Why are personality disorders so difficult to treat?

Personality disorderCC: AbsolutVision at Pixabay

Personality disorders are surprisingly common. While 9.1% of people suffer from one, a further 1.4% has a borderline form. In both cases, the person’s condition can affect their ability to work, socialize, and maintain normal relationships.

If you look back far enough, you’ll find the first theories of personality disorder entrenched in Greek history. As the forefathers of modern medicine, the Ancient Greeks proposed many of the theories we’re all aware of today. However, it wasn’t until the late-19th-century that stronger theories were proposed. Much like other common conditions, attempts to diagnose and treat personality disorders away from religion were lost in the medieval periods and beyond.

Despite their longstanding history in medicine and surprisingly common nature, personality disorders are still difficult to treat. So, what does the term mean? And why do modern psychiatrists struggle to tackle the issue?

What is a personality disorder?

Personality disorder is a blanket term that covers a range of mental health conditions. Each one is a disorder where the person feels, thinks, behaves, and interacts in ways that are socially destructive.

The commonest form is a borderline personality disorder. Such individuals suffer from disruptive thinking, persistent fear of abandonment, and they struggle to control their emotions. Similarly, those with an antisocial disorder will become frustrated easily and cannot reduce their anger.

There are roughly 10 different subtypes. While suffering from one of them makes life challenging for the person concerned, it also makes them difficult to live with. As a result, those who fear being abandoned or who have paranoid thoughts about their relationships with others see their worries come true.

Like many areas of mental health, the cause of these conditions isn’t fully known. Some believe you’re more likely to suffer from one if a parent does. Additionally, your risk increases when you experience a traumatic or abusive childhood.

What treatments are available?

No medication focuses on tackling the personality disorder directly. Instead, they focus on the symptoms that come with it. For example, many individuals who suffer from these conditions will also show signs of depression. As a result, their doctor may choose to prescribe an SSRI.

Depending on the type of traits they’re displaying, a lot of people with personality disorders also benefit from talking therapies. Thanks to advances in modern counseling, intricate approaches help patients make great strides. For example, CBT is useful for unpicking disruptive thinking patterns and EMDR reduces the signs of PTSD from childhood.

Why are personality disorders difficult to treat?

One of the main issues lies with the diagnosis. To a person with a personality disorder, their view of the world is as real as anybody else’s. For someone with a paranoid personality disorder, this may mean that their interpretation of a friendly “hello” being hostile is as rational as your interpretation that it’s friendly. As they believe that their way of thinking is normal, they may not be open to a diagnosis. Similarly, those who are misdiagnosed with conditions such as anxiety or depression may spend years battling through the wrong types of treatment.

It’s also important to realize that treating a personality disorder doesn’t mean curing it. The mental health problems the patient suffers from are interwoven with their personality. As it’s a part of their character, treatment focuses on coping mechanisms and talking therapies that they may need to engage with on a lifelong basis.

With their deeply entrenched nature in mind, it’s difficult to see how these conditions could ever be cured. But, they can benefit from tolerance and understanding, both from society and medical professionals.

About the Author

Laura McKeever
Laura has been a freelance medical writer for eight years. With a BSc in Medical Sciences and an MSc in Physician Assistant Studies, she complements her passion for medical news with real-life experiences. Laura’s most significant experience included writing for international pharmaceutical brands, including GSK.