Erratic behaviours, long-term dysfunction and tumultuous relationships.
Personality disorders are severe mental health conditions that cause distress and dysfunction. To understand them better it helps to consider what a personality is. Personality is a pattern of thoughts, feelings and behaviours that are consistent across time and different situations. Our personalities are often viewed as the summation of different traits, like extraversion and agreeableness1. Similarly, those with personality disorders experience dysfunction and distress, in consistent and long-term patterns. Including difficulty forming relationships, perceiving the world and sustaining employment.
Personality disorders are similar but different from mood disorders. Depression and Borderline personality disorder share similar symptoms like low mood. However, personality disorders tend to produce more dysfunctional behaviours and thoughts2. For example, borderline personality disorder is more associated with suicidality and erratic behaviours in relationships. Whereas depression is more associated with mood and feeling. Another key difference between personality and mood disorders is the duration and frequency of symptoms. Borderline personality disorder and bipolar are both associated with mood swings. Those mood swings are typically more frequent and quicker to change with Borderline than Bipolar3.
Personality disorders are often ego-syntonic whereas other psychological disorders are ego-dystonic. This refers to how someone feels about their dysfunctional thoughts, feelings and behaviours4. A good example is OCD and OCD Personality disorder. Those with OCD are ego-dystonic, meaning their OCD behaviours and thoughts do not align with their values. They are aware of how much it affects their life. If they perform a compulsion it’s due to the intensity of the obsession not because of a genuine desire to do it. However, those with OCD Personality disorder are ego-syntonic, meaning their OCD thoughts and behaviours do align with their values. They may even believe that their OCD is beneficial, with no downside. People with Personality Disorders often can’t see the negative effect of their condition. This can make treatment more difficult.
There are ten different types of personality disorders, which are divided into three clusters5. The different types within a cluster share common symptoms.
Cluster A contains personality disorders involving odd and eccentric behaviours and thinking6. These include Paranoid, Schizoid and Schizotypal Personality Disorders. Cluster B contains personality disorders involving unstable emotions and impulsive behaviours. These include Antisocial, Histrionic, Borderline and Narcissistic personality disorders. Cluster C contains personality disorders involving anxious and fearful thoughts and behaviours. These include Avoidant, Obsessive-compulsive and Dependent personality disorders.
Personality Disorders are commonly diagnosed by a psychiatrist or a psychologist. The first step is often consulting with your GP. Personality disorders can be managed and treated with medication and psychotherapy. For example, Dialectical Behaviour Therapy is an extension of Cognitive Behaviour Therapy designed specifically for borderline personality disorder7. Crisis management resources are also important when personality disorders lead to harmful behaviours.
By Will Sutherland
1. 12.1 Personality and Behaviour: Approaches and Measurement – Introduction to Psychology – 1st Canadian Edition. (2014, October 17). Opentextbc.ca. https://opentextbc.ca/introductiontopsychology/chapter/11-1-personality-and-behavior-approaches-and-measurement/
2. Health, P. B. (2022, April 12). What’s the Difference Between a Personality Disorder and a Mood Disorder? Promises Behavioral Health. https://www.promises.com/addiction-blog/difference-between-personality-disorder-and-mood-disorder/
3. Mental Health Conditions. (n.d.). NAMI Chicago. Retrieved July 2, 2022, from https://www.namichicago.org/mental-health-conditions
4. Syntonic and Dystonic. (n.d.). Richard B. Joelson, DSW. https://richardbjoelsondsw.com/articles/syntonic-dystonic/
5. Robitz, R. (2018, November). Psychiatry.org – What are Personality Disorders? Psychiatry.org. https://psychiatry.org/patients-families/personality-disorders/what-are-personality-disorders
6. Health direct. (2019, January 11). Personality disorders: an overview. Healthdirect.gov.au; Healthdirect Australia. https://www.healthdirect.gov.au/personality-disorders
7. Behavioral Tech. (2021). What is dialectical behavior therapy (DBT)? Behavioral Tech – Training, Continuing Education in Dialectical Behavior Therapy (DBT). https://behavioraltech.org/resources/faqs/dialectical-behavior-therapy-dbt/
8. Mayo Clinic. (2016). Personality disorders – Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/personality-disorders/symptoms-causes/syc-20354463