Different types of disorder

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Panic disorder is a type of anxiety disorder. It causes panic attacks, which are sudden feelings of terror when there is no real danger. You may feel as if you are losing control. You may also have physical symptoms, such as:

Fast heartbeat
Chest or stomach pain
Breathing difficulty
Weakness or dizziness
Sweating
Feeling hot or a cold chill
Tingly or numb hands

Panic attacks can happen anytime, anywhere, and without warning. You may live in fear of another attack and may avoid places where you have had an attack. For some people, fear takes over their lives and they cannot leave their homes.

Panic disorder is more common in women than men. It usually starts when people are young adults. Sometimes it starts when a person is under a lot of stress. Most people get better with treatment. Therapy can show you how to recognize and change your thinking patterns before they lead to panic. Medicines can also help.

NIH: National Institute of Mental Health

Panic Attacks and Panic Disorder (Mayo Foundation for Medical Education and Research) Also in Spanish
Panic Disorder (American Academy of Family Physicians) Also in Spanish
Panic Disorder: When Fear Overwhelms (National Institute of Mental Health) Also in Spanish

Mental Health Medications (National Institute of Mental Health)
Psychotherapies (National Institute of Mental Health)

Panic Disorder among Adults (National Institute of Mental Health)

ClinicalTrials. gov: Panic Disorder (National Institutes of Health)

Article: Patient characteristics and changes in anxiety symptoms in patients with panic. ..
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Anxiety and Depression Association of America
Find a Therapist (Anxiety and Depression Association of America)
Help for Mental Illnesses (National Institute of Mental Health) Also in Spanish
NAMI
National Institute of Mental Health Also in Spanish

Panic Disorder (American Academy of Pediatrics) Also in Spanish

Panic Disorder in Children and Adolescents (American Academy of Child and Adolescent Psychiatry)

Obsessive-Compulsive Disorder: MedlinePlus

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What is obsessive-compulsive disorder (OCD)?

Obsessive-compulsive disorder (OCD) is a mental disorder in which you have thoughts (obsessions) and rituals (compulsions) over and over. They interfere with your life, but you cannot control or stop them.

What causes obsessive-compulsive disorder (OCD)?

The cause of obsessive-compulsive disorder (OCD) is unknown. Factors such as genetics, brain biology and chemistry, and your environment may play a role.

Who is at risk for obsessive-compulsive disorder (OCD)?

Obsessive-compulsive disorder (OCD) usually begins when you are a teen or young adult. Boys often develop OCD at a younger age than girls.

Risk factors for OCD include:

Family history. People with a first-degree relative (such as a parent, sibling, or child) who has OCD are at higher risk. This is especially true if the relative developed OCD as a child or teen.
Brain structure and functioning. Imaging studies have shown that people with OCD have differences in certain parts of the brain. Researchers need to do more studies to understand the connection between the brain differences and OCD.
Childhood trauma, such as child abuse. Some studies have found a link between trauma in childhood and OCD. More research is needed to understand this relationship better.

In some cases, children may develop OCD or OCD symptoms following a streptococcal infection. This is called Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS).

What are the symptoms of obsessive-compulsive disorder (OCD)?

People with OCD may have symptoms of obsessions, compulsions, or both:

Obsessions are repeated thoughts, urges, or mental images that cause anxiety. They may involve things such as
- Fear of germs or contamination
- Fear of losing or misplacing something
- Worries about harm coming towards yourself or others
- Unwanted forbidden thoughts involving sex or religion
- Aggressive thoughts towards yourself or others
- Needing things lined up exactly or arranged in a particular, precise way
Compulsions are behaviors that you feel like you need to do over and over to try to reduce your anxiety or stop the obsessive thoughts. Some common compulsions include
- Excessive cleaning and/or handwashing
- Repeatedly checking on things, such as whether the door is locked or the oven is off
- Compulsive counting
- Ordering and arranging things in a particular, precise way

Some people with OCD also have a Tourette syndrome or another tic disorder. Tics are sudden twitches, movements, or sounds that people do repeatedly. People who have tics cannot stop their body from doing these things.

How is obsessive-compulsive disorder (OCD) diagnosed?

The first step is to talk with your health care provider about your symptoms. Your provider should do an exam and ask you about your medical history. He or she needs to make sure that a physical problem is not causing your symptoms. If it seems to be a mental problem, your provider may refer you to a mental health specialist for further evaluation or treatment.

Obsessive-compulsive disorder (OCD) can sometimes be hard to diagnose. Its symptoms are like those of other mental disorders, such as anxiety disorders. It is also possible to have both OCD and another mental disorder.

Not everyone who has obsessions or compulsions has OCD. Your symptoms would usually be considered OCD when you:

Can't control your thoughts or behaviors, even when you know that they are excessive
Spend at least 1 hour a day on these thoughts or behaviors
Don't get pleasure when performing the behaviors. But doing them may briefly give you relief from the anxiety that your thoughts cause.
Have significant problems in your daily life because of these thoughts or behaviors

What are the treatments for obsessive-compulsive disorder (OCD)?

The main treatments for obsessive-compulsive disorder (OCD) are cognitive behavioral therapy, medicines, or both:

Cognitive behavioral therapy (CBT) is a type of psychotherapy. It teaches you different ways of thinking, behaving, and reacting to the obsessions and compulsions. One specific type of CBT that can treat OCD is called Exposure and Response Prevention (EX/RP). EX/RP involves gradually exposing you to your fears or obsessions. You learn healthy ways to deal with the anxiety they cause.
Medicines for OCD include certain types of antidepressants. If those don't work for you, your provider may suggest taking some other type of psychiatric medicine.

NIH: National Institute of Mental Health

Obsessive-Compulsive Disorder (American Academy of Family Physicians) Also in Spanish
Obsessive-Compulsive Disorder (OCD) (National Institute of Mental Health)
Obsessive-Compulsive Disorder: When Unwanted Thoughts or Repetitive Behaviors Take Over (National Institute of Mental Health) Also in Spanish
When Unwanted Thoughts Intrude: Understanding Obsessive-Compulsive Disorder (National Institutes of Health) Also in Spanish

Mental Health Medications (National Institute of Mental Health)
Psychotherapies (National Institute of Mental Health)

Disorders Related to (And Sometimes Confused with) OCD (International OCD Foundation)
Hoarding: Issues for the Fire Service (National Fire Protection Association) - PDF
How to Find the Right Therapist (International OCD Foundation)

Hoarding disorder (Mayo Foundation for Medical Education and Research) Also in Spanish
Problem That Piles Up: When Hoarding Is a Disorder (National Institutes of Health) Also in Spanish

Obsessive Compulsive Disorder (OCD) among Adults (National Institute of Mental Health)

ClinicalTrials. gov: Hoarding Disorder (National Institutes of Health)
ClinicalTrials.gov: Obsessive-Compulsive Disorder (National Institutes of Health)

Article: Medical status of outpatients with obsessive-compulsive disorder in psychiatric department and. ..
Article: Operational Definitions of Treatment Response and Remission in Obsessive-Compulsive Disorder Capture...
Article: Meta-analysis of genome-wide association studies of hoarding symptoms in 27,537 individuals.
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American Psychiatric Association
Anxiety and Depression Association of America
Behavioral Health Treatment Services Locator (Substance Abuse and Mental Health Services Administration)
Find a Therapist (Anxiety and Depression Association of America)
Help for Mental Illnesses (National Institute of Mental Health) Also in Spanish
National Institute of Mental Health Also in Spanish

Obsessive-Compulsive Disorder (For Parents) (Nemours Foundation) Also in Spanish
OCD (Obsessive-Compulsive Disorder) (Nemours Foundation)
PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) Questions and Answers (National Institute of Mental Health) Also in Spanish

Obsessive-Compulsive Disorder (OCD) (Nemours Foundation)

Types of personality disorders and features of their treatment.

Paranoid, schizoid, dissocial, hysterical disorder, obsessive-compulsive, obsessive-compulsive, anxious, narcissistic

The main feature of personality disorders are pronounced maladaptive features of the psyche - such patients do not know how and cannot get along with others, adapt to new conditions. Previously, personality disorders were called psychopathy, but over time, experts adopted a Western point of view - psychopathy is still a separate mental disorder. There are several types of personality disorders, sometimes there are mixed types of the disease. Treatment should only be carried out by experienced professionals, but the main problem with this disorder is that patients for the most part do not recognize their mental problems.

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Types of personality disorders and features of their treatment

Every fifteenth inhabitant of our planet suffers from a personality disorder. Moreover, he himself hardly perceives his condition as a disease that requires an appeal to specialists. He will justify all his actions and consider his behavior normal. Treatment denies, and the consequences are unpredictable.

Personality disorder: adjustment difficulties

Personality disorder is a maladaptive pattern of behavior caused by a persistent mental disorder that is not associated with a physical or neurological disease. This pathology is difficult to correct, because the patient does not believe that he needs treatment. There is no motivation, which is a catalyst for positive changes. The individual himself does not seek to get rid of the violation and does not make good contact with psychotherapists. Late appeal to specialists leads to the fact that the patient gets an appointment with a psychiatrist already in the stage of deep neglect of the disease. It can be difficult to relieve symptoms and cure. The first signs of the disease are actively manifested in adolescence. Before this period, individual episodes are possible, but only after the period of puberty can we talk about the problem. Individuals with cognitive personality disorder do not understand why others talk about any of their problems. After all, they believe that behavior and actions are normal. People with personality disorders are poorly perceived in society. They often have difficulties in personal communication. But at the same time, patients do not feel pangs of remorse and have no sympathy for others. After a certain time, their relationship with the world is built not according to the principle of personal adaptation to society, but according to the scheme, when the society is forced to accept or not accept a problematic person. The lack of motivation and desire to be treated exacerbates the problem, since not every doctor can find an approach to such a patient, relieve the symptoms of exacerbation and help get rid of the problem.

Specific personality disorders

In Soviet times, overly emotional individuals were often called psychopaths. Such a characterization and classification was not inherent in Western psychiatry. Psychopathy is a serious violation of a behavioral nature, in which, against the background of underdevelopment of a number of personality traits, one clearly dominates. This includes a number of deviations. Types of personality disorders:

§ Paranoid - the patient is dominated by overvalued ideas. He attaches special importance to his personality. But he treats others with hostility, suspecting them of malicious intent. A person with a pathology does not recognize its presence. When relatives or friends pay attention to a cognitive deviation and try to take him to a specialist, he will assure that everything is in order with him and deny the existence of a problem. Very sensitive to criticism.
§ Schizoid - this diagnosis is characterized by introversion, isolation, decreased interest in life's things. The patient does not perceive the accepted norms of social behavior, often behaves eccentrically. Schizoid personality disorders are associated with a great passion for some kind of activity in which the individual succeeds. For example, he may be pathologically addicted to various health systems, to the point of attracting other people to his interests. Experts believe that in this way a certain asociality is replaced. Also, such patients may have problems with alcohol, drugs or other types of addiction.
§ Dissocial - a characteristic feature of this personality disorder is the patient's cognitive defiant behavior in order to get what he wants. With all this, such patients are able to win over people, including doctors. This type is especially pronounced in late adolescence.
§ Hysterical - the main goal of such patients is to draw attention to their person in any way, including defiant behavior. The diagnosis is more typical for women. Atypical capriciousness, inconstancy of desires, extravagance, deceit are observed. In order to attract attention, the patient invents non-existent diseases for himself, the symptoms of which can be given out by the autonomic system and which is difficult to remove.
§ Obsessive-compulsive - patients with this type of personality disorder pathologically strive for order and perfection. They have no sense of humor, they try to be perfect in everything. When the set ideal goals are not achieved, they can fall into depressive states.
§ Anxiety - such a personality disorder is characterized by the cultivation of a personal inferiority complex. Patients are in a state of perpetual anxiety and uncertainty. From childhood, such patients are shy and timid. Often suspect others of hostility. They are prone to depression.
§ Narcissistic - a deviation in which a person manifests narcissism from childhood, a desire to be constantly admired. Such a patient does not accept criticism: he reacts to it either with resentment or with aggression. Indifferent to the feelings of other people, prone to exploiting them to achieve their own goals.

Different forms of psychopathy require an individual approach to treatment. Personality disorders should not be confused with character accentuation. In the latter case, a person also has behavioral features, but they lie within the upper limit of the norm. In addition, it is adapted to social conditions. The classification of classical psychopathy is inappropriate here. Diagnosis and types are different.

Causes that cause personality and behavioral disorders

All specific personality disorders are usually divided into three clusters. Their classification:

§ types of cluster A psychopathy: paranoid and schizoid;
§ Cluster B psychopathy: hysterical, asocial, narcissistic;
§ Types of cluster B psychopathy: obsessive-compulsive, depressive.

The causes of cluster A psychopathy are considered to be genetic and hereditary. The fact is that among the relatives of patients who have a personality disorder, as a rule, there is at least one with schizophrenia. A hereditary predisposition to pathologies can also be traced in cluster B and C psychopathy. The first option can also be aggravated by problems with alcohol: in families of people who drink, children often develop with disorders. There is a version that cognitive specific personality disorders may be associated with hormonal disorders in the body. If a person has elevated levels of testosterone, estrone and estradiol, the consequences of this are manifested in the form of aggression. In addition, he does not produce enough endorphins, which, in turn, leads to depressive disorders. The social factor also plays an important role in the formation of the psychotype. For active children, space is important. If they are forced to be brought up in a closed space, small areas, this leads to the appearance of hyperactivity. Anxious babies from birth can become balanced if they are raised by emotionally stable parents. A calm mother can help a child become confident, and an anxious one can not remove, but increase his personal anxiety state. Character traits become noticeable already in early childhood. In adolescence, they can already develop as a personality disorder. Cognitive impairment is manifested in a decrease in memory, increased fatigue. Pathologies of the nervous system are observed more often in people with an asocial temperament.

Mixed personality disorder

This type of psychopathy has been less studied than others. The classification has no special criteria. The patient manifests forms of one or the other type of disorders that are not persistent. Therefore, this type of disorder is also called mosaic psychopathy. But it is also difficult for a person with a mixed type of disorder to get along in society because of the peculiarities of their behavior. Instability of character is often the basis that contributes to the development of various types of addiction. Mixed personality disorder may be accompanied by alcoholism, drug addiction, gambling addiction. Mosaic psychopathy can combine symptoms of the schizoid and paranoid types. Such people do not know how to build social contacts in society, they are obsessed with overvalued ideas. With the predominance of paranoid symptoms, patients suffer from increased suspicion. They are prone to scandals, threats, like to write angry complaints about everyone and everything. Specialists are alarmed if signs (classification) of several disorders coexist in one patient: schizoid, hysterical, asthenic, excitable. In this case, there is a high risk of developing schizophrenia. Brain injuries or complications after a number of diseases can lead to mosaic types of pathology. This mixed personality disorder is considered acquired. If we consider the situation in detail, it will look like this: a person already has an innate tendency to mosaic psychopathy, which, due to certain circumstances, is superimposed by organic pathology. Mosaic disorder requires specific treatment only when symptoms worsen, or if there is organic build-up. Then neuroleptics, tranquilizers, vitamins can be prescribed by a specialist.

Infantile personality disorder

With this type of psychopathy, signs of social immaturity are pronounced. A person is not able to withstand stressful situations and relieve tension. In difficult circumstances, he does not control his emotions in the same way as children do. Infantile personality disorders for the first time clearly declare themselves in adolescence. Hormonal storms that occur at this time with a person cause changes in the psycho-emotional sphere. As you get older, the diagnosis can only progress. It is possible to finally talk about the presence of the disease only after reaching 16-17 years. In stressful circumstances, the patient manifests himself immature, poorly controls aggression, anxiety, fear. Such a person is not hired for military service, they are denied employment in law enforcement agencies. Permits to carry weapons or obtain a driver's license are decided on a limited and strictly case-by-case basis, according to an assessment of signs and condition.

Transient personality disorder

This diagnosis refers to borderline conditions, when the symptoms of deviation are difficult to attribute to any type of personality disorder. The main causes of psychopathy are long-term stressful situations. In the modern world, a person is surrounded by many unfavorable factors: troubles at work, military operations, difficult family circumstances, financial failures, moving... All this disrupts the usual way of life and unbalances. If such circumstances last too long, the human psyche does not always have a reserve to survive and overcome them. Transient personality disorder has its own characteristics:

§ disorientation;
§ hallucinations;
§ nonsense;
§ inhibition of verbal and motor functions.

Even one of the symptoms can already signal a disorder. This diagnosis is special in that the disease does not last too long: sometimes only a day, and sometimes a month. It suddenly arises and just as it passes. Sometimes a person can go to sleep with a disturbance, and get up in a normal emotional state with residual effects in the form of increased anxiety or sleep disturbances. With each new stress, a spontaneous return of pathology is possible. Such a diagnosis does not pass without a trace. In the event that there are signs of delirium or hallucinations, such a person requires special treatment, because his condition can also threaten those around him. In the period between exacerbations, the patient experiences emotional burnout, in which nerve cells are also destroyed. Therefore, even for preventive purposes, it is recommended to take vitamins and herbal remedies. As historical examples show, partial transient personality disorder is not a benign condition. Many of the famous serial killers and maniacs had this diagnosis. They led a normal life, had families, work, but during the period of exacerbations they committed crimes. When Western experts studied the brains of executed criminals, they did not find significant changes in it. All its parts corresponded to the norm of a healthy person. And only stressful conditions could lead to the appearance of signs of a personality disorder, which entailed antisocial acts. Perhaps, if during the period when the first signs of the disease appeared, there would have been a person nearby who noticed this and helped to contact a specialist, such consequences could have been avoided. Being face-to-face with continuous stressful situations, the psyche simply could not stand it. The mechanism of the development of the disease was launched.

Treatment for personality disorders

When a person is diagnosed with psychopathy, they rarely agree with it. The peculiarity of this disease is that the patient does not see problems in himself, but looks for them in others. Treatment in this case is always difficult. According to statistics, only one in five of them agree to accept help. Treatment of psychopathy is carried out individually. It includes sessions of psychotherapy and, if necessary, the use of drugs. In difficult cases, when the antisocial behavior of the patient poses a threat to others, treatment can be carried out in a hospital. Disputes among specialists are caused by the treatment of borderline conditions. Some believe that the patient needs help only during exacerbations, while others insist on constant support. In any case, the treatment of psychopathy has been going on for many years. With the patient's tendency to impulsive acts that can threaten life and health, psychotropic drugs are connected.

Personality disorder - causes, types, types, symptoms, signs, diagnosis (test), 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.

Personality disorder symptoms

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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