Let’s clear up some of the confusion: What exactly are personality disorders, and how are they different from mood or anxiety disorders?
Possibly the most misunderstood mental illnesses are personality disorders, despite being some of the most common: around 10-13% of the worldwide population has a personality disorder, (Source 1) and 40-60% of psychiatric patients have personality disorders. (Source 2 – see reference list below.)
Receiving judgement and stigmatisation from even some mental health professionals, people with personality disorders often face an uphill battle when trying to be properly treated and understood.
The most basic misconception that many people have, is what personality disorders actually are. Put simply, they are a class of mental disorder involving patterns of thinking and behaviour that are deeply ingrained, have a significant impact on normal functioning, and differ greatly from what is normally expected from a person in a given culture. These patterns are rigid, maladaptive, and persist continuously over time. (Source 3)
The onset typically occurs in adolescence or early adulthood. Currently, an individual would not receive a personality disorder diagnosis until at least the age of 18. This is because, before this age, personality is not fully developed. The actual development of Personality Disorders occurs in childhood.
Personality Disorders affect at least two of these areas:
- How we think about ourselves
- How we respond emotionally
- How we control our behaviour
- How we relate to others
Personality Disorders are categorised into three clusters:
- Cluster A (odd, eccentric): Schizoid Personality Disorder, Schizotypal Personality Disorder, and Paranoid Personality Disorder
- Cluster B (dramatic, erratic, emotional): Borderline Personality Disorder, Narcissistic Personality Disorder, Histrionic Personality Disorder, and Antisocial Personality Disorder
- Cluster C (fearful, anxious): Obsessive-Compulsive Personality Disorder, Dependent Personality Disorder, and Avoidant Personality Disorder
What’s the difference between a personality disorder and a mood disorder/anxiety disorder?
- Personality disorders differ from other mental disorders in that they are more all-encompassing. They involve a deep-seated pattern of thought and behaviour that pervades across the individual’s entire life. This contrasts with, for example, an anxiety disorder, which would not tend to affect every aspect of an individual’s life. In other words, people with personality disorders will have difficulty with functioning, interpersonal relationships, and work or school obligations, while someone with anxiety may be able to have normally functioning relationships and a steady job.
- Mood disorders tend to be more episodic; individuals can go for several months or years without experiencing symptoms. In the case of personality disorders, symptoms persist continuously.
- Another difference is that people with anxiety or mood disorders usually realise they have a distressing problem that is out of their control, i.e. they are egodystonic. (Source 5) On the other hand, people with personality disorders are egosyntonic, meaning they think that their patterns of thought and behaviour make sense and that everyone else is causing the problem, rather than their own behaviour and thoughts being at fault. Therefore, it is more difficult for them to recognise that they have a disorder. This is seen starkly when comparing Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorder: the person with OCD is greatly distressed by their obsessions and intrusive thoughts, whereas the person with OCPD views their behaviours as rational, and the way things ‘should’ be. (Source 6) Therefore, people with anxiety or mood disorders are more likely to seek help than those with personality disorders.
- Mood and anxiety disorders can be directly treated with medication, however, no medication treats personality disorders; only the symptoms and/or comorbidities can be medicated, e.g. depression and anxiety. (Source 7)
What Causes Personality Disorders?
Research into personality disorders has been minimal. Thus, there has been no definitive cause determined for any personality disorder. We do know, however, that they are formed in early childhood. A combination of nature and nurture, i.e. abnormalities in the brain and adverse experiences in childhood, are cited as a key factor in the development of personality disorders. A family history of mental illness is also often linked to personality disorders. (Source 1)
Treatment for Personality Disorders
Psychotherapy is generally considered to be the best method of treatment for personality disorders. Cognitive Behavioural Therapy (CBT), and Dialectical Behaviour Therapy (DBT) are two of the most common types of talk therapies. DBT was in fact created specifically to treat Borderline Personality Disorder, one of the most prevalent personality disorders. Psychoanalytic, psychodynamic, and psychoeducation (educating the individual and their family about their disorder and treatment), are other types used. (Source 4)
As mentioned previously, there is currently no medication that specifically treats personality disorders. Medication can instead be used to treat symptoms of the disorders, or comorbidities. For example, many people with Borderline Personality Disorder have comorbidities such as depression and anxiety, which they may treat with medication. Medication can also be used to help with sleep disturbances, as good quality sleep is seen as an essential aspect of maintaining stable mental health. (Source 4)
Source 3: https://www.bmj.com/bmj/section-pdf/743078?path=/bmj/347/7924/Clinical_Review.full.pdf
Source 7: https://www.promisesbehavioralhealth.com/addiction-recovery-blog/difference-between-personality-disorder-and-mood-disorder/