Thursday, February 26, 2009

I have heard there are many types?

Personality disorder can show itself in different ways. The DSM-IV (The American Psychiatric Association’s manual of mental disorders) lists ten types. Each one is linked with a different set of attitudes, emotions, and behaviours. While some people will have only one type, other people may have elements of two or more. Paranoid personality disorder You are likely to feel very wary of others, imagining they have hidden motives, will use you, or take advantage of you, if you don’t stay vigilant. As a result, you will find it very difficult to trust other people. You will be suspicious and always on your guard, even with your friends, and you may feel that it’s not safe to confide in them. You may watch others closely, looking for signs of betrayal or hostility and you will read threats and menace, which others don’t see, into everyday situations. Others may complain that you are far too mistrustful.

Schizoid personality disorder

Having a schizoid personality disorder means that you aren’t really interested in forming close relationships with other people. Relationships interfere with your freedom and tend to cause problems. You prefer to be solitary and inward looking, and choose to live your life without interference from others. Other people will see you as a loner. Few things in life give you pleasure, and you may have little interest in sex or intimacy. Schizotypal personality disorder Making close relationships will be extremely difficult for you. People may describe you as eccentric, and you will find that you think differently to others. You might believe that you can read minds or that you have special powers, and you may be ridiculed for this. You may feel anxious and tense with others.

Borderline personality disorder (BPD)

BPD may cause a number of problems in different areas of your life. You may feel that you don’t have a strong sense of who you really are, and others may describe you as very changeable. You will suffer from mood swings, switching from one intense emotion to another very quickly, often with angry outbursts. You may end up doing things on impulse, which you later regret. This may include attempts to harm yourself in some way. You will probably also have a history of stormy or broken relationships, and you will have a tendency to cling on to very damaging relationships, because you are terrified of being alone. (See, also, Mind’s booklet, Understanding borderline personality disorder.) Histrionic personality disorder Being ignored is probably very comfortable for you, and you feel much more at ease as the ’life and soul of the party‘. But you may also feel that you have to entertain people and that you are dependent on their approval. You may flirt or behave provocatively to ensure that you remain the centre of attention, or find that other people influence you too easily. You may earn a reputation for being dramatic and overemotional. Because you love excitement and don’t tolerate boredom, you may behave recklessly or impulsively at times.

Narcissistic personality disorder You may believe that there are special reasons that make you different, better or more deserving than others, but because your self-esteem is rather fragile, you rely on others to recognise your worth and your needs. However, other people frequently overlook your special needs and fail to give you what you feel you deserve, so that you then feel badly done by, and grudging of others’ successes. Because of this, you put your own needs above other people’s, and demand they cater to you. People are likely to see you as selfish, because you miss or ignore what your expectations cost them. They may also describe you as being ‘grand’ or haughty.

Antisocial personality disorder (ASPD)

This is known as ‘psychopathy’ under the Mental Health Act (MHA) 1983. It is closely linked with adult criminal behaviour, so if you suffer from ASPD you will probably have a criminal record. You may also be a heavy drinker or a drug-user. Boredom is a problem for you and you may find it difficult to hold down a job for long or stay in a long-term relationship. You will tend to act impulsively and recklessly, often without considering the consequences for yourself or for other people. You may do things, even though they may hurt people, to get what you want, putting your needs above theirs. You believe that only the strongest survive and that you must do whatever it takes to lead a successful life, because if you don’t grab opportunities, others will. You may be regarded as being selfish and hard. Avoidant (or anxious) personality disorder (APD) Feeling inadequate or inferior to other people, and avoiding work or other social activities, is one sign of avoidant personality disorder. You expect disapproval and criticism, and you worry constantly about being ‘found out’ and rejected. You may be particularly worried about being ridiculed or shamed by others, so you avoid social relationships, friendships and intimacy. However, you feel lonely and isolated, and long to have the very relationships you avoid. It’s hard for others to understand the extent of your worries and not to believe you’re exaggerating your fear of ordinary social situations. They will see you as a loner.

Dependent personality disorder

You are likely to feel needy, weak and unable to make decisions or function properly without help or support. You allow others to assume responsibility for many areas of your life, finding it hard to say when you disagree with them because you fear losing their support. You could find yourself agreeing to things you feel are wrong, and put up with other people’s unreasonable behaviour to avoid being alone. Your self-confidence will be low, and you see other people as being much more capable than you are. Others may describe you as much too submissive and passive.

Obsessive-compulsive personality disorder (OCPD)

A preoccupation with orderliness and keeping everything under control can be a sign of OCPD. You are likely to set unrealistically high standards for yourself and others, and you generally think yours is the best way of making things happen, so you end up feeling responsible for everything. You worry when you or others make mistakes, and expect catastrophes if things aren't perfect.

*This booklet was written by Janet Gorman. Revised by Dr Sue Evershed with the help
of patients at Rampton Hospital.

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