Issue #20: The Truth About Personality Disorders
Learn about personality disorders, what causes them and which clusters exist
Dear mental health advocate,
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And now, back to the content. In this edition I will deep dive into personality disorders. A really big topic in psychology, with a lot of discussion and research. To narrow it down a bit, I initially want to discuss what a personality disorder is and which ones exist.
The Truth About Personality Disorders
A very important and big topic within the psychology field discusses personality disorders. It’s a concept that has led to a lot of discussion and research over the years. In popular culture personality disorders are often mentioned and used to define a character. Many people also quite carelessly throw around terms related to personality disorders without actually properly understanding the meaning behind them. For example, I regularly hear things like ‘Oh he is such a narcissist’ or ‘She really is borderline crazy’. While many normalize these terms, I would like to ask you all to not just use these words related to personality disorders lightly, because it can be harmful to others.
Today, I want to write a piece on personality disorders to help you understand how psychologists use these to describe certain types of behaviors and characteristics that occur in specific patterns. Suffering from a personality disorder is not a joke and can have a lot of consequences for the person involved. Only a mental health professional can diagnose this, so do not just put a label on either yourself or someone in your surroundings as this could be counterproductive and actually hurting your relationships. There are quite a lot of different ones, so in this newsletter I will mainly focus on what personality disorders are and provide you with a list of them all. In later editions, I will sporadically zoom in on a specific one to explain them more in detail.
What is a personality disorder?
To understand all the different types of personality disorders it is crucial to understand what a personality disorder actually is, as there are quite a lot of misconceptions about them. According to the Cleveland Clinic, the best way to define a personality disorder is as follows:
A personality disorder is a mental health condition that involves long-lasting, all-encompassing, disruptive patterns of thinking, behavior, mood and relating to others. These patterns cause a person significant distress and/or impair their ability to function.
As humans we all have a personality. Each person is unique in that way, as a personality is a complex mix between all sorts of traits and characteristics which show themselves in patterns. Although for each individual their personality may be unique, psychologists do classify certain patterns as disorders. Mostly, because these patterns seem to be rigid and have several similarities that make them easier to categorize. Many mental health professionals consider personality disorders to cause a distorted perception of reality and other ‘abnormal’ behaviors. The word abnormal is a difficult one here.
While we all have different characteristics and ways we behave, in many societies there are certain norms and values that dictate what is seen as normal and what not. However, this is a bit of a grey area and can vary in some cultures. For example, there is consensus that murder is wrong, but being very emotional and showing temperament might be seen as more acceptable in some places compared to others. This is what causes discussions among professionals, because what is exactly abnormal? Nevertheless, what is clear is that a personality disorder can cause issues with relationships, work and in other areas of life. What further complicates it is that people suffering from personality disorders often do not recognize the negative effect they might have on people.
What causes personality disorders?
This might be one of the most debated topics when discussing mental health disorders. Is it purely because of genes? Does the environment play an important role? There is not always clear consensus about this, but what is sure is that both are partially responsible. The complexity can be found more in which gene or life experience exactly plays a part here. So much research has been done and here is what has been found for example (based on information by American Psychological Association):
Genes: researchers have found that there seem to be genes which are responsible for aggression, anxiety and fear. These might influence the development of a personality disorder. Another study found a mutation in a serotonine transporter which could potentially correlate with obsessive-compulsive disorder.
Trauma and childhood experiences: what someone goes through when they are young can significantly impact their development, as their brain is still growing and forming patterns. This is why trauma during early childhood can result in maladaptive patterns later. For example, many people with borderline personality disorder have a history of childhood trauma like (sexual) abuse.
Which personality disorders exist?
Generally, there are ten different personality disorders that have been defined by psychologists and psychiatrists that can be found in the DSM-V (the Diagnostic and Statistical Manual of Mental Disorders). These ten are categorized in three different clusters based on their symptoms (with some overlap here and there). Bear in mind that it is possible for people to suffer from a personality disorder and also have symptoms from another one:
Cluster A personality disorders
These are defined by behavior that is considered to be eccentric and odd, often paired with unusual thinking patterns. The following ones are part of this cluster: paranoid, schizoid and schizotypal personality disorder.
Paranoid personality disorder: this one is characterized by paranoia, with the person constantly being suspicious of others and not trusting them without actually having any reason to. They hold grudges and become angry when they perceive disloyalty.
Schizoid personality disorder: this one occurs when a person preferably does not want to engage with others, form any relationship and rather wants to be alone. No pleasure is derived from social activities and there is hardly emotional expression. These people feel detached from others.
Schizotypal personality disorder: this one is marked by people with an intense discomfort with close and intimate relationships. They have social anxiety, a peculiar sense of reality and often superstitious. Often there is suspicious behavior and strange beliefs happening.
Cluster B personality disorders
This cluster is categorized based on erratic and dramatic behaviors and emotions. People suffering from these often are impulsive and show intense feelings.The following ones are part of this cluster: antisocial, borderline, histrionic (theatrical), and narcissistic personality disorder.
Antisocial personality disorder: this one is defined by someone not following social norms and values and instead doing what they want themselves. They lack respect and ignore other people’s needs and boundaries. Violence, no remorse and issues with the law occur frequently.
Borderline personality disorder: a person with BPD engages in risky and very impulsive behavior and goes up and down with their mood quite frequently. They are unstable and can threaten with suicide. Stress, paranoia and anger also happen many times, as they have difficulty regulating their emotions.
Histrionic (theatrical) personality disorder: this condition is also marked by unstable emotions and a misaligned self-image. In this case, they depend their self-worth on other people’s opinions. As a result, they resort to dramatic behavior and try to get attention.
Narcissistic personality disorder: if a person struggles with this, they show a sense of superiority and consider themselves to be special and more important than others. They expect to be admired and believe they achieve more and should be rewarded more. Other people’s needs and achievements are not recognized.
Cluster C personality disorders
In this cluster the people with these disorders suffer from a lot of anxiety and fears that impact their daily life and relationships. The following ones are part of this cluster: avoidant, dependent and obsessive-compulsive disorder.
Avoidant personality disorder: this one is defined by feelings of inadequacy and a fear of being judged negatively by other people, which results in avoiding social contact with others or being in situations where they could be judged. They are shy and timid, trying to not be rejected.
Dependent personality disorder: a person with this condition wants and needs to be taken care of, they are submissive and can be quite clingy. There is a helplessness and fear of being alone. Low confidence and not being able to make decisions are typical for this personality disorder.
Obsessive-compulsive disorder: not to be confused with OCD, this disorder (OCPD) is marked by the need to have rules and orderliness as well as the desire to be in control. There is rigidness and extreme perfectionism as well as workaholism.
Final say on personality disorders
There is a lot to say and discuss about personality disorders, but to avoid having a very long read I want to keep it a bit summarized for now. Each personality disorder in itself has a lot of background information and studies to examine what it looks like, so I will keep that for another edition. Findings indicate that around 9% of the US population suffers from a personality disorder, making them very prevalent. This is why I still want to stress the importance of knowing they exist and being aware of them. They are difficult to deal with, for all parties involved. The person suffering from it, as well as their environment. The issue with treatment is that they are hard to recover from, as many do not see problems themselves.
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My name is Alf Lokkertsen and I am a psychologist and writer, creating mental health content for you. My passion is to raise awareness about topics related to psychology, as it has helped me greatly in my personal life. I strongly believe that many problems could be avoided or dealt with better if everyone had some in-depth psychology knowledge.
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Alf, this is a super important piece because the world does not know about or understand at all personality disorders. And they should! Because this class of disorders is the root cause of most of humanity's struggles, including wars, persecution, and autocracy. Trump is a perfect example. In his case, the diagnosis is severe narcissistic personality disorder, complementing his demagogic talents. Look at the damage to the United States––to the world––one man's personality disorder is effecting. I believe personality disorder should be an object of study in all fields, including political science. Thanks for raising awareness.