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Depression blog
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June 7, 2008
Personality disorders can be managed
By Gabrielle J. Melin, M.D.
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Personality traits are a part of all of us and are influenced by our background and genetics. Sometimes a person will have an inflexible, maladaptive personality style. When this begins in early adulthood and results in significant impairment in functioning in life, it is termed a personality disorder. While these can be difficult to treat, recognition of a personality disorder is the first step in managing it. This is relevant to depression as this can impact depressive symptoms directly and can also impact the success of treatment.
There are many different personality disorders. We all may have some of these personality traits, but that doesn't mean that it meets the diagnostic criteria for a disorder. Types include: paranoid, schizotypal, schizoid, borderline, narcissistic, antisocial, dependent, obsessive compulsive (different than obsessive compulsive disorder or OCD) histrionic and avoidant.
Like other psychiatric disorders, the disorder's symptoms can range from mild to severe. When someone is under a lot of stress, the personality disorder can worsen. The person with the personality disorder will tend to blame everyone and everything else for their problems. Not having insight that their behavior affects their life is a hallmark of a personality disorder. You can easily see why an untreated personality disorder could negatively impact the successful treatment of depression.
For instance, borderline personality disorder is characterized by erratic mood swings, poor self-esteem and self-image, chaotic relationships, chronic suicidal ideation, suicide attempts, parasuicidal behavior, (such as cutting) impulsivity, paranoia under stress, hearing voices or seeing things (hallucinations) under stress, chronically feeling lonely and bored, being vulnerable to abandonment.
When reading this, one can see that some of the symptoms may appear to be similar to other psychiatric illnesses. For instance, paranoia under stress or hallucinations may make one think of schizophrenia. Severe mood swings may make one think of bipolar affective disorder. One symptom in isolation does not make a diagnosis as we have talked about before. The treatment for borderline personality disorder is a very specific kind of therapy call Dialectical Behavioral Therapy or DBT.
As always, a thorough evaluation by a trained professional is the best way to ensure proper diagnosis and treatment. Sometimes, symptoms will change or appear over time and the diagnosis may change. With insight, motivation and hard work, one can manage their personality disorder which in turn can help with successful treatment of depression.
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