Diagnosing a personality disorder
Personality disorders - Diagnosis and treatment
Diagnosis
If your doctor suspects you have a personality disorder, a diagnosis may be determined by:
- Physical exam. The doctor may do a physical exam and ask in-depth questions about your health. In some cases, your symptoms may be linked to an underlying physical health problem. Your evaluation may include lab tests and a screening test for alcohol and drugs.
- Psychiatric evaluation. This includes a discussion about your thoughts, feelings and behavior and may include a questionnaire to help pinpoint a diagnosis. With your permission, information from family members or others may be helpful.
- Diagnostic criteria in the DSM-5. Your doctor may compare your symptoms to the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
Diagnostic criteria
Each personality disorder has its own set of diagnostic criteria. However, according to the DSM-5, generally the diagnosis of a personality disorder includes long-term marked deviation from cultural expectations that leads to significant distress or impairment in at least two of these areas:
- The way you perceive and interpret yourself, other people and events
- The appropriateness of your emotional responses
- How well you function when dealing with other people and in relationships
- Whether you can control your impulses
Sometimes it can be difficult to determine the type of personality disorder, as some personality disorders share similar symptoms and more than one type may be present. Other disorders such as depression, anxiety or substance abuse may further complicate diagnosis. But it's worth the time and effort to get an accurate diagnosis so that you get appropriate treatment.
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- Complete blood count (CBC)
Treatment
The treatment that's best for you depends on your particular personality disorder, its severity and your life situation.
Often, a team approach is needed to make sure all of your psychiatric, medical and social needs are met. Because personality disorders are long-standing, treatment may require months or years.
Your treatment team may include your primary doctor or other primary care provider as well as a:
- Psychiatrist
- Psychologist or other therapist
- Psychiatric nurse
- Pharmacist
- Social worker
If you have mild symptoms that are well-controlled, you may need treatment from only your primary doctor, a psychiatrist or other therapist. If possible, find a mental health professional with experience in treating personality disorders.
Psychotherapy, also called talk therapy, is the main way to treat personality disorders.
Psychotherapy
During psychotherapy with a mental health professional, you can learn about your condition and talk about your moods, feelings, thoughts and behaviors. You can learn to cope with stress and manage your disorder.
Psychotherapy may be provided in individual sessions, group therapy, or sessions that include family or even friends. There are several types of psychotherapy — your mental health professional can determine which one is best for you.
You may also receive social skills training. During this training you can use the insight and knowledge you gain to learn healthy ways to manage your symptoms and reduce behaviors that interfere with your functioning and relationships.
Family therapy provides support and education to families dealing with a family member who has a personality disorder.
Medications
There are no medications specifically approved by the Food and Drug Administration (FDA) to treat personality disorders. However, several types of psychiatric medications may help with various personality disorder symptoms.
- Antidepressants. Antidepressants may be useful if you have a depressed mood, anger, impulsivity, irritability or hopelessness, which may be associated with personality disorders.
- Mood stabilizers. As their name suggests, mood stabilizers can help even out mood swings or reduce irritability, impulsivity and aggression.
- Antipsychotic medications. Also called neuroleptics, these may be helpful if your symptoms include losing touch with reality (psychosis) or in some cases if you have anxiety or anger problems.
- Anti-anxiety medications. These may help if you have anxiety, agitation or insomnia. But in some cases, they can increase impulsive behavior, so they're avoided in certain types of personality disorders.
Hospital and residential treatment programs
In some cases, a personality disorder may be so severe that you need to be admitted to a hospital for psychiatric care. This is generally recommended only when you can't care for yourself properly or when you're in immediate danger of harming yourself or someone else.
After you become stable in the hospital, your doctor may recommend a day hospital program, residential program or outpatient treatment.
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- Cognitive behavioral therapy
- Psychotherapy
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Lifestyle and home remedies
Along with your professional treatment plan, consider these lifestyle and self-care strategies:
- Be an active participant in your care. This can help your efforts to manage your personality disorder. Don't skip therapy sessions, even if you don't feel like going. Think about your goals for treatment and work toward achieving them.
- Take your medications as directed. Even if you're feeling well, don't skip your medications. If you stop, symptoms may come back. You could also experience withdrawal-like symptoms from stopping a medication too suddenly.
- Learn about your condition. Education about your condition can empower you and motivate you to stick to your treatment plan.
- Get active. Physical activity can help manage many symptoms, such as depression, stress and anxiety.
Activity can also counteract the effects of some psychiatric medications that may cause weight gain. Consider walking, jogging, swimming, gardening or taking up another form of physical activity that you enjoy. - Avoid drugs and alcohol. Alcohol and street drugs can worsen personality disorder symptoms or interact with medications.
- Get routine medical care. Don't neglect checkups or skip visits to your primary care professional, especially if you aren't feeling well. You may have a new health problem that needs to be addressed, or you may be experiencing side effects of medication.
Coping and support
Having a personality disorder makes it hard to engage in behavior and activities that may help you feel better. Ask your doctor or therapist how to improve your coping skills and get the support you need.
If your loved one has a personality disorder
If you have a loved one with a personality disorder, work with his or her mental health professional to find out how you can most effectively offer support and encouragement.
You may also benefit from talking with a mental health professional about any distress you experience. A mental health professional can also help you develop boundaries and self-care strategies so that you're able to enjoy and succeed in your own life.
Preparing for your appointment
Because personality disorders often require specialized care, your primary doctor may refer you to a mental health professional, such as a psychiatrist or psychologist, for evaluation and treatment. Taking a family member or friend along can help you remember something that you missed or forgot.
What you can do
Prepare for your appointment by making a list of:
- Your symptoms, including any that seem unrelated to the reason for the appointment
- Key personal information, including any major stresses or recent life changes
- All medications, including over-the-counter medications, vitamins, herbal preparations or other supplements that you're taking, and the doses
- Questions to ask your doctor
Basic questions to ask your doctor include:
- What type of personality disorder might I have?
- How do you treat my type of personality disorder?
- Will talk therapy help?
- Are there medications that might help?
- How long will I need to take medication?
- What are the major side effects of the medication you're recommending?
- How long will treatment take?
- What can I do to help myself?
- Are there any brochures or other printed material that I can have?
- What websites do you recommend visiting?
Don't hesitate to ask any other questions during your appointment.
What to expect from your doctor
During your appointment, your doctor or mental health professional will likely ask you a number of questions about your mood, thoughts, behavior and urges, such as:
- What symptoms have you noticed or have others said they notice in you?
- When did you or they first notice symptoms?
- How is your daily life affected by your symptoms?
- What other treatment, if any, have you had?
- What have you tried on your own to feel better or control your symptoms?
- What things make you feel worse?
- Have your family members or friends commented on your mood or behavior?
- Have any relatives had a mental illness?
- What do you hope to gain from treatment?
- What medications, vitamins, herbs or supplements do you take?
By Mayo Clinic Staff
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Types, Causes, Symptoms & Treatment
Overview
What is a personality disorder?
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.
There are 10 types of personality disorders, each with different characteristics and symptoms.
Personality is vital to defining who we are as individuals. It involves a unique blend of traits — including attitudes, thoughts and behaviors — as well as how we express these traits in our interactions with others and with the world around us.
Personality disorders may cause distorted perceptions of reality, abnormal behaviors and distress across various aspects of life, including work, relationships and social functioning. Additionally, people with a personality disorder may not recognize their troubling behaviors or the negative effect they have on others.
What are the types of personality disorders?
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the standard reference publication for recognized mental illnesses, organizes the 10 types of personality disorders into three main clusters (categories).
Each cluster has different symptoms in common.
Cluster A personality disorders
Cluster A personality disorders involve unusual and eccentric thinking or behaviors. These include:
- Paranoid personality disorder: The main feature of this condition is paranoia, which is a relentless mistrust and suspicion of others without adequate reason for suspicion. People with paranoid personality disorder often believe others are trying to demean, harm or threaten them.
- Schizoid personality disorder: This condition is marked by a consistent pattern of detachment from and general disinterest in interpersonal relationships. People with schizoid personality disorder have a limited range of emotions when interacting with others.
- Schizotypal personality disorder: People with this condition display a consistent pattern of intense discomfort with and limited need for close relationships. Relationships may be hindered by their distorted views of reality, superstitions and unusual behaviors.
Cluster B personality disorders
Cluster B personality disorders involve dramatic and erratic behaviors. People with these types of conditions display intense, unstable emotions and impulsive behaviors. Cluster B personality disorders include:
- Antisocial personality disorder (ASPD): People with ASPD show a lack of respect toward others and don’t follow socially accepted norms or rules. People with ASPD may break the law or cause physical or emotional harm to others around them. They may refuse to take responsibility for their behaviors and/or display disregard for the negative consequences of their actions.
- Borderline personality disorder (BPD): This condition is marked by difficulty with emotional regulation, resulting in low self-esteem, mood swings, impulsive behaviors and subsequent relationship difficulties.
- Histrionic personality disorder: This condition is marked by intense, unstable emotions and a distorted self-image.
For people with histrionic personality disorder, their self-esteem depends on the approval of others and doesn’t come from a true feeling of self-worth. They have an overwhelming desire to be noticed by others, and may display dramatic and/or inappropriate behaviors to get attention. - Narcissistic personality disorder: This condition involves a consistent pattern of perceived superiority and grandiosity, an excessive need for praise and admiration and a lack of empathy for others. These thoughts and behaviors often stem from low self-esteem and a lack of self-confidence.
Cluster C personality disorders
Cluster C personality disorders involve severe anxiety and fear. They include:
- Avoidant personality disorder: People with this condition have chronic feelings of inadequacy and are highly sensitive to being negatively judged by others. Though they would like to interact with others, they tend to avoid social interaction due to the intense fear of being rejected.
- Dependent personality disorder: This condition is marked by a constant and excessive need to be cared for by someone else. It also involves submissiveness, a need for constant reassurance and the inability to make decisions. People with dependent personality disorder often become very close to another person and spend great effort trying to please that person. They tend to display passive and clinging behavior and have a fear of separation.
- Obsessive-compulsive personality disorder (OCPD): This condition is marked by a consistent and extreme need for orderliness, perfectionism and control (with no room for flexibility) that ultimately slows or interferes with completing a task. It can also interfere with relationships.
This is a separate condition from obsessive-compulsive disorder (OCD), which is classified as an anxiety disorder. While people with OCD usually are aware that OCD is causing their behavior and accept they need to change, people with OCPD usually have little, if any, self-awareness of their behaviors.
People might have mixed symptoms of more than one personality disorder.
Who do personality disorders affect?
Anyone can have a personality disorder. But different types of personality disorders affect people differently.
Most personality disorders begin in the teen years when your personality further develops and matures. As a result, almost all people diagnosed with personality disorders are above the age of 18. One exception to this is antisocial personality disorder — approximately 80% of people with this disorder will have started to show symptoms by the age of 11.
Antisocial personality disorders are more likely to affect people assigned male at birth. Borderline, histrionic and dependent personality disorders are more likely to affect people assigned female at birth.
How common are personality disorders?
Approximately 9% of adults in the U.S. have some type of personality disorder, and about 6% of the global population has a personality disorder.
Borderline personality disorder (BPD) and antisocial personality disorder are the most frequently diagnosed personality disorders.
Symptoms and Causes
What causes personality disorders?
Personality disorders are among the least understood mental health conditions. Scientists are still trying to figure out the cause of them.
So far, they believe the following factors may contribute to the development of personality disorders:
- Genetics: Scientists have identified a malfunctioning gene that may be a factor in obsessive-compulsive personality disorder. Researchers are also exploring genetic links to aggression, anxiety and fear, which are traits that can play a role in personality disorders.
- Brain changes: Researchers have identified subtle brain differences in people with certain personality disorders. For example, findings in studies on paranoid personality disorder point to altered amygdala functioning.
The amygdala is the part of your brain that’s involved with processing fearful and threatening stimuli. In a study on schizotypal personality disorder, researchers found a volumetric decrease in the frontal lobe of their brain. - Childhood trauma: One study revealed a link between childhood traumas and the development of personality disorders. People with borderline personality disorder, for example, had especially high rates of childhood sexual trauma. People with borderline and antisocial personality disorders have issues with intimacy and trust, both of which may be related to childhood abuse and trauma.
- Verbal abuse: In one study, people who experienced verbal abuse as children were three times as likely to have borderline, narcissistic, obsessive-compulsive or paranoid personality disorders in adulthood.
- Cultural factors: Cultural factors may also play a role in the development of personality disorders, as demonstrated by the varying rates of personality disorders between different countries.
For example, there are remarkably low cases of antisocial personality disorders in Taiwan, China and Japan, along with significantly higher rates of cluster C personality disorders.
What are the symptoms of personality disorders?
Each of the 10 types of personality disorders has its own specific signs and symptoms.
But, in general, personality disorders involve problems with:
- Identity and a sense of self: People with a personality disorder generally lack a clear or stable image of themselves, and how they see themselves often changes depending on the situation or the people they’re with. Their self-esteem may be unrealistically high or low.
- Relationships: People with a personality disorder struggle to form close, stable relationships with others due to their problematic beliefs and behaviors. They may lack empathy or respect for others, be emotionally detached or be overly needy of attention and care.
Another distinguishing sign of personality disorders is that most people who have one often have little to no insight or self-awareness of how their thoughts and behaviors are problematic.
How do you know if someone has a personality disorder?
You can’t know for sure if someone has a personality disorder unless they receive a professional, medical diagnosis.
It’s important to understand the difference between personality types and personality disorders. A person who is shy or likes to spend time alone doesn’t necessarily have an avoidant or schizoid personality disorder.
The difference between personality style and a personality disorder can often be determined by assessing how the person’s personality affects different parts of their life, including:
- Work.
- Relationships.
- Feelings/emotions.
- Self-identity.
- Awareness of reality.
- Behavior and impulse control.
Some general signs of people with a personality disorder include:
- Their behavior is inconsistent, frustrating and confusing to loved ones and other people they interact with.
- They may have issues understanding realistic and acceptable ways to treat others and behave around them.
- They may be unaware of how their behaviors cause problems for themselves and/or others.
- If they’re a parent, their parenting style may be detached, overemotional, abusive or irresponsible. This can sometimes lead to physical, emotional or mental issues in their children.
Diagnosis and Tests
How are personality disorders diagnosed?
Personality disorders can be difficult to diagnose since most people with a personality disorder don’t think there’s a problem with their behavior or way of thinking.
Because of this, people with a personality disorder typically don’t seek help or a diagnosis for their condition. Instead, their loved ones or a social agency may refer them to a mental health professional because their behavior causes difficulty for others.
When they do seek help, it’s often due to conditions such as anxiety, depression or substance use, or because of the problems created by their personality disorder, such as divorce or unemployment, not the disorder itself.
Healthcare providers base the diagnosis of a specific personality disorder on criteria provided in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.
When a mental health professional, like a psychologist or psychiatrist, suspects someone might have a personality disorder, they often ask broad, general questions that won’t create a defensive response or hostile environment. They ask questions that will shed light on:
- Past history.
- Relationships
- Previous work history.
- Reality testing.
- Impulse control.
Because a person suspected of having a personality disorder may lack insight into their behaviors, mental health professionals often work with the person’s family, friends and/or parole officers to collect more insight about their behaviors and history.
Personality disorders are generally underdiagnosed because providers sometimes focus on the symptoms of anxiety or depression, which are much more common in the general population than personality disorders.
These symptoms may overshadow the features of any underlying personality disorder.
Management and Treatment
How are personality disorders treated?
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 behavior is problematic, so they don’t often seek treatment.
And even if a person with a personality disorder seeks treatment, modern medicine is still lacking in available treatment options — there are no medications currently approved to treat any personality disorder. But there are medications that can help with symptoms of anxiety and depression, which are common in people with a personality disorder.
But psychotherapy (talk therapy) can help manage personality disorders. Psychotherapy is a term for a variety of treatment techniques that aim to help you identify and change troubling emotions, thoughts and behaviors. Working with a mental health professional, like a psychologist or psychiatrist, can provide support, education and guidance to you and your family.
The main goals of psychotherapy for treating personality disorders include:
- Reducing immediate distress, such as anxiety and depression.
- Helping the person understand that their problems are internal and not caused by other people or situations.
- Decreasing unhealthy and socially undesirable behavior.
- Modifying the personality traits that are causing difficulties.
There are several different types of psychotherapy, and each personality disorder requires different types.
For example, studies show that dialectical behavior therapy (DBT) is effective for treating those with borderline personality disorder, and people with histrionic personality disorder often benefit from cognitive-behavioral therapy (CBT).
Prevention
Can personality disorders be prevented?
At this time, there’s no known way to prevent personality disorders, but many of the related problems might be lessened with treatment. Seeking help as soon as symptoms appear can help decrease the disruption to the person’s life, family and friendships.
Outlook / Prognosis
What is the prognosis (outlook) for personality disorders?
Since people with personality disorders often don’t seek proper medical attention, the overall prognosis for personality disorders is poor.
Untreated personality disorders may result in:
- Poor relationships.
- Occupational difficulties.
- Impaired social functioning.
Studies show that personality disorders are associated with elevated rates of:
- Unemployment.
- Divorce.
- Domestic abuse.
- Substance use.
- Homelessness.
- Crime (especially antisocial personality disorder).
In addition, people with personality disorders are more likely to visit the emergency room (ER), experience traumatic accidents and have early deaths by suicide.
Although the outlook is dire, studies show that collaborative care management can greatly improve outcomes for people with personality disorders if they stay committed to treatment.
If you know someone who has or may have a personality disorder, try to persuade them to seek treatment. It’s also important to educate yourself about the nature of the specific personality disorder so you can better understand what to expect.
A note from Cleveland Clinic
It’s important to remember that personality disorders are mental health conditions. As with all mental health conditions, seeking help as soon as symptoms appear can help decrease the disruptions to your life. Mental health professionals can offer treatment plans that can help you manage your thoughts and behaviors.
The family members of people with personality disorders often experience stress, depression, grief and isolation. It’s important to take care of your mental health and seek help if you’re experiencing these symptoms.
Personality disorder: treatment, symptoms, diagnosis
Summary:
- Causes of personality disorder
- Symptoms of disease
- Classification
- Diagnostics
- Principles of treatment
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Personality disorders are a fairly large group of mental illnesses with different symptoms and course.
They are distinguished by a tendency to a chronic, recurrent course, the patient's unwillingness to see a doctor, the desire to hide any clinical manifestations of a personality disorder.
Specialists of the medical center "Dependence 24" will conduct a comprehensive examination, make an accurate diagnosis. The treatment prescribed by our doctors will allow you to get rid of the main symptoms of the disease.
Causes of personality disorders
The etiology of the disease has not yet been fully elucidated. In modern psychiatry, there are several different theories that explain the appearance of signs of the disease. These are:
- Genetic causes. The role of hereditary factors is great in schizotypal personality disorder. It is assumed that the pathogenetic mechanisms of the development of this form of the disease are similar to those in schizophrenia.
- Comorbid mental illness. It is believed that personality disorder is one of the symptoms of a number of mental illnesses.
In some patients, the pathology progresses and more pronounced signs appear over time, while others remain in such a borderline state for years. - Psychological experiences. The relationship of personality development with the characteristics of upbringing, relationships with parents paid great attention to such masters of psychiatry as Z. Freud, K.G. Jung, A. Adler. The essence of their theory boils down to the fact that the experiences of unrest, fears in childhood lead to serious mental disorders in adolescents and in adulthood. In such cases, the basis of treatment is psychotherapy.
- Social environment. It is assumed that certain subspecies of personality disorders are associated with the peculiarities of upbringing and the situation in the family as a whole. If a child considers antisocial behavior to be the norm, such attitudes persist as they grow older.
Symptoms of disease
The first manifestations of a personality disorder usually occur in adolescents, less often in childhood, but the symptoms are fully “revealed” closer to 20–25 years.
Clinical manifestations of the disease cover all areas of psycho-emotional experiences, thinking, behavior in society. The patient is not capable of a flexible response to ongoing events, cannot fully perceive himself and others, build any relationship with them.
Typical depression, anxiety. But unlike neurosis or, for example, depression, the patient perceives everything that happens to him as something quite normal. A person does not consider himself ill, categorically refuses medical care, which significantly complicates treatment.
Classification
There are several main clinical varieties of the disease:
- Paranoid. Accompanied by pathological suspicion, tension, inability to relax, emotional rigidity. Often these symptoms are harbingers of schizophrenia.
- Schizoid. Complete self-absorption is characteristic, it is extremely difficult (and in principle it is not necessary) for people with such a diagnosis to establish social contacts, therefore they prefer work that does not involve intensive communication.
They do not seek to communicate with relatives, they are indifferent to what is happening around. Schizoids cannot openly express their emotions and desires, they experience them inside. Such people are very lonely, extremely rarely start a family, and various sexual disorders are characteristic. - Dissocial. The main symptom is an uncontrollable desire to enjoy at any cost, but at the same time, a person avoids work, activities that require effort on his part with all his might. Falsehood, resourcefulness, manipulations are typical (often - threats to commit suicide, complaints about deteriorating health). Adolescents suffering from this disease often run away from home. The patient looks quite healthy and satisfied with life, turns into a joke any talk about the need for treatment. But under the guise of external well-being lies tension, anxiety and irritability, which often becomes the cause of the development of alcoholism and drug addiction.
- Emotionally unstable.
It is manifested by short-term sudden episodes of loss of self-control, which is expressed in unjustified aggression (during an attack, a person can break something, hit another). Subsequently, the patient regrets his behavior, asks for forgiveness, blames himself for what happened. - Border. It is characterized by unstable self-esteem, a tendency to conflict, imbalance, irresponsibility. Demonstrative suicide attempts are possible (but there are clearly no serious intentions to commit suicide).
- Hysterical. Patients at any cost seek to attract attention to themselves through inappropriate behavior, simulation of serious illnesses. Indifference on the part of others causes outbursts of anger, accusations, irritability.
- Obsessive-compulsive. Accompanied by a pathological preoccupation with order, the desire for control, the desire to achieve perfection in the work performed. But at the same time, the paucity of the emotional sphere is also noted.
- Dissociative (multiple personality disorder).
It is extremely rare. A person has the impression that several personalities "live" in him at once, which differ from each other in character, habits, demeanor, etc.
Diagnosis
In the diagnostic examination of patients with personality disorders, various questionnaires and questionnaires are used, however, the diagnosis is complicated by the tendency of patients to distort the clinical picture, hide or vice versa, exaggerate individual symptoms.
The main criteria for the diagnosis of pathology are:
- Behavior and perception of the surrounding reality differs from those accepted in society. But at the same time, the peculiarities of religion, national culture, etc. are taken into account.
- Mental state leads to inadequate actions, incorrect awareness of reality.
- Identified mental abnormalities persist for a long time.
- No organic diseases. To do this, we give a referral for EEG, tomography, dopplerography of the brain, prescribe additional clinical tests, in some cases it is necessary to exclude the use of narcotic substances.
Principles of treatment
The doctors of our clinic warn that you should not expect a quick result. In some forms of pathology (for example, in multiple personality disorder), drug treatment plays a minor role. But if anxiety and anxiety are too pronounced, the patient may be prescribed anxiolytics, antipsychotics, and lithium-based drugs. With emotionally unstable, hysterical and borderline disorder, antidepressants, “mild” sedatives, have a good result. But because of the risk of side effects, they are prescribed only for a short time to stop signs of exacerbation.
In those situations where drugs can be dispensed with (as well as to enhance their effect), the specialists of the Addiction 24 medical center prefer individual or group psychotherapy. Psychotherapeutic treatment is aimed at:
- analysis of the patient's behavior;
- correction of relationships with other people;
- training in self-control, methods of correct way out of conflict situations;
- patients' awareness of their own emotional problems, etc.
If you have any questions about the methods of treatment, examination of patients with personality disorders, call us around the clock at 8 (495) 182-66-66. All our services are provided on a confidential basis. If necessary, a visit by a doctor to the house is possible.
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Kazantsev Alexey Vladimirovich
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Gamaev Anton Evgenievich
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Work experience 30 years
As a narcologist with many years of experience, I want to note the seriousness of the problem of beer alcoholism.
The risk of developing dependence on beer is no less than on strong alcohol. With the systematic use of beer, the body adapts to the toxic effect and begins to require larger portions for pleasure. The disease develops gradually, so the addict himself does not notice the changes and does not consider himself an alcoholic. We know how to help you, how to cope with beer alcoholism. Therapy in our clinic is possible in a hospital or at home, with a guarantee of anonymity.
Aleksey Vladimirovich Kazantsev
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Work experience 30 years
I want to address the relatives of patients undergoing treatment for alcoholism at home. Do not need self-activity. Trying to "strengthen" the therapeutic effect, family members often use folk remedies that allegedly relieve cravings for alcohol. The effectiveness of non-traditional methods is not confirmed by medical research. The safety of the interaction of decoctions and tinctures with medicines has not been proven.
An incorrect combination can cause severe intoxication, confusion, and an allergic reaction. Outpatient treatment of alcoholism in our clinic does not need an imaginary reinforcement of folk recipes. We guide patients according to a personal program, making every effort for a successful result.
Portnov Alexander Sergeevich
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Based on professional experience, I believe that one of the reasons for the breakdown after coding is the patient's deliberately false consent. Agreeing under pressure from relatives, a person does not understand and does not accept his illness, and therefore sooner or later returns to his former way of life. To avoid relapse, the duration of the encoding must be used to motivate treatment. The main thing is to convince them to ask for help. We will help you deal with addiction. Our psychotherapy sessions will help you strengthen your sobriety mindset and get sincere consent to a full course of treatment for alcoholism.
Zhanna Viktorovna Makhobey
I would like to draw attention to the problem of female alcoholism. The weaker sex is more prone to psychological dependence on alcohol due to vegetative lability, emotional instability, and increased sensitivity to traumatic events. At the same time, it is more difficult for a woman to admit dependence and trust a doctor. Therefore, the problem requires a delicate approach to the solution. Patients of our clinic can count on understanding and support. We will keep treatment confidential from the employer, colleagues, friends and relatives.
Zdanovich Aleksey Anatolyevich
As a family psychologist, I want to remind you that alcoholism is not a problem of an individual, but of the whole family. Life with an alcoholic person turns into a nightmare for his loved ones. The illness of one family member leads to co-dependence of relatives, destroys fundamental family foundations and values. A chance to change the situation is given by family psychotherapy and family counseling.
Comprehensive psychological assistance to families in our clinic is one of the leading areas of work. Our doctors have already helped thousands of people not only to get rid of alcoholism, but also to restore harmonious family relationships.
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Personality disorder - causes, types, types, symptoms, signs, diagnosis (test), treatment
Features
Causes
Symptoms
Diagnosis
Treatment
Personality disorder, the causes of which are not always obvious, used to be called constitutional psychopathy. This is a mental disorder that accompanies a person throughout life. The main changes affect the character, thinking and behavior, which causes difficulties in social adaptation. The psychopath breaks the norms and rules accepted in the social environment. The severity of the changes is different - from everyday inconsistency to criminal acts with subsequent restriction of freedom.
Features of personality disorder
World statistics of diseases states that about 10% of the world's population suffers from psychopathy. Each type of personality disorder accounts for an average of about 2% of cases. A distinctive feature is that the first manifestations are noticeable already in early childhood, practically unchanged throughout life.
Psychopathy is not quite a disease in the usual sense of the word. The disease has a beginning, progression and consequences in the form of organic (irreversible) disorders of the function and structure of organs. Psychopathy is a special, painful personality structure that does not undergo any changes in the changing conditions of life. This prevents the psychopath from adapting to the environment. Relatively speaking, a person with a personality disorder will behave in the same way with a first grader and a scientist, in a tram and a living room, not realizing that different people and situations require different behavior.
The problem of psychopathic personalities, anomalies of character was thoroughly studied by the Soviet and Russian psychiatrist Pyotr Borisovich Gannushkin, whose definitions of personality disorders have not lost their relevance to this day.
Causes of personality disorder
Experts consider several main reasons:
- genetic factor - practice shows that pathological character traits are found in representatives of different generations of the same family;
- an established vicious system of interpersonal relationships - the child does not have before his eyes an example of a normal, sympathetic and empathetic family;
- a psychopathic pattern (template, model) of behavior that the child unconsciously copies due to the lack of other examples;
- pathological pregnancy, difficult childbirth and diseases of early childhood;
- childhood abuse, physical or psychological;
- difficult childhood, unfavorable developmental conditions.
Researchers believe that genetic factors are of paramount, determining importance. This theory is confirmed by the twin method: identical brothers and sisters, separated in early childhood and raised in different families, behave exactly the same in adulthood. Twins who have never interacted with each other show the same types of personality disorder.
Symptoms of a personality disorder
Gannushkin identified 7 types of psychopathy. Since the 90s, when the 10th revision of the International Classification of Diseases, Injuries and Causes of Death came out, the condition has been called a personality disorder, but the essence has not changed. Each type of psychopathy has its own distinctive features.
Schizotypal personality disorder is distinguished by the minimization of social contacts, lack of need for communication, coldness, lack of empathy (the ability to empathize). Schizoids are attracted to fantasies, various distant theories, they are unable to perceive life directly, sensually.
Teamwork is not for them, they can be more or less successful in individual activities. Their main feature is indifference, both to themselves and to others. Such people sincerely do not understand what pleasure and joy are, because they have never experienced them.
Bipolar personality disorder according to Gannushkin includes 3 types: depressive, agitated and cyclothymic. Depressives are lifelong pessimists who are able to see only sad, gloomy sides in all the diversity of life. Excited - easy-going, carried away, often unable to foresee the consequences of their actions. The vast majority of gamblers and swindlers are of this type. Cyclothymics combine both of the above features, they are characterized by undulating mood swings, lack of stable attachments, blurring and diversity of interests.
Dissociative identity disorder in Western culture is called a split identity. It is believed that several personalities coexist in one person, which are periodically activated.
We have been using this diagnosis since 2000, but it does not take root well. Domestic psychiatrists consider this disorder a kind of psychological defense of a person who has experienced extreme, unbearably painful emotions. At the same time, a person perceives the events of his life as something that happened to others.
Narcissistic personality disorder refers to the Greek myth of Narcissus, a young man who preferred the love of a real girl to looking at his reflection in the water of a stream. Like the hero of a myth, a narcissist is convinced of his exclusivity and originality, and this applies to everything from appearance to achievements. The narcissist believes that real achievements are hindered by the envy of others who put up all sorts of obstacles. Own uniqueness requires constant confirmation, so the narcissist maintains relationships only with those who admire him.
Organic personality disorder - a consequence of damage to the brain tissue by various hazards: trauma, intoxication, infection.
Such a disorder occurs in the clinic in patients who have had a stroke, encephalitis, in alcoholics and drug addicts. In the latter, the condition is aggravated by the consequences of closed craniocerebral injuries, which they receive when falling from a height of their own height in a state of intoxication.
In a mild form of the disorder, the patient is disturbed by frequent headaches, weakness, fatigue, tearfulness, intolerance to stuffiness, meteorological dependence. Over time, thinking is disturbed, thoroughness, viscosity, concentration on minor details joins. Such a patient cannot separate the main from the secondary, speech becomes impoverished, emotions coarsen, periods of an evil-dreary mood (dysphoria) occur. An intellectual decline occurs, the patient cannot cope with the previous work, criminal episodes with fights and bodily injuries to the “offender” are not uncommon.
Borderline personality disorder is manifested by unstable mood, fluctuating from overestimation of oneself to humiliation.
Patients are impulsive, commit rash acts, anxious, suicidal. Any little thing causes a feeling of emptiness, fears of being unnecessary, "thrown out of life." This disorder is the basis for the formation of drug addiction and eating disorders.
Personality disorder diagnostics
It is desirable to carry out such a diagnosis as early as possible, because the disorder accompanies a person all his life. Problem children should be under the supervision of a child psychiatrist in order to overcome teenage difficulties with minimal losses. Even a single consultation with a specialist will allow parents to correct the behavior of the baby, as they will understand the motives of his actions.
A variety of tests for personality disorder are used in adolescents and adults. Popular tests based on the work of Eysenck, Beck, Freeman. The test is a questionnaire with several standardized answers, a lie scale is provided so that the subject cannot be misled.
The tests are fairly objective and are widely used in the clinic.
Personality disorder treatment
The basis of treatment is the choice of a life path, profession and occupation suitable for the type of personality. This is where a clinical psychologist can help. An occupation corresponding to a personality type can make a person so successful that no one will notice the disorder.
In severe cases, when the time for professional orientation is missed, medications (antidepressants, tranquilizers, nootropics), psychotherapeutic methods, including psychoanalysis, are used. Treatment options for advanced personality disorders are limited, especially in patients with addiction or irreversible brain damage.
The best solution for suspected psychopathy is timely consultation with an experienced psychiatrist.
Article author:
Novikov Vladimir Sergeevich
psychotherapist, clinical psychologist, kmn, member of the Professional Psychotherapeutic League
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