What makes each person unique? It is the veritable character, in all humans, that is made of a pattern of feelings, thoughts and behavior. This in short is 'PERSONALITY'.

Personalities take shape from a combination of one's childhood experience, upbringing and heredity. According to a French psychoanalyst, Jacques Lacan, 'a person is composed of many diverse and fragmentary images of self'.

Personality Disorder

A person may be diagnosed with 'personality disorder', when pervasive pattern of behaviors and thoughts cause problems at work and in relationships. There is a consequent impedance in carrying out their day-to-day tasks. People with personality disorders have difficulties dealing and coping with everyday stress compared to people with normal or healthy personalities.

'Personality Disorder' is defined by the American Psychiatric Association as 'an enduring pattern of the inner experience and behavior that deviates markedly from the expectations of the individual's culture who exhibits it, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment'.

World Health Organization defines 'Personality disorder' as 'a severe disturbance in the character, logical condition and behavioral tendencies of the individual, usually involving several areas of the personality, and nearly always associated with considerable personal and social disruption'.

Earlier people thought that environment and early experiences that prevents the advancement and development of adaptive patterns in a person resulted in personality disorders. It is also believed that disorders in the personality develop when personality itself develops. Later some researches showed that psychological, biological and genetic factors were involved with personality disorder. However, inconsistent data from further researches made it impossible to specify the cause.

Some of the other risks for personality disorder are -

• Child neglect,

• Child abuse,

• Substance abuse, and

• Physical abuse.

It is now believed that a combination of environmental and scientific factors lead to problems in a person's personality.

When is the diagnosis made?

People with personality disorders possess numerous distinctive psychological features with a rigid, ongoing pattern. Depending on the intensity of the symptoms, personality disorders can be classified from mild to severe.

When the disorder is mild, people might carry on with their lives normally. Under stress, the symptoms strengthen and seriously interfere with their functioning. They could have trouble with -

• Self-image


• Interpersonal relationships


• Controlling their impulses and emotions


• Perception (not only of others but even of themselves)

A diagnostic criteria established by the Diagnostic and Statistical Manual-IV should be met to diagnose a person with 'Personality disorder'.

Other disorders have to be ruled out before this diagnosis is made. There could be similar characteristics in patients with personality disorders and other medical illnesses such as:

• Depression
• Anxiety disorders
• Schizophrenia
• Post- traumatic stress syndrome

Types of Personality Disorders

The Diagnostic and Statistical Manual classifies personality disorders into 10 different categories. Since patients may not always fall under one specific category, they are classified into 3 broader clusters.

Cluster A ODD OR ECCENTRIC DISORDERS	Cluster B DRAMATIC, EMOTIONAL, OR ERRATIC DISORDERS	Cluster C ANXIOUS OR FEARFUL DISORDERS
Paranoid Personality Disorder Schizoid Personality Disorder Schizotypal Personality Disorder	Antisocial Personality Disorder Borderline Personality Disorder Histrionic Personality Disorder Narcissistic Personality Disorder	Avoidant Personality Disorder Dependent Personality Disorder Obsessive-Compulsive Personality Disorder

Treatment

The first goal in treating personality disorders is to relieve symptoms like depression or anxiety.

There are drugs that can help control symptoms like angry outbursts, impulsiveness and depression. Short term therapy does not cure personality disorder, since character change occurs over a long period of time. Drugs that are commonly used are -

• Antidepressants

• Antipsychotic

• Mood stabilizers

The effect of the treatment differs widely from person to person, depending on the type of disorder. Treatment should, therefore, be individualized.

Psychotherapy is the keystone of treatment. Dynamic or Psychoanalytic psychotherapy sessions use the relationship between the patient and the therapist to understand how a person's traits affect relationships. Some other forms of therapy are Cognitive Behavioral Therapy, Cognitive Analytical Therapy and Dialectic Behavioral Therapy.

Along with therapy sessions, support from family and kindness from society helps to calm these disturbed minds.

Source-Medindia
PADMA/L