Types and types of personality disorders, their symptoms and therapy

Treatment of personality disorder.

What is a personality disorder?

Weirdos, originals or psychopaths?
They surround us everywhere, we see them every day. In the modern international classification of diseases, these conditions are defined as personality disorders. Among ordinary people, the term “severe character” is common, which partially corresponds to the concept of psychopathy. We doctors are not interested in the Greek and Latin terminology of medical protocols. We are interested in what we can do about this in order, if necessary, to smooth out the extremes, teach the patient to manage emotions and actions and remain in society without harming himself and others. Personality disorders are a group of mental illnesses. They involve long-term, persistent changes in thought processes and behavior that are unhealthy and inflexible. The behavior of such people can usually cause serious problems in interpersonal relationships in the family, on the street and at work. People with personality disorders have trouble coping with everyday stresses and problems. They often conflict with other people.

The cause of the development of personality disorders can be various factors that damage the brain, for example, alcohol, drugs, various toxins (spice, etc.), brain injuries, etc., as well as various disorders of brain development during intrauterine development, birth injuries , or is determined genetically. However, childhood experiences may also play a role in the development of these disorders.

The symptoms of each individual personality disorder are different. They can occur in mild, moderate or severe form. People with personality disorders often have problems in large part due to a lack of awareness that they have problems. For them, their thoughts are normal and they often blame others for their problems. However, such people can receive quite effective help. Treatment for personality disorders usually includes complex therapy, which should be selected strictly individually.

Personality disorders are special mental conditions in which a person differs significantly from the average person in terms of how they think, perceive, feel and relate to others. The main changes are visible in the way a person perceives, feels and experiences interaction with the environment, distorted ideas about other people. All this leads to “strange” behavioral reactions, which can be expressed as mild and perceived by others as a characterological feature, or can have a more severe course, which can lead to antisocial behavior and pose a danger to others.

The main symptoms of a personality disorder are:

• Having negative feelings such as distress, anxiety, worthlessness, or anger;
• Avoiding other people and feeling empty (emotionally disconnected);
• Difficulty or inability to manage negative feelings;
• Frequent conflicts with other people, or insults and threats of violence (often escalating in conflicts to assault);
• Difficulties in maintaining stable relationships with loved ones, especially spouses and children;
• Periods of loss of contact with reality.

Symptoms usually worsen with stress (stress, anxiety, menstruation, etc.).

People with personality disorders often have other mental health problems, especially mental health symptoms such as depression and substance abuse (alcoholism, drug addiction, substance abuse, etc.).

Interesting facts about personality disorder

A behavioral personality disorder is any condition that is the opposite of mental health.

It manifests itself in quite a variety of ways, so they classify 10 distinct types of mental disorders, each of which has characteristic symptoms and manifests itself in a certain way.

· Personality disorders usually cause problems with other people or addiction to alcohol and drugs.

· There are several different types of disorders, but there is some overlap between them.

· Treatment includes psychotherapy, which often needs to be long-term. Therapy can be individual or in a group.

· Some people with a personality disorder are prone to developing psychosis, depression and anxiety .

· Behavioral disorders may require treatment with medication, but are often treated with psychotherapy.

Psychological disorders treatment

Treatment of psychological disorders in patients of any age can only be prescribed by an experienced specialist. Previously, the patient undergoes a thorough health examination. It is carried out in order to exclude the possibility of the presence of a physiological disease. Passing symptoms can be provoked, for example, by endocrine or neurological disorders.

After eliminating physiological causes, the patient's psychological state is examined. An important part is collecting a family history. The fact of hereditary damage to psychological diseases has not been confirmed at the moment, but there are cases of familial predisposition. Doctors suggest that they may be associated with family habits and hereditary character traits.

The following are used in therapy:

• medications: antipsychotics, antidepressants, mood stabilizers;
• psychological classes, both individual and in groups;
• Physical therapy classes are shown.

Often patients may be advised to find an additional hobby. It can distract the patient from unpleasant thoughts.

What is a personality disorder

A personality disorder is a mental disorder in which a person has personality traits that deviate from the generally accepted norm. This manifests itself in the form of unreasonable or incomprehensible reactions in personal and social situations.

A person’s personality includes stable patterns of perception of the external world and ways of thinking. These patterns characterize a person. Our personality consists of a number of characteristics that are manifested to a greater or lesser extent in relationships with other people.

Such traits are mostly unconscious to the person himself.

We all have a certain perception of the world around us. This allows you to roughly determine how another person will react in a particular situation. These features are very stable. So we pay attention if the other person responds completely differently than we expect.

If patterns of ways of perceiving and reasoning differ significantly from the way the average person in a culture perceives, thinks, feels, and relates to others, it may be a personality disorder.

Diagnosis of psychological disorders

When diagnosing psychological disorders, doctors must first prescribe an examination of all body systems. This is necessary to exclude physiological causes of pathology.

Patients are prescribed ECHO, MRI, CT, and examination by an endocrinologist and neurologist is recommended. A study of the medical history is carried out. Psychological manifestations often become side effects of taking certain medications. For example, prescribed in the treatment of neurological diagnoses.

An important part of the diagnosis is a personal conversation with the patient. It is recommended to involve close relatives and those people with whom the patient is in constant contact.

How do behavioral disorders manifest themselves?

All behavior patterns are stable in adulthood, but are established early in childhood. They will be expressed in several different areas of mental and social function.

Personality disorder is a disorder in personality development. This means that this group of disorders often begins in adolescence and continues into adulthood.

When a person has a personality disorder, they often, but not always, experience varying degrees of discomfort and impairment in their ability to function in society.

A personality disorder is not the result of other mental disorders. But it may precede them.

Personality disorders include a group of deviations where an individual personality disorder develops in accordance with the most characteristic personality traits. There is some overlap between several types.

Psychological developmental disorders

These pathologies in ICD-10 are included in the heading F80-F89. The diseases included in it always begin in childhood, including infancy. Their development requires a delay in the development of the nervous system or its damage associated with pathological maturation. They are characterized by a constant course, there are no relapses.

The lesions affect motor functions, speech, and visual-spatial skills. In most cases, environmental factors in this pathology are important, but not decisive. At the same time, the etiology of the lesion is not precisely defined, due to which an exact determination of the causes of developmental disorders cannot be established at the moment. Today it is also common to include autistic disorders among such pathologies.

Characteristic symptoms of various types

Paranoid personality disorder

· This personality type is characterized by suspicion and mistrust.

· Such people tend to interpret the actions of others as hostile or full of contempt.

· Sensitive to real or perceived dangers and public opinion.

· People with this disorder have excessive faith in their knowledge and abilities.

· They often avoid close relationships with others and are afraid to get closer.

· Look everywhere for ulterior motives and find unfriendly intentions behind what others do.

· Question the loyalty or selflessness of friends and family members.

· People with this type of disorder often appear cold and distant.

· They like to take the blame for others.

Schizoid personality disorder

· People with this personality type are shy, often refuse to get close or establish contact, and have little emotionality.

·Prefer to do everything alone and do not know how to work in a team.

· They sincerely want to be alone and have no secret desire for popularity.

· Looking for a job that involves little social contact.

· They don't need attention or acceptance. As a result, their social skills are underdeveloped.

· They are sometimes perceived by others as completely isolated individuals.

·It is difficult for an outsider to gain their trust.

Schizotypal personality disorder

· Many experts believe that this is a mild form of schizophrenia.

· These people have strange behavior. They express feelings that are inappropriate to the situation.

· Such a person can reason with others in an illogical way that is incomprehensible to the majority and has difficulty finding contact with others.

· Sometimes they believe that they have unusual qualities or that certain events are connected in some secret way. This is called magical thinking.

· Often busy with their own (which may sometimes seem strange to others) activities.

· They have difficulty concentrating for long periods of time.

· It is difficult for their thinking to follow others and be stereotyped.

Narcissistic personality disorder

· Such people are extremely self-absorbed.

· They seek attention, praise and adoration in the eyes of others.

· They have an inflated opinion of their own greatness, are unable to empathize and tend to humiliate others, increasing their self-esteem at their expense .

· They exaggerate their importance and value in the eyes of others.

· Expect others to recognize their uniqueness, outstanding talents, and attractive appearance.

· They choose their friends carefully because they believe that not everyone is worthy of their friendship and prefer those who recognize their superiority.

· Interested in making a good first impression, but find it difficult to maintain long-term friendships.

· They are not interested in the feelings of others and like to use others for their own personal gain.

Dissocial (antisocial) personality disorder

This personality disorder is also called psychopathy.

· There is a misconception that people with dissocial personality disorder have poor social skills. This is often not the case.

· Typical of these people is their lack of conscience.

· Seem to be socially irresponsible and appear to others as exploitative, calculating, impulsive and merciless.

· People with this disorder often commit crimes. They perceive their victims as weak and think that they deserve to be deceived.

· Frequently lie, steal or deceive.

· In many cases, they are careless with money and do things without thinking about the consequences.

· They can be aggressive and care much more about their own interests than about the needs of others.

Histrionic personality disorder

· These people are constantly looking for attention and are willing to do a lot for it.

· They are dramatic, emotionally unstable, but have superficial feelings.

· They want to constantly be the center of attention.

· Often prevents others from dominating the conversation or being the life of the party.

· Use loud speech, make loud and significant statements, and constantly seek praise and recognition.

· Dress provocatively or exaggerate illness to attract attention.

· They sincerely believe that everyone around them loves them.

· Often manipulated and exaggerated.

Emotionally unstable (borderline) personality disorder

Emotionally unstable disorder is often called borderline.

· These people are usually impulsive and have strong and fluctuating feelings.

· Their self-perception, e.g. their understanding of who they are and what they stand for often changes. From the outside it looks as if they have no inner core or opinion.

· They experience a strong inner emptiness, which they unsuccessfully try to get rid of on their own. To drown out such feelings, this type of personality often begins to abuse alcohol or drugs.

· May behave in self-destructive ways and enter into unstable relationships with other people to whom they are uncritically attached.

· Have many partners in a short time because they cannot be alone and try to avoid it by any means.

· The mood is constantly changing, and there are emotional outbursts.

· They react sharply to strong and unbearable feelings and cause themselves pain. Suicide attempts are not uncommon for this type of disorder.

· Their thinking is categorical. There is only black and white, and there are no shades.

· Often enter into intense, conflictual relationships with others.

· Get ​​frustrated quickly when you don't achieve what you want.

· They are afraid of being abandoned or abandoned, thus trying to avoid inner emptiness.

Obsessive personality disorder

· People with this disorder are extremely concerned about order and tend to idealize everything.

· They are perfectionists, conscientious performers, accustomed to controlling everything and paying a lot of attention to unimportant details.

· The pressure to do everything “right” often disrupts their productivity or leads to complete inaction and constant dissatisfaction with themselves.

· Get ​​caught up in details and lose track of the big picture.

· Make excessive demands on themselves and others.

· They are overly critical of others if they do not meet their requirements.

· They avoid working in a team and think that others are too careless or incompetent, and it is best to do any task themselves.

· Have difficulty making decisions because they are afraid of making a mistake.

· Have problems expressing feelings.

Avoidant personality disorder

· These people are characterized by social anxiety.

· Individuals with this disorder feel inadequate.

· Avoid social contacts and teamwork.

· They are afraid of being rejected, they long to be loved and accepted.

· They are distinguished by touchiness and vulnerability.

· Exaggerate the possible difficulties of new situations in order to avoid participation and inaction.

· They live in their own imaginary world, which overshadows the real one.

· Unlike sour personality disorders, people with subtle personality disorder strive for social relationships with others. But they feel that they cannot do this.

· They are often depressed and have low self-esteem.

Dependent personality disorder

· Typical of this disorder is the desire to take care of others at the expense of one’s own interests.

· They are not confident in themselves , shift responsibility to others, and are helpless without external support.

· They cling to other people and are afraid of losing them.

· May contemplate suicide when relationships break down.

· Give others the opportunity to make important decisions for themselves.

· Often stay in relationships even when they are abused.

· Sensitive to criticism.

· Rejections are hard to deal with.

· They often feel helpless and depressed.

Comparative characteristics

First of all, a parallel is drawn between SPD and schizophrenia. The symptoms of the diseases are really similar, so with the naked eye it is difficult to distinguish one from the other. However, obvious differences are still present.

Although schizotypal disorder has many features similar to schizophrenic disorder, its course is more favorable.

Symptoms in patients with schizophrenia are more intense. Hallucinations and delusions are persistent, obsessive, and force a person to break away from reality. A persistent personality defect is formed. The intellectual sphere suffers to a greater extent, manifesting itself in illogicality and absurdity of thinking. The disease leaves a negative imprint on a person’s consciousness.

Schizoid and schizotypal personality disorders are very similar. The diseases can be called related. The distinctive criterion is still the same intensity of expression, only now the “blanket over itself” is pulled by the SPD. The disease includes illusory, mild hallucinatory manifestations, and other psychotic symptoms. In schizoid disorder, changes affect more the emotional sphere.

A common thread running through both disorders is emotional shifts: alienation and emotional coldness. Sensory disturbances stand out sharply against the background of both conditions, which makes diagnosis difficult.

But if schizoid disorder manifests itself in childhood, then the schizotypal personality appears at an older age.

A young man, 21 years old, tells his medical history: “Just recently, everything was fine with me. He had a great respect for physics and took part in Olympiads. He became interested in microbiology and entered medical school. At the same time, I played the guitar and studied foreign languages ​​(I speak three). Suddenly everything stopped abruptly. I didn't want to do anything. I abandoned my studies and then my hobbies. Soon he dropped out of life.”

Since schizotypal disorder is accompanied by obsessive actions, it is differentiated from obsessive-compulsive disorder. Hallucinatory manifestations make it possible to compare the disease with paranoid states.

The disorder is similar to autistic diseases due to its detachment from social contacts and stereotypical behavior.

Due to its wide range of symptoms, SPD has been associated with many diseases. Experts do not recommend using the diagnosis everywhere, since its recognition is difficult.

To make a diagnosis, the International Classification of Diseases has approved criteria, of which a person must have at least 4 over the past two years:

• emotional detachment;
• pretentious behavior;
• avoidance of social contacts;
• magical thinking;
• paranoid tendencies;
• obsessive thoughts without attempts to resist on sexual, aggressive topics, dysmorphophobic thoughts;
• derealization, depersonalization;
• psychotic episodes: illusions, hallucinations, delusions without external intervention;
• detailed, stereotypical thinking, intricate speech.

How to diagnose

The diagnosis is made based on:

· Consultation with a specialist.

· Collect information from surrounding people.

· Test results or filling out questionnaires.

These activities are aimed at identifying symptoms and signs of a particular disorder. Such diagnostics take a long time before the type of disorder and methods of treatment can be definitively determined.

Alcohol or drug abuse, increased anxiety and depression are the most noticeable signs of the disease in the early stages.

When to see a doctor

People should see a doctor if they believe they have symptoms of borderline personality disorder and these symptoms significantly affect their ability to work, enjoy life and form relationships.

It is important to remember that seeking help for mental illness is just as important as seeking help for physical illness, as both can cause negative consequences.

It is important to seek medical help immediately if a person experiences any suicidal thoughts or self-harm. These people require inpatient hospitalization to receive the care and support they need.

Causes

The following factors are considered common prerequisites for behavioral personality disorder.

· Innate tendencies or temperamental traits.

· Inherited (genetic) conditions play a significant role, contributing to approximately 50% of the development of personality disorder.

· Methods of raising a person in childhood.

· Example of parental behavior and the atmosphere in which the personality was formed. The quality of relationships is especially important in the first years of life. If there was physical punishment , neglect, mental instability of loved ones, lack of security. For example, emotionally unstable personality disorder is often observed in people who were sexually abused as children.

The causes of many disorders have not yet been thoroughly studied. But we can confidently judge that they are provoked by a combination of biological, psychological and social factors in early childhood and they intensify in adulthood.

Psychological disorders list

This list is currently incredibly wide, but experts identify the largest groups:

• Alcohol addiction, caused by a pathological passion for drinking alcoholic beverages, often caused by a violation of social adaptation. This also includes drug addiction. Admission leads to persistent mental disorders.
• Schizophrenia, in which the patient most often experiences perceptual disturbances. Often accompanied by fantastic delusions and hallucinations.
• Pathologies of the brain, most often first manifested in childhood, sometimes in adolescents, the pathology intensifies as they grow older.
• Disorders that occur in the emotional sphere, often called affective disorders. This section includes bipolar disorder, which is increasingly being diagnosed today.
• Neuroses and numerous variants of phobias that arise from a combination of internal and external conflicts.
• Physiological disorders associated with pathologies of eating, sexual, labor, and sleep dysfunction.
• Disorders that occur in adults are associated with pathological conditions in the field of social adaptation, and there is a lack of development in the emotional sphere. Patients often deny the presence of problems and refuse any medical care options.
• Cases of mental retardation. In such a situation, all areas of life suffer, the patient needs constant monitoring, and is almost always unable to care for himself.

In the modern world, everyone can sometimes suspect one or another type of psychological illness. But an accurate diagnosis can only be established in a medical institution by a qualified doctor. If you suspect the presence of a pathology, it is recommended to immediately contact a specialist.

Therapy for personality disorders

The goal of treatment for personality disorders is that the person should be able to function better in society and adapt to their environment.

Therapy also aims to reduce acute symptoms such as psychosis. People with certain personality disorders are especially susceptible to it.

The key treatment for mild behavioral personality disorders is long-term talking treatment (long-term psychotherapy). Work with a specialist can take place individually or in small groups.

Severe personality disorders require hospitalization and medication during crises. The main treatment is long-term psychotherapy.

Differences between schizotypal disorder and schizophrenia in psychiatry

The diagnosis of “schizotypal disorder” excludes severe psychotic disorders characteristic of schizophrenia, among them: delusional, hallucinatory, movement disorders (catatonia), clouding of consciousness.

In addition, with schizotypal disorder there are never such severe outcomes as with schizophrenia, for example, apathetic-abulic dementia.

In addition, with schizotypal disorder there are never such severe outcomes as with schizophrenia, for example, apathetic-abulic dementia.

How the disorder develops

Personality traits are usually stable after a person has grown up. This means that it is difficult to change on your own, without treatment or outside help. Some psychological traits, such as impulsivity, decline with age. However, in some cases there may be delayed maturation and personality changes.

People with personality disorders typically suffer from depression and anxiety, eating disorders, and substance abuse. In addition, there are a lot of crimes and suicide attempts against the background of deviations. The incidence of these complications depends on the type of disorder and whether it is treated or not.

Treatment results vary. But the prognosis is better for those who receive treatment.

Types of psychological disorders

In modern medicine, there are several main types of psychological disorders, which differ in symptoms and types of manifestation. Often, to eliminate the disease or enter a state of stable remission, depending on the type, different treatment options are required.

Neuropsychological disorder

Differs in manifestations of destructive behavior. In most cases, it is caused by improper functioning of the brain. Stand out:

• Exogenous or external causes associated with head injuries, illnesses, chemical poisoning, psychological trauma. May be associated with disorders of the cardiovascular system, leading to impaired blood supply to the brain.
• Endogenous or internal causes, which are mostly genetic, caused by a violation in the set of chromosomes.

Due to the commonality of psychotypes, they can often be transmitted from parents to children. Among the provoking factors are some diseases, including cerebral vascular sclerosis, diabetes mellitus, cerebrovascular accidents, and infectious diagnoses. Can be triggered by taking drugs and alcohol.

Mixed developmental disorders

In ICD13 they are classified as F83. The first manifestation is most often noted in childhood or infancy. Typically associated with chromosomal or genetic disorders. Accompanied by speech and school skills impairments. Motor functions may be impaired. They are diagnosed only in the case of a complete combination of several psychological disorders aggravated by life circumstances.

Specific psychological development disorder

Today, this category of pathological disorders has been poorly studied. An accurate diagnosis is complicated by the unreasonable combination of violations of the proper and timely acquisition of language skills, accompanied by motor disorders. But it is not recognized as intellectual retardation as such.

Mixed specific psychological development disorders

They are also established in the case of a combination of several factors recognized in the ICD10. Verbal intelligence suffers, and there are disturbances in the development of speech functions. There may be cases of disorientation and problems with logic are identified. Memory suffers.

How often do deviations occur?

On average, it is estimated that about 10% of the population meets the requirements for a diagnosis of one or more specific types of personality disorders. But many people don't seek help. Such cases have not been confirmed and are not included in these statistics.

According to the World Health Organization, out of 10 people, 2-3 individuals have characteristic problems. Most often they are expressed in sleep disturbances , sexual deviations, eating disorders (bulimia, obesity), panic attacks or behavioral disorders.

Major psychological disorders

Currently, experts suggest that by 2021, psychological disorders may take fifth place in the list of diseases leading to disability. According to Russian doctors, pathologies can be diagnosed in at least every resident of modern Russia. Approximately similar levels of indicators are observed in all developed countries of the world.

All the reasons for the occurrence of such pathologies are not known to modern doctors today. Conducted research shows that the list of provocateurs may equally include genetic predisposition and external life events. Diseases of the nervous system, leading to psychological pathologies, are caused by all factors that disrupt the activity of the central nervous system.

Despite the inability to identify the exact cause of the onset of psychological disorders, these pathologies can now be successfully treated. Depending on the degree of damage, treatment uses only courses of psychotherapy or medications, including antipsychotics and antidepressants.

Currently, psychiatrists are highlighting an increase in the number of confirmations of diagnoses of depressive disorders and phobias. They can often be accompanied by bipolar disorder.

The danger of each of these diagnoses is a violation of the patient’s socialization. Even a violation at the mildest level leads to a decrease in the level of performance. Patients become socially isolated. They often prefer loneliness and family ties are disrupted. Pathology leads to the appearance of suicidal thoughts.

Another large group is fears. They are established whenever a level of panic is detected in the perception of objects, natural phenomena, or events. Modern man often becomes pathologically afraid of spiders, the dark, water, and some animals. The reason can actually be any factor. Moreover, in such a situation, fear is not caused by a natural sense of self-preservation. It is inexplicable and appears unreasonably. The concern is that in reality there is no threat to health, much less life.

The number of diseases associated with unreasonable feelings of fear is incredibly large. Many of us also encounter their manifestations during rush hour in a subway car or in a large chain store. The crowds of people that surround us here are unpleasant even for healthy people. But it is not rejection that speaks of pathology, but rather fear at the level of a panic attack, in which the patient may begin to choke and may faint.

The list of major pathological disorders includes alcohol and drug addiction, bulimia, anorexia, and obesity. Doctors often encounter pathological sleep disorders.