Definition

Personality disorder is a mental disorder in which individuals have rigid and unhealthy patterns of thinking, functioning, and behaving. Individuals with personality disorders have problems understanding and relating to other people because of their difficulty understanding social situations. This causes significant impairment and limitations in relationships, social activities, work, and learning.

This disorder usually begins to appear during adolescence or young adulthood. Based on similar symptom characteristics, there are groupings of personality disorder types, namely clusters A, B, and C. Some of these types may become very prominent at older age.

Cluster B personality disorders are characterized by dramatic, highly emotional, and unpredictable ways of thinking or behaving. This cluster includes antisocial personality disorder, borderline personality disorder, histrionic personality disorder, and narcissistic personality disorder.

Causes

Personality is formed from childhood through the interaction of genetic factors and the growth and development environment. Some personality traits can be passed from parent to child through genes. This inherited trait is called temperament. Apart from that, where a person grows up, their experiences, and how the child's relationships with family members and other people can determine the formation of a child's personality.

Therefore, genetic and environmental factors are thought to play a role in causing personality disorders. Genetic factors cause a person to be susceptible to experiencing personality disorders, while environmental factors will trigger that vulnerability to develop into a real disorder.

Risk factor

Although the exact cause of personality disorders is still unknown, several factors are thought to increase a person's risk of experiencing a personality disorder. The factors are:

• The presence of family members with a history of personality disorders or other mental disorders
• Raised in a loud, abusive, unstable, and broken family
• Was diagnosed with behavioral disorder as a child

Symptoms

Antisocial personality disorder

The word antisocial does not mean that the person does not want to talk to others but rather that they violate social and legal rules. Antisocial individuals oppose society and are therefore called 'antisocial'. They tend to ignore the feelings and rights of others and usually only focus on themselves and their goals.

Symptoms of antisocial personality disorder include:

• Doesn't care about other people's needs or feelings
• Often lies, steals, uses aliases, deceives others
• Often dealing with legal issues
• Often violates other people's rights
• Behaving aggressively, impulsively and often violently
• Doesn't care about the safety of oneself or others
• Has persistent irresponsible behavior
• No regrets for the negative behavior carried out

Borderline personality disorder

Individuals with this disorder have a low self-image. They depend on others to stabilise themselves and place their self-worth in relationships. They can manipulate other people so that people don't leave them. This makes people with borderline personalities often idolize someone until that person makes a mistake. Their opinion of that person will change 180 degrees until they end the relationship.

People with this disorder also often have inconsistent moods; their moods can change from positive to negative without any clear cause. Other symptoms of this disorder include:

• Impulsive and risky behavior such as unsafe intimate relations, gambling, binge eating
• Unstable or fragile self-image
• Unstable and intense relationships with friends or partners
• An unstable mood is often a reaction to stress
• Harmful or suicidal behavior, or threats to harm oneself
• A great fear of being alone or abandoned
• Constant feeling of emptiness
• Often displays intense anger
• Frequent paranoia caused by stress
• Black-and-white thinking

Histrionic personality disorder

People with this disorder constantly want attention and actively seek attention. Therefore, they pay great attention to their appearance and demeanour. Symptoms of this disorder include:

• Very emotional, dramatic, or sexually provocative to attract attention
• Speaking dramatically, expressing extreme opinions without supporting facts or details
• Easily influenced by other people
• Emotions are shallow and change quickly
• Very concerned about physical appearance
• Thinks that his relationships with other people are very close, closer than reality
• Narcissistic personality disorder
• Believing that he is special and more important than other people
• Fantasizing power, success, and attractiveness
• Unable to understand other people's needs and feelings
• Exaggerating one's achievements or talents
• Hope always to be praised and admired
• Arrogant
• Has hopes of getting favors and benefits, often takes advantage of others
• Envious of other people, does not want to acknowledge other people's success
• Believes that other people are jealous of him

Diagnosis

To diagnose a personality disorder, the doctor will interview the patient and their family members or caregivers regarding their medical history. A physical examination can also be carried out to determine whether a medical cause is underlying the symptoms experienced. The doctor may also examine to check the level of alcohol or other compounds in the body.

In addition, a psychiatric examination can be carried out to determine the patient's thoughts, feelings, and behavior with the help of a questionnaire. The family can also provide information to strengthen the diagnosis further. 

Sometimes, determining the type of personality disorder is not easy because some of the symptoms of each type of disorder are similar, and more than one type of disorder can also appear. Some people with certain types of disorders can have symptoms of other types.

The diagnosis of a type of personality disorder does not have to cover all the symptoms present, and not everyone who has strong emotional responses and dramatic behaviour is a personality disorder sufferer. In general, a diagnosis of a personality disorder is made if the symptoms bother a person and cause problems in at least two ways:

• How to view self-image, other people, and everyday events
• Appropriateness of emotional responses to various situations
• Daily functions in dealing with other people
• The ability to control one's impulses

Management

Personality disorders are long-term, so therapy takes a long time, from months to years. The best therapy choice is based on the type of personality disorder, its severity, and its impact on life. The choice of therapy usually falls on psychotherapy, which can be accompanied by or without medication.

• You can talk about your mood, feelings, thoughts and behavior during a psychotherapy session. You will also learn to cope with the stress and disturbances you experience. Psychotherapy can be done individually, in a group, or with family or friends.
• Medications, there are no specific medications for personality disorders that have been approved as the primary treatment option; instead, there are only medications to control the symptoms of the disorder.

Some cases of personality disorders are so severe that they require hospitalization; this is done if the sufferer tends to hurt or endanger themselves or others around them.

Complications

Untreated personality disorders can cause significant problems in daily life and will worsen over time. This problem is not only experienced by individuals with personality disorders but also by those closest to them.

This disorder can cause problems with relationships with other people, work, and learning and can lead to social isolation or drug and alcohol abuse.

Prevention

Until now, there is no known way to prevent personality disorders. However, there are ways to prevent various problems arising from this disorder, including seeking help as soon as possible.

When to see a doctor?

Suppose you have symptoms of a personality disorder that you feel are disturbing you and your relationships with the people around you. In that case, it is advisable to consult a psychiatrist or psychologist.