Just the term “personality disorders” can be hard to hear, whether you are diagnosed with one, or your loved one is. One of the big reasons is because personality disorders carry a set of challenges when it comes to treatment. Why is this? Why are personality disorders difficult to treat, and what should you know about them?
Exploring Why Personality Disorders Are Difficult To Treat
Before getting into the specifics and answering “why are personality disorde
rs difficult to treat,” it’s useful to have the background into what these mental disorders are, and how they affect people.
There are ten personality disorders. Each is grouped into one of three categories. These are:
- Cluster A personality disorders—defined by eccentric or odd thinking and behaviors
- Cluster B personality disorders—characterized by overly emotional, dramatic and unpredictable thoughts and behaviors
- Cluster C personality disorders—primarily anxious and fearful behaviors and emotions define these personality disorders
When someone has a personality disorder, it influences how they feel, how they respond to their environment and other people, their relationships and their behavior. Personality disorders are thought to result from a combination of genetic and environmental factors. When someone has a personality disorder, it leads them to deviate from societal norms in how they think and behave.
The long-term element of personality disorders and the widespread effects are two of the reasons why personality disorders are difficult to treat.
Personality disorders lead to long-term patterns of behavior, and they often start to appear in late adolescence and early adulthood. When someone has an untreated personality disorder, it affects their daily functionality and their ability to form and maintain relationships.
What Are the Types of Personality Disorders?
The following are the specific types of personality disorders.
- Antisocial personality disorder (cluster B): Marked by disregard for the rights and feelings of others. Someone with antisocial personality may lie, be deceptive, and behaves on impulse.
- Avoidant personality disorder (cluster C): Someone with this disorder will have intense shyness, feelings of being inferior and be highly sensitive to criticism whether real or perceived.
- Borderline personality disorder (cluster B): Defined by unstable personal relationships and intense moods and emotions. Someone with borderline personality disorder may have extreme fears of being abandoned, may attempt suicide and may have strong anger outbursts.
- Dependent personality disorder (cluster C): Someone with dependent personality disorder has a difficult time being on their own or even making decisions without someone else. They fear being without someone to reassure them, and they feel helpless on their own.
- Histrionic personality disorder (cluster B): When someone has histrionic personality disorder they display excessive emotions and are constantly seeking attention. They may feel anxious or distressed if they aren’t the center of attention.
- Narcissistic personality disorder (cluster B): Narcissistic personality disorder is characterized by a need for admiration combined with a lack of empathy for other people. People with narcissistic personality disorder have a false sense of self-importance, but under that is often a fragile sense of self-esteem.
- Obsessive-compulsive personality disorder (cluster C): Someone with this personality disorder is obsessed with order, rigidity, and They want to control other people and situations, and they are so focused on schedules and work or projects that they are unable to form relationships.
- Paranoid personality disorder (cluster A): Signs of paranoid personality disorder include extreme suspiciousness and distrust of others, as well as seeing people as intentionally being harmful or hurtful to them.
- Schizoid personality disorder (cluster A): Defined by detachment from relationships and a lack of emotion. Someone with this personality disorder seems to have no desire to be with other people or form relationships and doesn’t care about receiving praise or criticism.
- Schizotypal personality disorder (cluster A): Symptoms include being uncomfortable in close relationships and having peculiar behaviors and speech patterns. This disorder may also include extreme social anxiety.
How Are Personality Disorders Diagnosed?
Just as personality disorders can be difficult to treat, diagnosis is a challenge as well. When someone has a personality disorder, they very rarely see an issue within themselves. They see others or outside forces as the problem.
Most people with other mental health disorders know they have a problem, and the fact that it is a problem causes them distress.
For example, consider social anxiety. Someone with social anxiety knows their fears about being in social situations are irrational, but they can’t help or control it. They can then recognize the irrationality and talk about their symptoms with a health care provider so their social anxiety can be treated.
This rarely happens when someone has a personality disorder. A health care provider can look at certain long-term patterns of thinking and behavior to make a diagnosis. However, it’s usually more helpful to talk to people close to the person with the personality disorder.
When making a diagnosis, a doctor or health care provider will try to get permission to speak to someone who knows the person with the disorder well. This is valuable because while someone with a personality disorder may not realize the effects of their behavior, the people around them are often significantly impacted.
Why Are Personality Disorders Hard to Treat?
So, what are the specific reasons why personality disorders are difficult to treat? First, people with personality disorders tend to be resistant to change, even when the changes will be beneficial. People with personality disorders often experienced trauma early in life, and it’s difficult to treat those deep-rooted issues.
Even though personality disorders are difficult to treat, treatment is possible.
When someone has a personality disorder, one of the first-line treatment approaches is cognitive behavioral therapy or CBT. CBT allows a person within a personality disorder to start gaining a sense of mindfulness and awareness over the true negativity of their thoughts and long-held beliefs. This sense of recognition can then lead someone with a personality disorder to be able to make changes.
Another reason why personality disorders are so difficult to treat is that they often occur with co-occurring mental health disorders. For example, substance abuse, anxiety, depression, and bipolar disorder are all co-occurring disorders frequently seen in patients with personality disorders. It’s important that these conditions be treated as well as the personality disorder to improve outcomes.
Medications can be part of a treatment plan for someone with or without a co-occurring disorder. Medications sometimes used to treat personality disorders, and other mental health disorders include antidepressants, mood stabilizers, antipsychotics, and anti-anxiety medications.
Finding a therapist who has experience with personality disorders can be useful as well. Not all therapists will have an understanding of working with a patient who is resistant to change and has a personality disorder.
There isn’t a cure for personality disorders, but when people receive treatment, and they follow their treatment plan, they often experience remission from symptoms.
Are personality disorders difficult to treat? Yes. Can they be treated? The answer is also yes.