What is a Personality Disorder

Personality disorders are long term patterns of thoughts and behaviors that cause serious problems with relationships and daily life. People with personality disorders have difficulty dealing with everyday stresses and problems. They often have difficulty with relationships with other people.

 The exact cause of personality disorders is not known but genes and childhood experiences may play a role.

Symptoms vary depending on the specific personality disorder. Treatment usually includes psychotherapy and sometimes medicine.

 Paranoid personality disorder is people who show paranoid behavior are always suspicious of others, and often become irritable and hostile. Older adults may have paranoid delusions, become very agitated, or even assault someone.

People who show schizoid behavior are not usually interested in social relationships and may behave oddly or in ways that isolates and separates them from others. Older adults with schizoid behavior may have poor, strained, and sometimes no relationships.

 In schizotypal behavior, people may have strange, unusual, or inappropriate behaviors or beliefs that may lead to conflicts with other people.

Behavior that is antisocial shows little regard or respect for standard rules and laws of society. Antisocial people often do not seem to have a conscience or care about others.

 People who show borderline behavior have unstable emotions, which lead to unstable relationships. They may have emotional outbursts or injure themselves.

 People who show histrionic behavior are over emotional and want to be the center of attention. They are often disorganized and lack inhibitions.

 People who are narcissistic think that they should have and think that they are entitled to whatever they want. They often act superior, self-important, and arrogant. They do not seem to care about others.

People who show avoidant behavior are shy, inhibited, and very sensitive to rejection and how others look at them. This often leads to having not many social relationships and little support. 

People who show dependent behavior rely completely or almost completely on others to make decisions and for support.  

People who are obsessive-compulsive are constantly worried about cleanliness and keeping everything in order. They are perfectionists and do not want to compromise.

In passive-aggressive behavior, people tend to resist authority or any demands placed on them by not taking any action, procrastinating. These people often criticize and resent others.

People who show depressive behavior view life as always gloomy and miserable, with no hope of change in the future. These people often have low self-esteem and feel guilty. They often have major or clinical depression in later life.

The causes of personality disorder is both early life experiences and genetic. Severe changes in personality may develop during later life because of the stresses experienced by older adults. Many older adults become overwhelmed by losses, medical problems, and stresses that build up over time. Especially people who are not able to cope well or do not have the personal, social, or financial resources to shield them from these stresses. Being admitted to a hospital or nursing home can be a particularly stressful event, because of the loss of familiar environment, personal items, privacy, and the control over one's schedule.

Personality disorders can be diagnosed only by a psychiatrist. The diagnosis can be very difficult in older adults. It requires a detailed lifetime history. People with some types of personality disorders may be reluctant to speak openly with a psychiatrist. This means that mental health professionals often need to observe someone for a long time before being able to make a diagnosis.

Separating personality disorders from underlying medical or psychological problems is also difficult. For example, major or clinical depression, psychosis, or other psychiatric problems can distort personality features. Brain damage or tumors can also lead to dramatic changes in personality.

In personality disorder, extreme, inflexible, and difficult personality traits become a part of someone's overall personality. Many older adults who appear to have troubling personality problems do not have a personality disorder. Some people just have trouble adapting to changes. An adjustment disorder develops when a healthy and well-adjusted person suddenly shows personality changes as a result of severe stress.

Personality disorders may continue unchanged over time, or they may fluctuate in progress. Treatment for personality disorders includes many forms of psychotherapy, depending on the situation.  Medication treatments are used, including medications for depression, anxiety, and psychoses. The best treatment approach is usually a combination of psychotherapy and drug treatment.