It takes two to tango!

We've all faced that boss, colleague, parent or even a significant other who comes across as different, difficult to understand or in extreme cases exhausting to deal with.

Many a times, our inability to healthily interact with someone suffering from a personality disorder might also be due to some inherent niggles, hidden within ourselves.

In this article by our SAL buddy, Ananya Phadke we're going to educate ourselves through the gamut of Personality Disorders.

Reminder again: oxygen mask on self first. Healing begins by protecting and understanding ourselves before we try to course-correct someone else.

PERSONALITY DISORDERS

Unpredictable, Mad, Dangerous are words unfortunately most of us have thrown around because of our lack of knowledge.

Over the next 3 minutes worth of read, we will enlist the 3 clusters of personality disorders (PD)

The behavior that characterises Cluster A Personality Disorders is, to the outsider, eccentric or unusual ways of thinking. The following three disorders are a part of it: Paranoid PD, Schizoid PD, Schizotypal PD.

• PARANOID PD involves high levels of paranoia in every aspect of life. 

- Reluctant to make contact with people

- Highly distrustful, cold and distant

- Childhood experiences and trauma are possible causes 

- Treatment involves removing the ingrained beliefs, via psychotherapy

For family members or friends: 

1. Speak unambiguously, use simple sentences to reduce misinterpretation 

2. Educate yourself - know what to expect

3. Accept the patient’s beliefs but be firm - remember that they don’t think they’re wrong! 

4. Maintain your own health first

• SCHIZOID PD shows lack of interest in social activities

- Don’t desire relationships, and tend to be secretive and aloof

- Being brought up by cold and neglectful parents might be a cause

As a family member or friend:

1. Express support - Offer transportation to appointments, etc.

2. Avoid judgement - don’t try to prove them that they’re wrong! 

3. Adjust your expectations

• SCHIZOTYPAL PD: They have eccentric ideas, and thus may dress and speak in peculiar ways, have illusions and increased paranoia.

Family and friends should: 

1. Encourage a daily schedule - sleeping early, timely activities 

2. Offering positive reinforcement for responsibilities they take

3. Provide reassurance and show interest in their life

One main cause of these disorders might be genetics. Also, because social awkwardness and isolation is present, people wouldn’t willingly seek help. 

Almost every time, the person wouldn’t think that there is anything wrong at all, because that’s their normal! Group therapy, CBT, family therapy, talk therapy and medications are the way in!

Next up we explore CLUSTER B!

Overly emotional, dramatic. Unpredictable!

There are 4 personality disorders under B: Narcissistic PD, Borderline PD, Histrionic PD, Antisocial PD.

• Narcissistic PD: Wanting the best of everything, needing attention, believing they’re superior, trouble handling criticism. 

- This confidence is a facade hiding low self-esteem

- Trouble with relationships

- Issues at work & school

- Overprotective or neglectful parents may increase the risk

Loved ones can help by: 

1. Don’t call them a narcissist! Don’t attempt to reason - It will drain you more.

2. Set boundaries and take care of yourself

• Borderline PD: Experiencing a rollercoaster of emotions all within hours, fleeting self image, feeling empty. 

- Speak to a friend who you trust, let out your feelings

- Identify patterns like when you project negative feelings onto others 

- Choose something to watch on TV which is opposite of what you’re feeling

• Histrionic PD: Shifting dramatic expressions of emotions and excessive attention seeking, this is the biggest symptom. If you suffer from this disorder, you would: 

- Believe relationships are stronger than they are

- Use dramatic statements to express

- Want the limelight and attention and act inappropriately to get it

- Build a stronger sense of self could reduce the anxiety of needing attention 

• Antisocial PD: Can range from criminality without remorse to impulsivity and irritability. Patients wouldn’t feel empathetic or sympathetic, and would lack a moral compass. 

- Maintaining positive relationships becomes difficult 

- Symptoms start to show before the age of 15 (burning things, hurting animals)

- Unstable homes or abuse/neglect in childhood may increase the risk

Family and friends of patients, you can: 

1 Urge them to get help, take initiative for them

2. Learn to accept that while the behavior might not be cured, it can be “controlled".

These disorders show overlapping symptoms but are manageable with a combination of psychotherapy & medication. Loved ones are urged to get their oxygen masks on first!

And last in our Personality disorder series, we explore CLUSTER C!

Intense fear and anxiety marks these. They're namely: Avoidant PD, Obsessive-Compulsive Disorder, Dependent PD.

• Unjustified fear and shyness defines AVOIDANT PD! They're overly sensitive to criticism, feel inferior to others, prefer solitary assignments, have low self esteem and hold back from relationships. 

- They accept treatment: want to change for the better! 

- Genetics play a role! Environmental influences can be peer and family rejection as a child. 

- Affects 2.5% of the population

- CBT, talk and schema therapy: aim to improve social skills, remove negative thinking patterns

- Self help (before therapy):

1. Meditative techniques - stress and anxiety buster

2. Join support groups for support!

• Unreasonable fears and thoughts leading to obsessive disorder, that's OBSESSIVE COMPULSIVE DISORDER. 

- May be caused because of difficulty in communication between the front part of the brain and deeper regions - can be hereditary! 

- Obsessions: recurring and persistent thoughts which cause distressing emotions - needing symmetry!

- Compulsions: behaviours lead to by obsessions, to try reducing the stress! - cleaning, arranging

- Treatment is usually medications and CBT

- Stress and worry majorly triggers OCD! Hence, self help includes:

1. Find your coping mechanism to stress and use it!

2. Journal to understand your trends and reactions! 

• Behaving submissively, needing reassurance, fear of abandonment, being sensitive to criticism and heavily relying on others are signs of DEPENDENT PD. 

- Feel anxiety, hopelessness and panic attacks as a result

- Building healthy relationships and improving self-esteem is the aim of psychotherapy

- Self help: understand that you’re self sabotaging! Journal and challenge your beliefs. Almost every time, you’ll realise that this is anxiety and not reality.

- DPD obviously largely impacts families and relationships - educate yourself, establish strong venting methods! 

This marks the end of the Personality Disorder Series! This has hopefully given you a basic understanding to be more mindful of people around you :)

We'd be more than happy to hear your thoughts/suggestions.

Courtesy Ananya Phadke and SAL Foundation