Dr. Jonathan Hoffman
Personality Disorder…or Just Another Annoying Person?
Updated: Jul 14, 2022
Teenagers sling denigrating names like “weirdo,” “sicko” and “baby” at other kids whose behavior makes them stand out from the group. Adults, being more sophisticated, use other appellations to indicate disfavor, including many borrowed from psychiatric nomenclature.
For instance, an usually neat or rigid person may be called “OCD” (obsessive- compulsive disorder) or a very moody individual “bipolar.” Lately, “personality disorder (PD)” has become a popular label to bandy about, as in: “Did you see how Josephine was acting at work on Friday? She has such a personality disorder.” People even know some of the various kinds of PDs. So, if Josephine was really being annoying, she might be called a “borderline.”
But when terms move from medical textbooks to the popular lexicon, it’s easy to lose sight of what they really mean. While cynics might observe that South Florida is an easy place for those with strange or bothersome personalities to hide in plain sight, actual PD’s cause enormous suffering to those afflicted and their families. Their cause is not well understood, although there seem to be factors that increase vulnerability – such as certain genetic markers and a history of trauma.
How Common Are Personality Disorders?
PDs are fairly common; the major psychiatric manual lists 10 varieties of them. These conditions have been subcategorized into three clusters: Cluster A persons (paranoid, schizoid and schizotypal PDs) present as extremely eccentric and peculiar. The Bs (antisocial, borderline, histrionic and narcissistic) are looked as unstable, overreactive, and dramatic, while the Cs (avoidant, dependent, and obsessive compulsive) are those who appear overly nervous and afraid.
If you’re noticing these clusters bear an unfortunate resemblance to “weirdo,” “sicko,” and “baby,” then you have caught onto the fact that these disorders often begin in adolescence and are characterized by both enduring over time and representing significant discrepancies from social norms.
Even though youngsters may appear as if they have a PD, in may cases, this will turn out to be either a transitory reaction to a difficult situation or a phase they eventually grow out of. Those with true PDs – not just difficult or unusual personality traits – are often quite impaired or in psychological turmoil – or both. These people come nowhere close to their potential in work or relationships.
Symptoms of Personality Disorders
Having a PD has nothing to do with one’s intelligence, but having one can make individuals feel isolated, hypersensitive, untrusting, negative about themselves and not certain about who they are or the purpose of their life. Those having borderline personality disorder, in particular, suffer from an unstable sense of identity and often lead chaotic, self-destructive lives.
Of special not is borderline’s tendency to first idealize others and then, abruptly, start loathing them. For an extreme but illuminating case, think about Glenn Close’s character in the movie “ Fatal Attraction” – first putting the Michael Douglas character she had a brief affair with on a pedestal, then later trying to kill him.
Having a PD connotes being inflexible and resistant to change and constructive criticism- even in the face of mounting problems and lack of success. People with these conditions often have great trouble taking responsibility for their own feelings, behaviors and life outcomes. They can even lash out at those who are genuinely trying to help, including loved ones and mental health professionals.
Therefore, they are frequently unwilling to accept assistance or find excuses to drop out of treatment before it has a chance to work. Sadly, in the most severe cases, the resources, patience and skills of helpers are prone to being worn out. People with PDs are at high risk for self-injury and suicidality, and often find themselves in a revolving door of incomplete or failed treatments, including psychiatric hospitalizations.
Understanding & Treating Personality Disorders
But now, there is a renewed hope for the understanding and treatment of PDs. There is psychological treatment for borderline personality disorder called dialectic behavior therapy (DBT) that combines cognitive-behavioral therapy with age-old Eastern techniques for achieving inner harmony, such as the practice of mindfulness and meditation.
Advances in psychiatric medications, especially when combined with longer-term psychotherapy and social support, have also provided relief and improved quality of life for may with PDs. The biggest challenge may be finding more effective ways of motivating those with PDs to have the trust to enter and stick to the treatments and relationships and professionals that will give them the best chance to improve their lives.
In the interim, please consider helping those with the affliction and their families by not buying into the PD or borderline punch lines, insults and gossip. Only annoying people do that.
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