“I'm so good at beginnings, but in the end I always seem to destroy everything, including myself.” ― Kiera Van Gelder
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Personality disorders are complex and misunderstood. Personality disorders are not immutable defects in personality, they are flawed coping strategies. Children who experience trauma develop ways of thinking and behaving that help them get what they need to survive in violent, abusive, neglectful, inconsistent, or invalidating environments. People with personality disorders continue to use the same strategies as they grow up, but the thinking and behaviors that helped them as children become dysfunctional in adulthood. Some of these thoughts and behaviors lead to trouble in school, at work, and in life in general. People with personality disorders can repeatedly destroy relationships with friends, romantic partners, and colleagues, and in the process, they can be incredibly self-destructive as well.
These strategies often involve behaviors that most people engage in at times, but in personality disorders the behaviors are more extreme and pervasive. For instance, everybody can sometimes be emotionally reactive and make impulsive decisions, but a person with Borderline PD will display severe emotional reactivity and impulsivity in most situations in their lives. In a neglectful family environment, this may have helped to get family members to attend to their needs. As an adult, these behaviors can lead to difficulty maintaining relationships, loss of employment, and legal trouble. Similarly, at times, we can all withdraw from people and need time alone, but a child in an abusive family might learn to do this all the time to avoid drawing the abuser’s attention. If that child continued to withdraw and avoid other people as they grew up, and as an adult that behavior became pervasive, they could develop Schizoid PD. People with Schizoid PD display little emotion, avoid developing connections with other people, and live solitary lives.
People often believe that personality disorders are untreatable. Treatment can be more challenging than treatment for other psychiatric disorders, but people with personality disorders can get better. With effective treatment, most people with personality disorders will no longer meet the diagnostic criteria.
If you would like more information about treatment for personality disorders at Owl & Eagle Health and Wellness in Golden or Greenwood Village, Colorado, Contact Us or Book Now to schedule an in-person or telehealth appointment today.
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Personality Disorders Q &A
What causes personality disorders?
Personality disorders are caused by the following risk factors:
- Heredity. If people in your family have personality disorders, you are more likely to have a personality disorder as well.
- Reactive temperament. People who have been more sensitive and emotionally reactive since early childhood are at higher risk of personality disorders.
- Childhood trauma. Children who experience physical or sexual abuse, especially if it occurs repeatedly over a long period, are more likely to develop personality disorders.
- Rejection, invalidation, or emotional abuse. When parents or other important people in a child’s life emotionally abuse, manipulate, or reject the child, or if they disregard or dismiss the child’s thoughts or feelings, the child is more likely to develop a personality disorder.
What are the symptoms of personality disorders?
Symptoms common to all personality disorders include the following:
- Patterns of thoughts, feelings, or behavior that started in childhood and have caused difficulty in multiple areas of life (ie: school, work, relationships, etc.)
- Negative ideas about self and other people (ie: feelings of superiority or inferiority, beliefs that people can’t be trusted, or that people are gullible and easily taken advantage of, etc.)
- Dysfunctional emotional responses (ie: emotional over-or under-reactivity compared with most other people)
- Dysfunctional impulse control (ie: persistent impulsivity or excessive control of thoughts and behavior)
- Limited insight into the dysfunctional nature of their own thoughts and behavior and a tendency to blame problems on other people
Specific types of personality disorders and their key features include:
- Borderline Personality Disorder: fear of abandonment, lack of a clear identity, emotional reactivity, impulsive behavior, and unstable relationships
- Narcissistic Personality Disorder: lack of empathy, feelings of superiority, and desire for admiration, power, wealth, or special treatment
- Antisocial Personality Disorder: lack of empathy, lack of regard for other people’s rights, and pattern of exploiting, manipulating, and violating people
- Histrionic Personality Disorder: strong emotions, dramatic self-presentation with clothing, hairstyle, makeup, speech, and gestures, and attention-seeking behavior
- Paranoid Personality Disorder: fear and distrust of others, pervasive belief that people are dangerous, belief that people dislike them and are trying to harm them
- Schizoid Personality Disorder: preference to be alone and lack of desire for relationships with others
- Schizotypal Personality Disorder: odd or eccentric behavior or speech, magical thinking, and discomfort in close relationships
- Avoidant Personality Disorder: shyness, feelings of inferiority, and avoiding people due to fear of rejection
- Dependent Personality Disorder: need to be taken care of by others, allowing others to treat them poorly due to fear of losing the relationship
- Obsessive Compulsive Personality Disorder: perfectionism, need for control and order, and rigid and uncompromising beliefs and behavior
How are personality disorders treated?
Treatment for personality disorders can be challenging, because people with personality disorders often do not realize that their own thoughts and behaviors are dysfunctional. They may not seek treatment at all, or may get stuck in patterns of blaming other people rather than working on their own contributions to their problems. They may have a pattern of idealizing psychiatric providers and therapists until they say or do something that the patient doesn’t like or agree with, at which point they may leave treatment prematurely. However, if people with personality disorders stay in treatment, and fully engage and participate, treatment can be very effective.
At Owl & Eagle Health and Wellness, our board certified psychiatric nurse practitioners and psychotherapists offer skillful, effective, and compassionate care for people with personality disorders. We will perform a thorough diagnostic evaluation to identify personality disorders and other co-occurring psychiatric disorders. We will work with you to create a treatment plan incorporating psychiatric interventions, psychotherapy, and evidence based integrative care such as nutritional recommendations, vitamins, supplements, exercise, yoga, meditation, and breathwork.
Medication can be used to treat symptoms of personality disorders, such as anxiety, depression, mood swings, or angry outbursts, and symptoms of any co-occurring psychiatric disorders. Most psychiatric medications have manageable side effects, and most resolve in the first weeks of treatment. Genetic testing can help identify which medications are most likely to be effective and well tolerated. Specialized psychotherapy such as Dialectical Behavioral Therapy (DBT) can help people with Personality Disorders develop awareness of their dysfunctional patterns of thought and behavior, understand how these patterns developed, and learn to develop healthier and more functional patterns of thought and behavior. In patients whose symptoms do not improve sufficiently with these initial treatments, transcranial magnetic stimulation (TMS) and ketamine assisted therapy can be very helpful. This holistic treatment approach can improve your symptoms and help you work toward optimal overall health and wellness.
If you are interested in treatment for personality disorders at Owl & Eagle Health and Wellness in Golden or Greenwood Village, Colorado, Contact Us or Book Now to schedule an in-person or telehealth appointment today.
Sources:
https://www.mentalhealth.gov/basics/mental-health-myths-facts
https://mhanational.org/mentalhealthfacts
https://www.nimh.nih.gov/health/statistics/personality-disorders