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What is a personality disorder (PD)?
- A “personality” is the collection of ways
that we think, feel and behave that makes each of us an
individual.
- Most of the time, our personality allows us
to get on reasonably well with other people but for some of us,
this isn't true.
- If you have a personality disorder, parts of
your personality make it hard for you to live with yourself and/or
other people. You don't learn from experience how to change the
unhelpful parts of yourself
You may have a personality disorder
if you find it difficult to:
- make or keep relationships
- get on with people at work or with friends
and family
- keep out of trouble
- control your feelings or behaviour.
and
- you are unhappy or distressed and/or find
that you upset or harm other people.
How common is PD?
Probably about 1 in 10 people has a PD.
Personality disorders tend to fall into three
groups:
Cluster A - 'Suspicious' –
includes:
Paranoid
You are suspicious of other people – you feel
that they are being nasty to you. You are sensitive to rejection
and tend to hold grudges.
Schizoid
You don't have strong emotions, don't like
contact with other people and prefer your own company. You have a
rich fantasy world.
Schizotypal
You have odd ideas and difficulties with
thinking. Other people see you as eccentric. You may see or
hear strange things.
Cluster B - 'Emotional and
impulsive' - includes
Antisocial
You don't care about the feelings of others,
get easily frustrated, fight, commit crimes and find it hard to
have close relationships. You do things on the spur of the moment,
don't feel guilty and don't learn from unpleasant experiences.
Borderline, or Emotionally
Unstable
You do things without thinking, find it hard
to control your emotions, and feel empty. You feel bad about
yourself and often self-harm. You make relationships quickly, but
easily lose them. You can also feel paranoid or depressed and, when
stressed, may hear noises or voices.
Histrionic
You over-dramatise events and tend to be
self-centered. Your emotions are strong, but change quickly. You
worry a lot about your appearance and crave excitement.
Narcissistic
You feel very important and dream of success,
power and status. You crave attention, tend to exploit others and
ask for favours that you don’t return.
Cluster C - 'Anxious' – includes:
Obsessive-Compulsive (aka
Anankastic)
You are perfectionist, worry about detail and
are perhaps rigid. You are cautious and find it hard to make
decisions. You have high moral standards, tend to judge other
people and worry about doing the wrong thing. You are sensitive to
criticism and may have obsessional thoughts and behaviours.
Avoidant (aka
Anxious/Avoidant)
You are very anxious and tense, you worry a
lot, feel insecure and inferior. You want to be liked and accepted
and are sensitive to criticism.
Dependent
You rely on others to make decisions for you
and do what others want you to do. You find it hard to cope with
daily tasks, feel hopeless and incompetent and easily feel
abandoned by others.
Professional help
This can include:
Individual
Therapy
Counselling and dynamic psychotherapy,
cognitive therapy, cognitive analytical therapy and dialectical
behaviour therapy.
Treatment in a therapeutic
community
A place where you can attend (or sometimes
stay in) for several weeks or months. Most of the work is done in
groups. You learn from being with other people in a unit. It
differs from 'real life' in that any disagreements or upsets happen
in a safe place. The staff and other patients help you to get
through such problems and learn from them.
Medication
Antipsychotic drugs can reduce the
suspiciousness of cluster A personality disorders (paranoid,
schizoid and schizotypal). They can also help with borderline
personality disorder if people feel paranoid, or are hearing noises
or voices.
Antidepressants can help with
the mood and emotional difficulties of people with cluster B
personality disorders. Some selective serotonin reuptake inhibitor
antidepressants can also reduce anxiety in cluster C personality
disorders.
Mood
stabilisers such as lithium, carbamazepine, and sodium
valproate may also reduce impulsiveness and aggression.
How effective is treatment?
The evidence is weak because treatments are
usually quite complicated, so it is hard to know what part actually
worked. The studies are also usually small and rather too short,
and the ways of measuring improvement are poor.
Which approach is best for me?
This depends on what you prefer as well as the
type of personality disorder that you have. However, a lot depends
on what is available in your area.
For more in-depth information see our main leaflet.
This leaflet is made available through the
generosity of the Charitable Monies Allocation Committee of the
mental health charity St Andrew's, Northampton
February 2009. This is an
abridged version of our main leaflet.
© February 2008 Royal
College of Psychiatrists http://www.rcpsych.ac.uk/.
You can link to, download, print, photocopy and distribute this
leaflet free of charge. But you must not change it or repost it on
a website.
Charity registration number (England
and Wales) 228936 and in Scotland SC038369
Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.
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