Personality disorders
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Personality disorders are a group of mental health conditions where a person’s thinking, behavior, and emotional responses are inflexible and maladaptive, causing problems in daily functioning, relationships, and self-perception. These traits are persistent, begin in adolescence or early adulthood, and differ significantly from cultural expectations.
🧠 WHAT IS A PERSONALITY DISORDER?
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It’s not just “personality quirks.”
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Personality disorders involve deeply ingrained patterns that:
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Disrupt relationships
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Impair work or social life
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Cause emotional distress
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The individual may have poor insight and often doesn't recognize the issue.
🧩 TYPES OF PERSONALITY DISORDERS (DSM-5)
Grouped into three clusters:
🔹 Cluster A: Odd/Eccentric
| Type | Traits |
|---|---|
| Paranoid | Distrust, suspicion of others |
| Schizoid | Detached, limited emotional expression |
| Schizotypal | Eccentric, magical thinking, social anxiety |
🔸 Cluster B: Dramatic/Emotional
| Type | Traits |
|---|---|
| Antisocial | Disregard for others, impulsivity, deceit |
| Borderline | Emotional instability, fear of abandonment, self-harm |
| Histrionic | Attention-seeking, shallow emotions |
| Narcissistic | Grandiosity, need for admiration, lack of empathy |
🔶 Cluster C: Anxious/Fearful
| Type | Traits |
|---|---|
| Avoidant | Extreme shyness, fear of rejection |
| Dependent | Need to be taken care of, fear of separation |
| Obsessive-Compulsive (OCPD) | Preoccupation with order, control, perfectionism (not OCD) |
🧪 DIAGNOSIS
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Based on clinical interviews, history, and psychological assessments
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Symptoms must:
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Be long-term and inflexible
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Cause functional impairment
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Be not due to substance use or another medical/mental condition
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Common tools:
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Structured interviews
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Personality inventories (e.g., MMPI, SCID-II)
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💊 TREATMENTS
Treatment can be complex and long-term, often requiring multi-modal approaches:
1. Psychotherapy (Mainstay of treatment)
| Type | Benefits |
|---|---|
| Dialectical Behavior Therapy (DBT) | Best for borderline PD; improves emotion regulation and reduces self-harm |
| Cognitive Behavioral Therapy (CBT) | Challenges distorted thinking, improves coping |
| Mentalization-Based Therapy (MBT) | Enhances understanding of own and others' mental states |
| Schema Therapy | Targets deep-rooted negative beliefs from childhood |
| Psychodynamic Therapy | Explores unconscious patterns and early relationships |
2. Medications (Not curative, but helpful for symptoms)
| Symptom | Medications |
|---|---|
| Depression, anxiety | SSRIs (e.g., sertraline, fluoxetine) |
| Mood swings, impulsivity | Mood stabilizers (e.g., lamotrigine) |
| Psychosis or severe agitation | Antipsychotics (e.g., quetiapine) |
| Sleep disturbance | Low-dose sedatives (short-term use) |
3. Group Therapy & Peer Support
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Provides safe social practice
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Enhances interpersonal skills
4. Hospitalization
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Used only for severe crises, like suicidal behavior
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Goal is stabilization, not long-term treatment
🧭 LONG-TERM OUTLOOK
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With consistent therapy, symptoms can improve significantly.
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Some types (like borderline) show notable recovery over time.
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Requires patience, structure, and long-term support.
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