Beyond the Label: Understanding Personality Disorders

Around 9% of adults in the United States possess a personality disorder. The most common ones are borderline personality disorder (BPD), which usually begins during your teenage years, and antisocial personality disorder, which may reveal itself even earlier.

Our board-certified psychiatric nurse practitioner, Bosede Iwuamadi, DNP, PMHNP, provides treatment options for people dealing with personality disorders, anxiety and depression, and other mental health issues via telehealth at Newstone Behavioral Health in Garland, Texas.

What constitutes a personality disorder?

Your personality reflects the way you think and feel about yourself and others. People who have personality disorders generally harbor unhealthy thoughts and behaviors. Their long-term distorted view of reality, disruptive beliefs, and disruptive actions often cause ongoing social, relationship, and work problems.

Traditional DSM labels

The Diagnostic and Statistical Manual of Mental Disorders (DSM) lists the standard classifications used by mental health professionals. It divides personality disorders into three clusters, A, B, and C, as follows: 

Cluster A:

1. Schizotypal personality disorder displays unique thoughts and behaviors
2. Schizoid personality disorder shows a lack of interest in forming relationships
3. Paranoid personality disorder reveals extreme paranoia, fear, and distrust of others 

Cluster B: 

1. Narcissistic personality disorder shows a lack of empathy and feelings of superiority
2. Histrionic personality disorder uses dramatic behavior to gain attention
3. Antisocial personality disorder exhibits a long-term pattern of manipulating others
4. Borderline personality disorder demonstrates impulsive thoughts and actions.

Cluster C 

1. Obsessive-compulsive personality disorder craves order and control
2. Avoidant personality disorder shuns others due to shyness and fear of rejection
3. Dependent personality disorder remains co-dependent on others to their detriment

We realize many people with a personality disorder don’t recognize some of their troubling behaviors or how they negatively affect others. Dr. Iwuamadi goes beyond these somewhat restrictive labels to put you on a better path towards self-knowledge and recovery. 

A 3D perspective

While these categories have long been used to define personality disorders, Dr. Iwuamadi prefers an individualized approach, known as the DSM-5 Dimensional Approach. Rather than seeing personality traits as black-and-white, the doctor prefers to view them on a spectrum.

The Dimensional Approach examines how symptoms present and how much they impair quality of life. It notes five areas:

1. Negative affectivity, the tendency to experience negative emotions
2. Detachment, social distancing, and emotional withdrawal
3. Antagonism, aggression towards others, plus a lack of empathy
4. Disinhibition, difficulty controlling emotions, and a desire for immediate gratification
5. Psychoticism, anti-social, egocentric behavior  

Dr. Iwuamadi realizes your risk of personality disorders is partially dependent upon genetics and cultural background, as well as childhood trauma and/or abuse, and adjusts your therapy accordingly.

How we treat personality disorders

The doctor suggests different treatment options to help you better manage your behavior and symptoms, such as: 

Dialectical Behavior Therapy (DBT)

Cognitive behavioral therapy (CBT) techniques include dialectical behavior therapy (DBT) to strengthen your interpersonal effectiveness, mindfulness, emotion regulation, and distress tolerance. DBT is especially productive for individuals with borderline personality disorder.

Psychodynamic psychotherapy

Focused more upon the patient’s relationship with the outside world than the therapist, psychodynamic psychotherapy, a form of talk-therapy, works well with personality disorders and other types of issues.

Self-care to the rescue

Dr. Iwuamadi may also recommend certain lifestyle adjustments, such as:

1. Avoid alcohol and drugs that may worsen symptoms.
2. Exercise to help manage stress and depression.
3. Practice meditation, mindfulness, yoga, and other stress management techniques.
4. Connect with friends and family to avoid isolation.

Dr. Iwuamadi helps you restructure your core beliefs to modify unhealthy thoughts and behavioral patterns gradually. Our team also encourages you and your family to learn all about your condition to feel more in control and empowered.

Take the first step

The Chinese proverb, “the journey of a thousand miles begins with one step,” certainly holds true with personality disorders and other deeply ingrained psychological issues.

If you experience long-term difficulties relating to others and/or a poor self-image, or display overly aggressive or narcissistic behavior, you may possess a personality disorder. The good news is we offer support as you take that initial leap of faith towards wellness.

Dr. Iwuamadi and our compassionate team help you understand and manage your personality disorder or other mental health issues via telehealth. Reach out today to Newstone Behavioral Health in Garland, Texas.