disorders are common.

causes

There is no generally accepted definition of the causes of personality disorders. The development of a personality disorder is seen as a result of a complex interplay of family and social interactions and genetic predispositions. The psychosocial aspects of the development of personality disorders are assessed differently by the individual psychotherapeutic schools.

While depth psychology sees the causes in childhood disorders such as a problematic social environment (e.g. parental home) or early psychotraumas, psychoanalysis focuses on individual psychological aspects of personality development.

Behavioral medicine pursues a different approach, personality disorders as the result of reinforcing the behavioral foundations established in childhood or adolescence through operant conditioning (consolidation of behavioral schemes through positive or negative reinforcement, for example through the social environment) and model learning (consolidation of general behavior through learning on a specific example).

This theory forms the basis for the treatment methods of behavior therapy, which has become increasingly important compared to classical psychotherapeutic methods due to proven success in the treatment of personality disorders, in particular also the so-called borderline personality disorder.

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Diseases with this symptom

• schizophrenia
• Dissocial Personality Disorder
• narcissism

• Alzheimer
• Brain tumor
• multiple personality disorder

• Borderline syndrome
• Paranoid schizophrenia
• Munchausen Syndrome

Complications

Personality disorders can be associated with other mental disorders. The frequency of such accompanying illnesses (comorbidities) differs, however, depending on the personality disorder present. About 50 percent of people who have an eating disorder also have a personality disorder. Anxiety disorders are particularly common in obsessive-compulsive personality disorder.

Depressive disorders such as dysthymia and (major) depression are frequent complications. Its core characteristics are the loss of joy and interest as well as the depressive mood. In a sense, dysthymia is a weaker, but longer-lasting form of depression. At the same time, however, more severe depressive episodes are also possible.

People with a personality disorder also have an increased risk of suicide, which is also different for different personality disorders. For example, people who suffer from borderline personality disorder have a suicide risk of around ten percent. If the personality disorder is accompanied by [[[self-harming behavior self-harming behavior]], various physical complications are also possible. These include loss of blood, inflammation of the wounds, and damage to the affected nerves or muscles.

Injuries and scars can also lead to stigmatization and exclusion of those affected. Social difficulties are also possible as a result of a personality disorder. Workplace complications and relationship problems are just as possible as financial difficulties. Such factors, in turn, can adversely affect the personality disorder, making it worse or helping to maintain it.

When should you go to the doctor?

A personality disorder can lead to various complications and should therefore always be treated by a doctor. In many cases, however, the person concerned does not notice that they have a personality disorder. For this reason, it is important to get help from friends and family to get the affected person for treatment. In severe cases, treatment in a closed clinic may also be necessary. A doctor should generally be consulted if the personality disorder causes complaints in life and in everyday life.

Above all, this includes social withdrawal and an aggressive attitude on the part of the patient towards other people and activities. Likewise, impaired perception, headaches and insomnia can indicate a personality disorder and must be treated. A doctor must also be consulted if the personality disorder leads to inferiority complexes or thoughts of suicide. Both symptoms can be life-threatening and should be treated.

If the personality disorder occurs after consuming alcohol or other drugs, a doctor can be seen if the use cannot be interrupted. In this case, withdrawal is usually necessary.

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Treatment & Therapy

For personality disorders, psychotherapeutic methods are the primarily indicated treatment methods. As already mentioned, there is the possibility of depth psychological and psychoanalytic treatment methods on the one hand and behavioral therapeutic methods on the other. Accompanying drug treatment with antidepressants or antipsychotics can be useful, and in the case of comorbid depression it is even indicated.

The treatment of personality disorders places very high demands on the therapist and, depending on the type of personality disorder, is often fraught with complications such as suicidality, self-harming behavior, substance abuse or even violence and delinquency. In addition, comorbidity with depression is common, and rarely with psychotic disorders. Treatment for a personality disorder takes a long time and it is doubtful whether a personality disorder can be completely cured with the treatments available.

Success has been proven, but even in those cases in which the diagnosis of personality disorder could no longer have been made after treatment, it cannot be said that a personality disorder has been completely cured.

Outlook & forecast

A personality disorder is a very serious disorder of the psyche and must always be treated by a doctor or a psychologist. Therefore, no universal prediction can be made as to whether a personality disorder can be cured or not. These chances of success depend heavily on the personal characteristics of the person concerned.

Without treatment, the personality disorder will usually not go away on its own. It often continues to develop and grows stronger. The affected person withdraws more and more and is socially excluded. It leads to severe depression, sleep disorders and aggressive behavior. A loss of reality is also relatively common. In the worst case, the personality disorder can be so severe that it leads to suicide.

Treatment usually takes place with medication and by a psychologist. The main aim of the psychologist is to determine the reasons for the personality disorder. It can also occur after an accident that has damaged the brain. In these cases, treatment is only possible to a very limited extent.

The quality of life decreases with the personality disorder. In most cases, therapy is successful and can largely contain the personality disorder. However, it can reappear if there are uncomfortable situations for the patient.

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Prevent

Since the first signs of a personality disorder often manifest in childhood or adolescence, treatment by a child and adolescent psychotherapist should start here.

In many cases, this can prevent or at least mitigate the development of a personality disorder in adulthood. However, there is no prevention in the true sense of the word, as the causes have not (yet) been sufficiently clarified. However, it can be assumed that if personal development is as undisturbed as possible in childhood and adolescence, without too many harmful influences, a personality disorder is unlikely to develop.

Aftercare

If a patient with a personality disorder has been treated as an inpatient in a clinic, doctors and therapists often recommend subsequent outpatient treatment. A clinic can offer its own aftercare service for patients, which can include discussion groups, psychoeducation and / or individual discussions with a therapist or psychiatrist.

The aim of such offers is often to support the patient on his way back to his everyday life and to gradually become more independent. Relationship conflicts that are typical of a personality disorder can become topical again through everyday life. In some cases, therapists involve relatives in the treatment by inviting them to one or more sessions if the patient agrees.

In outpatient therapy, patients often work long-term on how they can shape their everyday lives in order to reduce stress factors and better manage their personality disorder. After the final completion of outpatient psychotherapy, people with a personality disorder can continue to apply what they learned in therapy.

Since the treatment is usually very individual, the aftercare cannot easily be generalized. With the support of their therapists, many patients develop strategies that are individually tailored to them on how to deal with relapses or crisis situations.

You can do that yourself

Everyday life with a personality disorder leads in many cases to tension with roommates, family or friends. For this reason, it is helpful to inform loved ones about the mental illness. Talking openly about wants and needs helps others respond appropriately. This also applies to dealing with the disease.

A clear structure can help in everyday life. However, it depends on the type of personality disorder and any other psychological problems: Someone who tends to be compulsive may benefit from learning to let go.

A job or hobbies usually have a stabilizing effect and are a good opportunity for practical self-help with personality disorders. Anyone who is overwhelmed with a full job can also find out about the possibilities for internships or volunteer work. A subsidized measure that supports such efforts may be possible, for example in the context of vocational rehabilitation or as a measure by the employment office.

Since personality disorders are often associated with a high risk of suicide, it makes sense to take appropriate safety measures in everyday life. It is particularly important to recognize early warning signs. These warning signs can be different for each person - therapy can help identify them individually. In addition, it often makes sense to initiate a confidante and to ask for help in good time as soon as suicidal thoughts arise.