Personality disorders - diagnosis and treatment (2023)

To diagnose

If your doctor suspects that you have a personality disorder, the diagnosis can be determined by:

• Physical exam.The doctor may perform a physical exam and ask detailed questions about your health. In some cases, your symptoms may be related to an underlying physical health problem. Your evaluation may include laboratory tests and an alcohol and drug screening test.
• Psychiatric evaluation.This includes a discussion of your thoughts, feelings, and behavior, and may include a questionnaire to help make a diagnosis. With your permission, information from family members or others may be helpful.
• Diagnostic criteria in the DSM-5.Your doctor can compare your symptoms to the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association.

diagnostic criteria

Each personality disorder has its own diagnostic criteria. However, according to the DSM-5, a diagnosis of a personality disorder generally involves a significant long-term departure from cultural expectations that results in significant distress or impairment in at least two of these areas:

• The way you perceive and interpret yourself, other people and events.
• The adequacy of your emotional responses
• How well does it work with other people and in relationships?
• When you can control your impulses

Sometimes it can be difficult to determine the type of personality disorder because some personality disorders share similar symptoms and more than one type may be present. Other medical conditions, such as depression, anxiety, or substance abuse, can further complicate the diagnosis. But it's worth the time and effort to get an accurate diagnosis so you can get the right treatment.

Treatment

The most appropriate treatment for you depends on your individual personality disorder, its severity, and your life situation. A team approach is often required to ensure that all of your psychiatric, medical and social needs are met. Because personality disorders are long-term, treatment can take months or years.

Your treatment team may include your GP or another GP, as well as:

• Psychiatrist
• psychologist or other therapist
• psychiatric nurse
• pharmacist
• Social worker

If you have mild, well-controlled symptoms, you may only need treatment from your GP, psychiatrist or other therapist. If possible, see a psychologist who has experience treating personality disorders.

Psychotherapy, also called talk therapy, is the main method used to treat personality disorders.

psychotherapy

During psychotherapy with a mental health specialist, you can learn more about your condition and talk about your moods, feelings, thoughts, and behaviors. You can learn to manage stress and manage your disorder.

Psychotherapy can be offered in individual sessions, group therapy, or sessions attended by family members or even friends. There are different types of psychotherapy: your psychotherapist can decide which is best for you.

Social skills can also be trained. During this training, you can use the insights and knowledge you gain to learn healthy ways to manage your symptoms and reduce behaviors that affect your ability to function and your relationships.

Family therapy provides support and education to families dealing with a family member who has a personality disorder.

medicine

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

• Antidepressants.Antidepressants may be helpful if you suffer from depression, anger, impulsiveness, irritability, or hopelessness that can accompany personality disorders.
• mood stabilizers.As the name suggests, mood stabilizers can help smooth out mood swings or reduce irritability, impulsiveness, and aggression.
• antipsychotic drugs.Also known as antipsychotics, they can be helpful if your symptoms include a loss of reality (psychosis) or, in some cases, if you have anxiety or anger problems.
• anti-anxiety medications.These can help if you suffer from anxiety, restlessness, or insomnia. But in some cases, they can reinforce impulsive behaviors, so they are avoided in certain types of personality disorders.

hospital and residential treatment programs

In some cases, a personality disorder can be so severe that it is necessary to be admitted to a hospital for psychiatric treatment. This is generally only recommended if you are unable to care for yourself properly or if you are in imminent danger of harming yourself or others.

Once you are stable in the hospital, your doctor may recommend a day hospital program, inpatient program, or outpatient treatment.

lifestyle and home remedies

Along with your professional treatment plan, consider these lifestyle and self-care strategies:

• Take an active part in your care.This can support your efforts to deal with your personality disorder. Don't skip therapy sessions, even if you don't feel like going there. Think about your treatment goals and work to achieve them.
• Take your medication as directed.Even if you feel fine, don't skip your medication. If you stop doing it, the symptoms may come back. Withdrawal symptoms can also occur if you suddenly stop taking a medication.
• Learn more about your condition.Education about your condition can empower and motivate you to follow your treatment plan.
• Be active.Physical activity can help control many symptoms, such as depression, stress, and anxiety. Activity can also counteract the effects of some psychiatric medications that can cause weight gain. Consider walking, jogging, swimming, gardening, or some other form of physical activity you enjoy.
• Avoid drugs and alcohol.Alcohol and street drugs can worsen personality disorder symptoms or interact with medications.
• Get routine medical care.Don't neglect checkups or skip visits to your GP, especially if you're not feeling well. You may have a new health issue that needs to be addressed or you may be experiencing side effects from medications.

face and support

A personality disorder makes it hard for you to engage in behaviors and activities that can help you feel better. Ask your doctor or therapist how to improve your coping skills and get the support you need.

If your loved one has a personality disorder

If you have a loved one with a personality disorder, work with your psychologist to determine the most effective way to offer support and encouragement.

You may also benefit from speaking with a psychiatrist about your condition. A psychotherapist can also help him develop boundaries and self-care strategies so he can enjoy his own life and be successful.

Prepare for your date

Because personality disorders often require specialized treatment, your doctor may refer you to a mental health professional, such as a psychiatrist or psychologist, for evaluation and treatment. Taking a family member or friend with you can remind you of something you lost or forgot.

What can you do

Prepare for the appointment by making a list of the following:

• your symptoms,including anyone not related to the reason for the appointment
• important personal information,including major stress or recent life changes
• all medicines,including any over-the-counter medications, vitamins, herbal supplements, or other dietary supplements you are taking and the dosage
• Questions to askyou doctor

Some of the basic questions to ask your doctor include:

• What type of personality disorder could I have?
• How do you treat my type of personality disorder?
• Does speech therapy help?
• Are there medications that can help?
• How long do I have to take the medication?
• What are the main side effects of the drugs you recommend?
• How long will the treatment go on for?
• What can I do to help myself?
• Are there brochures or other printed materials that I may have?
• What sites do you recommend visiting?

Feel free to ask additional questions during your consultation.

What to expect from your doctor

During your appointment, your doctor or psychotherapist will likely ask you a variety of questions about your mood, thoughts, behavior, and impulses, such as:

• What symptoms have you noticed or have other people said that they noticed it?
• When did you or she first notice the symptoms?
• How is your daily life affected by your symptoms?
• What other treatment have you had, if any?
• What have you tried yourself to feel better or manage your symptoms?
• What things make you feel worse?
• Have your family or friends commented on your mood or behavior?
• Did anyone in your family have a mental illness?
• What do you hope to get out of the treatment?
• What medications, vitamins, herbs, or supplements do you take?