Personality disorders are mental health conditions that are characterised by rigid and unhealthy patterns of thinking, behaving, or functioning. These patients often have trouble relating to other people and situations, and they might have trouble with perception of the world around them. Patients with personality disorders often are not aware that they are suffering from this kind of condition and might blame others for the challenges that they experience on a daily basis.
These conditions often start to be expressed during the teenage years or early adulthood. There are many kinds of personality disorders. There are three main types of personality disorders that cause different symptoms.
These conditions are marked by eccentric or odd thinking and behaviour. Paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder are included in this cluster. These patients have a pervasive mistrust of others and their motives, and they might believe that everyone is out to get them or harm them. They are also usually convinced that others are trying to slight them or insult them, and they might see normal interactions as personal attacks. Cluster A disorders are also linked with a tendency to hold grudges and unjustified suspicions that partners or spouses are unfaithful to them.
These patients often experience dramatic or overly emotional and unpredictable behavioural patterns and thinking. This personality disorder group includes borderline personality disorder, narcissistic personality disorder, and histrionic personality disorder. There is a wider array of symptoms associated with Cluster B disorders, but many of these patients seek attention, are excessively dramatic in order to be noticed, or might suffer from unstable or fragile self-images. These people also tend to be very afraid of being alone and might suffer from intense emotions that they struggle to control.
This cluster of behavioural disorders is often characterised by anxious or fearful behaviour and thinking. This cluster includes obsessive-compulsive personality disorder, dependent personality disorder, and avoidant personality disorder. These patients are usually timid, shy, and worried about being unattractive or inferior. They might also be very sensitive to rejection or criticism and struggle to be alone or care for themselves.
The causes of these mental health conditions can be complex to identify, and in some patients, there is no known cause for the development of these disorders. In some patients, genetics plays a role as both a cause and a risk factor for the expression of these mental health disorders. Living in a chaotic, unstable, or unsafe home situation while growing up can also be a cause and a risk factor for these mental health disorders.
It is thought that personality disorders are caused by a combination of environmental stresses and genetic influences. Patients almost always have a history of abuse or neglect in childhood, and they are likely to have been diagnosed with a childhood conduct disorder as well.
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Diagnosis of these mental health conditions often begins with a physical exam. In some patients, underlying health conditions can exacerbate a personality disorder condition. A psychiatric evaluation is necessary to diagnose the particular mental health condition that the patient is suffering from. Information about other family members with mental health conditions is usually also needed in order to make a more accurate diagnosis of these patients.
Some patients express symptoms from all of the clusters, while others only experience a few limited symptoms from one. Getting an accurate diagnosis can sometimes require working with a specialist in personality disorders.
Treatment of these mental health conditions requires supportive care from a regular physician, as well as the help of a psychiatrist or psychologist. Social workers are sometimes also involved in helping these patients to get the supportive care that they need to be able to feel healthier and happier again. These conditions require lifelong treatment, and it can take years for patients to bring symptoms under control, even with excellent treatment protocols on their side.
Antidepressants, mood stabilisers, and antipsychotics can benefit patients when used in combination with therapy. Some patients benefit from being admitted to a care facility for more intensive support until a medication and psychotherapy regimen has been sorted out for their unique needs. Many patients will need to avoid drugs and alcohol as these can make mental health conditions worse. Joining support groups can also help those with personality disorders to be able to cope with the challenges of their mental health condition.
Prevention of these conditions is not usually possible because they are so often linked to genetics. However, there are indications that abuse of drugs and alcohol can be a factor in the development of these kinds of mental health challenges. Maintaining a healthy diet and being active every day can help to prevent things like depression and anxiety, which can exacerbate personality disorders or make them show up during the teen years.