Mental Health Resources: Personality Disorders

Paranoid Personality Disorder Symptoms

People with this disorder:

• Doubt the commitment, loyalty, or trustworthiness of others, believing others are exploiting or deceiving them.
• Are reluctant to confide in others or reveal personal information because they are afraid the information will be used against them.
• Are unforgiving and hold grudges.
• Are hypersensitive and take criticism poorly.
• Read hidden meanings in the innocent remarks or casual looks of others.
• Perceive attacks on their character that are not apparent to others; they generally react with anger and are quick to retaliate.
• Have persistent suspicions, without reason, that their spouses or lovers are being unfaithful.
• Are generally cold and distant in their relationships with others, and might become controlling and jealous to avoid being betrayed.
• Cannot see their role in problems or conflicts, believing they are always right.
• Have difficulty relaxing.
• Are hostile, stubborn, and argumentative.
• Tend to develop negative stereotypes of others, especially those from different cultural groups.

Schizoid Personality Disorder

• Prefer being alone and choose to do activities alone
• Don't want or enjoy close relationships
• Feel little if any desire for sexual relationships
• Feel like you can't experience pleasure
• Have difficulty expressing emotions and reacting appropriately to situations
• May seem humorless, indifferent or emotionally cold to others
• May appear to lack motivation and goals
• Don't react to praise or critical remarks from others

Schizotypal Personality Disorder

• Dress, speak, or act in an odd or unusual way
• Be suspicious and paranoid
• Be uncomfortable or anxious in social situations due to their distrust of others
• Have few friends
• Be very uncomfortable with intimacy
• Tend to misinterpret reality or to have distorted perceptions (for example, mistaking noises for voices)
• Have odd beliefs or magical thinking (for example, being overly superstitious or thinking of themselves as psychic)
• Be preoccupied with fantasy and daydreaming
• Tend to be stiff and awkward when relating to others
• Come across as emotionally distant, aloof, or cold
• Have limited emotional responses or seem “flat”

Antisocial Personality Disorder

• Disregard for right and wrong
• Persistent lying or deceit to exploit others
• Being callous, cynical and disrespectful of others
• Using charm or wit to manipulate others for personal gain or personal pleasure
• Arrogance, a sense of superiority and being extremely opinionated
• Recurring problems with the law, including criminal behavior
• Repeatedly violating the rights of others through intimidation and dishonesty
• Impulsiveness or failure to plan ahead
• Hostility, significant irritability, agitation, aggression or violence
• Lack of empathy for others and lack of remorse about harming others
• Unnecessary risk-taking or dangerous behavior with no regard for the safety of self or others
• Poor or abusive relationships
• Failure to consider the negative consequences of behavior or learn from them
• Being consistently irresponsible and repeatedly failing to fulfill work or financial obligations

Borderline Personality Disorder

• An intense fear of abandonment, even going to extreme measures to avoid real or imagined separation or rejection
• A pattern of unstable intense relationships, such as idealizing someone one moment and then suddenly believing the person doesn't care enough or is cruel
• Rapid changes in self-identity and self-image that include shifting goals and values, and seeing yourself as bad or as if you don't exist at all
• Periods of stress-related paranoia and loss of contact with reality, lasting from a few minutes to a few hours
• Impulsive and risky behavior, such as gambling, reckless driving, unsafe sex, spending sprees, binge eating or drug abuse, or sabotaging success by suddenly quitting a good job or ending a positive relationship
• Suicidal threats or behavior or self-injury, often in response to fear of separation or rejection
• Wide mood swings lasting from a few hours to a few days, which can include intense happiness, irritability, shame or anxiety
• Ongoing feelings of emptiness
• Inappropriate, intense anger, such as frequently losing your temper, being sarcastic or bitter, or having physical fights

Histrionic Personality Disorder

• Be uncomfortable unless he or she is the center of attention
• Dress provocatively and/or exhibit inappropriately seductive or flirtatious behavior
• Shift emotions rapidly
• Act very dramatically—as though performing before an audience—with exaggerated emotions and expressions, yet appears to lack sincerity
• Be overly concerned with physical appearance
• Constantly seek reassurance or approval
• Be gullible and easily influenced by others
• Be excessively sensitive to criticism or disapproval
• Have a low tolerance for frustration and be easily bored by routine, often beginning projects without finishing them or skipping from one event to another
• Not think before acting
• Make rash decisions
• Be self-centered and rarely show concern for others
• Have difficulty maintaining relationships, often seeming fake or shallow in their dealings with others
• Threaten or attempt suicide to get attention

Narcissistic Personality Disorder

• Have an exaggerated sense of self-importance
• Have a sense of entitlement and require constant, excessive admiration
• Expect to be recognized as superior even without achievements that warrant it
• Exaggerate achievements and talents
• Be preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate
• Believe they are superior and can only associate with equally special people
• Monopolize conversations and belittle or look down on people they perceive as inferior
• Expect special favors and unquestioning compliance with their expectations
• Take advantage of others to get what they want
• Have an inability or unwillingness to recognize the needs and feelings of others
• Be envious of others and believe others envy them
• Behave in an arrogant or haughty manner, coming across as conceited, boastful and pretentious
• Insist on having the best of everything — for instance, the best car or office

Avoidant Personality Disorder

• They are oversensitive and easily hurt by criticism or disapproval.
• They have few, if any, close friends and are reluctant to become involved with others unless certain of being liked.
• They experience extreme anxiety (nervousness) and fear in social settings and in relationships, leading them to avoid activities or jobs that involve being with others.
• They tend to be shy, awkward, and self-conscious in social situations due to a fear of doing something wrong or being embarrassed.
• They tend to exaggerate potential problems.
• They seldom try anything new or take chances.
• They have a poor self-image, seeing themselves as inadequate and inferior.

Dependent Personality Disorder

• A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts, as indicated by five or more of the following:
• Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others.
• Needs others to assume responsibility for most major areas of their life.
• Has difficulty expressing disagreement with others because of fear of loss of support or approval. (Note: Does not include realistic fears of retribution.)
• Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy).
• Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant.
• Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for themself.
• Urgently seeks another relationship as a source of care and support when a close re­lationship ends.
• Is unrealistically preoccupied with fears of being left to take care of themself.

Obsessive-compulsive Personality Disorder

• perfectionism to the point that it impairs the ability to finish tasks
• stiff, formal, or rigid mannerisms
• being extremely frugal with money
• an overwhelming need to be punctual
• extreme attention to detail
• excessive devotion to work at the expense of family or social relationships
• hoarding worn or useless items
• an inability to share or delegate work because of a fear it won’t be done right
• a fixation with lists
• a rigid adherence to rules and regulations
• an overwhelming need for order
• a sense of righteousness about the way things should be done
• a rigid adherence to moral and ethical codes

(Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/9784-paranoid-personality-disorder; Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/schizoid-personality-disorder/symptoms-causes/syc-20354414; WebMD, https://www.webmd.com/mental-health/schizotypal-personality-disorder; Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/antisocial-personality-disorder/symptoms-causes/syc-20353928; Mayo Clinic https://www.mayoclinic.org/diseases-conditions/borderline-personality-disorder/symptoms-causes/syc-20370237; Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/9743-histrionic-personality-disorder; Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/symptoms-causes/syc-20366662; Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/9761-avoidant-personality-disorder; Psychology Today, https://www.psychologytoday.com/us/conditions/dependent-personality-disorder; Healthline, https://www.healthline.com/health/obsessive-compulsive-personality-disorder#symptoms)

Psychotherapy

During psychotherapy with a mental health professional, people can learn about their condition and talk about moods, feelings, thoughts, and behaviors. They can learn to cope with stress and manage the disorder.

Psychotherapy may be provided in individual sessions, group therapy, or sessions that include family or even friends. There are several types of psychotherapy — a mental health professional can determine which one is best for each person.

Social Skills Training

During this training they can use the insight and knowledge they gain to learn healthy ways to manage their symptoms and reduce behaviors that interfere with functioning and relationships.

Schema Therapy

Schema therapy is a newer type of therapy that combines elements of cognitive behavioral therapy (CBT), psychoanalysis, attachment theory, and emotion-focused therapy, among others. In schema therapy, you’ll work with a therapist to uncover and understand your schemas, sometimes called early maladaptive schemas. Schema therapy aims to teach you how to ensure your emotional needs are met in a healthy way that doesn’t cause distress.

Family Therapy

Provides support and education to families dealing with a family member who has a personality disorder.

Mentalization-Based Therapy (MBT)

Mentalizing, or the ability to focus on and differentiate between your own emotional state of mind and that of others, and understand how one’s mental state influences behavior, is a normal cognitive function that is limited in those with some personality disorders. Enhancement of mentalization and improved emotional regulation are at the core of MBT treatment.

Medications

There are no medications specifically approved by the Food and Drug Administration (FDA) to treat personality disorders. However, several types of psychiatric medications may help with various personality disorder symptoms.

• Antidepressants. Antidepressants may be useful for a depressed mood, anger, impulsivity, irritability, or hopelessness, which may be associated with personality disorders.
• Mood stabilizers. As their name suggests, mood stabilizers can help even out mood swings or reduce irritability, impulsivity, and aggression.
• Antipsychotic medications. Also called neuroleptics, these may be helpful if symptoms include losing touch with reality (psychosis) or in some cases if there are anxiety or anger problems.
• Anti-anxiety medications. These may help if someone has anxiety, agitation, or insomnia. But in some cases, they can increase impulsive behavior, so they're avoided in certain types of personality disorders.

(Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/personality-disorders/diagnosis-treatment/drc-20354468; Healthline, https://www.healthline.com/health/schema-therapy-2)

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