Personality Disorders

A personality disorder is a pervasive, inflexible, enduring pattern of maladaptive inner experience and behaviour, that deviates from social norm and causes impairments in social and biological functioning.

One's personality develops as a consequence of a complex interplay between genetic, environmental and personal factors. People with personality disorders display distortions in self image, mood regulation, control of impulses and interpersonal functioning. Personality disorders skew one's peception of external events in a way that puts them at conflict with themselves or others. 

Personality disorders are classified into 3 main clusters. Cluster A's are seen as odd and eccentric and ( Schizoid, schizotypal and paranoid ). Cluster B's are seen as dramatic, impulsive, emotional and erratic ( Dissocial, boderline and histrionic). Cluster C's are seen as anxious and fearful. Personality disorders predispose to the emergence of a number of mental illnesses including depression, anxiety disorders and schizophrenia.

Rarely do people with personality issues, develop a clear insight into their own distress and the distress they cause to others. This delays any help seeking behaviour.

Personality disorders are easily identifiable if one knows what to look for. In the past personality disorders were perceived as untreatable, however psychotherapeutic measures and medication have proven efficacy in a number of personality disorders.

The personality develops through childhood and establishes by the mid twenties. Poor parenting and an unfavourable environment will lead to the development of maladaptive coping stratergies.  

Intervening at an eariler age will carry better prognosis. This makes effective parenting and a nurturing school paramount in development of a well rounded personality. Below, you will find short descriptions of some personality disorders.

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People with paranoid personality disorder have difficulty confiding with others and have trust issues. They may suspect the fidelity of their spouse or partners and the intention of the actions of others.

Schizoids are seen as aloof and uninterested in relationships, interactions and rewards. They are seen as cold and gain little pleasure from life. They may show little or no interest in sex or intimacy.

Those with a schizotypal personality are seen  as odd and eccentric. Bizzare explanations for events and excessive spirutual thinking. They are often called pseudophilosophical thinkers, due to their extensive formulations with shallow explanations.

Antisocials usually lack empathy and indulge in excessive substance use and criminal acts. They have the striking lack of an ability to learn trough experience or from mistakes and blame others for their behavior.

Boderline personality disorder was previously beleived to occur only in females, but not anymore. It is associated with deep rooted fears of abandonment, impulsivity, labile mood states, stormy relationships, and acts of self harm such as cutting oneself.

People with a histrionic personality are seen as theatrical and over indulging. They often dress seductively or are unusually loud and love attetion. They feel uncomfortable in situations where they arent the center of attention. 

Some people are apprehensive and anxious in unfamiliar situations. They are unusually sensitive to critisism and constantly worry about rejection. Low self esteem is a constant worry.They refrain from being in unfamiliar situations and unfamiliar people.They are said to have an avoidant personality.

A few with an obsessive personality have an excessive need for control, rigidity and an excessive need for perfection that interferes with productivty. This rigidity especially in terms of excessive hygeine or neatness is often imposed on loved ones.

Most of us have a few traits from each of the personalaity types. When disturbances in relationships, work or play arise from these abberant personality traits, it becomes a personality disorder.Poor insight is the norm in people suffering from personality issues. It becomes very important for loved ones to recognize sub optimal coping mechanism and seek care when appropriate. Though considered untreatable in the past, difficult personality traits can respond well to psychotherapy, behavioral techniques and medication.

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Psychiatry is a medical speciality, like surgery, general medicine and paediatrics. It involves the study, diagnosis and management of mental illnesses and distressing conditons, pertaining to both the mind and body. Misconceptions about psychiatric illness and treatment have some how prevented help seeking behaviour in those who need it the most. This Wall has to go, wherin visiting a psychiatrist should no longer be taboo, and people should be able to openly and freely discuss mental health issues. More here.

Dr Vikas Prabhav is a psychiatrist in anna nagar, chennai. he runs The Vivid Mind  mental wellness clinic in Anna Nagar. We aim at providing holistic, multimodal care for those suffering from mental illnesses and adjustment issues. We offer effective management strategies for depression, anxiety, unexplained physical symptoms, addictions, child/adolescent problems and other behavioural issues.The information provided in this website does not substitute for a medical consult.