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Author Topic: Ten things to know about Personality Disorder - National PD Programme  (Read 613 times)
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« on: December 05, 2009, 09:56:13 AM »

Very brief but (in my opinion) helpful overview:
color=#846f17]Ten things to know about Personality Disorder[/color]
1. Personality disorder is not an illness you catch or are born with, but is a “way of being” you develop while growing up. It means some aspects of your personality cause repeated problems in life - particularly with relationships. The troubled relationships can be with family and friends, work and care services – and frequently with all of them.
2. There are 10 diagnosable personality disorders. Many clinicians – and service users – do not find these categories useful, as most people with severe problems have a mixture of them, and the exact diagnosis does not help in deciding on treatments. Many professionals would rather use less perjorative labels such as ‘complex PTSD’ or ‘attachment disorder’, or scales to show how everybody is on a scale from mild to severe: “everybody has a personality and nobody is perfect”.
3. These 10 are often divided into 3 clusters, A, B & C:
    * cluster A: “odd or eccentric” (paranoid, schizoid, schizotypal)
    * cluster B: “dramatic emotional or erratic” (histrionic, narcissistic, antisocial, borderline)
    * cluster C: “anxious and fearful” (obsessive-compulsive, avoidant and dependent)
4. They are very common – some research says up to 13% of the general population, 25% of GP consultations in deprived urban areas, most people in prisons, at least half of homeless people and between a third and two thirds of inpatients in psychiatric hospitals. We generally work on a figure of about 4% who would benefit from help.
5. People diagnosable with personality disorder are more likely to have diagnosable ‘mental illnesses’ as well – for example, depression, eating disorders and panic attacks are very commonly found with PD, and so re addictions including ‘poly-drug’ abuse.
6. The ones who are unhappiest with their personality and seek help are mostly those who in cluster B: borderline, histrionic and narcissistic. “Antisocial” also in cluster B was previously known as “psychopathic” and is very high in prison populations. Those in cluster A “live in their own world”, and do not often seek help from services, although those diagnosable with paranoid PD may be very suspicious of services and make complaints. This is also true of obsessive-compulsives in cluster C. The others in cluster C are often too fearful and shy to seek help.
7. Up until 2002, doctors and nurses were taught not to diagnose personality disorder unless they had no other option. When people were diagnosed with it, they were usually “written off” – and excluded from services, often in hurtful ways. This is why it has previously been called “A diagnosis of exclusion”
8. The causes are a combination of what sort of brain you inherit, and what experience you have in early life. Experts differ in deciding how much of each, but everybody agrees it is a combination.
9. Whatever the cause, it is now accepted that unsympathetic treatment can make people worse. This has been called the “cycle of rejection”, and it can happen anywhere that people diagnosable with PD relate to others. There are new training programmes to help prevent this.
10. Without knowing it or doing it deliberately, people diagnosable with PD can stir up emotions in others. Professionals must have ways of dealing with this, usually through suitable supervision and chance to “offload”. In some treatments, understanding what is happening is part of the therapy. Other staff coming across people with these problems also need ways to deal with it, so that they are not left with bad feelings (for example, angry, hostile or useless) that are not really “their own”.

Have you read the Lessons?
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