Personality Disorders

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• QWhat are the symptoms of narcissistic personality disorder?

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  A NewYork-Presbyterian Hospital answered

  People with narcissistic personality disorder have the following characteristics:

  • react to criticism with feelings or rage, shame or humiliation
  • take advantage of others to achieve own goals
  • have a grandiose sense of self-importance
  • hold a belief that his/her problems are unique and can only be understood by other special people
  • have a preoccupation with fantasies of unlimited success, power, beauty, intelligence, or ideal love
  • require constant attention and admiration
  • be unable to recognize and experience how others feel
  • be preoccupied with feelings of envy
• QWhat happens to people who have borderline personality disorder?

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  A Dr. Marni Feuerman, LCSW, MFT , Marriage & Family Therapy, answered on behalf of MDLIVE

  The first signs of borderline personality disorder usually appear by late childhood. The most common early signs are impulsive and reckless behavior. The disorder often fully develops in the late teens to early twenties. The risk of suicide associated with borderline personality disorder is greatest in the young adult years and gradually decreases with age. In the adult years, the disorder causes intense emotions, impulsive behaviors, and unstable relationships. Uncontrolled emotions and fear of being abandoned often lead to job losses, failed marriages, and uncompleted education.

  Treatment can be very challenging. People with borderline personality disorder frequently have difficult relationships with their doctors. They often see others as either "good" or "bad." A shift from one view to the other, called splitting, can occur suddenly in any relationship for minor reasons.  These changes in feeling often are a source of tension between a person with borderline personality disorder and doctors. Splitting is also a common source of tension in relationships with friends and family members

  Severe symptoms such as self-destructive and suicidal behavior, irrational thinking, and emotional problems related to relationships may improve as you begin treatment. Some symptoms may last longer, such as feelings of anger or emptiness or abandonment, suspiciousness, and difficulty tolerating being alone. .  Often other disorders occur along with borderline personality disorder as well and also need treatment (for example, depression or substance abuse).

  The majority of those with this disorder gain more stable emotions, relationships, and employment during their 30s or 40s. Many people who get treatment for borderline personality disorder do decrease destructive behaviors, often within the first year of treatment.  According to the research, around half of those diagnosed with borderline personality disorder no longer have many of the behaviors associated with the disorder after about 10 years of treatment.

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• QWhat are the symptoms of borderline personality disorder?

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  A Dr. Karyn Hall , Psychology, answered

  Borderline Personality Disorder (BPD) is primarily an emotion regulation disorder. This means that the individual with BPD has difficulty effectively managing his or her emotions. Dr. Marsha Linehan, treatment developer of Dialectical Behavior Therapy, says that BPD is about self dysregulation, relationship dysregulation, cognitive dysregulation, emotion dysregulation, and behavior dysregulation. The dysregulation of self is about not having a clear identity, chronic feelings of emptiness, and some experiencing episodes of dissociation. Relationship dysregulation reflects the fears of abandonment and chaotic relationships. Cognitive dysregulation includes occasional paranoid thinking and cognitive distortions. Behavior dysregulation includes self-harm actions and suicide attempts as well as other impulsive and destructive behaviors. Emotion dysregulation refers to the intense anger and the difficulties with mood that interfere with their daily functioning.

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• QWhat is the treatment for narcissistic personality disorder?

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  A NewYork-Presbyterian Hospital answered

  Treatment of narcissistic personality disorder usually consists of individual, group or family therapy, structure (scheduling one's time so there are no long periods of unplanned time), support, medications for specific symptoms, limit-setting, consistent rules, education about the illness, social skills training, behavior modification and learning more effective communication and coping skills. Inpatient or day hospitalization may be necessary when symptoms make the patient a danger to self or others.
• QWhat is narcissistic personality disorder?

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  A NewYork-Presbyterian Hospital answered

  Narcissistic personality disorder is a persistent pattern of grandiosity, hypersensitivity to the evaluation of others, and lack of empathy that begins early in adulthood and is present in a variety of contexts.

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• QWhat is paranoid personality disorder (PPD)?

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  A Sigma Nursing answered

  Paranoid personality disorder is part of the Cluster A group of personality disorders. This group is characterized by eccentric or odd behavior and thinking. People with this disorder harbor suspicion or mistrust of others with little or no valid reason. They fear others intend to harm them and that there are malicious and harmful motives behind the actions of others. They may feel alienated, isolated, and emotionally detached from others.
• QWhat causes borderline personality disorder?

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  A Dr. Karyn Hall , Psychology, answered

  The exact cause or causes of borderline personality is unknown at this time. Most believe it is the result of a biological vulnerability or predisposition combined with events in the environment. Marsha Linehan, treatment developer of Dialectical Behavior Therapy, proposed the biosocial theory. She suggests that people with BPD are born with a predisposition and then experience an invalidating environment which leads to difficulty with emotion regulation and other issues. Invalidation means that the person's internal experience (thoughts and feelings)  is judged by significant people to be unacceptable or wrong. The person learns they cannot trust their internal experience. Her ideas have not been proven and are only a theory. 

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• QWhat is a neurotic personality?

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  A RealAge answered

  A person with a neurotic personality exhibits characteristics of excessive worry and anxiety over normal life events. Symptoms of a neurotic personality may include:

  • depression
  • unrealistic fears
  • obsessions
  • repetitive, compulsive behaviors
  • irritability
  • feeling tense
  • low self-esteem

  
  Neuroticism can occur on a continuum. Some experts speculate that being mildly neurotic may actually have some health benefits by causing people to think twice about engaging in risky or potentially unhealthy behavior. On the other hand, people with high neuroticism are known to be more likely to smoke, drink, use drugs, and engage in unsafe sex. If the symptoms and traits associated with having a neurotic personality begin to interfere with normal, everyday functioning, treatment -- including therapy/counseling and possibly anti-anxiety medicines -- may be recommended. 
• QWhat is the difference between borderline personality disorder and bipolar?

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  A Dr. John Preston, PsyD , Psychology, answered

  Borderline Personality Disorder (BPD) and Bipolar Disorder have two things in common: significant emotional instability and poor impulse control (e.g. poor judgment and making rapid decisions that often cause the person great harm; inability to control ones emotions). Beyond this, the two are quite different.

  Bipolar disorder is a genetically-transmitted biologically-based mood disorder. It has two forms: Bipolar I (those diagnosed have both major depressive episodes and episodes of mania) and Bipolar II (major depression and episodes of hypomania).

  Manic episodes include the following symptoms: hyperactivity or agitation, racing thoughts, rapid, pressured speech, decreased need for sleep, psychotic symptoms, such as delusions or hallucinations (psychosis occurs in 70% of manic episodes), very impaired impulse control and poor judgment. There are 2 types of mania: euphoric mania (grandiosity, up-beat, euphoric)…delusions: “I am the smartest person in the world) and dysphoric mania (severe depression, marked irritability, and suicidal ideas and impulses). Hypomania is a mild version of mania: upbeat mood, decreased need for sleep, out-going, but no psychotic symptoms.

  Bipolar episodes can be ignited by major life stresses, sleep deprivation and/or substance abuse. They also can arise spontaneously (appear to come out of the blue

  BPD does not have spontaneous mood changes. Rather people suffering from this disorder are very sensitive, especially to interpersonal rejections or fears of abandonment. Periods of depression, extreme anxiety, and anger can be sparked by what to others may be seen as small stressors (e.g. someone does not return their phone call). BPD does not have these classic manic symptoms: decreased need for sleep, extreme grandiosity, rapid thoughts, and pressured speech. People with BPD always have a history of very chaotic interpersonal relationships and intense emotional instability.

  Bipolar disorder can be successfully treated with psychiatric medications (mood stabilizers), although this treatment is often very challenging. People with BPD are sometimes treated with antidepressants (that target irritability and impulsivity); however the outcome of such treatments is usually marginal. The treatment for BPD is psychotherapy.

  
  

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• QWhat is a personality disorder?

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  A Dr. Joni Johnston , Psychology, answered

  We all have various personality traits; some of us are naturally organized, extroverted, trusting, and so forth. Sometimes those traits work for us and sometimes they can work against us; a person with the need to be organized, for example, may have more trouble coping with unstructured or spontaneous situations but may be very good at planning or paying attention to detail. Additionally, most of us can reign in those natural characteristics when necessary; we're not likely to be as outgoing, for example, towards a complete stranger or someone who approaches us late at night when we're walking alone.

  Someone with a personality disorder, however, has a rigid way of thinking and acting that persists in spite of adverse consequences to themselves or others. This is someone whose personality trait is at the extreme end of the spectrum. Someone with narcissistic personality disorder, for example, has a sense of entitlement, unrealistically grandiose view of himself, and lack of empathy for others that pervades all interactions with others.

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