What is a personality disorder?

Psychiatrists understand a personality disorder when someone does not behave normally over a long period of time, has often done so since adolescence and would like to behave differently but cannot. It must be excluded that the unusual behavior of a person has other causes. For example: As a result of another mental illness or because he or she has used drugs or had an accident in which the brain was damaged.

By definition, personality is the sum of a person's psychological characteristics and behavior. Personality traits are those traits that characterize someone over a longer period of time. They distinguish him or her from other people. These can be traits that describe how someone feels or experiences situations, or how someone thinks or behaves towards others.

The personality is formed on the one hand by influences from the genes inherited from the parents . On the other hand, however, it is also life experiences that shape them. Depending on the personality trait, genetics or the environment have a greater or lesser influence. As a rule, the personality - depending on the quality - remains quite stable in the course of life, but changes are quite possible.

A personality disorder is by definition from the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-5) a "persistent pattern of inner experience and behavior" that:

• noticeably deviates from the expectations of the socio-cultural environment
• is profound and inflexible
• begins in adolescence or early adulthood
• is stable over time
• and leads to suffering or impairment.

Personality disorder: symptoms

The symptoms of a personality disorder vary widely, depending on which personality disorder it is. Psychiatrists and psychotherapists categorize the many different personality disorders into three larger groups (see chapter “ Personality disorders: types ”).

In addition, there are also people whose illness psychiatrists and psychotherapists cannot exactly assign to a personality disorder. So that you can still get a diagnosis and help, there is the so-called combined personality disorder. The symptoms of combined personality disorder can vary widely.

Personality disorder: types

If you look at the German population as a whole, around eight percent of people suffer from a personality disorder . If only psychiatric patients are included, the frequency rises to 40 to 60 percent. On average, women fall ill as often as men. Depending on the type of personality disorder, the number of sufferers differs greatly.

In order to sort the many different personality disorders more clearly, psychiatrists and psychotherapists subdivide into three larger categories. Group A includes personality disorders in which the sick often behave strangely and eccentrically.

Group A personality disorders:

• paranoid personality disorders
• schizoid personality disorder
• schizotypal personality disorder

Group B summarizes those personality disorders in which those affected can be described as dramatic, emotional or moody.

Group B personality disorders:

• histrionic personality disorder
• narcissistic personality disorder
• antisocial personality disorder (also called antisocial personality disorder)
• Borderline Personality Disorder

Ultimately, psychiatrists and psychotherapists in group C of personality disorders summarize those diseases in which sufferers often show fear and anxiety.

Group C personality disorders:

• Avoidant self-insecure personality disorder (also called anxious avoidant personality disorder)
• Dependent personality disorder (also called dependent personality disorder or asthenic personality disorder)
• obsessive-compulsive personality disorder (also called anankastic personality disorder)

Narcissistic Personality Disorder

Those who suffer from a narcissistic personality disorder often exaggerate themselves and their abilities . Affected people are constantly looking for success and admiration. They behave arrogantly and arrogantly towards others . Actually, they are only interested in themselves. So there is a lack of empathy towards others who are manipulated or exploited by narcissists.

Although they may appear confident to others through their self-expression, those with narcissism are sensitive and easily offended . They are not good at handling criticism. People with narcissistic personality disorder build very high demands on themselves through their behavior - which is why they often do not finish tasks or exams at work or even an apprenticeship or study for fear of failing.

In summary: People who suffer from narcissistic personality disorder have low self-esteem and want to hide this at all costs through exaggerated self-expression .

It is estimated that around 1 in 100 people will develop narcissistic personality disorder.

Histrionic Personality Disorder

People with histrionic personality disorder are always looking for attention and approval from other people . You are open and very extroverted. Histrionics quickly recognize what someone else's needs have and how they must behave in order to be liked. The recognition is intended to reduce feelings of loneliness and inferiority.

Histrionics are emotional, spontaneous and react extremely to positive and negative feelings . However, these reactions also quickly subside. The emotional state can change quickly.

Histrionic men are different from women who develop histrionic personality disorder. Men are strong, macho and seductive . Women often behave childishly seductive to submissive . However, both place great value on their external appearance.

Such behavior does not necessarily have to lead to suffering. People with histrionic personality disorder seek treatment primarily when their solicitation for recognition no longer works or they are getting older and less attractive, which can damage their self-esteem and lead to depression for those affected .

It is estimated that around two in 100 people develop histrionic personality disorder.

Borderline personality disorder

Borderline personality disorder is a serious mental illness that affects around three percent of people. The main characteristic is emotional instability . This instability manifests itself in relationships with others, but also in self-image. Sick people tend to be very impulsive. It is not uncommons for them to injure themselves or sometimes other people.

In the ICD-10, the diagnosis classification system of the World Health Organization (WHO), the disease is called "emotionally unstable personality disorder". There it is divided into two further sub-types: an impulsive type and a borderline type.

Schizoid personality disorder

People with schizoid personality disorder are very cautious about interpersonal relationships . They show feelings only very weakly. You seem cool and distant.

Affected people often live withdrawn and have few social contacts. However, they do not suffer in the same way as others, and loneliness is not necessarily uncomfortable for them . Conversely, it is more the contact with other people that people with a schizoid personality disorder cannot gain anything positive from.

Sometimes the schizoid personality disorder leads to suffering in those affected. Namely when the relationship with a partner suffers from numbness and detachment. Or even when those affected are looking for a partner but cannot find one. However, if the disorder is very pronounced, those affected usually have no desire for a partnership.

Schizoid personality disorder occurs in about one percent of the population. Those affected rarely seek psychiatric or psychotherapeutic help.

Schizotypic personality disorder

People with schizotypic personality disorder are characterized by acting strangely . They ignore common manners, often appear bizarre or peculiar to others and, moreover, often live socially delimited.

Schizotypic people also have a different way of thinking or perception. Often the attention is impaired or they give particular weight to certain impressions that others would ignore. For outsiders, the peculiarities often become clear in the way people with a schizotypic personality disorder speak. Affected people often speak vaguely and awkwardly, using strange metaphors .

In addition, people with schizotypic personality disorder are often very socially anxious. They are sensitive, sometimes to the point of paranoia.

About three percent of people in the general population develop a schizotypic personality disorder.

Dissocial Personality Disorder

Antisocial personality disorder, also known as antisocial personality disorder, is characterized by the fact that those affected often disregard and violate the rights of others. They are easy to irritate, impulsive and not very empathetic. In addition, those affected are often aggressive and violent, which is why they often come into conflict with the law.

Anyone suffering from dissocial personality disorder usually does not think about the consequences of what they do. Those affected do not feel real remorse. People with dissocial disorders get bored quickly because they always have the same everyday life at work or in a relationship. Then they look for variety and excitement. As a result, those affected are often unreliable and manipulate others - always for their own benefit.

Dissocial personality disorder often begins in childhood or early adolescence and persists into adulthood . Overall, men are more often affected than women. In the population, between three and seven percent of men develop an antisocial personality disorder, with women it is around one to two percent. The disorder is also called psychopathy or sociopathy.

Paranoid personality disorder

Individual with paranoid personality disorder are suspicious and suspicious of others . They believe that those around them are always up to evil. Those affected constantly expect other people to attack or injure them. As a result, they often withdraw and are reluctant to enter into relationships. They don't get along well with criticism.

Overall, around one to two percent develop the paranoid personality disorder. When making a diagnosis, psychiatrists and psychotherapists take care not to confuse the disease with a delusional disorder with paranoia.

Insecure Personality Disorder

There are many different names for avoidant self-insecure personality disorder, but they essentially mean the same thing:

• avoidant-insecure personality disorder
• insecure avoidant personality disorder
• Anxious Avoidant Personality Disorder

Affected people are very cautious in social situations . They often think that they are inadequate, find themselves unattractive and incapable, and are very sensitive to negative judgments. They don't like to speak their minds, nor do they like to be the center of attention. They prefer to avoid social situations entirely. As a result, they often live in social isolation.

About one to three percent of people in the general population develop an avoidant, self-insecure personality disorder.

Compulsive Personality Disorder

Anyone suffering from an obsessive-compulsive personality disorder, also known as an anankastic personality disorder , is overly concerned with order, perfection, or control . Affected people try very hard not to make any mistakes . Depending on the situation, other people appreciate such “proper” behavior. But compulsive people make the same demands they have on their own behavior on other people. This not infrequently leads to conflicts. In addition, flexibility and efficiency often lag behind accuracy.

Compulsive personality disorder affects about two in a hundred people on average.

Impulse control disorder

Under the heading “Abnormal habits and impulse control disorders”, the ICD-10, the diagnosis classification system of the World Health Organization, summarizes several different diseases. These include:

• Pathological gambling
• Pathological arson (pyromania)
• Pathological stealing (kleptomania)
• Trichotillomania (pulling hair out)
• Other abnormal habits and impulse control disorders
• Abnormal habit and impulse control disorder, unspecified

All disorders have in common that those affected keep repeating a certain action even though they do not want to. The actions are also of no benefit to those affected. On the contrary: they are often harmful.