Personality Disorders : Everything you need to know - Psychiatry | ๐๐ฎ๐๐ฅ ๐๐จ๐ฅ๐
Jun 19, 2021 20:32 ยท 2519 words ยท 12 minute read
Hello there i’m going to talk about a very very interesting mental disorder today which most of us are suffering from it could be you me or any one of us because the special thing about this disorder is that the person who has doesn’t know about his problem and if you remind him he will never accept that he’s suffering from any disorder and that is the personality disorder so before i go deeper into the disorder let’s understand the basics so that we can have maximum understanding of this disorder first meaning of personality it can be defined as the distinctive pattern of thought emotion and behavior that make up an individual’s a style of interacting with the physical and social environment and this is also the dynamic organization within the individual that determines his unique adjustment with the environment and what are the personality traits these are normal and prominent aspects of personality and these are broadly described by the big five first openness to experience people who are high in openness enjoy adventure they appreciate art imagination and new things they will be sensation seeking they love to have new experiences like bungee jumping sky diving etc and people who are low in openness would avoid new experiences and they are not adventurous second is the conscientiousness people high in conscientiousness are organized and have a strong sense of duty they are disciplined and achievement focused they are good planners people low in conscientiousness are more spontaneous and freewheeling they may be careless third is extraversion on the basis of this distinguished personality trait we easily differentiate the people into extrovert and introvert let me explain you the meaning of extrovert and introvert extrovert people are very very talkative they speak a lot they will be sociable and mostly they prefer group activities they can impress a big audience introvert they speak less they need their alone time and they prefer solitary activities it doesn’t mean they are shy they can perfectly be fine and at the same time they will be charming at parties fourth agreeableness it measures the extent of a person’s warmth and kindness agreeable people are very trusting helpful and compassionate disagreeable people are very suspicious of others and they are less likely to be cooperative fifth neuroticism it refers to the degree of emotional stability people who are high in neuroticism very frequently and easily slip into anxiety and depression any kind of criticism will be difficult to handle for them and people who are low in neuroticism they tend to be emotionally stable and now you should understand that the personality disorders result when these personality traits become abnormal that has become inflexible and maladaptive and cause significant social or occupational impairment or subjective distress we can also say that if the personality of an individual deviates from the social norms and is the reason for his unhappiness and impairment he is diagnosed with a personality disorder overall the prevalence of personality disorder is up to 20 onset is in early adulthood or adolescence symptoms remain stable up to the adult life and resolution of abnormal patterns of behavior occurs by 40 years of age which is known as maturity and this personality disorder is egocentronic ego syntonic it means the individual doesn’t find anything wrong with himself and hence they do not seek any psychiatric help i’m going to demonstrate you that if you are going to inform someone if you are going to remind someone that he is suffering from a personality disorder how he is going to react i’ll show you here dude i think you are suffering from some problem some of your activities i did not like i think there is some problem and you should see a psychiatrist so basically you are saying that my activities are abnormal and what i’m doing is not normal right yeah free kind information i am completely all right who are you man who the hell are you to tell me that i have some problem i think you need a psychiatrist you look like a psycho go to hell see i told you right i told you if you inform someone that he is suffering from a personality disorder he will never accept because he’s suffering from a personality disorder even that person will not know that he’s suffering from any person will not now i would like to elaborate the word ego syntonic and ego dystonic i asked one question during my lecture that if a person is gay or lesbian is it normal or abnormal some medicals replied sir it’s normal and some replied it’s abnormal and one of them replied sir it must be completely normal after all the government has legalized it right okay fine jokes apart but i’m going to explain you if a person is happy with his sexual orientation whether he is homosexual or bisexual it is ego syntonic it means it satisfies his ego and if a person is not happy with his sexual orientation and he’s getting anxious and getting panic that he won’t be accepted by society and his family it’s ego dystonic means it does not satisfy his ego now let’s understand the personality disorders dsm-5 has classified personality disorder into three clusters cluster a cluster b and cluster c cluster a contains disorders which are thought to be odd and eccentric and somewhere similar to schizophrenia these include like paranoid schizoid and schizotypal cluster b has disorders and they are considered emotional erratic and dramatic and these are histrionic antisocial narcissistic and borderline cluster c has disorders which are considered anxious and fearful and tears and fortune these include avoidant dependent and ocd personality disorder let’s understand all of them one by one first cluster a paranoid personality disorder the people who are suffering from disorder they will have the paranoia relentless mistrust and suspicious of others without adequate reason to be suspicious they are very very sensitive people and they believe in the conspiracy theories how we are going to manage them psychotherapy is the treatment of choice and medications like benzodiazepine and antipsychotics can be used for agitation and paranoia schizoid personality disorder they are emotionally cold socially detached self absorbed and lost in their dreams and they may have their own fantasy world solitary and sheltered lifestyle they have and they look very very secretive you appreciate him or criticize he will be indifferent they may have lack of sexual interest as they are uncomfortable with human interaction how to manage them of course psychotherapy and medicines like benzodiazepine antipsychotics and antidepressants schizotypal personality disorder they have unconventional and odd beliefs or you can say the magical thinking superstitious nature they have socially withdrawn with odd eccentric and inappropriate behavior so they do not have any close relationship they have unusual perceptual experiences vague circumstantial or stereotyped thinking and sometimes short-term psychosis like illusion hallucinations and delusions like ideas they will have these all symptoms are almost similar to schizophrenia so in icd-11 this is no more considered as a personality disorder it is classified as psychotic disorder along with schizophrenia so how we are going to manage this personality disorder psychotherapy and medicines like antipsychotics antidepressants and benzodiazepine and whatever we have learned so far about cluster a personality disorder like paranoid schizoid and schizotypal they all have some similar features like schizophrenia so cluster a disorders are considered as schizophrenic spectrum disorders means they lie somewhere in between the normal and schizophrenia now let’s understand the disorders of cluster b first histionic personality disorder full of drama patients behave in extroverted way they exaggerate the expression of emotions shallow and levial effectivity they have attention seeking attitude sometimes they behave in a seductive manner and use physical appearances to draw the attention there is an attempt to look beautiful and gorgeous associated features may include egocentricity self-indulgence anticipating appreciation every time feelings that are easily hurt and persistent manipulative behaviors to achieve own needs anger outburst or the tantrums are very very common societal gestures may be made at times interpersonal relationships are often stormy let me remind you that some features of histrionic personality disorder exist in every household our moms right i’m not saying that our moms have this personality disorder i’m seeing some features like exaggeration and full of drama have a look excuse me mom i need 15 000 bucks 15 000 bucks why actually my friends are going for a picnic to go i also want to go there uh please give me 15 000 bucks fifteen thousand bucks mom it’s just fifteen thousand do you understand the importance of fifteen thousand bucks your father is working day and night he’s working so hard and you just want to waste his money you want to go to gua okay mom fine i’m not going to go to goa fine okay i will go to see some museums okay and i will also go to visit some temples museums and temples also okay fine i will give you seventeen thousand bucks okay and visit some historical places also okay don’t go to goa goodbye so the most successful method of management is psychoanalysis and psychoanalytical psychotherapy narcissistic personality disorder people who have this disorder will have ideas of grandiosity and inflated sense of self-importance he will think this is all about me and i’m the best that is heightened sense of self importance they believe that they are special and very talented they are preoccupied with fantasies of unlimited success they have lack of empathy with others and exploited behavior they always want admiration they should always be praised by everyone at the same time they are unable to face any criticism they have fragile self-esteem an underlying sense of inferiority easily get depressed by minor events they are susceptible to have development of depression when faced with rejection i will demonstrate you here dude i think you look good i look good right actually very good what a personality i have man i think i’m the best this is all about me this is all about me everyone appreciates me really i’m so good i’m so good dude i think you are losing some hairs and very soon you are going to be back i am really good i’m good who is he man he doesn’t know anything okay i’m good see i told you narcissistic people i’m sure you might have come across with so many people like him okay fine so how we are going to treat the narcissistic personality disorder first of all always it’s psychotherapy and patients may go into depression so we can use antidepressants bpd which is known as borderline personality disorder it is also known as emotionally unstable personality disorder they are always in the state of crisis they have significant mood swings they may start feeling angry anxious or frustrated without any reason unstable and intense interpersonal relationships pattern they will have they are indulged into self-destructive acts like overdoses of medicines slashing of wrists they harm themselves simply to seek help from others or express anger or just numb themselves to the overwhelming painful feelings they have these patients are also very impulsive in certain areas like spending sex and substance use and they excessively use a defense mechanism of splitting wherein they consider each person to be either all good or all bad so this is really a serious problem how we are going to manage them first is psychotherapy second is the dialectical behavior therapy this is a type of cbt where patients are motivated to think positive and not to get involved into self-destructive acts and pharmacotherapy like antidepressants antipsychotics and mood stabilizers like lithium and wall product anti-social or dyssocial personality disorder the name itself antisocial easy to understand right this disorder is synonymous with all terms like psychopathy and sociopathy but does not always mean the criminal behavior they have persistent attitude of irresponsibility and disregard for social norms rules and regulations and incapacity to maintain enduring relationships they do not have regard for rights of others and frequently violate them they frequently get involved in unlawful behavior such as lying theft and deception they easily get aggressive and violent they have lack of remorse and guilt for others substance use disorders like alcoholism is frequently seen in these patients history of the conduct disorder in young age may support the diagnosis further and there are no any psychotic feature in this personality disorder so how we are going to treat first of all it’s psychotherapy and some and some medicines like beta blockers and and the carbon as p let’s talk about cluster c personality disorders first of all avoidant or anxious personality disorder what will happen to a boy who proposed many girls and got rejected by all what will happen to a boy who got discriminated and i was and was not allowed to play with other kids what will happen to a man who got rejected by all companies for a job they will develop fear of rejection they are afraid that they would be criticized or rejected in social situations they have persistent and progressive feelings of tension and apprehension and a belief that they are inferior to others actually they develop inferiority complex so they tend to remain socially withdrawn they avoid all social or professional activities that involve significant interpersonal contact because of fear of criticism disapproval or rejection so how we are going to treat avoidant personality disorder individual psychotherapy a group psychotherapy cbt assertiveness training and medicines like beta blockers and ssri dependent personality disorder these patients are dependent on others for every day decisions all major decisions in their lives are taken by someone else they seek excessive amount of advices and reassurance from others they feel uncomfortable or helpless when they are alone they have difficulty in saying no to others because of fear of loss of support and treatment is psychotherapy benzodiazepine and beta blockers are given for symptomatic relief now very important personality disorder obsessive compulsive personality disorder ocd this is different from the neurotic disease oct neurotic is ego dystonic but now we are talking about personality disorder ocd this is ego syntonic these patients are preoccupied with rules and regulations they have feelings of excessive doubts and preoccupation with details and perfectionism which always result in significant delays they are inflexible and insist that others agree to their demands they are obsessed with their work and excessively devoted to work and may not have time for leisure activities they are very formal and serious and often lack a sense of humor how we are going to manage the patient of ocd personality disorder 100 psychotherapy so the personality disorders according to cluster a cluster b cluster c are over so this was all about the personality disorders i hope you have enjoyed and learned all the types of personality disorders thank you so much you.