What is personality disorder?
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Answers:
Psychology is more an art form than a science. There is no "Theory of Everything" from which one can derive all mental health phenomena and make falsifiable predictions. Still, as far as personality disorders are concerned, it is easy to discern common features. Most personality disorders share a set of symptoms (as reported by the patient) and signs (as observed by the mental health practitioner).
Patients suffering from personality disorders have these things in common:
They are persistent, relentless, stubborn, and insistent (except those suffering from the Schizoid or the Avoidant Personality Disorders).
They feel entitled to - and vociferously demand - preferential treatment and privileged access to resources and personnel. They often complain about multiple symptoms. They get involved in "power plays" with authority figures (such as physicians, therapists, nurses, social workers, bosses, and bureaucrats) and rarely obey instructions or observe rules of conduct and procedure.
They hold themselves to be superior to others or, at the very least, unique. Many personality disorders involve an inflated self-perception and grandiosity. Such subjects are incapable of empathy (the ability to appreciate and respect the needs and wishes of other people). In therapy or medical treatment, they alienate the physician or therapist by treating her as inferior to them.
Patients with personality disorders are self-centered, self-preoccupied, repetitive, and, thus, boring.
Subjects with personality disorders seek to manipulate and exploit others. They trust no one and have a diminished capacity to love or intimately share because they do not trust or love themselves. They are socially maladaptive and emotionally unstable.
No one knows whether personality disorders are the tragic outcomes of nature or the sad follow-up to a lack of nurture by the patient's environment.
Generally speaking, though, most personality disorders start out in childhood and early adolescence as mere problems in personal development. Exacerbated by repeated abuse and rejection, they then become full-fledged dysfunctions. Personality disorders are rigid and enduring patterns of traits, emotions, and cognitions. In other words, they rarely "evolve" and are stable and all-pervasive, not episodic. By 'all-pervasive", I mean to say that they affect every area in the patient's life: his career, his interpersonal relationships, his social functioning.
Personality disorders cause unhappiness and are usually comorbid with mood and anxiety disorders. Most patients are ego-dystonic (except narcissists and psychopaths). They dislike and resent who they are, how they behave, and the pernicious and destructive effects they have on their nearest and dearest. Still, personality disorders are defense mechanisms writ large. Thus, few patients with personality disorders are truly self-aware or capable of life transforming introspective insights.
Patients with personality disorder typically suffer from a host of other psychiatric problems (example: depressive illnesses, or obsessions-compulsions). They are worn-out by the need to reign in their self-destructive and self-defeating impulses.
Patients with personality disorders have alloplastic defenses and an external locus of control. In other words: rather than accept responsibility for the consequences of their actions, they tend to blame other people or the outside world for their misfortune, failures, and circumstances. Consequently, they fall prey to paranoid persecutory delusions and anxieties. When stressed, they try to preempt (real or imaginary) threats by changing the rules of the game, introducing new variables, or by trying to manipulate their environment to conform to their needs. They regard everyone and everything as mere instruments of gratification.
Patients with Cluster B personality disorders (Narcissistic, Antisocial, Borderline, and Histrionic) are mostly ego-syntonic, even though they are faced with formidable character and behavioral deficits, emotional deficiencies and lability, and overwhelmingly wasted lives and squandered potentials. Such patients do not, on the whole, find their personality traits or behavior objectionable, unacceptable, disagreeable, or alien to their selves.
There is a clear distinction between patients with personality-disorders and patients with psychoses (schizophrenia-paranoia and the like). As opposed to the latter, the former have no hallucinations, delusions or thought disorders. At the extreme, subjects who suffer from the Borderline Personality Disorder experience brief psychotic "microepisodes", mostly during treatment. Patients with personality disorders are also fully oriented, with clear senses (sensorium), good memory and a satisfactory general fund of knowledge.
Other Answers:
A personality disorder is a fundamentally backward way of interacting with others or viewing the world that affects your day-to-day life. Others include antisocial personality disorder (commonly known as a sociopath), borderline personality disorder (You have no fixed personality), and histrionic personality disorder (a need to be overly dramatic).
Personality disorders are pervasive chronic psychological disorders, which can greatly affect a person's life. Having a personality disorder can negatively affect one's work, one's family, and one's social life. Personality disorders exists on a continuum so they can be mild to more severe in terms of how pervasive and to what extent a person exhibits the features of a particular personality disorder. While most people can live pretty normal lives with mild personality disorders (or more simply, personality traits), during times of increased stress or external pressures (work, family, a new relationship, etc.), the symptoms of the personality disorder will gain strength and begin to seriously interfere with their emotional and psychological functioning.
Those with a personality disorder possess several distinct psychological features including disturbances in self-image; ability to have successful interpersonal relationships; appropriateness of range of emotion, ways of perceiving themselves, others, and the world; and difficulty possessing proper impulse control. These disturbances come together to create a pervasive pattern of behavior and inner experience that is quite different from the norms of the individual's culture and that often tend to be expressed in behaviors that appear more dramatic than what society considers usual. Therefore, those with a personality disorder often experience conflicts with other people and vice-versa. There are ten different types of personality disorders that exist, which all have various emphases.
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