What are personality disorders?
Personality disorders are enduring patterns of behaviour, cognition and emotional functioning that deviate significantly from the expectations of the individual's culture, appear in late adolescence or early adulthood and cause suffering or functional impairment. These patterns affect how the person relates to themselves, others and the world around them.
Why are personality disorders grouped together?
For clinical purposes, personality disorders are organised into three groups (clusters):
- Cluster Aeccentric or strange behaviour (schizoid, schizotypal)
- Cluster Bdramatic, emotional or erratic behaviour (e.g. borderline, narcissistic)
- Cluster Canxious or fearful behaviour (e.g. obsessive-compulsive)
This division helps to understand the “family” of symptoms, but each person is unique and there can be overlap between types.
Borderline Personality Disorder
What characterises the borderline type?
This type shows emotional instability, intense and unstable relationships, fear of abandonment, chronic feelings of emptiness, impulsiveness and sometimes self-injurious behaviour.
Typical signs and behaviours
- Rapid mood swings
- Idealisation and belittling of close people
- Impulsivity in areas such as spending money, sex or substance abuse
- Persistent feeling of inner emptiness
- Self-injurious behaviour
Practical considerations
Recognising these signs allows early referral for treatment, something that can significantly improve the prognosis.
Narcissistic Personality Disorder
What is the narcissistic type?
People with this pattern tend to have fragile self-esteem, a constant search for admiration, a lack of empathy for others and beliefs in superiority.
Signs and behaviour
- Fantasies of unlimited success, power or beauty
- The need to be recognised as special
- Exploitation of others to achieve personal ends
- Envy or the conviction that others envy you
Practical considerations
In the clinical context, the challenge lies in both diagnosis and adherence to treatment, as the individual may have difficulty recognising their own vulnerabilities.
Schizoid Personality Disorder
What defines the schizoid type?
This type is characterised by a preference for solitary activities, little desire for close relationships, little emotional expression and social withdrawal.
Signs and behaviour
- Indifference to praise or criticism
- Little or no desire for intimate relations
- Leisure activities almost always solitary
- Affective and emotional coldness
Practical considerations
These people may only seem “reserved”, but that doesn't mean they're fine, there may be emotional suffering that goes unnoticed.
Obsessive-Compulsive Personality Disorder (OCPD)
Difference between PPOC and POC
PPOC is an enduring pattern of perfectionism, rigidity, need for control and inflexibility. POC is an anxiety disorder with specific obsessions and compulsions.
Signs and behaviour
- Excessive preoccupation with rules, lists and organisation
- Perfectionism that makes it difficult to complete tasks
- Difficulty delegating tasks
- Rigidity in moral or ethical values
Practical considerations
Perfectionism and rigidity can limit quality of life and make it difficult to adapt in personal and professional environments.
Causes and Contributing Factors
Main factors
- Genetics and heredity
- Early life experiences (trauma, neglect, parenting style)
- Combined biological and environmental factors
Why it takes so long to appear
Personality patterns become more evident in late adolescence or adulthood, when the personality structure is more consolidated.
Diagnosis and clinical assessment
Elements of the diagnosis
- Assessment of life history and emotional functioning
- Identification of persistent and dysfunctional patterns
- Exclusion of other mental health conditions
The importance of early intervention
The earlier the disorder is identified, the better the chances of adaptation and treatment.
Treatment and possible approaches
Psychotherapy
- Dialectical behaviour therapy
- Cognitive-behavioural therapy
- Schema-focused therapy
Medical treatment
Medication can be used to treat associated symptoms, such as anxiety or depression, but not the personality disorder itself.
Life strategies and support
- Education about the disorder
- Development of social skills
- Ongoing family or psychosocial support
Living with a personality disorder: what to know
- Recognise that the disorder is not the person's fault
- Improvement is possible with specialised treatment and support
- The changes are gradual, but they can bring greater stability and well-being
When to seek specialised help?
- If there is persistent emotional distress
- When there is an impact on relationships, work or self-esteem
- In case of impulsive, self-injurious or self-destructive behaviour
Conclusion
Personality disorders are complex but treatable conditions. With the right diagnosis, professional support and the active involvement of the person, it is possible to achieve greater emotional stability and a better quality of life.
