Personality disorders: When experience and behavior deviate from the “norm”

Our personality is made up of all our traits and behavior. Changes are possible, but most characteristics remain relatively stable throughout life. And it is this unique personality that sets us apart from every other person in the world. But what exactly is a personality disorder? And how can there be a “disorder” if we are all different anyway?

Personality disorder diagnosis

A personality with disorder value differs from that of other persons by the following characteristics:

  • Experience and behavior deviate significantly from the expectations of the sociocultural environment
  • Little flexibility in behavior – affected persons, despite negative consequences, react in certain situations in the same way again and again
  • High level of suffering due to the effects of one’s own behavior, as it severely impairs the quality of life and one’s own achievement of goals.
  • Clearly deviating perception, thinking and feeling in relationships
  • Frequent conflicts with fellow human beings
  • No stable self-image

The first signs of a personality disorder usually appear in childhood and adolescence. In order to make a diagnosis, it must be ruled out that the symptoms do not occur in the context of drug use, an accident with brain damage or another mental illness.Important: About ten percent of the German population suffers from a personality disorder. Within the various personality disorders, the numbers again differ greatly.In addition, inmost cases those affected also suffer from at least one other mental illness, particularly frequently depression, anxiety disorders, eating disorders and addictivedisorders.

What personality disorders are there?

The above characteristics are the intersection of the wide variety of personality disorders. To get an overview of all existing expressions, there is a division into three major categories:

Cluster A – Affected individuals behave oddly and eccentrically.

  • Paranoid personality disorder: distrust, affected persons permanently expect attacks from their fellow human beings, strong withdrawal, hesitant entering into relationships, poor handling of criticism.
  • Schizoid personality disorder: Very reserved in relationships, feelings are hardly shown, affected persons seem very distant and have few social contacts, but the resulting loneliness need not necessarily be unpleasant.
  • Schizotypal personality disorder: Affected persons appear peculiar and ignore common manners, altered way of thinking, perception and style of speech, high sensitivity to paranoia.

Cluster B – Affected persons are particularly emotional, dramatic and or moody.

  • Histrionic personality disorder: permanent search for recognition, positive and negative feelings fade away quickly, affected persons are very extroverted and attach great importance to their external appearance, suffering often arises only when there is a lack of external affirmation
  • Narcissistic personality disorder: low self-esteem, which is to be hidden by an exaggerated self-portrayal, constant search for success and admiration, affected persons often appear arrogant, are quickly offended and have little empathy
  • Dissocial personality disorder: Affected persons violate the rights of others, are easily irritable, impulsive, aggressive, show no remorse, manipulation of others, lack of guilt.
  • Emotionally unstable personality disorder: tendency to uncontrolled outbursts of anger and violence, frequent conflicts, mood swings, intense/crisis relationships, self-harm, great efforts not to be abandoned

Cluster C – affected persons are particularly anxious and fearful

  • Avoidant-self-insecure personality disorder: reticent in social situations, low self-esteem, fear of negative evaluation, sufferers do not like to be the center of attention and avoid expressing their opinions
  • Dependent personality disorder: great need for care, separation anxiety, clinging and submissive behavior, helplessness, sufferers ask for advice a lot
  • Obsessive-compulsive personality disorder: order, perfection and control are striven for to a high degree, sufferers do not want to make mistakes, get into conflicts due to the same expectations of others, lack of flexibility and efficiency

Combined personality disorder

Since personality can consist of innumerable facets, some disorder patterns cannot be clearly assigned to a diagnosis. In order to be able to make a diagnosis in these cases as well, the term combined personality disorder is used.

Case study – Living with a paranoid personality disorder

As already mentioned, a personality disorder has an impact on almost all areas of life. The following example shows how high the pressure of suffering can be even in everyday interpersonal encounters and events:Ms. S. is at her employer’s Christmas party. As she enters the venue, she hears a group of colleagues laughing loudly. Ms. S. immediately thinks that her colleagues are laughing at her. So are all the other guests, who whisper and giggle with their counterparts. She feels excluded and ashamed and suspects that quite horrible rumors are being spread about her, deliberately intended to damage her reputation at work. Intruth, all her colleagues are talking about completely different things, funny experiences, their vacations and leisure activities. Ms. S. is incensed and shouts for everyone to stop gossiping about her immediately. She cannot be calmed down even by her friendly colleagues and leaves the party in a state of dissolution.

How does such a disorder develop?

The wide variety of personality disorders already suggests that there is no one cause. Rather, it is a combination of psychosocial and genetic factors. While genetic factors only play a major role in some disorders, such as dissocial personality disorder, psychosocial factors are always a trigger. Psychological problems of the parents, unfavorable upbringing styles, lack of social support, traumatic experiences, violence or abuse can be responsible for a disorder. However, why certain factors lead to an illness in some people and not in others has not yet been conclusively researched.

Therapy options

First of all: Many personality disorders are curable if a suitable therapy is chosen! Since the disorder has usually existed for a long time, therapy often takes several years. The goal is not a complete change of the personality, but a change in concrete behaviors and thought structures that burden the affected person in daily life. The aim is to improve coping with stressful situations and interpersonal conflicts and to correct the unfavorable self-image. In the course of this, the parallel existing disorders are also treated. Depending on the disorder, medication may also be administered.

  • Berger, Mathias: Mental illness. Munich, 2019.
  • Falkai, Peter et al: Diagnostisches und Statistisches Manual Psychischer Störungen DSM-5. Göttingen, 2018.
  • Fiedler, Peter & Herpertz, Sabine: Personality disorders. Basel, 2016.
  • Renneberg, Babette & Herpertz, Sabine: Personality disorders. Göttingen, 2020.

Categories: Personality Disorders

Verena Klein
Author Verena Klein
"LIMES Schlosskliniken specializes in the treatment of mental and psychosomatic illnesses. With the help of the blog, we as a clinic group would like to examine the various mental illnesses in more detail and present different therapies as well as current topics."

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