What Are Personality Disorders?

Discussion in 'Braaaaiiiinnnns...' started by BadBoy, Sep 27, 2015.

  1. BadBoy

    BadBoy Member

    I mean I can take a stab at what they mean and probably look up some stuff but uh... I'm mainly asking cause I think I might have one, Avoidant Personality Disorder (AvPD) specifically and it's really fucking with my head. The description fits more than any other description of any mental illness I've ever seen and I'm both scared and confused. For a long time I thought being extremely wary of other people and having emotional blowups at other people and just flat-out avoiding the consequences cause I couldn't deal, I didn't (and don't) know how to avoid the damage or heal trust was just a part of me, but then I got more into actually working on my mental illness and I basically accepted it as part of brainweird that needed fixing. Now I learn that it's probably not, that it most likely actually is a part of my personality and I'm more than a little freaked out. How does this work?
  2. Dischordian

    Dischordian The Original Freak-Machine

    Depends what you mean by "how does this work"

    Basically personality disorders as a whole are characterised as (in the DSM and in slightly different words in the ICD 10):

    "An enduring pattern of inner experience and behavior the deviates markedly from the expectations of the individual's culture. This pattern is manifested in two (or more) of the following areas:
    1.Cognition (i.e., ways of perceiving and interpreting self,other people and events)
    2.Affectivity (i.e., the range, intensity, liability, and appropriateness of emotional response)
    3.Interpersonal functioning
    4.Impulse control"

    In layman's terms that is basically "Solid personality traits (as opposed to fluctuations of mood and circumstance) that are notably different/unusual to the acceptable norm of your culture, that affects at least two of, how you think, what you feel, how you interact with other people and your impulse control". Some other conditions also apply, mainly inflexibility in changing these behaviours (people with personality disorders tend, but not always, to not be able to try something different when faced with a troubling or stressful situation, at least not without intense professional help. Generally they will rely on the same behaviour, even if it is maladaptive or destructive), that these personality traits have been stable since at least adolescence, and isn't better explained by either substance abuse or another mental illness. The other caveat with anything classified as a mental -illness- is that these personality traits must also cause a significant amount of distress, harm, or disruption in day to day function.

    In practice personality disorders can be a little... dicey, diagnostically. Cluster B types (the "dramatic" subtype, though I don't know that they use that classification anymore, I'm not totally up to date on my DSM-V) are usually the easiest to pick out and diagnose, the other clusters have a kind of weird overlap with other classified mental illnesses that makes their diagnosis less common and more murky For example, Avoidant Personality Disorder has a lot of features that correspond to social anxiety/phobia. BUT generally the difference would come in treatment - anxieties and phobias can be lessened with medication and behavioural therapy, whereas Personality Disorders are usually (though not always) not as responsive (especially to medication unless there is comorbid mood or psychosis issues, which isn't uncommon sadly) and require more intense therapy and construction of coping strategies.

    (FUN FACT! Did you know there is an Obsessive Compulsive Personality Disorder that is a separate and distinct disorder from Obsessive Compulsive Disorder? There is a distinction, but it's pretty fuckin hard to see until you really plumb treatment options and find out all the normal OCD treatments wont work for some reason).

    If you're wondering about diagnosis, it's likely (though I'm speaking as someone from the UK, I don't know if this will hold true where you are) any psychiatrist would check for it being social phobia or generalised anxiety first. Unfortunately what I've noticed is that a lot of people who get personality disorders diagnosed is that they usually go through several mis-diagnosises first. That's not unique to personality disorders, but it IS more common.

    The good news is while you don't really get "cured" of personality disorders exactly (much like you can't really be cured of a mood or psychotic disorder), it's completely possible to learn other ways of coping with a therapist who knows their shit about the particular disorder you have.

    I hope my relatively recent undergrad psych degree is of some help here. As ever, I'd say if you're worried, speak to a professional, bring in your observations and experiences along with diagnostic criteria. But also prepared to be open minded and for the possibility that you might get diagnosed as something else first.
    Last edited: Sep 29, 2015
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  3. BadBoy

    BadBoy Member

    Huh. Well I have actually suspected myself of having social anxiety but beeen confused by the fact that I actually like attention, and I'm not sure I don't just have that? I'm going to try bringing it up with the psychiatrist I'm seeing this week for depression meds.

    Would you mind elaborating a little more on the differences between treatment for PDs and other similar mental illnesses, like social anxiety and AvPD, for example?
  4. Dischordian

    Dischordian The Original Freak-Machine

    Basically, personality disorders are about learned behaviours and strategies gone really wrong. Every human being I've ever met has SOME maladaptive ways of dealing with things (like a friend who avoids conflict to the detriment of other things, or the person who gets extremely defensive over criticism) but personality disorders basically take that to a level that causes significant distress or difficulty functioning. So this isn't a case of your brain not biologically doing something it ought to (or doing too much of something) in the case of say, a mood disorder or even anxiety disorders. For these illnesses medication is often used in conjunction with therapy because your brain is doing something a little weird, whether it's you've got a more activated sympathetic nervous system (what controls your flight/fight response), or you're not producing or maintaining enough of a neurotransmitter, or the like. Personality disorders, unless they're comorbid with something else (like I said, that's sadly common) are pretty much entirely down to LEARNED behaviour, and that is often a harder cookie to crumble and doesn't respond to pretty much any medication you throw at someone. Though it's also true that most other disorders (like social phobia for example) also have maladaptive learned behaviours, they're often only part of the story, and frequently -caused- by the underlying problem. For example, the socially phobic would avoid social situations because their anxiety goes wildly out of check, their heart races, they feel like they're going to die, the entire body goes into panic mode. The AvPD might experience those symptoms too, but the origination is different. It's based off how you've learned to interact with people, your past experiences, and the ingrained behaviours you've picked up as you've grown. That's why PDs have that caveat that the maladaptive traits/behaviours in question must be present BEFORE adulthood. You pretty much don't get personality disorders that didn't start while you're still growing and learning how to interact with the world. So to continue the example, the person with AvPD gets anxious because they don't know how to deal with the social situation, or they know that their way of dealing with it will cause a stressful outcome (such as offending or alienating someone), or they've learned to expect that people will shun them or there will be some kind of unpleasant outcome, and CANNOT change how they react (again, as before, this is the "rigid and unchanging behaviour" part of the PD diagnosis).

    What that big ol' wall of text basically means is - you cannot medicate someone's personality to be different. You can't medicate away behaviours and learned ways of coping. The way to change how you fundamentally think and ARE is only really achievable through a lot of therapy with a specialist, and even then, it is HARD. Especially if you're like basically any other human being and feel that your personality is a part of your identity. How do you reconcile that part of your identity is actively hurting you? Again, not to say other disorders don't have a bit of this too (depression and poor self esteem or negative self talk go hand in hand, but it's not JUST poor self esteem or negative self talk at work making you depressed, and those things are usually behaviours you've learned long before depression rears its head) but a personality disorder is entirely made up of it.

    If it feels like the distinctions are kind of blurry, yeah, they kind of are, unfortunately. Also, I'm not necessarily very good at explaining it without being really wordy, for which I apologise. If you've any other questions I'll absolutely try to answer to the best of my ability.

    Oops, I should also mention, as far as phobias go. Most phobias respond very well to behavioural therapy in particular, which is basically training your brain to stop associating the phobic stimulus with anxiety and terror. It's a basic, if clever form of conditioning that works really well for people with phobias, but that sort of thing would not work with a PD, because it's too simplistic. PDs are those huge, gnarly weeeds that infiltrate everything, and the anxiety and avoidance caused by AvPD is a set of developed traits, not a single association gone wrong.
    Last edited: Sep 29, 2015
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  5. BadBoy

    BadBoy Member

    That kinda makes sense? And it makes sense that they would want to rule out biological causes first. I certainly don't feel like I'm paranoid or phobic, I really like the idea of attatchment, but when it comes down to it I'm really not good at making or maintaining relationships.
  6. ectoBiologist

    ectoBiologist I'm a wise guy

    I would like to weigh in on this conversation if that's okay. My first diagnosis included amongst other things Borderline Personality Disorder. I was in denial of having that disorder as time went on, and to this day I still feel like that maybe it was untreated PTSD and undiagnosed psychotic disorders (maybe something on the schizophrenic spectrum etc). Well, I have very close online friends who have known me for literally over a decade and have concluded that yes, I probably very well did have Borderline Personality Disorder.

    Then I met a therapist that didn't like the idea of personality disorders. She and I discussed our academic difference in opinions over the validity of personality disorders and whether or not personalities even exist. Basically, my therapist decided to throw away that label for me and said she wanted to treat my symptoms instead of just having me accept this diagnosis and think to myself that I couldn't ever change because this was part of my "personality", something that may not even exist according to her opinion. After a year of intense DBT and a couple of hospitalizations (a hospital I should mention that absolutely DRILLS DBT into you), I began to recover from BPD symptoms.

    It's been nearly 7 years since my diagnosis of BPD and I've recovered so much that I pretty much don't exhibit the symptoms in a likely manner. If I become symptomatic, it's easier for me to recognize my patterns and change my behavior. My feelings and thoughts haven't actually changed, but my /behavior/ has. I don't know if this gives you hope at all? But I personally believe that a personality disorder doesn't have to be a "death sentence" or like a diagnosis that means you can never change and get better. It takes a lot of work for sure, but if you want to change, I think you can with a lot of hard work.

    Although, I don't know if this works for ALL personality disorders... because I'm thinking about antisocial personality disorder and I'm just not sure about that one... hmm.. more research on my end is needed to make a more concrete opinion. So take this anecdote with a grain of salt.
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  7. BadBoy

    BadBoy Member

    I'm honestly comfused about the idea of having an "unchanging" personality. If all you're talking about is the thoughts and feelings though that makes more sense. Behavior can always change.

    Still, confusing, since most of the PDs seem to be defined or at least verified by behavior.

    If it doesn't change your emotions though, how does it help you survive?
  8. ZeroEsper

    ZeroEsper Well-Known Member

    (I don't have a diagnosed PD, but I can give a Psych-major answer)

    The feelings themselves aren't always the problem, it's what you do with them. For instance, feeling sad is a normal part of life. Lets say that when I feel sad I push everyone away (used to be true). Well, when I was lonely, I felt worse, and I dug myself into an even bigger sadness pit. Avoiding others was the behavior I engaged in. By learning to change the behavior and actually talk to and interact with others, I started learning to pull myself out of sadness spirals. This helped minimize the negative consequences of my actions, thus sparing me more sadness in the future. By learning to change your behavior, you can develop more adaptive tendencies in your daily life. It's okay to still feel sad or hurt or angry. The goal is that you don't fall into maladaptive behaviors (for instance, screaming at people you love, abusing substances, etc). This can help you stabilize your life, because you're not engaging in self-destructive tendencies or hurting the people around you, which makes it easier to cope with everyday life. That's the goal in providing therapy to people with personality disorders - helping them live a more adaptive life by not turning to harmful and self-destructive behaviors.

    I hope that made sense. Sorry, my cognitive resource pool is more like a cognitive resource puddle right now.
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  9. Dischordian

    Dischordian The Original Freak-Machine

    In addition to that, typical maladaptive behaviours DID help you survive at some point, even if they're fucking your shit up now. At some point, you learn that x behaviour helps you in y situation. If it's an ugly situation like abuse or instability, you learn to cope. Once you're away from those situations, those coping methods are no longer necessary and are often pretty damn damaging (and probably were damaging to begin with, but the payoff of helping you cope with a stressful situation would make that behaviour seem "worth it" even if it did have a cost). It's why most people who have PDs have pretty rough or stressful upbringings. These kind of things rarely happen in a vacuum.
  10. shinji

    shinji not your savior

    also, avpd Official here, i am not as good at talking about the scientific or medical standpoint of these things, so i can offer you my experience as the difference between these things, and also, am up for discussion and bouncing off of me if you want to talk about this being a potential thing for you... everyone is different but, i can offer my standpoint

    keep in mind these are just my jumbled thoughts on avpd, not 100% fact in any way

    i will say a lot of people with avpd struggle with the attention thing, i really hate attention personally but solely because it makes me really anxious. yet at the same time, i really do enjoy positive attention... it's just that i can't enjoy it for long before i start to get paranoid that it is fake, or i am going to be rejected in the long run for this attention, etc. i even had a year where i was more 'recovered' and spent an entire few months being really popular online because i thought it was what could fix me, but it ended up making my symptoms ten times worse because i suddenly had so much attention and i couldn't handle it, i completely fell apart

    which of course led to losing a big chunk of friends because i stopped talking to everyone cold turkey, which begins the kind of 'cycle' of having a personality disorder. your brain is always kind of jumbled and you really have to spend an excruciating amount of time unpacking your thought process. like, i will actively ignore and avoid people i care about out of terror for their reaction to anything i do, and then simultaneously freak out and feel 'validated' when they suddenly abandon me, as if i somehow didn't start it by shutting myself away. my partner with schizotypal personality disorder does a similar thing, where he will be paranoid about someone trying to hurt me, it will happen to come true once or twice, and that will suddenly be validation for every paranoid idea or delusion he has ever had

    avpd also comes with things like paranoia and really intense escapism, a lot of people with avpd build 'worlds' for themselves and kind of stay there. i also have an inability to pursue my interests because of avpd. i have Very Intense Passions about things but i am completely unable to grow in them because i am terrified of failure or rejection, i.e. i love love art but i cannot draw most days let alone share my work because of this. most people with avpd appear to have no passions or ambitions in life. this is really not true, we just don't know how to go after them because we are so terrified of what might happen. (when i do get really bad, though, i do lose a lot of my passion and become devoid of interests - which is hard for me, personally, since having special interests also define so much of me) also a lot of moodiness and instability obviously - a lot of personality disorder symptoms do overlap across the spectrum, but especially in those within the same cluster. someone with avpd can have dependent tendencies or borderline tendencies, for example, but not have dpd or bpd

    personality disorders are weird because unlike anxiety (i have phobias outside of my avpd, like disease/emetophobia) i can recognize its anxiety and rationalize it as intrusive thoughts or my brain attacking me, but with my avpd, it is something i could never pinpoint or realize was messing with my head. i think that is what makes it a little hard to analyze... things that are ingrained into your person are harder to read into, i.e. i also am autistic and i still can't fully conceptualize it because it's just who i am, not a list of symptoms, if that makes sense. it is the same with my avpd, for me, but in a way i don't like celebrating because it is still a mental illness. whereas my anxiety and/or depression, i can recognize as an extension of me

    it's weird. there is a lot of weird stuff specifically about avpd, too, like how it is very highly comorbid with c-ptsd (which i also have) and how it isn't defined as a post-traumatic personality disorder, and yet, it is also most often defined by being triggered by trauma occurring. (the idea is that its genetic and can be triggered by bad things happening, and it is true that 99.9% of people with avpd have had awful childhoods, thus also why the comorbidity of cptsd)

    also, this could be wrong, but, i think we tend to see personality disorders in the realm of age 13-20 because idk, speaking for myself, we are all pretty young, but doctors still see 17-21 as 'adolescence', so that is actually why it is not diagnosable when you are under 18 usually. because i find most doctors believe you develop it fully when you are between the ages of 17-20s. i showed my avpd symptoms from a young age, but my symptoms also got way worse once i hit 19, and it varies
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  11. ZeroEsper

    ZeroEsper Well-Known Member

    Oh yes, this, I'm sorry if I came across condescendingly or made it seem like maladaptive behaviors are something you should be blamed for, because this post is totally correct, they come from a time you needed them to survive.
  12. Dischordian

    Dischordian The Original Freak-Machine

    @ZeroEsper Oh no not at all! I was just expanding on your point since @BadBoy was asking how these behaviours can help people survive. You came across fine :)
    • Like x 1
  13. BadBoy

    BadBoy Member

    Still useful, thanks.

    Oh god this is so me. I go through this cycle where I'm like "Yes I should reach out to my friends, they like me and I like them, and if I never talk to them they won't talk to me!" to uncertainty as to if they really like me whether or not they actually respond to deciding I've done something terrible to them and now they're mad and won't tell me and it's all awful I'm awful and then I stop talking to people without warning, and of course cause they're actually people who care about me they think I just need space and don't contact me. :| And here I was wondering why I have two IRL friends.

    This, I really relate to this. It's really frustrating to me, and actually one of the things I want to work on in therapy. We'll see how that goes.

    Yeah I have both of those too.

    I actually draw quite a lot, but it's because I've set a personal goal to draw every day. I get really antsy about sharing my work, especially about the amount of attention it receives, even though logically I know it takes about 10 years of constant effort to really acquire a fan base & get your work out there. My art blog updates about once or twice a month despite drawing pretty much every day.

    I'm a little worried about this. There's someone I really like who I would like to be my life partner but I can't.. approach them or tell them that, no matter how much I like them or how well the relationship's going. I'm kind of worried that if I do I'll suffocate them.

    Oh thank you, that's another thing I was wondering about. That makes sense.

    That.. makes a lot of sense actually. I was bullied in elementary school so even though my home life has always been ok I was a pretty miserable child, and I was recently sexually assaulted.

    That actually makes my therapist's reaction make a lot more sense. I told her about the identification and she brought up all the other reasons why it could possibly be something else, and I got a little mad at her (I was already uncomfortable, but eh).

    Last edited: Oct 1, 2015
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  14. shinji

    shinji not your savior

    ah, i am glad anything i could say could be helpful to you ^^

    other things i find are avpd specific rather than social anxiety specific, if it helps you:

    - identity issues, which come with most pds i think. it ties into the escapism for avpd, but there are a lot of avoidant people who are 'self-deserting', meaning they completely abandon their own person because they find themselves that unbearable, and tend to pour their identity into something else, or completely reject living as a person altogether, but are 100% aware they are doing it so it can get pretty bad/depressive. goes a lot into the fantasy world stuff too, people with avpd view themselves as inferior and unappealing so some of us abandon ourselves because of it

    - hypersensitivity that is way more extreme than just normal anxiety. it is hard to explain. for example, any amount of criticism will make me completely shutdown. one time i got an anon who agreed with some meta i posted, and then linked me to someone elses meta being like, 'but this is good too and touches on things you didn't,' and i was an absolute wreck, i deleted all my posts and was convinced i was a complete idiot, that nothing i say is worthwhile, and didnt talk to anyone for hours. also this sucks because if i make a mistake with a friend i wont talk to them for days out of fear that they hate me or ill mess up again and this in the end makes them think that i hate them

    - for some reason a lot of people with avpd have phobias. i guess the theory is that sometimes being so scared of people becomes overwhelming that we need to direct the energy to something else too. so some people with avpd are like, literally afraid of ovens, or are deathly terrified of the dog next door, and more often than not these things develop in ways like... i was terrified of going to school for sensory and avpd reasons, so i suddenly became terrified of getting sick to the point where i couldnt function or leave my bed, and the theory was that going to school would get me sick, it was just a projection of my terror of going to school. brains are weird,

    - something i know i do and a lot of other people with avpd do is we kind of... exaggerate in our head how bad a situation is going to be so we can avoid it. i have work every weekend and on the friday, without fail, i will run myself into an anxiety attack about how its going to be so bad and im going to have a meltdown and im going to mess up and get fired somehow and all these bad things will happen, and its literally never that bad. (it is if i get sensory overload, but my job is actually very lax about these things, im allowed to sit in the dark basement if im not ok) i do this about basically every public outing, i dont even realize im doing it. my brain just blows it completely out of proportion until i can convince myself or someone else its impossible for me to do the thing

    sorry if this is derailing at all from your initial question for this thread. even now i can honestly tell you i am stricken with anxiety that someone is going to be judging me for writing these posts in this thread! it is stressful, but it is good to pinpoint what exactly is wrong so you can treat it accordingly. i was treating my avpd wrong for so many years and it made it worse

    and again, if you need to bounce anything off me, im not an expert but i can say 'hey i get that too!' or, yeah. i can also offer you my skype if you prefer that
  15. BadBoy

    BadBoy Member

    Yeah it kinda is off topic but that doesn't mean it's not useful. I would give you my skype but this is a sock so nah sorry :x

    How did you make your PD worse, if you don't mind explaining?
  16. pixels

    pixels hiatus / only back to vent

    this is totally ot by now, but as someone who's more-concretely bpd and had ocpd floated as a potential diagnosis: the difference between ocd and ocpd is that people with ocpd think that their behavior is "normal" and that attempts to change this behavior are inherently fruitless because they're not doing anything "wrong". like, it's clearly disrupting their lives, but ocd people are bothered by this, whereas ocpd people, when this is pointed out to them, will dig their heels in harder and insist that it's everyone else who has the problem.

    that's kinda what marks the difference between a personality disorder and any other type of axis disorder, whether it be mood or paraphilia or whatever. it probably makes no sense, but that's brains for you.

    /making this all about me
    • Like x 2
  17. BadBoy

    BadBoy Member

    I'm confused. I don't think unwillingness to change is the defining trait of PDs, or else why would anyone get therapy for them?
  18. pixels

    pixels hiatus / only back to vent

    wikipedia sez:

    This is a distinct disorder from obsessive–compulsive disorder (OCD), which is an anxiety, rather than a personality, disorder, and the relation between the two is contentious. Some, but not all, studies have found high comorbidity rates between the two disorders, and both may share outside similarities – rigid and ritual-like behaviors, for example. Hoarding, orderliness, and a need for symmetry and organization are often seen in people with either disorder. However, attitudes toward these behaviors differ between people affected with either of the disorders: for people with OCD, these behaviors are unwanted and seen as unhealthy, being the product of anxiety-inducing and involuntary thoughts, while for people with OCPD they are experienced as rational and desirable, being the result of, for example, a strong adherence to routines, a natural inclination towards cautiousness, or a desire to achieve perfection.​

    that's the difference between ocd and ocpd. not sure if it carries over into, say, cluster b's, because this ain't a cluster b.
  19. Morven

    Morven In darkness be the sound and light

    I'd say in general that personality disorders are things that are more core to the personality (duh) and thus much less likely to be viewed by those who have them as a separable part from their conception of their self.
  20. ectoBiologist

    ectoBiologist I'm a wise guy

    This is why I don't like saying I have Borderline Personality Disorder anymore...?
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