Personality disorder, also known as borderline personality disorder, is a type of mental disorder in which a person has an inability to think, function and behave in a healthy way. These disorders usually begin in adolescence or early adulthood and can cause serious difficulties in various areas of a person's life.
Personality disorders usually manifest as an excess or deficit of a particular personality trait, which is inflexible or interferes with healthy functioning. The DSM-5 (Diagnostic and Statistical Manual of the American Psychiatric Association) and other diagnostic manuals define different traits and symptoms under different personality disorders.
For example, borderline personality disorder is characterized by symptoms such as difficulty controlling emotional balance, instability in relationships and uncertainty in identity integrity, while narcissistic personality disorder is associated with an excessive self-esteem, a tendency to manipulate others and a lack of empathy. Treatment of personality disorders is usually through psychotherapy, medication or a combination, and the course of treatment varies depending on the person's symptoms, life circumstances and personal preferences. Untreated personality disorders can lead to serious impairments in functioning and a reduced quality of life.
What are the Types of Personality Disorders?
Cluster A (Eccentric) Personality Disorders
Paranoid Personality Disorder: In this disorder, the person constantly believes that others have malicious intentions and that they are constantly being watched or targeted. They display a suspicious, jealous and defensive attitude.
Schizoid Personality Disorder: In this disorder, the person avoids social relationships and displays emotional coldness and apathy. They may have a rich inner life oriented towards their own inner world, but they avoid relating to other people.
Schizotypal Personality Disorder: In this disorder, the person exhibits bizarre thoughts, behaviors and speech patterns. They are prone to surreal experiences or paranoid thoughts. They may have difficulty with social relationships and are often prone to social isolation.
Cluster B (Dramatic) Personality Disorders
"Cluster B" or "Dramatic Personality Disorders" refers to a group of personality disorders that form a subcategory of personality disorders according to the DSM-5 (Diagnostic and Statistical Manual of the American Psychiatric Association). The personality disorders included in this cluster usually show prominent and dramatic features on emotional and behavioral levels.
Antisocial Personality Disorder: In this disorder, the person consistently violates other people's rights and feelings, does not conform to the norms of society and tends to exploit or manipulate other people. Symptoms such as committing crimes, engaging in illegal behavior and not taking responsibility can be seen.
Borderline Personality Disorder: In this disorder, the person experiences symptoms such as emotional instability, self-destructive tendencies, uncertainty in identity integrity, intense conflicts in relationships and a sense of emptiness. People with borderline personality disorder often exhibit suicidal thoughts or behaviors.
Histrionic Personality Disorder: In this disorder, the person tends to attract attention, dramatize and emotionally exaggerate. They can be intense but superficial in personal relationships. There is emotional instability and a tendency to constantly seek the approval of other people.
Narcissistic Personality Disorder: In this disorder, the person is overly self-important, may tend to manipulate others, exaggerates success and shows a lack of empathy. They tend to use other people for their own benefit.
These personality disorders usually begin in early adulthood and affect a person's ability to function. Treatment is usually done through psychotherapy and focuses on alleviating the person's symptoms and improving their functioning. Medication can help manage some symptoms, but does not have the potential to solve the underlying problems.
Cluster C (Anxious) Personality Disorders
"Cluster C" or "Anxious Personality Disorders" refers to a group of personality disorders that form a subcategory of personality disorders according to the DSM-5 (Diagnostic and Statistical Manual of the American Psychiatric Association). The personality disorders included in this cluster are usually characterized by excessive worry, fear and insecurity. The personality disorders included in Cluster C are:
Obsessive-Compulsive Personality Disorder: In this disorder, the person shows symptoms such as excessive regularity, perfectionism, a need for control and regulation, and a tendency to take on too much work and responsibility. They may lack flexibility and feel the need to control other people and relationships.
Anxious Personality Disorder: In this disorder, the person is often anxious, fearful and insecure. They have difficulty in social interactions and coping with new situations. They may be hypersensitive to criticism and often compare themselves to others.
Depressive (Dysthymia) Personality Disorder: In this disorder, the person often experiences an inner sense of sadness and emptiness and has difficulty enjoying life. They may have low self-esteem and see negative events in an extreme way. They may experience social isolation and difficulties in relationships.
These personality disorders usually begin in early adulthood and affect a person's ability to function. Treatment is usually done through psychotherapy and focuses on alleviating the person's symptoms and improving their functioning. Medication can help manage some symptoms, but does not have the potential to solve the underlying problems.
Causes of Personality Disorder
No specific cause of personality disorders has been clearly identified and they often develop as a result of the interaction of multiple factors. Here are some possible factors that play a role in the development of personality disorders:
Genetic Factors: Personality traits are often influenced by genetic inheritance. People with a family history of personality disorders are more likely to develop the same disorders. However, genetic predisposition alone does not guarantee the development of a personality disorder; environmental factors are also important.
Environmental Factors: Adverse environmental factors such as traumatic experiences in childhood, abuse, neglect, separation or family conflicts can play an important role in the development of personality disorders. Such experiences can affect a person's emotional and cognitive development and lead to the formation of certain personality traits.
Biological Factors: Imbalances in brain chemistry or abnormalities in brain structures are thought to play a role in the development of personality disorders. For example, some research suggests that people with borderline personality disorder have differences in brain structure.
Individual Factors: Individual characteristics, such as a person's natural tendencies, poor adaptive skills, emotional regulation abilities and coping skills in the face of life stress, may play a role in the development of personality disorders.
Cultural and Social Factors: Cultural norms, societal expectations and social norms can influence personality development and promote or inhibit the emergence of certain personality disorders.
Personality disorders have a complex etiology and are often the result of a combination of multiple factors. Each individual's situation is different and the factors that contribute to the development of personality disorders may vary from person to person.
Personality Disorder Symptoms
Personality disorders are usually characterized by a marked and persistent deviation or abnormality in the way a person thinks, feels, relates and behaves. Symptoms can vary according to the type and severity of the personality disorder, but in general can manifest as
Emotional instability: Some personality disorders, such as Borderline personality disorder, are characterized by symptoms such as emotional fluctuations, quick anger, intense sadness or anxiety.
Problems in Social Relationships: Individuals with personality disorders often experience difficulties in social relationships. They may show over-dependence, avoidance, distrust or manipulative behaviors in relationships.
Uncertainty in Identity Integrity: Some personality disorders, especially borderline personality disorder, can lead to uncertainty about oneself. The person constantly struggles to define and understand themselves.
Inability to Stay in Place: In some types, such as histrionic personality disorder, individuals may exhibit extreme behaviors in order to draw attention to themselves and receive constant attention.
Aggression or Hostility: Some personality disorders, such as antisocial personality disorder, can be associated with aggression towards other people, rule-breaking and illegal behavior.
Perfectionism or Control: Some personality disorders, such as obsessive-compulsive personality disorder, are characterized by excessive perfectionism, need for control and regularity.
Lack of Empathy: In some disorders, such as narcissistic personality disorder, the ability to understand and empathize with the feelings of others is lacking.
These symptoms do not apply to everyone with a personality disorder and each individual's symptoms may be different. The diagnosis assesses whether the symptoms are long-lasting and far-reaching and should be made by a specialist.
Diagnostic Methods for Personality Disorder
The diagnosis of personality disorders is usually made by a psychiatrist or clinical psychologist using specific assessment methods. Here are some common methods used in the diagnostic process:
Clinical Assessment: A health professional (usually a psychiatrist or clinical psychologist) conducts clinical interviews to assess the person's symptoms, medical and psychosocial history. These interviews are used to identify the symptoms of a particular personality disorder and to understand whether they may be associated with another condition.
Interview: The person's emotional state, relationships and life experiences are discussed in detail. This is used to understand the person's specific personality traits, behaviors and thoughts.
Questionnaires and Tests: Standardized personality tests and questionnaires are used to assess a person's specific personality traits. For example, tests such as the Minnesota Multiphasic Personality Inventory (MMPI) and the Millon Clinical Multiaxial Personality Inventory (MCMI) are commonly used.
Observation: The behavior of individuals with personality disorders can be determined by observation. Observations, especially in a clinical setting, can help assess the person's difficulties in relationships and social interactions.
Medical and Psychiatric Evaluation: Personality disorders may co-occur with other psychiatric disorders. Therefore, medical evaluations, such as physical examinations and laboratory tests, may also be part of the diagnostic process.
Diagnosis of personality disorders usually involves assessing whether symptoms are prominent and persistent. The diagnosis is often based on data from several different sources of information and requires expertise and experience to make an accurate diagnosis. The diagnostic procedure is customized to fit the person's specific situation and symptoms.
Personality Disorder Treatment Methods
Treatment of personality disorders is often a long-term process and requires an individualized approach. Treatment is usually conducted by a psychiatrist, clinical psychologist or therapist and is customized to the specific symptoms, the person's needs and life circumstances. Here are some common methods used in the treatment of personality disorders:
Psychotherapy: Psychotherapy is used to support and improve a person's emotional, cognitive and behavioral regulation. Different therapy modalities can help relieve symptoms of personality disorder and improve functioning. This includes methods such as cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), psychodynamic therapy and schema therapy.
Medication: Medications prescribed by a psychiatrist may be used to help manage certain symptoms. For example, antidepressants may be used to control emotional fluctuations or anxiolytic medication for anxiety. However, medication alone cannot cure personality disorder, but it can help manage symptoms.
Group Therapy: Group therapy can help a person develop social skills, empathy and interact with others in a supportive environment. This form of therapy can help the individual develop relationship skills and increase access to social support.
Family Therapy: Family therapy can help improve relationships within the family and help family members better support the person with a personality disorder. This form of therapy can increase family members' understanding and improve communication skills.
Rehabilitation Services: Individuals with personality disorders may benefit from rehabilitation services aimed at increasing functioning and improving daily living skills. These services can provide support in areas such as work, education, housing and social skills.
Treatment for personality disorder can be time-consuming and challenging, but with the right support and an appropriate therapy plan, it is possible to improve functioning and quality of life. Starting treatment early and consistently adhering to treatment can increase the chances of success.