Mental disorders and personality disorders

definitions, comparison/limitations, examples, therapeutic approach

Mental disorders and personality disorders are two distinct categories of psychological disorders that significantly affect an individual’s mental state and behaviour. Although they have different characteristics and symptoms, both can cause significant difficulties in a person’s daily life and require therapeutic intervention.

Both mental disorders and personality disorders are psychological conditions that cause a high degree of distress, especially for the individual, but can sometimes cause a high level of distress for people close to them.

What are mental disorders?

Mental disorders are, by definition, a set of clinically significant symptoms or behaviours that are often associated with either increased discomfort or impaired functioning.

Mental disorders, also called psychiatric or psychiatric disorders, affect an individual’s level of mental and emotional functioning. Mental disorders can involve changes in thinking, emotions, behaviour or moods. Mental disorders can be caused by a combination of genetic, biological, psychological and environmental factors.

Examples of mental disorders include major depression, generalised anxiety disorder, other anxiety disorders, obsessive-compulsive disorder, sexual disorders, eating disorders, sleep disorders such as insomnia, and other disorders such as schizophrenia and bipolar disorder.

What are personality disorders?

Personality disorders are elements of complex psychopathology, and according to DSM-5, a personality disorder is a persistent pattern of inner experiences and behaviour that is significantly different of the specific norms of the cultural model of origin, is pervaziv (with a tendency to generalize), rigid, which begins in adolescence or young adulthood, which establishes itself over time and leads to dysfunction and distress, with potentially harmful consequences for the person concerned or others around them. There are two perspectives through which personality disorders can be analysed, namely dimensional and categorical. The best known is the categorical view, according to which there are 10 personality disorders, grouped into 3 clusters. Cluster A is represented by schizoid, schizotypal and paranoid personality disorders. Cluster B comprises borderline, narcissistic, histrionic and antisocial personality disorders. Cluster C consists of avoidant, dependent and obsessive-compulsive personality disorders.

Types of personality disorders

In the DSM-5(Diagnostic and Statistical Manual of Mental Disorders), the following 10 personality disorders are described:

1. Paranoid personality disorder

It is characterized by excessive suspicion of others, a tendency to interpret others’ intentions as negative, and a reluctance to open up and trust others.

2. Schizoid personality disorder

These people avoid social relationships and social activities, show a lack of interest in interpersonal relationships and indifference to the approval or criticism of others.

3. Schizotypal Personality Disorder

It manifests itself in eccentric or superstitious ideas, discomfort in social relationships and cognitive and perceptual distortions.

4. Antisocial personality disorder

People with this disorder are characterized by indifference to the rights of others and disregard or violation of these rights, lack of remorse for harmful actions, tendency to manipulate and exploit others for their own benefit.

5. Borderline personality disorder

These individuals have a high level of emotional instability, intense and unstable interpersonal relationships, unstable self-image, very high fear of abandonment and a tendency to engage in impulsive or self-destructive behaviour.

6. Histrionic Personality Disorder

It is characterized by excessive need for attention and admiration, or excessive expression of emotions.

7. Narcissistic personality disorder

It is characterized by excessive grandiosity, constant need for admiration, lack of empathy and arrogance.

8. Avoidant personality disorder

These individuals exhibit excessive social inhibition, avoidance of new social situations or interpersonal relationships for fear of rejection or criticism, strong feelings of inadequacy and hypersensitivity to negative evaluations.

9. Dependent Personality Disorder

Characterized by excessive dependence on others especially in making decisions and getting emotional support, excessive submission, need for protection, fear of separation and distrust in own abilities.

10. Obsessive-compulsive personality disorder

It is characterized by excessive concern for order, perfectionism and rigidity in rules and organization.

Comparison between mental disorders and personality disorders

There are several similaritiesbetween mental disorders and personality disorders:

👉 Both types of disorders affect the mental and emotional state of the individual, causing distress and difficulties in everyday life

👉 both can manifest at a lower or higher level of severity

👉 both can affect a person’s functionality

👉 Both can be successfully treated with therapeutic interventions and medication.

Mental disorders are conditions that have a negative impact on an individual’s level of mental and emotional functioning, while personality disordersrefer to specific and rigid patterns of behaviour and thinking.

While mental disorders can occur at any ageand risk becoming chronic if left untreated, personality disorders begin in adolescence or young adulthoodonce the personality structure is consolidated. Personality disorders are also generally more difficult to treat because they involve profound changes in personality structure, requiring greater efforts on the part of the affected person, such as motivation, willingness to change, perseverance.

In practice, the strict demarcation of these two categories can be difficult because there are cases where mental disorders and personality disorders can co-exist. Some mental disorders, such as bipolar disorder, can affect the way an individual manifests their personality. In addition, because a person may have several disorders at the same time or there may be overlap between their symptoms, it can sometimes be difficult to diagnose and intervene.

Last but not least, mental and personality disorders are still a sensitive topic in Romanian society, with people with such disorders experiencing increased levels of stigma-related stress.

Examples of mental disorders

👉 Generalized Anxiety Disorder: a person with this disorder has excessive worry and persistent anxiety about various aspects of life, worrying about a variety of things. 👉 Schizophrenia: a person with schizophrenia experiences hallucinations, delusions and disturbances in thinking and behaviour, disorganised speech or behaviour and other symptoms. 👉 Anorexia nervosa: people with anorexia have an exaggerated fear of gaining weight, restrict food intake and have distortions about their own body.

Examples of personality disorders

👉 Borderline Disorder : a person with this personality disorder will have unstable relationships characterized by absolute idealization and denigration (e.g., will have relationships that oscillate between absolute love and absolute hate), impulsivity (excessive shopping, sexual promiscuity, impulsive eating), and will exhibit fear of abandonment, whether real or perceived (e.g., not answering the phone).

👉 Narcissistic Personality Disorder: a person with this personality disorder will have excessive grandiosity, a need for admiration, an exaggeration of self-importance, believes themselves to be unique and special unlike others, takes advantage of personal relationships and exhibits a lack of empathy and exaggerated attention seeking.

👉 Avoidant personality disorder: a person with avoidant personality disorder shows excessive social inhibition, fears of rejection and feelings of inferiority, may avoid relationships unless they are sure they will not be rejected or criticised, and social contexts, is concerned about being embarrassed.

Therapeutic Approach

1. Individual psychotherapy

There are a variety of psychotherapeutic approaches, which can be used to manage symptoms and change behavioural patterns that promote these symptoms. For example, cognitive behavioural therapy focuses on identifying and changing dysfunctional thoughts and behaviours associated with both mental and personality disorders.

2. Couple or family therapy

Sometimes mental or personality disorders have a strong impact on relationships, and couple or family therapy can strengthen relationships, improve communication and support changes in dealing with conflict or problematic situations.

3. Transcranial Magnetic Stimulation (TMS)

A lesser-known method of intervention for mental disorders is TMS. This is a non-invasive procedure of neuromodulation and neurostimulation of the brain, i.e. repetitive stimulation of nerve cells in the brain so that they function normally or at optimised parameters. Even in personality disorders there are often associated mental disorders, and in this case it is useful to use this type of intervention.

4. Drug therapy

In some cases, medication may be prescribed to manage severe symptoms associated with mental disorders and/or personality disorders. There are several classes of drug treatment that are used in such cases, such as: antidepressants, antipsychotics, anxiolytics.

Conclusions

Mental disorders and personality disorders are complex and diverse conditions that affect a person’s mental state and behaviour. Although they differ in manifestations and characteristics, they can interact and coexist within the same person. Diagnosis and treatment of these disorders require personalised and integrated approaches using psychotherapeutic interventions, other innovative intervention methods with proven scientific efficacy and/or, where appropriate, drug treatment.

Author: Psih. Nicoleta Daba – Clinical Psychologist

Bibliography:

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). . https://doi.org/10.1176/appi.books.9780890425596
  2. Sperry, L. (2018). DSM-5 personality disorders. Bucharest, Romania: Editura Trei (translation by Camelia Dumitru).

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