Expert Psychiatric Care for Personality Disorders

Genetics: Your genetics play a major part in the development of Personality Disorders. If a family member has a Personality Disorder or a mental health condition, the chances of you developing a similar disorder are higher. You may also inherit certain traits or tendencies, which affect how you think and behave in different situations. For instance, research has shown a strong link between genetics and conditions such as Antisocial or Borderline Personality Disorder.

Environmental Stress: Cultural and societal influences — like social norms, values, and expectations can also influence the development of Personality Disorders. For example, growing up in a culture that places an overly strong emphasis on success and career may cause you to develop narcissistic tendencies and symptoms. On the other hand, a culture built around conformity and governmental obedience may see higher instances of dependent or avoidant personality traits.

Personality Traits: Extreme personality traits can contribute greatly to the development of Personality Disorders. These traits influence how you perceive yourself and others. Over time these maladaptive traits can contribute to patterns that disrupt personal relationships, work, and daily life.

Schizoid Personality Disorder

• Strong preference for being alone and lack of interest in forming close relationships
• Emotional coldness, detachment, or flattened affect (appearing indifferent to praise or criticism)
• Little to no desire for sexual experiences with others
• Limited range of emotional expression, or appearing emotionally distant
• Minimal interest in participating in too many activities
• Difficulty relating to others or responding to social cues

Schizotypal Personality Disorder

• Odd beliefs, magical thinking, or superstitions (e.g., believing in telepathy or having special powers)
• Unusual perceptual experiences, such as hearing voices or seeing things that aren’t there
• Eccentric behaviours, speech, or appearance (e.g., unusual clothing or mannerisms)
• Suspiciousness or paranoid thoughts
• Inappropriate or limited emotional responses, often mismatching social cues
• Excessive social anxiety, even in familiar situations, often driven by paranoid fears
• Few close relationships due to discomfort with intimacy

Cluster B (Dramatic, Emotional, or Erratic Disorders)

Antisocial Personality Disorder

• Disregard for societal rules and the rights of others
• Lying, using aliases, or conning others for personal gain
• Reckless disregard for the safety of self or others, including engaging in illegal activities
• Impulsivity and failure to plan, leading to unstable relationships and financial trouble
• Irritability, aggression, and violent behaviour
• Consistent irresponsibility, including inability to maintain work or honour financial obligations
• Lack of remorse for harm caused to others, whether physical, emotional, or financial

Borderline Personality Disorder

• Intense and unstable interpersonal relationships
• Deep fear of abandonment
• Rapid mood swings, including intense episodes of anger, Depression, or Anxiety lasting a few hours to a few days
• Chronic feelings of emptiness or boredom
• Impulsive, self-damaging behaviours, such as substance abuse, reckless driving, or binge eating
• Recurrent suicidal behaviour, threats, or self-harming actions (e.g., cutting oneself)
• Difficulty controlling anger, leading to outbursts or physical fights
• Stress-related paranoid thoughts or severe dissociative symptoms

Histrionic Personality Disorder

• Constantly seeking attention and approval from others, often through dramatic or exaggerated behaviour
• Inappropriate sexual or provocative behaviour, aimed at getting attention
• Rapidly shifting and shallow expression of emotions, often seeming insincere or exaggerated
• Consistent use of physical appearance to draw attention to oneself
• Highly suggestible, easily influenced by others or by trends
• Perceives relationships as closer or more intimate than they are
• Discomfort when not the centre of attention, leading to theatrical or attention-seeking behaviour
• Overly emotional or dramatic speech

Narcissistic Personality Disorder

• Huge sense of self-importance, exaggerating achievements and talents
• Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
• Belief that they are special and unique, and can only be understood by or should associate with other special or high-status people
• Need for excessive admiration and constant validation from others
• Sense of entitlement, expecting favourable treatment or compliance with their expectations
• Exploitation of others to achieve personal goals, without regard for their feelings
• Lack of empathy, unable or unwilling to recognise the needs or feelings of others
• Envy of others or belief that others are envious of them
• Arrogant or haughty attitude and behaviour

Cluster C (Anxious or Fearful Disorders)

Avoidant Personality Disorder

• Extreme sensitivity to criticism or rejection, leading to avoidance of social interactions or work activities that require interpersonal contact
• Feelings of inadequacy and being socially inept or inferior to others
• Reluctance to engage in new activities or take personal risks due to fear of embarrassment or failure
• Avoidance of intimate relationships, despite wanting them, due to fear of rejection
• Low self-esteem and constant feelings of shame or inadequacy
• Excessive reluctance to try new things or meet new people, preferring familiar routines
• Extreme shyness or Anxiety in social settings

Dependent Personality Disorder

• Difficulty making everyday decisions without excessive advice or reassurance from others
• Needing others to assume responsibility for most major areas of their life
• Not disagreeing due to fear of losing support or approval
• Difficulty initiating projects or doing things independently due to lack of self-confidence
• Going to excessive lengths to obtain support, including volunteering for unpleasant tasks
• Feeling helpless or uncomfortable when alone due to exaggerated fears of being unable to take care of oneself
• Feeling an urgent need to seek a new relationship as a source of care and support when a close relationship ends
• Unrealistic preoccupation with fears of being left to care for oneself

Obsessive-Compulsive Personality Disorder (OCPD)

• Preoccupation with details, rules, lists, order, and schedules
• Perfectionism that interferes with completing tasks
• Excessive devotion to work and productivity
• Inflexibility about matters of morality, ethics, or values
• Reluctance to work with others, unless they submit to their way of doing things

Paranoid Personality Disorder: Those with Paranoid Personality Disorder have extremely suspicious dispositions and tend to believe most people are out to get them in some way, even when there’s no sufficient reason to think so. They might misinterpret casual remarks for personal attacks and hold onto grudges for a long time. Their deeply mistrusting natures often lead to self-isolation and damaged relationships.

Schizoid Personality Disorder: People with Schizoid Personality Disorder have solitary natures and tend to avoid close relationships of any kind, including families. As a result, they come across as socially withdrawn and emotionally detached. Their emotional range is so limited that they seem indifferent to praise and criticism.

Schizotypal Personality Disorder: Schizotypal Personality Disorder involves abnormal thoughts and behaviours, such as believing in ghosts and magic, and also unclear or distorted speech. People with this disorder tend to struggle with developing and maintaining close relationships, and may come across as ‘odd’, ‘eccentric’, or ‘suspicious’.

Cluster B (Dramatic, Emotional, or Erratic Disorders)

Cluster B Personality Disorders involve dramatic and erratic behaviours. People with these types of conditions display intense, unstable emotions and impulsive behaviours.

• Antisocial Personality Disorder : Those with Antisocial Personality Disorder often lack empathy and disregard the feelings of others. They break the rules frequently, act impulsively, and engage in deceitful or manipulative behaviours without remorse. They struggle to maintain jobs and relationships because of their aggressive and irresponsible natures.

• Borderline Personality Disorder (BPD) : A broken sense of identity, insecurity, and impulsive behaviours are the typical traits of someone with Borderline Personality Disorder (BPD). People with BPD often suffer from intense mood swings and a constant fear of abandonment. To manage their volatile emotions, they may end up harming themselves or taking huge risks of some kind.

• Histrionic Personality Disorder : Craving to be the centre of attention is the defining trait of someone with a Histrionic Personality Disorder. Such people also suffer from an extreme need for approval. Consequently, they tend to be overly dramatic, a little too emotionally expressive, and prone to flirtatious or provocative mannerisms to get what they want, which is gaining praise or attention at all costs.

• Narcissistic Personality Disorder : Those with Narcissistic Personality Disorder suffer from a false sense of superiority and as a result, expect to be given special treatment. They have little to no sympathy for others, tend to exploit people for their benefit and struggle with accepting criticism. They also suffer from a constant need for admiration. Beneath all the false confidence, however, they are very fragile and emotionally vulnerable.

Cluster C (Anxious or Fearful Disorders)

Cluster C Personality Disorders are associated with high levels of Anxiety and fearfulness. People with these conditions often feel insecure, dependent, or overly concerned about their surroundings.

• Avoidant Personality Disorder : Being extremely scared of rejection and equally sensitive to criticism, people with Avoidant Personality Disorder tend to avoid social situations of any kind. They might want close relationships like most people, but because of their deep-rooted insecurity, low self-esteem, and fear of ridicule, they end up living in isolation.
• Dependent Personality Disorder : People with Dependent Personality Disorder live in constant fear of abandonment or being left to survive on their own. As a result, they rely heavily on others to make decisions for them and try their best to stay in their good books and avoid conflict, lest they be left alone. Unsurprisingly, they tend to have submissive personalities and struggle to be assertive in relationships.
• Obsessive-Compulsive Personality Disorder (OCPD) : People with Obsessive-Compulsive Personality Disorder (OCPD) are overly preoccupied with control, as well as things being in order and ‘just right’. This isn’t like Obsessive-Compulsive Disorder (OCD), for the person is not driven by intrusive thoughts; instead, they become excessively focused on rules and details, which makes them inflexible and inefficient at times.

Treatment of Personality Disorders

Personality Disorders are some of the most difficult disorders to treat in psychiatry. This is mainly because people with Personality Disorders don’t think their behaviour is problematic, so they don’t often seek treatment.

• Psychotherapy : Therapy is the primary treatment for Personality Disorders. Cognitive-Behavioural Therapy (CBT) and Dialectical Behaviour Therapy (DBT) help you recognise and change problematic thoughts and behaviours. Psychotherapy can also help with handling emotions better and building good relationships.
• Medication : No medications are approved as yet for treating Personality Disorders. However, certain medications may be prescribed at times to help manage symptoms of Personality Disorders. Common medications prescribed include antidepressants, mood stabilisers, and antipsychotic drugs.
• Complementary Therapies : Alternate therapies such as mindfulness, yoga, and nature therapy can increase a sense of internal and external awareness which is beneficial for you. Art, music, and dance therapy can help you express emotions that you may not be able to convey otherwise.
• Stress Management : Healthy routine and stress management can help you regulate emotions. Chronic stress can worsen the challenges associated with Personality Disorders.