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Personality Disorders

What Is a Personality Disorder?

Personality disorders are deeply ingrained, rigid ways of thinking and behaving that result in impaired relationships with others and often cause distress for the individual who experiences them. Mental health professionals formally recognize 10 disorders that fall into three clusters, although there is known to be much overlap between the disorders, each of which exists on a spectrum:

Cluster A — Odd or eccentric disorders, including paranoid personality disorder, as well as schizoid and schizotypal personalities.

Cluster B — Dramatic or erratic disorders, including narcissistic personality disorder, histrionic personality disorder, and borderline personality disorder.

Cluster C — Anxious or fearful disorders, including avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder.

How Do You Identify Someone With A Personality Disorder?

The first signs of a personality disorder usually appear in late adolescence or early adulthood, though in hindsight, feature of the disorder can be identified in childhood behavior, even though children are not formally diagnosed with these disorders. Although the disorders grouped within each cluster have similar symptoms and traits, one person may not have the exact same symptoms as another person with the same disorder, nor to the same degree. People with one personality disorder commonly have symptoms of at least one additional disorder, so it is important not to attempt a diagnosis if one is not a mental health professional, nor should one confront a person by asking whether the individual believes he or she has a disorder. People are usually unaware of their differences because they perceive their own distorted thought processes, emotional responses, and behaviors as normal.

Can Personality Disorders Be Treated and Cured?

Personality disorders present unique treatment challenges. However, people with personality disorders who are motivated to change can make great strides and benefit from targeted therapeutic interventions. Most personality disorders are ego-syntonic, meaning they are compatible with a person's self-concept. As such, there is little or no motivation to alter behavior, nor is the behavior perceived as dysfunctional. The innate nature of personality disorders also makes them treatment-resistant; these maladaptive ways of thinking and behaving are foundational, and are now understood to reflect brains that developed anomalously.

When a person is motivated to change, interventions such as Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) can be very helpful. Borderline personality disorder, wherein a person feels great distress at interpersonal problems is especially amenable to good CBT and DBT.

Just because a disorder cannot be "cured" does not mean an individual will not live a rewarding life and make contributions to society. Those struggling to do so can be supported with empathy and encouragement. Discussions with an individual who may be afflicted with a personality disorder are most fruitful when they are future-focused and centered on behavioral choices and consequences, rather than on what the person "should" do or why they behave as they do.

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