1. Understanding Personality Disorders

    October 3, 2013

    by Jessica Galbraith

    Personality disorders are widely misunderstood by the general public. Although an estimated 10% of people have some type of personality disorder (Mental Health Foundation), the negative stigma that is attached to them makes diagnosing and follow-up treatment difficult. There are ten major types of personality disorders, which cover a wide range of personality spectrum.

    Getting diagnosed can be a challenge in itself, and usually includes psychological testing by a registered psychologist or psychiatrist, extensive interviews, and meeting strict criteria specified by Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association. Let us explore what exactly constitutes a personality disorder, the diagnostic process, and the treatment options available to those who have been diagnosed.

    Getting diagnosed with a personality disorder can be scary, but also brings relief.

    What is a personality disorder?

    Each of us has our own unique personality which determines how we behave, process, and feel. We each react to situations differently, from social engagements to trauma. As we go through life, we learn to cope with these experiences. For someone with a personality disorder, this becomes much more difficult. They may feel isolated, misunderstood, and have a generally hard time in every aspect of life. The illness affects their relationships and how they process their feelings.

    What types of personality disorders are there?

    There are ten officially recognized personality disorders, which are categorized into three groups.

    •  Suspicious Disorders: paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder.
    •  Emotional and Impulsive Disorders: anti-social personality disorder, borderline personality disorder, histrionic personality disorder, narcissistic personality disorder
    •  Anxious Disorders: avoidant personality disorder, dependent personality disorder, obsessive compulsive personality disorder

    Depression and anxiety are often present with a personality disorder, however the severity can range from mild to unmanageable. In addition, many sufferers deal with issues such as self-harm, eating disorders, panic attacks, and substance abuse.

     on the edge of suicide

    90% of people who commit suicide have a diagnosable personality disorder.

    Diagnosing and Treatment

    Getting diagnosed is often the biggest issue in mental health. Most people don’t seek help until they are forced to by family or friends, or until their illness escalates into a serious situation. Once a healthcare professional is able to assess what the person is dealing with, they will check if they meet enough criteria to be officially diagnosed with a disorder. A large majority of people who suffer from a mental health disorder, meet the criteria for two or even three others. There is usually multiple interviews to determine if the issues are constant or only related to a recent life changing event such as a divorce or loss. Once it has been established that they are dealing with a personality disorder, a treatment plan is devised. For many years, the general consensus was that there was no cure for mental illness. This is changing rapidly however, as research and mental illness education is becoming more accepted and prevalent. Those who have been diagnosed with a personality disorder, more often than not, face a lifetime struggle trying to find a balance through medication and therapy. The goal is usually to manage the disorder as much as possible rather than fix it. Medication can help side issues such as anxiety and depression, and psychotherapy is effective in addressing feelings and concerns as they arise.

    Common Misconceptions

    Unfortunately, there are a lot of myths out there on mental illness. One of the most common is that personality disorders are not treatable. While treatment is never expected to ‘fix’ the person, it does make life manageable; many people live normal lives with families, jobs, and a functional day-to-day. Another common myth is that mental illness isn’t a real condition. This of course, just isn’t the case. Mental illness is as real as any physical illness and has been linked to genetics and other neurological factors. Mental illness is also commonly believed to be a weakness in a person, and that it is something they should be able to snap out of. These types of misconceptions do tremendous harm to those who suffer with personality disorders. It can deter them in seeking help and creates feelings of shame.

    The misconceptions about mental illness are immense, but education initiatives are slowly making their mark.  As the general public becomes more informed, hopefully the myths and stigmas attached to mental illness will fade. There is still very limited research on the long-term benefits of various treatment options, but more and more research is being done. The future for those who suffer with mental illness has never looked better; but there is still a long way to go.

    Image Credits: http://www.flickr.com/photos/mytudut/5180391961 and http://www.flickr.com/photos/h-k-d/3685379062/

  2. Just what is bipolar disorder exactly?

    June 17, 2013

    living with bipolar disorder

    by: Tricia Chilcott

    What is bipolar disorder?

    What is bipolar disorder? Who gets it? What are the symptoms? What about medications? These
    are all important questions about bipolar disorder, and I’m going to try and answer them here.
    According to the National Institute of Mental Health, bipolar disorder is ‘ a brain disorder that
    causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day
    tasks. Symptoms of bipolar disorder are severe. They are different from the normal ups and
    downs that everyone goes through from time to time. Bipolar disorder symptoms can result in
    damaged relationships, poor job or school performance, and even suicide’.

    Living with bipolar disorder

    I know from experience just how much havoc being bipolar can create in your life. Since I was
    diagnosed 8 years ago, I’ve had 4 hospital stays, with the first one lasting 6 weeks, and the most
    recent stay lasting 3 weeks. This has been a huge burden on my family, and problematic in my
    marriage as well. I made the decision to go off my meds back in December, and by February I
    had crashed hard, thus landing me back in the hospital. It was not a pretty sight in the slightest.
    Thanks to a good doctor and a wonderful husband, I’m back on my meds and doing fantastically.
    But what about medications for bipolar? There are a number of medications avaialble, and
    literally hundreds of ways they can be mixed together to try and find the perfect cocktail.
    Medications include mood stabilizers such as lithium, anticonvulsants such as Lamictal, atypical
    antipsychotics such as Abilify, and antidepressants such as Zoloft. One issue with medication
    management is that many people with bipolar disorder have comorbid conditions, making
    them need additional medications as well. For example, in addition to being bipolar, I also have
    ADHD, PTSD, and anxiety, so my cocktail consists of Concerta, Welbutrin, Abilify, Klonopin,
    Ambien, and Xanax. My psychiatrist is trying to convince me that I need Trileptal as well, but
    it’s a battle he’s not winning.

    Who gets bipolar disorder?

    So who gets bipolar disorder? It is estimated that approximately 2% of the general population
    has bipolar disorder whether diagnosed or not. According to the DSM-IV, there are actually
    4 variations of bipolar disorder, which include Bipolar I, Bipolar II, Bipolar-NOS, and
    cyclothymia. What do all of these mean? People with Bipolar I not only have the severe downs,
    but they have severe ups as well, or they have what’s called a mixed state, which includes
    features of both depressive and manic symptoms. People with Bipolar II don’t have the manic
    highs, instead they swing from very depressed to hypomanic. Bipolar-NOS are people who have
    symptoms, but don’t fall into either of the above two categories. And then cyclothemia is a mild
    form of bipolar disorder, one in which the person experiences highs and lows, but not the very
    low depressive states, and not the high manic states. You may also have genetic predisposition to bipolar disorder. It’s been recently discovered that that bipolar disorder, ADHD, and schizophrenia may all be linked to the same set of genes.

    You are in excellent company

    So what does this all mean for the bipolar patient? It can mean a lot of time spent with a doctor
    figuring out medications. It can mean a lot of frustration as medications are sorted out and
    therapy is started. But it also means you are in excellent company! You may feel alone in this battle, but many others have fought it and won. I’m sure you’ve heard of Abraham Lincoln, as well as Winston Churchill, and even Charles Dickens. Or perhaps you’ve heard of a lovely lady named Marilyn Monroe? Kurt Cobain? Or if you’re more current than that, how about Catherine Zeta-Jones? These creative geniuses all have or had bipolar disorder. Many bipolar patients are creative geniuses in their own right, but it comes with that hefty price tag of the extreme mood swings.

    Don’t give up!

    One thing many people living with bipolar disorder pride themselves on is having the ability
    to walk that fine line between insanity and brilliance. We may stumble and fall off that tight rope occasionally, but there is hope for us, and we are not alone in our fight with this. There is support available, there is treatment that works, and recovery is possible. I am living proof of
    this, as are many other successful bipolar people I know. So don’t give up! Don’t give in! The night is always darkest before the dawn, and when you’re in the pits of despair and want to give up, that is the darkest hour. But I promise you, the dawn will come, perhaps when you least expect it. You’ll find a medication that works, a treatment plan that is right for you, and you will see that there is a light at the end of the tunnel. I was in the pit of despair for a long time, but I pulled myself out of it with the help of medications and therapy. I know for a fact this can happen for others suffering from this disease as well. Keep the faith, and hold on tight to the knowledge that there is the right treatment plan for you, and you too can lead a productive life as well. Good luck, and God bless!

    Image Credit: Spencer Williams

  3. 1 in 10 affected: Understanding Personality Disorders

    April 26, 2013

    personality disorders

    Image Credit: Alexis Tejeda

    It is estimated that 10% of the population have some form of personality disorder (PD) (source: BBC Health). Does this figure surprise you? Alarm you? If so, you are not alone. In fact, our shocking lack of general awareness has led mental health charity Mind to describe PD as ‘one of the most misunderstood and stigmatized diagnoses in mental health.

    These long-held misconceptions mean that, for people living with a diagnosis, the world can feel like a lonely place.

    Given the fact that PDs are so common, why do most of us know so little about them? And how can we begin to break down the walls that leave people with PD feeling isolated?

    This article explains what we mean by the term ‘personality disorder’ and offers practical advice about helping others and helping yourself, both at home and in the workplace.

    What are personality disorders?

    The term ‘personality disorder’ does not just refer to one condition. Mind explains that psychologists tend to categorize personality disorders under three general sub-headings:

    • Suspicious (paranoid, schizoid, schizotypal, antisocial)
    • Emotional and Impulsive (borderline, histrionic, narcissistic)
    • Anxious (avoidant, dependent, obsessive compulsive)

    People in the first category tend to be wary of others and unwilling to form close relationships. People in this category are often diagnosed with schizophrenia. People in the second category tend to be prone to mood swings and often display unpredictable behaviour. People in the third category tend to feel as though they need complete control over every aspect of their lives, which can lead to obsessive behaviour.

    Aren’t people with personality disorders dangerous?

    Frightening stories in the press have certainly not helped this myth. While it is true that Anti-Social Personality Disorder (ASPD) is common amongst people with a criminal conviction, clinical psychologists proved that most people with a PD are neither violent nor dangerous. Because PDs can lead to feelings of depression and low self-worth, often the individual is more likely to harm themselves than to harm others.

    Conditions such as ASPD are at the more serious end of the spectrum. Most people with a PD experience symptoms that are somewhere in between.

    What are the causes?

    There is some evidence to suggest that personality disorders are genetic. It is also thought that experiencing abuse or trauma, particularly at a young age, can be a triggering factor.

    Whatever the causes, treatment options such as Cognitive Behavioural Therapy (CBT) offered by clinical psychologists or psychotherapist tend to focus on how to deal with the symptoms in the present, rather than looking into the past. CBT is one of many modern treatment options that some people find very effective.

    Helping others

    Some people misunderstand the symptoms of a personality disorder and assume that the sufferer is simply being melodramatic or exaggerating their problems. When family or friends offer advice, the person’s condition means that they only hear the negatives and may even feel as though others are turning against them. At the heart of their condition is the desire to be loved and accepted, but often, they do not know how to ask.

    To help a loved one who has been diagnosed with a personality disorder, do not judge or criticize them. Often this ‘tough love’ approach can make them feel hurt and ashamed. Instead, remind them of the things you love about their personality, as well as their strengths and abilities. Equip yourself with information about their condition and offer to go with them to see a mental health professional who will be able to explain the different treatment approaches. Encourage them to do activities that bring out their best qualities, for example joining a club or interest group, which will help to build their self-esteem. If unsure how to deal with certain situations, speak to their counselling psychologists or psychotherapist.

    Helping yourself

    The good news is that the government finally recognizes the need for improved treatment of PD, and today a wide range of treatment options are available. Whichever treatment is prescribed, it will usually involve group and individual psychotherapy, encouragement to continue with the programme, education and planning for crisis. Psychological treatments can be offered as an in- or out-patient at a hospital or day centre. Above all, the relationship of trust between you and your social worker, psychologist, therapist or psychiatrist is the key to progress.

    Some people also find that their condition improves as they get older, as the experiences they gather help them to deal with life’s ups and downs.

    Personality Disorders in the Workplace

    Many people with a personality disorder have an ordinary career. In fact, in 2005, psychologists from the University of Surrey found that a large proportion of highly successful business executives studied had histrionic, narcissistic or obsessive personality disorders.

    Unfortunately, personality disorders can sometimes cause problems in the workplace. In these cases, the individual’s condition means that they are less effective at handling the pressures and social politics of the working environment.

    In this situation, the employer should deal sensitively and tactfully with specific problems and complaints without being accusatory or judgmental. The focus should be on reinforcing appropriate workplace conduct and goal-setting.

    If you feel that your personality disorder has led to discrimination in the workplace or any other situation, mental health solicitors can provide you with the legal support you need and deserve.

    The 10% ratio means that it is more than likely that someone you know – a friend, colleague or acquaintance – is affected by a personality disorder. Educating ourselves is the best way to understand and help individuals with one of these conditions and, eventually, defeat the stigma that surrounds them.

    For more information, visit mental health charity Mind.org.uk.