Help For a Personality Disorder
Treatment for people with personality disorders can be psychological (talking therapies) and/or physical (medication).
1. Psychological: talking treatments or therapies
* Counselling – talking and listening. This depends on a trusting relationship between the counsellor and the person
counselled.
* Dynamic psychotherapy – looks at how past experiences affect present behaviour.
* Cognitive therapy – a way to change unhelpful patterns of thinking.
* Cognitive analytical therapy – a way to recognise and change unhelpful patterns in relationships and behaviour.
* Dialectical behaviour therapy – this uses a combination of cognitive and behavioural therapies, with some techniques
from Zen Buddhism. It involves individual therapy and group therapy.
* Treatment in a therapeutic community – this is a place where people with long-standing emotional problems can go to (or
sometimes stay) for several weeks or months. Most of the work is done in groups. You learn from getting on – or not
getting on - with other residents. It differs from 'real life' in that any disagreements or upsets happen in a safe place.
The staff and other residents help you to get through such problems and learn from them. Users/residents often have a
lot ofsay over how the place runs, but have to be prepared to stay and work through difficult periods.
2. Physical
Medication can help in some personality disorders.
Antipsychotic drugs (usually at a low dose)
* Can reduce the suspiciousness of the three cluster A personality disorders (paranoid, schizoid and schizotypal).
* Can help with borderline personality disorder if people feel paranoid, or are hearing noises or voices.
Antidepressants
* Can help with the mood and emotional difficulties that people with cluster B personality disorders (antisocial or
dissocial, borderline or emotionally unstable, histrionic, and narcissistic) have.
* Some of the selective serotonin reuptake inhibitor antidepressants (SSRIs) can help people to be less impulsive and
aggressive in borderline and antisocial personality disorders.
* Can reduce anxiety in cluster C personality disorders (obsessive-compulsive, avoidant and dependent).
Mood stabilisers
Medication such as lithium, carbamazepine, and sodium valproate can also reduce impulsiveness and aggression.
These medications and treatments also help if someone with a personality disorder develops depression or schizophrenia.
The type of therapy offered depends on:
* individual preference (of the patient/service user);
* the type of personality disorder;
* the availability of the treatment in that geographical area.
If you have a personality disorder, you may not need treatment at all – but you might find medication or talking treatments helpful, and sometimes both. Admission to hospital usually happens only as a last resort (e.g. when a person with borderline personality disorder is harming themselves badly) and for a short time. A lot of the help that was once only offered in hospital wards is now available in day centres or clinics.
How common are personality disorders?
* About 40-70% of people on a psychiatric ward will have a personality disorder.
* 30-40% of psychiatric patients being treated in the community by a psychiatric service will have a personality disorder.
* Around 10-30% of patients who see their general practitioner (GP) will have a personality disorder.
Do personality disorders change with time?
Yes. There is evidence that they tend to improve slowly with age. Antisocial behaviour and impulsiveness, in particular, seem to reduce in your 30s and 40s.
It can, however, sometimes work in the opposite direction. For example, schizotypal personality disorder can develop into the mental illness schizophrenia.
Do interventions/treatments work?
There is evidence for both psychotherapies and medication, but it is weak because:
* the interventions are usually quite complicated, so it is difficult to know what part (or parts) of the intervention are
actually having an effect;
* the number of participants is usually small;
* the ways of measuring improvement are poor;
* the studies into interventions and treatments have mostly been quite short.
Treatment for people with personality disorders can be psychological (talking therapies) and/or physical (medication).
1. Psychological: talking treatments or therapies
* Counselling – talking and listening. This depends on a trusting relationship between the counsellor and the person
counselled.
* Dynamic psychotherapy – looks at how past experiences affect present behaviour.
* Cognitive therapy – a way to change unhelpful patterns of thinking.
* Cognitive analytical therapy – a way to recognise and change unhelpful patterns in relationships and behaviour.
* Dialectical behaviour therapy – this uses a combination of cognitive and behavioural therapies, with some techniques
from Zen Buddhism. It involves individual therapy and group therapy.
* Treatment in a therapeutic community – this is a place where people with long-standing emotional problems can go to (or
sometimes stay) for several weeks or months. Most of the work is done in groups. You learn from getting on – or not
getting on - with other residents. It differs from 'real life' in that any disagreements or upsets happen in a safe place.
The staff and other residents help you to get through such problems and learn from them. Users/residents often have a
lot ofsay over how the place runs, but have to be prepared to stay and work through difficult periods.
2. Physical
Medication can help in some personality disorders.
Antipsychotic drugs (usually at a low dose)
* Can reduce the suspiciousness of the three cluster A personality disorders (paranoid, schizoid and schizotypal).
* Can help with borderline personality disorder if people feel paranoid, or are hearing noises or voices.
Antidepressants
* Can help with the mood and emotional difficulties that people with cluster B personality disorders (antisocial or
dissocial, borderline or emotionally unstable, histrionic, and narcissistic) have.
* Some of the selective serotonin reuptake inhibitor antidepressants (SSRIs) can help people to be less impulsive and
aggressive in borderline and antisocial personality disorders.
* Can reduce anxiety in cluster C personality disorders (obsessive-compulsive, avoidant and dependent).
Mood stabilisers
Medication such as lithium, carbamazepine, and sodium valproate can also reduce impulsiveness and aggression.
These medications and treatments also help if someone with a personality disorder develops depression or schizophrenia.
The type of therapy offered depends on:
* individual preference (of the patient/service user);
* the type of personality disorder;
* the availability of the treatment in that geographical area.
If you have a personality disorder, you may not need treatment at all – but you might find medication or talking treatments helpful, and sometimes both. Admission to hospital usually happens only as a last resort (e.g. when a person with borderline personality disorder is harming themselves badly) and for a short time. A lot of the help that was once only offered in hospital wards is now available in day centres or clinics.
How common are personality disorders?
* About 40-70% of people on a psychiatric ward will have a personality disorder.
* 30-40% of psychiatric patients being treated in the community by a psychiatric service will have a personality disorder.
* Around 10-30% of patients who see their general practitioner (GP) will have a personality disorder.
Do personality disorders change with time?
Yes. There is evidence that they tend to improve slowly with age. Antisocial behaviour and impulsiveness, in particular, seem to reduce in your 30s and 40s.
It can, however, sometimes work in the opposite direction. For example, schizotypal personality disorder can develop into the mental illness schizophrenia.
Do interventions/treatments work?
There is evidence for both psychotherapies and medication, but it is weak because:
* the interventions are usually quite complicated, so it is difficult to know what part (or parts) of the intervention are
actually having an effect;
* the number of participants is usually small;
* the ways of measuring improvement are poor;
* the studies into interventions and treatments have mostly been quite short.
