Children with borderline personality disorder - a cheat sheet for parents. How mental illness develops

The modern systematics of mature personality disorders is based on the classification of P. B. Gannushkin (1933), G. E. Sukhareva (1959) and the types of accentuated personalities in adults, according to K. Leonhard (1964, 1968). In accordance with ICD-10, the following types of personality disorders are distinguished.

Paranoid (paranoid) personality disorder

The main feature of this type of personality is the tendency to form overvalued ideas that influence the behavior of a person. The assessment of the current situation is subject to affective logic, its analysis is subjective, judgments are often erroneous, and they cannot be corrected. The content of paranoid syndromes at the height of their development is determined by the ideas of reformism, jealousy, litigation, persecution, hypochondria and love.

Diagnostic criteria for paranoid personality disorder:

Over-sensitivity to failure and rejection;

Tendency to be constantly displeased with someone, refusal to forgive insults, harm and being treated down;

Suspicion and a general tendency to distort the facts by misinterpreting the neutral or friendly actions of others as hostile or suspicious;

A militantly scrupulous attitude to issues related to the rights of the individual, which does not correspond to the actual situation;

Recurring unjustified suspicions about the sexual fidelity of a spouse or sexual partner;

A tendency to experience one's increased significance, which is manifested by the constant attribution of what is happening to one's own account;

Preoccupation with non-essential "conspiratorial" interpretations of events happening to or around the person.

Long before the formation of a paranoid personality structure, affective disturbances, increased excitability, irascibility, irritability, and a tendency to fixate on negatively colored experiences are noted. They are characterized by an increased sense of justice, accuracy and conscientiousness, excessive straightforwardness in judgments, stenism, decisiveness, a desire for independence, and an overestimation of their own merits.

Paranoid manifestations develop under the influence of external objective factors, the most frequent and significant among which are psychogenic and somatic diseases.

The formation of paranoid psychopathy always occurs gradually, with the growth and deepening of anomalous personality traits and the aggravation of sepatocharacterological features, the development of persistent and systematized, as a rule, monothematic paranoid ideas of various content.

Schizoid personality disorder characterized by isolation, secrecy, external isolation and coldness, isolation of judgments from the real situation. Lack of internal unity and consistency mental activity in general, there is a paradoxical and bizarre emotional life. Emotional disharmony is manifested by a combination hypersensitivity to one side of life while at the same time emotional coldness to others. Outwardly, these faces look eccentric, strange, eccentric. Their affective reactions are often outwardly unexpected and inadequate. They have no empathy for the troubles and troubles of others. Along with this, they often turn out to be highly gifted and intelligent individuals, prone to non-standard conclusions and statements.

In accordance with the ICD-10, the following features are characteristic of schizoid personality disorder:

Little or no pleasure;

Emotional coldness, alienated or flattened emotionality;

Inability to show warm and tender feelings towards other people, as well as anger;

Weak response to both praise and criticism;

Little interest in sexual contact with others;

Heightened preoccupation with fantasy and interpretation;

An almost constant preference for solitary activities;

Marked insensitivity to prevailing social norms and conditions;

Lack of close friends or trusted connections and desire to have such connections.

Emotionally unstable personality disorder(excitable type) was described earlier under different names "emotionally labile" (Schneider, 1923), "reactively labile" (P. B. Gannushkin, 1933) or "emotively labile" (K. Leonhard, 1964, 1968) and etc. In childhood, labile adolescents, as a rule, do not particularly stand out among their peers. Only a few show a tendency to neurotic reactions. However, almost everyone's childhood is filled with infectious diseases caused by opportunistic flora. Frequent sore throats, continuous colds, chronic pneumonia, rheumatism, pyelocystitis, cholecystitis and other diseases, although they do not occur in severe forms, they tend to take a protracted and recurrent course. Perhaps the factor of "somatic infantilization" plays an important role in many cases of the formation of a labile type. The main personality trait of an emotionally unstable type is extreme mood variability. We can talk about the emerging formation of a labile type in cases where the mood changes too often and too abruptly, and the reasons for these fundamental changes are insignificant. An unflattering word spoken by someone, an unfriendly glance of a casual interlocutor, an inopportune rain, a button torn off a suit can plunge you into a dull and gloomy mood in the absence of any serious troubles and failures. At the same time, some pleasant conversation, interesting news, a fleeting compliment, a well-dressed suit for the occasion, heard from someone, although unrealistic, but tempting prospects can cheer up, even distract from real troubles, until they again remind anything about yourself. During a psychiatric examination during frank and exciting conversations, when you have to touch the most different parties life, for half an hour you can see more than once ready to well up tears and soon a joyful smile. The mood is characterized not only by frequent and abrupt changes, but also by their significant depth. The state of health, and appetite, and sleep, and ability to work, and the desire to be alone or only with a loved one, or to rush into a noisy society, into a company, into people depend on the mood of a given moment. According to the mood, the future is either colored with iridescent colors, or it seems gray and dull, and the past appears either as a chain of pleasant memories, or seems to consist entirely of failures, mistakes and injustices. The same people, the same environment, sometimes seem cute, interesting and attractive, sometimes boring, boring and ugly, endowed with all sorts of shortcomings. An unmotivated change of mood sometimes creates the impression of superficiality and frivolity. But this judgment is not true. Emotionally unstable individuals are capable of deep feelings, for great and sincere affection. This primarily affects their attitude towards relatives and friends, but only to those from whom they themselves feel love, care and participation. Attachment to them persists, despite the ease and frequency of fleeting quarrels. Loyal friendship is no less characteristic of labile teenagers. In a friend, they spontaneously look for a psychotherapist. They prefer to be friends with those who, in moments of sadness and discontent, are able to distract, console, tell something interesting, cheer up, convince that “everything is not so scary”, but at the same time, in moments of emotional upsurge, they will easily respond to joy and fun, satisfy the need for empathy. Emotionally labile adolescents are very sensitive to all kinds of signs of attention, gratitude, praise and encouragement - all this gives them sincere joy, but does not at all induce arrogance or conceit. Reproaches, condemnations, reprimands, lectures are deeply experienced and are capable of invading into hopeless despondency. Labile adolescents endure real troubles, losses, misfortunes extremely hard, revealing a tendency to reactive depressions, severe neurotic breakdowns. The reaction of emancipation in labile adolescents is expressed very moderately. They feel good in the family if they feel love, warmth and comfort there. Emancipatory activity manifests itself in the form of short bursts, due to the vagaries of the mood and usually interpreted by adults as simple stubbornness. Self-esteem is sincere. Emotionally labile adolescents are well aware of the peculiarities of their character, they know that they are “mood people” and that everything depends on their mood. Giving a report to weaknesses of their nature, they do not try to hide or obscure anything, but, as it were, offer others to accept them as they are. In the way others relate to them, they reveal surprisingly good intuition, immediately, with nerve contact, feeling who is disposed towards them, who is indifferent, and in whom there is at least a drop of hostility or hostility. The reciprocal attitude arises immediately and without attempts to conceal it.

Histrionic Personality Disorder manifested by egocentrism, the desire to appear in their own eyes and in the eyes of others better and more significant than it really is. The desire to attract attention is manifested in theatricality, demonstrative emotional reactions, posturing. Such persons strive to be constantly in the center of attention of others, therefore they are always emotionally animated, tend to imitate the behavior and facial expressions of persons significant to them, to fantasy and pseudology. In a subjectively unfavorable or uncomfortable situation, they easily have affective reactions with sobs, expressive gestures, acting out scenes, often with hysterical seizures, breaking dishes, and threats of suicide. But true suicidal attempts of this type of lime are very rare. The manifestations of hysterical psychopathy in some cases are more complex and are characterized by more vivid polymorphic fantasies, an altered idea of ​​the real situation and one's place in it, the appearance of brightly colored visions that reflect the psychogenic situation. In other cases, hysterical disorders are more elementary and are expressed in hysterical paralysis, paresis, an unexpected feeling of suffocation (“lump in the throat”), blindness, deafness, gait disorders (astasia-abasia), hysterical fits. All these violations are transient, occur in traumatic situations and disappear against the background of the normalization of the real situation. But hysterical forms of response tend to consolidate over time and later appear in the form of a cliché that determines the characteristics of behavior.

According to ICD-10, for the diagnosis of hysterical personality disorder, it is necessary to identify the following grounds:

Self-dramatization, theatricality, exaggerated expression of emotions;

Suggestibility, slight influence surroundings or circumstances;

Superficiality and lability of emotionality;

Constant desire for excitement, recognition from others and activities in which the person is in the spotlight;

Inadequate seductiveness in appearance and behavior;

Excessive preoccupation with physical attractiveness.

Anancastic personality disorder from childhood, it manifests itself insignificantly and is limited to timidity, timidity, motor awkwardness, a tendency to reasoning and early "intellectual interests". Sometimes already in childhood obsessive phenomena are found, especially phobias - fear of strangers and new objects, darkness, fear of being behind a locked door, etc. Less often, one can observe the appearance of obsessive actions, neurotic tics, etc. The critical period when the anancaste character is revealed as fully as possible is the first grades of the school. During these years, a serene childhood is replaced by the first requirements for a sense of responsibility. Such demands represent one of the most sensitive blows to the psychasthenic character. Upbringing in conditions of "increased responsibility", when parents impose non-childish cares for the supervision and care of younger children or helpless old people, the position of the eldest among children in difficult material and living conditions contributes to the formation of psychasthenia.

The main features of personality disorder according to the anancaste type in adolescence are indecisiveness and a tendency to reasoning, anxious suspiciousness, love of introspection and, finally, the ease of formation of obsessions - obsessive fears, fears, actions, rituals, thoughts, ideas. The anxious suspiciousness of the anancaste adolescent differs from similar features of the astheno-neurotic and sensitive types. If the astheno-neurotic type is characterized by fear for one's health (the hypochondriacal orientation of suspiciousness and anxiety), and the sensitive type is characterized by anxiety about attitudes, possible ridicule, gossip, unfavorable opinions of others about oneself (relative orientation of suspiciousness and anxiety), then the fears of a person with the anancaste structure of the personality is entirely addressed to the possible, even unlikely in the future (futuristic orientation). No matter how terrible and irreparable something happens, no matter how some unforeseen misfortune happens to them themselves, and even worse - with those close to whom they find pathological attachment. The dangers are real and the hardships that have already happened are much less frightening. Adolescents are especially characteristic of anxiety for their mother - no matter how she falls ill and dies, although her health does not inspire any fear in anyone, no matter how she gets into a disaster, does not die under transport. If the mother is late from work, delayed somewhere without warning, the psychasthenic teenager does not find a place for himself. Specially invented signs and rituals become protection from constant anxiety for the future. Another defense is specially developed pedantry and formalism. Indecisiveness and reasoning in an anancaste teenager go hand in hand. Such teenagers are strong in words, but not in actions. Any independent choice, no matter how insignificant it may be, for example, which movie to go to see on Sunday, can be the subject of long and painful hesitation. However, already decision must be executed immediately. Persons with an anancaste personality structure do not know how to wait, showing amazing impatience. They often have to see an overcompensation reaction in relation to their indecision and tendency to doubt. This reaction is manifested by self-confident and peremptory judgments, exaggerated decisiveness and hasty action at times when unhurried prudence and caution are required. The resulting setbacks further increase indecision and doubt.

According to ICD-10, anancaste personality disorder is diagnosed when the following signs are identified:

Excessive tendency to doubt and caution;

Preoccupation with details, rules, lists, order, organization, or schedules;

Perfectionism (striving for perfection), preventing the completion of goals and objectives;

Excessive conscientiousness, scrupulousness, and inappropriate preoccupation with productivity to the detriment of pleasure and interpersonal relationships;

Increased pedantry and adherence to social conventions;

Rigidity and stubbornness;

Unreasonably insisting that others do everything exactly as they do, or an unreasonable unwillingness to allow others to do anything;

The appearance of unstable and unwanted thoughts and desires.

Anxious (avoidant, avoidant) personality disorder from childhood it is manifested by fearfulness and timidity. Such children are often afraid of the dark, shun animals, afraid to be alone. They shun too lively and noisy peers, do not like overly mobile and mischievous games, risky pranks, avoid large children's companies, feel timidity and shyness among strangers, in a new environment and are generally not inclined to easy communication with strangers. All this sometimes gives the impression of isolation, isolation from the environment and makes one suspect autistic tendencies inherent in schizoids. However, with those to whom these children are accustomed, they are quite sociable. They often prefer games with kids to their peers, feeling more confident and calmer among them. The early interest in abstract knowledge, "children's encyclopedia", characteristic of schizoids, also does not appear. Many willingly prefer quiet games, drawing, modeling to reading. To relatives, they sometimes show extreme affection, even with a cold attitude or harsh treatment on their part. They are distinguished by obedience, often reputed to be a "home child". The school frightens them with a crowd of peers, noise, fuss, fuss and fights during breaks, but, getting used to one class and even suffering from some classmates, they are reluctant to move to another team. They usually study hard. They are afraid of all kinds of control, checks, exams. Often they are embarrassed to answer in front of the class, afraid to stumble, cause laughter, or, conversely, they answer much less than they know, so as not to be considered an upstart or an overly diligent student among classmates. The onset of puberty usually passes without any complications. Difficulties in adaptation often occur at the age of 16-19. It is at this age that both main qualities of the sensitive type, noted by P. B. Gannushkin, appear - "extreme impressionability" and "a pronounced sense of one's own insufficiency."

The reaction of emancipation in anxious adolescents is rather weakly expressed. Children's attachment to relatives remains. The guardianship of elders is not only tolerated, but even willingly obeyed. Reproaches, lectures and punishments from relatives, rather, cause tears, remorse and even despair than the protest usually characteristic of adolescents. A sense of duty, responsibility, high moral and ethical requirements are formed early on both to others and to oneself. Peers are horrified by rudeness, cruelty, cynicism. In itself, many shortcomings are seen, especially in the field of moral, ethical and volitional qualities. The source of remorse in male adolescents is often the onanism so frequent at this age. There are self-accusations of "vileness" and "lechery", cruel reproaches for the inability to refrain from addiction. Masturbation is also attributed to its own weakness in all areas, timidity and shyness, failure in studies due to allegedly weakening memory or thinness, sometimes characteristic of a period of growth, disproportionate physique, etc. The feeling of inferiority in anxious adolescents makes the reaction of hypercompensation especially pronounced. They seek self-affirmation not away from the weak points of their nature, not in areas where their abilities can be revealed, but precisely where they especially feel their inferiority. Girls tend to show their cheerfulness. Timid and shy boys put on the guise of swagger and even deliberate arrogance, trying to show their energy and will. But as soon as the situation unexpectedly requires bold determination, they immediately give up. If it is possible to establish trusting contact with them and they feel sympathy and support from the interlocutor, then behind the sleeping mask “nothing at all” turns out to be a life full of reproaches and self-flagellation, subtle sensitivity and exorbitantly high demands on oneself. Unexpected participation and sympathy can change arrogance and bravado into violent tears. Due to the same reaction of hypercompensation, adolescents with this type of personal constitution find themselves in public positions (headmen, etc.). They are put forward by educators attracted by obedience and diligence. However, they are only enough to carry out the formal side of the function entrusted to them with great personal responsibility, but informal leadership in such teams goes to others. The intention to get rid of timidity and weak-willedness pushes the boys to engage in power sports: wrestling, dumbbell gymnastics, etc.

According to ICD-10, the diagnosis of this type of personality disorder is possible if the following manifestations are detected:

Constant general feeling of tension and heavy forebodings;

Ideas about their social incapacity, personal unattractiveness and humiliation in relation to others;

Increased preoccupation with criticism or rejection in social situations;

Reluctance to enter into a relationship without guarantees to please;

Limited lifestyle due to the need for physical security;

Avoidance of social or professional activities that involve significant interpersonal contact due to fear of criticism, disapproval, or rejection.

Hyperthymic type of personality disorder described in detail by K. Schneider (1923) and P. B. Gannushkin (1933) in adults and G. E. Sukhareva (1959) in children and adolescents. P. B. Gannushkin gave this type the name “constitutionally excited” and included it in the group of cycloids. Information from relatives indicates that since childhood, hyperthymic adolescents are distinguished by great mobility, sociability, talkativeness, excessive independence, a penchant for mischief, and a lack of a sense of distance in relation to adults. From the first years of life, they make a lot of noise everywhere, love the company of their peers and strive to command them. Educators of children's institutions complain about their restlessness. The first difficulties may come to light when entering school. With good abilities, a lively mind, the ability to grasp everything on the fly, restlessness, distractibility, and indiscipline are revealed. Therefore, they study very unevenly - they will flash with fives, then they will grab twos. The main feature of hyperthymic adolescents is almost always a very good, even high spirits. Only occasionally and for a short time this sunshine is overshadowed by outbursts of irritation, anger, aggression.

The good mood of hyperthymic adolescents is in harmony with good health, high vitality, often blooming appearance. They always have a good appetite and healthy sleep. The reaction of emancipation is especially pronounced, because of this, conflicts easily arise with parents, teachers, educators, petty control, daily guardianship, instructions and moralizing, “study” in the family and in public meetings lead to them. All this usually only causes an intensification of the "struggle for independence", disobedience, deliberate violation of rules and regulations. Trying to escape from the care of the family, hyperthymic adolescents willingly leave for camps, go on hiking trips, etc., but even there they soon come into conflict with the established regime and discipline. As a rule, a tendency to unauthorized absences, sometimes prolonged, is found. True escapes from the house in hyperthyms are rare. The grouping reaction takes place not only under the sign of constant attraction to peer companies, but also the desire for leadership in these companies. An irrepressible interest in everything around makes hyperthymic teenagers illegible in choosing acquaintances. Contact with random strangers is not a problem for them. Rushing to where "life is in full swing", they can sometimes find themselves in an unfavorable environment, fall into an asocial group. Everywhere they quickly master, adopt manners, customs, behavior, clothes, fashionable hobbies. Alcoholization represents for hyperthyms serious danger from adolescence. They drink in company with friends, prefer shallow euphoric stages of intoxication, but easily get on the path of frequent and regular drinking. The hobby reaction differs in hyperthymic adolescents by the richness and variety of manifestations, but most importantly, by the extreme inconstancy of the hobby. Collections are replaced by games of chance, one sports hobby is replaced by another, one circle changes to another, boys often pay a fleeting tribute to technical hobbies, girls - to amateur performances. Accuracy is by no means their distinguishing feature either in their studies, or in the fulfillment of promises, or, which is especially striking, in money matters. They do not know how to calculate and do not want to, they willingly borrow, pushing aside the unpleasant thought of subsequent retribution. Always a good mood and high vitality create favorable conditions for reassessing one's abilities and capabilities. Excessive self-confidence encourages "to show oneself", to appear before others in a favorable light, to brag. But they are characterized by sincerity of enthusiasm, real self-confidence, and not a strained desire to “show themselves more than they really are,” like real hysteroids. Deceit is not theirs feature, it may be due to the need to dodge in a difficult situation. Self-assessment of hyperthymic adolescents is characterized by sufficient sincerity.

Hyperthymia-unstable variant psychopathization is the most frequent. Here, the thirst for entertainment, fun, risky adventures increasingly comes to the fore and pushes to the neglect of classes and work, to alcoholism and drug use, to sexual excesses and delinquency, which ultimately can lead to an asocial lifestyle. The decisive role in the fact that hyperthymic-unstable psychopathy grows out of hyperthymic accentuation is usually played by the family. Both excessive guardianship - hyperprotection, petty control and cruel dictate, and even combined with the dysfunction of intra-family relations, and hypo-custody, neglect can serve as incentives for the development of hyperthymic-unstable psychopathy.

Hyperthymno-asteroid variant occurs much less frequently. Against the background of hyperthymia, hysteroid features gradually emerge. When faced with life's difficulties, in case of failures, in desperate situations and with the threat of serious punishments, there is also a desire to pity others (up to demonstrative suicidal actions), and to impress with their originality, and to brag, “splurge”. Perhaps the environment also plays an important role in the development of this type. Upbringing according to the “idol of the family” type (Gindikin, 1961), indulgence in childhood whims, an excess of praise about imaginary and real abilities and talents, the habit of always being in sight, created by parents, and sometimes by the wrong actions of educators, cause difficulties in adolescence which may prove to be insurmountable.

Hyperthymia-affective variant psychopathization is characterized by an increase in the features of affective explosiveness, which will create a resemblance to explosive psychopathy. Outbursts of irritation and anger, often characteristic of hyperthyms, when they meet opposition or fail, here they become especially violent and arise at the slightest provocation. At the height of affect, control over oneself is often lost: abuse and threats break out without any regard for the situation, in aggression own forces are not commensurate with the forces of the object of attack, and resistance can reach "violent frenzy." All this usually allows us to talk about the formation of an excitable type of psychopathy. This concept, it seems to us, implies a very combined group. The similarity of hyperthymic affectivity with the explosiveness of epileptoids remains purely external: there is a great forbearance, a tendency to easily forgive insults and even be friends with those with whom you have just been in a quarrel. Other epilentoid features are also absent. Perhaps, in the formation of this variant of psychopathization, craniocerebral injuries, which are not so rare in boys of the hyperthymic type, can play a significant role.

Disorders of the dependent personality type are manifested from childhood by restless sleep and poor appetite, capriciousness, shyness, tearfulness, sometimes night terrors, nocturnal enuresis, stuttering, etc. The main features of an addicted person are fatigue, irritability and a tendency to ppochondria. Fatigue is especially evident in mental activities. Moderate physical exercise are better tolerated, but physical stress, such as the atmosphere of sports competitions, is unbearable. The irritability of dependent persons differs significantly from the anger of epileptoids and the irascibility of hyperthyms and is most of all similar to affective outbursts in adolescents of the emotionally labile type. Irritation, often for an insignificant reason, easily pours out on others, sometimes accidentally falling under a hot hand, and is just as easily replaced by repentance and even tears. Unlike epileptoids, affect does not differ either in gradual boiling, or in strength, or in duration. In contrast to the irascibility of hyperthyms, the reason for outbreaks is not necessarily the opposition encountered, the affect also does not reach violent fury. The tendency to ppochondrization is a particularly typical feature. Such teenagers carefully listen to their bodily sensations, are extremely susceptible to iatrogenic, willingly treated, put to bed, and undergo examinations. The most common source of hypochondriacal experiences, especially in boys, is the heart. Delinquency, running away from home, alcoholism and other behavioral disorders are not typical for addicted teenagers. But this does not mean that they do not have specific adolescent behavioral responses. The desire for emancipation or the craving for grouping with peers, not receiving direct expression due to asthenia, fatigue, etc., can gradually warm up unmotivated outbursts of irritation towards parents, educators, elders in general, induce parents to accuse parents of what their health little attention is paid, or to generate dull dislike for peers in whom specifically adolescent behavioral reactions are expressed directly and openly. Sexual activity is usually limited to short and rapidly exhausting bursts. They are drawn to peers, miss their company, but quickly get tired of them and look for rest, loneliness or company with a close friend. The self-esteem of addicted adolescents usually reflects their hypochondriacal attitudes. They note the dependence of a bad mood on feeling unwell, poor sleep at night and drowsiness during the day, weakness in the morning. In thinking about the future, the central place is occupied by concerns about one's own health. They are also aware that fatigue and irritability dampen their interest in the new, make intolerable criticism and objections that constrain their rules. However, not all features of the relationship are noted well enough.

According to ICD-10, for the diagnosis of a dependent personality type, it is necessary to identify the following signs:

The desire to shift to others most of the important decisions in your life;

Submission of one's own needs to the needs of other people on whom they depend, and inadequate compliance with their desires;

Unwillingness to make even reasonable demands on people on whom this person is dependent;

Feeling uncomfortable or helpless in solitude due to excessive fear of being unable to live independently;

Fear of being abandoned by a person with whom there is a close connection, and being left to oneself;

Limited ability to make day to day decisions without increased advice and encouragement from others.

Types of personality disorder in children

The pathocharacterological properties that unite this group of personality disorders are impulsivity with a pronounced tendency to act without regard for the consequences and lack of self-control, combined with mood instability and violent affective outbursts that occur at the slightest pretext. There are two types of this variant of personality disorders - impulsive and borderline.

impulsive type corresponds excitable psychopathy. Psychopathy of this type, as E. Kraepelin points out, is characterized by unusually strong emotional excitability. Its initial manifestations are found even in preschool age. Children often scream and get angry. Any restrictions, prohibitions and punishments cause them violent reactions of protest with malice and aggression. In the lower grades, these are “difficult” children with excessive mobility, unbridled pranks, capriciousness and touchiness. Along with irascibility and irritability, they are characterized by cruelty and gloom. They are vindictive and quarrelsome. Early revealed tendency to a gloomy mood is combined with periodic short-term (2-3 days) dysphoria. In communicating with their peers, they claim leadership, try to command, establish their own rules, which often causes conflicts. Most of the time they are not interested in learning. They are not always kept at school or vocational schools, and once they start working, they soon leave.

The formed psychopathy of the excitable type is accompanied by bouts of anger, rage, affective discharges, sometimes with an affectively narrowed consciousness and a sharp motor excitation. In temper (especially easily occurring during alcoholic excesses), excitable individuals are able to commit rash, sometimes dangerous actions. In life, these are active, but incapable of long-term purposeful activity, uncompromising, tough people, with vindictiveness, with viscosity of affective reactions. Among them, there are often people with disinhibition of drives, prone to perversions and sexual excesses.

Subsequent dynamics excitable psychopathy, as shown by the works of V. A. Gurieva and V. Ya. Gindikin (1980), is heterogeneous. At favorable course psychopathic manifestations are stabilized and even relatively fully compensated, which is largely facilitated by positive influences environment and necessary educational activities. Behavioral disturbances in such cases by the age of 30-40 are significantly smoothed out, and emotional excitability gradually decreases. However, a different dynamic is possible with a gradual increase in psychopathic features. Disorderly life, inability to restrain impulses, joining alcoholism, intolerance to any restrictions, and finally, a tendency to violent affective reactions serve in such cases as the causes of a long-term violation of social adaptation. In the most severe cases, acts of aggression and violence committed during affective outbursts lead to a collision with the law.

The borderline type has no direct analogues in the domestic systematics of psychopathy, although in some personal parameters it is comparable to an unstable type of psychopathy. Borderline personality disorder overlaps with other personality disorders - primarily hysterical, narcissistic, dissocial, needs to be differentiated from schizotypal disorder, schizophrenia, anxiety-phobic and affective disorders (see description of the dynamics of borderline personality disorder).

The borderline personality is distinguished by increased impressionability, affective lability, vividness of imagination, mobility of cognitive processes, constant "inclusion" in events related to the sphere of current interests or hobbies, extreme sensitivity to obstacles on the way to self-realization, functioning at the maximum of possibilities. Difficulties in the sphere of interpersonal relations, especially the situation of frustration, are also perceived sharply. The reactions of such subjects even to trivial events can acquire an exaggerated, demonstrative character. As emphasized by M. Smiedeberg (1959), they too often experience those feelings that are usually found only in a stressful situation.

Initial pathological manifestations ( emotional lability, suggestibility, a tendency to fantasies, a quick change of hobbies, instability of relationships with peers) are found already in adolescence. These children ignore school rules and parental prohibitions. Despite good intellectual abilities, they do not do well, because they do not prepare for classes, get distracted in class, and reject any attempts to regulate their daily routine.

To distinctive features borderline personalities include the lability of self-esteem, the variability of ideas about both the surrounding reality and one's own personality - a violation of self-identification, the inconstancy of life attitudes, goals and plans, the inability to resist the opinions of others. Accordingly, they are suggestible, susceptible to external influences, easily adopt forms of behavior not approved by society, indulge in drunkenness, take stimulants, drugs, they can even acquire criminal experience, commit an offense (most often we are talking about petty fraud).

psychopaths border type easily fall into dependence on other, sometimes unfamiliar people. Approaching, they quickly form a complex structure of relationships with excessive subordination, hatred or adoration, the formation of overvalued attachments; the latter serve as a source of conflict and suffering associated with the fear of separation and impending loneliness, and may be accompanied by suicidal blackmail.

The life path of borderline individuals seems to be very uneven, replete with unexpected turns in the social route, family status. Periods of relative calm are replaced by all sorts of collisions; transitions from one extreme to another are easy - this is a sudden love that overcomes all obstacles, ending with an equally sudden break; and passion for a new business with objectively high professional success, and a sudden abrupt change places of work after a minor industrial conflict; it is also wanderlust leading to relocation and progression. However, despite all the upheavals of life, these people do not lose their sanity when in trouble, they are not as helpless as they might seem, they can find an acceptable way out of the situation at the right time. The "zigzags" of behavior inherent in most of them do not prevent a fairly good adaptation. Easily adapting to new circumstances, they retain their ability to work, find work, and rebuild their lives.

Within the framework of the dynamics of borderline personality disorder, phases that are erased, not accompanied by manifest affective symptoms, are observed, unfolding mainly in the autopsychic sphere. Long periods rise with increased activity, a sense of optimal intellectual functioning, a heightened perception of the surrounding life can be replaced (most often due to psychogenic or somatic - pregnancy, childbirth, intercurrent illness - provocation) dysthymic phases. In these cases, complaints about a decrease in mental capabilities, a feeling of incompleteness of feelings and cognitive functions, and in more severe cases, the phenomena of mental anesthesia are brought to the fore in the clinical picture in these cases.

Among other pathological reactions, judging by the descriptions of J. G. Gunderson, M. Singer (1965), Ch. Perry, G. Kjerman (1975), J. Modestine (1983), in borderline disorders, psychogenically provoked transient outbreaks with mottled clinical picture, including, along with affective, dissociative hysterical, poorly systematized delusional disorders. Although these psychopathological manifestations ("minipsychoses"), as a rule, are quickly reduced, their nosological qualification is fraught with difficulties. First of all, it is necessary to exclude schizophrenia, affective and schizoaffective psychoses.

The criteria that reduce the validity of the diagnosis of an endogenous disease are such features of "minipsychoses" as psychogenic provocation, transient nature, complete reversibility in the absence of a tendency to systematization and chronification.

Pathologies related to human activity in the mental plane include a personality disorder, the symptoms of which can only be determined with a detailed acquaintance with the disease. To understand what kind of condition it is, you need to pay attention to the behavior of the patient and, if they are detected, consult a doctor. Better yet, take preventive measures to eliminate a serious disease.

Mental illness is a whole cluster of disorders to which the ailment we are describing is directly related. To understand more competently in this matter, you need to start with the usual examples for us. Let's start with the fact that each of us is an individual with a certain, normal type of thinking, perception of reality, environment, attitude to various situations, time, space, etc. As soon as it comes teenage years, until recently, an unintelligent child is already able to show his personal character traits, has his own style of behavior. Despite the fact that with age certain features are activated or fade away, they still accompany a person until the last moment of life. But this is an example ordinary person not suffering from mental illness. In the case of a patient, a personality disorder is a rigidity, maladaptation of traits that cause a malfunction in its functioning. Sick people from time to time undergo psychological protection for no reason or irritating factors, which is why such people remain maladaptive, with an immature type of thinking, and so on, almost all their lives.

According to international standards, there is a code "Personality disorder microbial 10", since the problem affects all areas of human life, and only experienced specialist is able to identify ten types of disorders, three specific clusters of illness, based on clinical indicators.

Personality disorder affects all areas of human life

Personality disorder: symptoms and signs

Let us first study the signs of mental deviation. A person with a disorder may long time hide their features, which is called frustration in medicine and at certain moments show their anger, aggression towards others. A large number of patients are worried about their lives, they almost always have problems with employees, relatives, friends. Pathology is often accompanied by mood swings, anxiety, panic attacks, excessive intake of psychotropic, sedative drugs, moreover, there is a failure in eating behavior.

Important: experts pay attention to the fact that in severe forms of the disease, a person can fall into deep hypochondria, is capable of violent actions, self-destructive actions.

In the family, the patient can behave very contradictory, be too emotional, tough or conniving, allow family members anything that leads to the development of somatic and physical pathologies in children.

For reference: studies have shown that approximately 13% of the total population of the planet suffers from PD, and the pathology of an antisocial nature is more common among men than among women (ratio 6 to 1), the borderline condition is more common in women (ratio 3 to 1).

Symptoms of personality deviations

Provoking factors of the disease can occur in childhood, adolescence. At first, they can definitely be considered, but with the stage of growing up, already in the future life, there is no specific delineation. The manifestation of signs is not observed in specific aspects, but relates to all spheres of human activity - emotional, mental, interpersonal, volitional. The main symptoms of the disease include:

• pathology in the character manifests itself totally: at work, at home, among friends;
• pathology in the personality remains stable: it begins in childhood and pursues all life;
• due to problems with behavior, character, etc., social maladjustment occurs, regardless of the attitude of the environment.

Personality disorder can be identified by a number of symptoms

Personality disorder: types

According to the psychoanalytic classification, doctors distinguish a number of disorders and the most characteristic of them are:

socialized conduct disorder

In this case, a person (a child, a teenager and older) seeks to draw the attention of others with their inconsistency with generally accepted social norms of behavior. Persons with such a pathology always have a certain charm, special manners, strive to impress others. Their main character trait is to receive benefits without investing any physical effort. Literally from childhood, they are accompanied by a continuous series of wrong deeds: absenteeism from school, running away from the garden, at home, constant lies, fights, joining gangs, criminal groups, theft, drug use, alcohol, manipulation of loved ones. The peak of pathology most often falls on the pubertal period from 14 to 16 years.

Unsocialized conduct disorder

This type of behavior is accompanied by persistent dissociation, aggression, disruption of relationships with peers and relatives. Domestic psychiatry calls the type "deviant", the symptoms of which are manifested:

• Affective excitability - irritability, fits of anger, aggression (fights, humiliation, insults) predominate in the character. With prohibitions and restrictions, a protest reaction arises - refusal to attend school, teach lessons, etc.
• Mental instability - excessive suggestibility, dependence on the pleasures received from external conditions, a tendency to deceive.
• Violation of desires - vagrancy, running away from home, aggression, sadistic inclinations, violation of sexual behavior (preversion).
• Impulsive-epileptoid - a tendency to protracted outbursts of affective behavior, a long exit from a state of anger, revenge, stubbornness.

Personality disorder of organic etiology

Psychopathy is an organic disorder that occurs as a result of past illnesses brain:

• traumatic brain injury;
• infectious diseases: encephalitis, meningitis;
• excessive alcohol consumption;
• taking drugs;
• abuse of psychotropic drugs;
• neoplasms in the brain;
• atherosclerosis, diabetes, hypertension;
• autoimmune pathologies;
• powerful intoxication.

According to experts, the disorder often becomes a companion of epilepsy, approximately 10% of the total number of patients suffer from mental disorders.

Important: the listed provoking factors can cause serious damage to the human psyche, so it is necessary to consult a doctor in time for adequate treatment in order to prevent mental disorders.

seasonal personality disorder

Many of us are familiar seasonal depression, especially in those times of the year when there is little sun, it rains, the sky is overcast. But do not confuse this state with affective human behavior, repeated at certain times of the year. In persons with SAD, the problem also occurs due to a lack of sunlight, the main supplier of the hormone of cheerfulness, joy, and energy. But at the same time, they absolutely cannot cope with a behavior disorder, which is expressed in such signs as:

• long sleep;
• feeling of brokenness;
• desire to sleep during the daytime;
• earlier awakening;
• low mood;
• drop in self-esteem;
• feeling of hopelessness, despair;
• tearfulness;
• inability to cope with everyday activities, activities;
• irascibility;
• attacks of aggression, anger, irritability;
• tension, anxiety.

At affective disorder it is difficult for a seasonal person to endure any stress, even minor troubles, he does not control not only social, but also food, sexual behavior, which leads to weight gain, sexual problems.

Tearfulness is one of the symptoms of a personality disorder.

Pathology can occur at any age, but more often it affects people aged 18 to 30 years.

Personality and behavior disorder in adulthood

In this case, the pathology can be expressed in different ways, it all depends on what clinical manifestations accompany a person throughout life. matter individual characteristics personality, how his relationship with others developed. Many signs are acquired not only at an early age, but also in later stages. Symptoms such as mixed, long-lasting, refer to protracted and deeply rooted behaviors, as a person managed to survive a lot of serious situations, and the psyche developed a response.

A factor in the development of disorders in venerable age there are also a number of diseases inherent in the aging body.

Important: a personality disorder is a very serious diagnosis, and for it you can miss a more dangerous illness - schizophrenia, so you need to urgently contact a specialist and undergo a thorough examination.

Personality disorder and work

For persons with PD of certain types, it is necessary to select work taking into account the characteristics of behavior. With the right choice, work helps a person to realize himself, adapt with society, meet financial needs, and most importantly, switch from frustration to more positive activities. Employment includes several stages:

1. Protected- the patient works under the constant supervision of a doctor or a social worker, the work is simplified, the mode is sparing.
2. Transition- work with the usual mode, but the control by the social worker or doctor continues.
3. General grounds- work on usual place, with in-house training, control is maintained.

Not a single specialist will give universal recommendations regarding the employment of a person with PD. It all depends on individual abilities and the severity of the symptoms of the disease.

Work and labor are not at all prohibited in personality disorders, but, on the contrary, are shown

With complex forms of disorders, doctors do not recommend getting a job, attending educational institutions until effective treatment has been completed and the diagnosis has been eliminated.

How to Treat a Personality Disorder

To eliminate symptoms such as anxiety, panic, depression and others, medication is being taken. The number of drugs includes psychotropic, neuroleptic drugs, serotonin inhibitors. Risperidone is used to exclude depresonalization.

Psychotherapy is aimed at correcting inadequate signs, but it is worth remembering that the treatment will be lengthy. The cognitive-behavioral method allows the patient to pay attention to his behavior, and not the consequences caused by his actions. The specialist can force the patient to obey his orders, for example, stop screaming, speak quietly, calmly, control himself during the moments of attacks. Of no small importance is the participation of relatives of the patient, who should also know the diagnosis of "personality disorder", what it is, communicate with a specialist and develop a certain demeanor. Positive results can be expected after 5-6 months of continuous exposure to the patient. The optimal duration of treatment is from 3 years.

How to be diagnosed with a personality disorder

In Russia, free medical and advisory assistance is provided to people with PD. There is no record of patients with this diagnosis, as in the past. After appropriate treatment, patients are under dynamic examination in the dispensary for some time, that is, it is necessary to visit doctors within six months. To remove the diagnosis is mainly sought by persons wishing to find a job as a driver, security guard. If the patient does not visit a doctor for five years, then his card is transferred to the medical archive, from where it can be claimed by law enforcement agencies, the personnel department, etc.

Removal of the diagnosis is possible after a successful treatment course

It is theoretically possible to remove the diagnosis only after 5 years, but only if the patient has been under observation for a year, and the doctor canceled medical therapy. For premature removal of the diagnosis, it is necessary to contact a psychiatric clinic, undergo an examination, and obtain the approval of the commission. Some people with PD, feeling completely healthy, are confident in the positive decision of doctors, but the latter, in turn, may draw the opposite conclusion.

Our society consists of completely different, dissimilar people. And this can be seen not only in appearance - first of all, our behavior is different, our reaction to life situations, especially stressful ones. Each of us - and probably more than once - has come across people with, as the people say, whose behavior does not fit into generally accepted norms and often causes condemnation. Today we will look at mixed personality disorder: the limitations that this ailment entails, its symptoms and methods of treatment.

If there is a deviation from the norm in a person's behavior, bordering on inadequacy, psychologists and psychiatrists consider this a personality disorder. There are several types of such disorders, which we will discuss below, but most often diagnosed (if this definition can be considered a true diagnosis) is mixed. As a matter of fact, this term is appropriate to use in cases where the doctor cannot attribute the patient's behavior to a certain category. Practitioners notice that this is observed very often, because people are not robots, and it is impossible to single out pure types of behavior. All personality types known to us are relative definitions.

Mixed Personality Disorder: Definition

If a person has disturbances in thoughts, behavior and actions, he has a personality disorder. This group of diagnoses refers to mental. Such people behave inappropriately, they perceive stressful situations in a different way, in contrast to absolutely healthy mentally people. These factors cause conflicts at work and in the family.

For example, there are people who cope with difficult situations on their own, while others seek help; some tend to exaggerate their problems, others, on the contrary, downplay them. In any case, such a reaction is absolutely normal and depends on the nature of the person.

People who have mixed and other personality disorders, alas, do not understand that they have mental problems, so they rarely seek help on their own. Meanwhile, they really need this help. The main task of the doctor in this case is to help the patient understand himself and teach him to interact in society without harming himself or others.

Mixed personality disorder in ICD-10 should be searched under F60-F69.

This condition lasts for years and begins to manifest itself in childhood. At the age of 17-18, the formation of personality takes place. But since at this time the character is only being formed, such a diagnosis at puberty is incorrect. But in an adult, when the personality is fully formed, the symptoms of a personality disorder only worsen. And it's usually a type of mixed disorder.

In ICD-10 there is another heading - /F07.0/ "Personality disorder of organic etiology". It is characterized by significant changes in the habitual image of premorbid behavior. The expression of emotions, needs and drives is especially affected. Cognitive activity may be reduced in the area of ​​planning and anticipation of consequences for oneself and society. The classifier contains several ailments in this category, one of them is personality disorder due to mixed diseases(eg depression). Such a pathology accompanies a person all his life if he does not know about his problem and does not fight it. The course of the disease is undulating - there are periods of remission, during which the patient feels excellent. Transient-mixed personality disorder (that is, short-term) is quite common. However, concomitant factors in the form of stress, alcohol or drug use, and even menstruation can cause a relapse or worsening of the condition.

Aggravated personality disorder can lead to grave consequences including causing physical harm to others.

Causes of Personality Disorder

Personality disorders, both mixed and specific, usually occur on the background of brain injuries as a result of falls or accidents. However, doctors note that both genetic and biochemical factors, as well as social ones, are involved in the formation of this disease. Moreover, the social plays a leading role.

First of all, this is the wrong parental upbringing - in this case, the character traits of a psychopath begin to form in childhood. In addition, none of us understands how destructive stress really is for the body. And if this stress is excessively strong, it can later lead to a similar disorder.

Sexual abuse and other traumas of a psychological nature, especially in childhood, often lead to a similar result - doctors note that about 90% of women with hysteria in childhood or adolescence were raped. In general, the causes of pathologies that are designated in the ICD-10 as personality disorders due to mixed diseases should often be sought in the patient's childhood or adolescence.

How do personality disorders manifest?

People with personality disorders usually have accompanying psychological problems - they turn to doctors for depression, chronic tension, problems with building relationships with family and colleagues. At the same time, patients are sure that the source of their problems is external factors that are independent of them and beyond their control.

So, in people diagnosed with mixed personality disorder, the symptoms are as follows:

• problems with building relationships in the family and at work, as noted above;
• emotional disconnection, in which a person feels emotional emptiness and avoids communication;
• difficulties in managing their own negative emotions, which leads to conflicts and often even ends in assault;
• periodic loss of contact with reality.

Patients are dissatisfied with their lives, it seems to them that everyone around is guilty of their failures. It was previously believed that such an ailment was not treatable, but recently doctors have changed their minds.

Mixed personality disorder, the symptoms of which are listed above, manifests itself in different ways. It consists of a number of pathological features that are inherent in the personality disorders described below. So, let's look at these types in more detail.

Types of personality disorders

paranoid disorder. As a rule, such a diagnosis is made to arrogant people who are confident only in their point of view. Tireless debaters, they are sure that only they are always and everywhere right. Any words and actions of others that do not correspond to their own concepts, the paranoid perceives negatively. His one-sided judgments cause quarrels and conflicts. During decompensation, the symptoms intensify - paranoid people often suspect their spouses of infidelity, as their pathological jealousy and suspicion increase significantly.

Schizoid disorder. It is characterized by excessive isolation. Such people with the same indifference react to both praise and criticism. They are so cold emotionally that they are not able to show either love or hate to others. They are distinguished by an expressionless face and a monotonous voice. The world around for the schizoid is hidden by a wall of misunderstanding and embarrassment. At the same time, he has developed abstract thinking, a tendency to reflect on deep philosophical topics, and a rich imagination.

This type of personality disorder develops in early childhood. By the age of 30, the sharp corners of pathological features are somewhat aligned. If the patient's profession is associated with minimal contact with society, he successfully adapts to such a life.

dissocial disorder. A type in which patients have a tendency to aggressive and rude behavior, disregard for all generally accepted rules, and a heartless attitude towards relatives and friends. In childhood and puberty, these children do not find a common language in the team, often fight, behave defiantly. They run away from home. At a more mature age, they are deprived of any warm attachments, they are considered " difficult people”, which is expressed in the cruel treatment of parents, spouses, animals and children. This type is prone to commit crimes.

Expressed in impulsiveness with a hint of cruelty. Such people perceive only their opinion and their outlook on life. Small troubles, especially in everyday life, cause them emotional stress, stress, which leads to conflicts, which sometimes turn into assault. These individuals do not know how to assess the situation adequately and react too violently to ordinary life problems. At the same time, they are confident in their own significance, which others do not perceive, treating them with prejudice, as patients are sure.

hysterical disorder. Hysterics are prone to increased theatricality, a tendency to suggestibility and sudden mood swings. They love to be the center of attention, confident in their attractiveness and irresistibility. At the same time, they argue rather superficially and never take on tasks that require attention and dedication. Such people love and know how to manipulate others - relatives, friends, colleagues. TO mature age long-term compensation is possible. Decompensation can develop in stressful situations, during menopause in women. Severe forms are manifested by a feeling of suffocation, a coma in the throat, numbness of the limbs and depression.

Attention! A hysteric may have suicidal tendencies. In some cases, these are just demonstrative attempts to commit suicide, but it also happens that the hysteric, due to his tendency to violent reactions and hasty decisions, may quite seriously try to kill himself. That is why it is especially important for such patients to contact psychotherapists.

It is expressed in constant doubts, excessive caution and increased attention to the details. At the same time, the essence of the type of activity is missed, because the patient is only worried about the details in order, in lists, in the behavior of colleagues. Such people are sure that they are doing the right thing, and constantly make comments to others if they do something “wrong”. The disorder is especially noticeable when a person performs the same actions - shifting things, constant checks, etc. In compensation, patients are pedantic, accurate in their official duties, even reliable. But during the period of exacerbation, they have a feeling of anxiety, obsessive thoughts, fear of death. With age, pedantry and thrift develop into selfishness and stinginess.

Anxiety disorder is expressed in a feeling of anxiety, timidity, low self-esteem. Such a person is constantly worried about what impression he makes, tormented by the consciousness of his own far-fetched unattractiveness.

The patient is timid, conscientious, tries to lead a secluded life, because he feels safe in solitude. These people are afraid of offending others. At the same time, they are quite well adapted to life in society, since society treats them with sympathy.

The state of decompensation is expressed in poor health - lack of air, rapid heartbeat, nausea, or even vomiting and diarrhea.

Dependent (unsustainable) personality disorder. People with this diagnosis differ passive behavior. They shift all responsibility for decision-making and even for own life on others, and if there is no one to shift it to, they feel incredibly uncomfortable. Patients are afraid of being abandoned by people who are close to them, are distinguished by humility and dependence on other people's opinions and decisions. Decompensation manifests itself in a complete inability to control one's life in the event of the loss of a "leader", confusion, and a bad mood.

If the doctor sees pathological features inherent in different types of disorders, he makes a diagnosis of "mixed personality disorder".

The most interesting type for medicine is a combination of a schizoid and a hysteric. These people often develop schizophrenia in the future.

What are the consequences of mixed personality disorder?

1. Such deviations in the psyche can lead to a tendency to alcoholism, drug addiction, suicidal tendencies, inappropriate sexual behavior, hypochondria.
2. Improper upbringing of children due to mental disorders (excessive emotionality, cruelty, lack of a sense of responsibility) leads to mental disorders in children.
3. Mental breakdowns are possible when performing ordinary daily activities.
4. Personality disorder leads to other psychological disorders - depression, anxiety, psychosis.
5. impossibility full contact with a doctor or therapist due to distrust or lack of responsibility for their actions.

Mixed Personality Disorder in Children and Adolescents

Personality disorder usually manifests itself in childhood. It is expressed in excessive disobedience, antisocial behavior, rudeness. At the same time, such behavior is not always a diagnosis and may turn out to be a manifestation of a completely natural formation of character. Only if this behavior is excessive and persistent can one speak of a mixed personality disorder.

An important role in the development of pathology is played not so much by genetic factors as by upbringing and social environment. Eg, hysterical disorder can occur against the background of insufficient attention and participation in the life of the child by the parents. As a result, about 40% of children with conduct disorders suffer from it in the future.

Mixed Adolescent Personality Disorder is not considered a diagnosis. The disease can be diagnosed only after the puberty period is over - an adult already has a formed character that needs correction, but is not completely corrected. And during puberty, these behaviors are often the result of a "rebuild" that all teenagers go through. The main type of treatment is psychotherapy. Young people with severe mixed personality disorder in the stage of decompensation cannot work in factories and are not allowed into the army.

Personality Disorder Treatment

Many people who have been diagnosed with mixed personality disorder are primarily interested in how dangerous the condition is and whether it can be treated. For many, the diagnosis is made quite by accident, patients claim that they do not notice its manifestations behind them. Meanwhile, the question of whether it is treated remains open.

Psychiatrists believe that it is almost impossible to cure a mixed personality disorder - it will accompany a person throughout his life. However, doctors are confident that its manifestations can be reduced or even achieved stable remission. That is, the patient adapts to society and feels comfortable. At the same time, it is important that he wants to eliminate the manifestations of his illness and fully goes into contact with the doctor. Without this desire, therapy will not be effective.

Medications in the treatment of mixed personality disorder

If an organic personality disorder of mixed genesis is usually treated with drugs, then the disease we are considering is psychotherapy. Most psychiatrists believe that drug treatment does not help patients because it does not aim at changing the character, which patients mainly need.

However, you should not give up medicines so quickly - many of them can alleviate a person's condition by eliminating certain symptoms, such as depression, anxiety. At the same time, medications should be prescribed carefully, because patients with personality disorders very quickly develop drug dependence.

Antipsychotics play a leading role in drug treatment - taking into account the symptoms, doctors prescribe drugs such as Haloperidol and its derivatives. It is this drug that is most popular among doctors for personality disorders, as it reduces the manifestations of anger.

In addition, other drugs are prescribed:

• Flupectinsol successfully copes with suicidal thoughts.
• "Olazapine" helps with affective instability, anger; paranoid symptoms and anxiety; has a beneficial effect on suicidal tendencies.
• - mood stabilizer - successfully copes with depression and anger.
• "Lamotrigine" and "Topiromat" reduce impulsiveness, anger, anxiety.
• Amitriptine also treats depression.

In 2010, doctors were investigating these drugs, but the long-term effect is unknown, as there is a risk of side effects. At the same time, the National Institutes of Health in the UK in 2009 released an article stating that experts do not recommend prescribing medication if there is a mixed personality disorder. But in treatment concomitant diseases drug therapy can give a positive result.

Psychotherapy and mixed personality disorder

Psychotherapy plays a leading role in treatment. True, this process is lengthy and requires regularity. In most cases, patients within 2-6 years achieved stable remission which lasted at least two years.

DBT (dialectical - a technique that was developed by Marsha Linehan in the 90s. It is aimed mainly at treating patients who have experienced psychological trauma and cannot recover from it. According to the doctor, pain cannot be prevented, but suffering can be. Specialists help their patients to develop a different line of thinking and behavior, which will help to avoid stressful situations in the future and prevent decompensation.

Psychotherapy, including family therapy, is aimed at changing interpersonal relationships between the patient and his family and friends. Usually the treatment lasts about a year. It helps to eliminate distrust, manipulativeness, arrogance of the patient. The doctor looks for the root of the patient's problems, points them out to him. Patients with a syndrome of narcissism (narcissism and narcissism), which also refers to personality disorders, are recommended a three-year psychoanalysis.

Personality disorder and driver's license

Are the concepts of "mixed personality disorder" and "driving license" compatible? Indeed, sometimes such a diagnosis can prevent the patient from driving a car, but in this case, everything is individual. The psychiatrist must determine which types of disorders predominate in the patient and what their severity is. Only on the basis of these factors does the specialist make the final "vertict". If the diagnosis was made years ago in the army, it makes sense to visit the doctor's office again. Mixed personality disorder and a driver's license sometimes do not interfere with each other at all.

Limitations in the life of the patient

Patients usually do not have problems with employment in their specialty, and they interact with society quite successfully, although in this case everything depends on the severity of pathological features. If there is a diagnosis of "mixed personality disorder", the restrictions cover almost all areas of a person's life, since he is often not allowed to join the army and drive a car. However, therapy helps smooth out these sharp corners and live like a completely healthy person.

About 10% of people suffer from personality disorders (in other words, constitutional psychopathy). Pathologies of this kind are outwardly manifested by persistent behavioral disorders that adversely affect the life of the patient himself and his environment. Of course, not every person who behaves eccentrically or unusually for others is a psychopath. Deviations in behavior and character are considered pathological if they are traced from adolescence, extend to several aspects of life and lead to personal and social problems.

paranoid disorder

A person with paranoid personality disorder does not trust anyone or anything. He painfully perceives any contacts, suspects everyone of malevolence and hostile intentions, negatively interprets any actions of other people. We can say that he considers himself the object of a worldwide villainous conspiracy.

Such a patient is constantly dissatisfied or afraid of something. At the same time, he is aggressive: he actively accuses those around him of exploiting him, offending him, deceiving him, etc. Most of these accusations are not only unfounded, but also directly contradict the real state of affairs. A person suffering from a paranoid disorder is very vindictive: he can remember his real or imaginary grievances for years and settle scores with "offenders".

Obsessive Compulsive Disorder

An obsessive-compulsive personality is prone to absolute pedantry and perfectionism. Such a person does everything with exaggerated accuracy, strives to subordinate his life once and for all to established schemes. Any little thing, such as changing the arrangement of dishes on the table, can infuriate him or cause a tantrum.

A person suffering from obsessive-compulsive disorder considers his lifestyle to be absolutely correct and the only acceptable one, therefore he aggressively imposes such rules on others. At work, he interferes with his colleagues with constant nit-picking, and in the family he often becomes a real tyrant, not forgiving his loved ones even the slightest deviation from his ideal.

antisocial disorder

Antisocial personality disorder is characterized by the rejection of any rules of behavior. Such a person does not study well because of a lack of ability: he simply does not complete the tasks of the teacher and does not go to classes, because this is a prerequisite for learning. For the same reason, he does not come to work on time and ignores the instructions of his superiors.

The behavior of the antisocial type is not protest: a person violates all the norms in a row, and not just those that seem wrong to him. And he very quickly comes into conflict with the law, starting with petty hooliganism and damage or misappropriation of other people's property. Offenses usually have no real motivation: a person beats a passerby for no reason and takes his wallet without needing money. Those who suffer from antisocial disorder are not kept even in criminal communities - after all, they also have their own rules of conduct, which the patient is unable to follow.

Schizoid disorder

The schizoid personality type is characterized by a refusal to communicate. The person seems unfriendly, cold, detached to others. He usually does not have friends, does not contact anyone except his closest relatives, he chooses his work in such a way as to do it alone, without meeting people.

The schizoid shows little emotion, is equally indifferent to criticism and praise, and is practically not interested in sex. It is difficult to please a person of this type with something: he is almost always indifferent or dissatisfied.

schizotypal disorder

Like schizoids, people with schizotypal personality disorder avoid making friendships and family ties, preferring to be alone, but they have a different initial message. Individuals with schizotypal deviations are extravagant. They often share the most ridiculous superstitions, consider themselves psychics or magicians, can dress strangely and express their views in detail, artistically.

People with schizotypal disorder have a variety of fantasies, visual or auditory illusions that are almost unrelated to reality. Patients present themselves as the main actors events that have nothing to do with them.

hysteroid disorder

A person suffering from hysteroid personality disorder believes that he is deprived of the attention of others. He is ready to do anything to be noticed. At the same time, the hysteroid does not see a significant difference between real achievements worthy of recognition and scandalous antics. Such a person perceives criticism painfully: if he is condemned, he falls into rage and despair.

The hysteroid personality is prone to theatricality, pretentiousness of behavior, exaggerated demonstration of emotions. Such people are very dependent on other people's opinions, selfish and very indulgent to their own shortcomings. Usually they seek to manipulate loved ones, blackmail and scandals to get them to fulfill any of their whims.

narcissistic disorder

Narcissism manifests itself in the belief in unconditional superiority over other people. A person suffering from this disorder is confident in his right to universal admiration and demands worship from everyone he comes across. He is incapable of understanding other people's interests, empathy and a critical attitude towards himself.

Persons prone to narcissism constantly brag about their achievements (even if in reality they don’t do anything special), demonstrate themselves. The narcissist explains his any failure with envy of his success, with the fact that others are unable to appreciate him.

borderline disorder

This pathology is manifested in the extreme instability of the emotional state. A person instantly goes from joy to despair, from stubbornness to gullibility, from calmness to anxiety, and all this without real reasons. He often changes his political and religious beliefs, constantly offends his loved ones, as if deliberately pushing them away from him, and at the same time he is terribly afraid of being left without their support.

Borderline disorder means that the person will periodically become depressed. Such individuals are prone to repeated suicide attempts. Trying to console themselves, they often fall into drug or alcohol addiction.

avoidant disorder

A person suffering from avoidant disorder considers himself completely worthless, unattractive and unlucky. At the same time, he is very afraid that others will confirm this opinion, and as a result he avoids any communication (except for contacts with people who are guaranteed not to express a negative opinion), in fact, he hides from life: he does not meet anyone, tries not to take on new business, fearing that nothing will work out.

dependent disorder

A person with dependent personality disorder suffers from a completely unfounded belief in his own helplessness. It seems to him that without the advice and constant support of loved ones, he will not survive.

The patient completely subordinates his life to the requirements (real or imaginary) of those persons whose help he seems to need. In the worst case, a person cannot remain alone at all. He refuses to make independent decisions, requires advice and recommendations, even on trifles. In a situation where he is forced to show independence, the patient panics and begins to follow any advice, regardless of what result they may lead to.

Psychologists believe that the origins of personality disorders lie in childhood and youthful impressions, in the circumstances that accompanied a person for the first 18 years of his life. Over the years, the condition of such patients almost does not change. Personality disorders are not corrected with medication. These patients are treated using psychotherapeutic methods (family, group and individual sessions) and methods such as environmental therapy (living in special communities). However, the likelihood of improvement in the majority of patients is low: 3 out of every 4 people with personality disorders do not consider themselves sick and refuse to be diagnosed and treated by specialists.

Self-hatred - and no compromises. How do people with borderline personality disorder live?

Borderline personality disorder (BPD) is considered one of the most difficult mental disorders to treat.

The International Classification of Diseases identifies the following symptoms of BPD:

disorder of self-perception, goals and internal aspirations;

chronic feeling of emptiness;

tendency to get involved in tense and unstable interpersonal relationships

self-destructive behavior, including suicidal gestures and attempts.

Doesn't sound fun, right? The disorder is treated with difficulty, the main remedy is psychotherapy.

We talked to two newly diagnosed girls about their lives with BPD and asked a psychotherapist how to help such people.

Luba, 26, IT specialist, Germany

- How are you feeling now?

My condition is difficult to describe in one word. Actually, I have more than one mental illness. I have problems with borderline personality disorder and anorexia, otherwise I am stable - thanks to medication and psychotherapy.

Before the conversation, I asked you to express the essence of BPD in one phrase. Your answer is the inability to build relationships. How does it manifest itself?

I cannot be stable in any relationship: romantic, friendly, working. I cannot see everything in an adequate light, because I see only black and white. Either everything is great, or everything is very bad, and it changes instantly. If today I idealize a person and I develop an unhealthy dependence on him, then tomorrow it can go away at the snap of my fingers, because of nonsense: I said something wrong, I did something wrong - and immediately became enemy number one. Or it gets really boring. The first love passes, and when normal relationships begin for everyone, they end for me.

- Is chasing passions such a way to correct emotional instability?

No, rather, emotions are like drugs for us. People with BPD often use alcohol and drugs, are often addicted to adrenaline and other addictive things - we want to fill ourselves with some emotions, but not because you are unstable, but because you do not have these emotions. You feel the emptiness inside and shove everything there: different people, some activities, alcohol, etc.

- What type of therapy are you undergoing to adapt to BPD?

I am currently changing therapists. I am changing cognitive-behavioral psychotherapy to an emotional subtype of cognitive-behavioral therapy, that is, I will learn how to work with emotions.

Does Germany stigmatize the mentally ill? How do your friends react when they find out that you have a disorder?

There is no stigmatization in Germany, but my Russian colleagues also know about it and are loyal.

I'm generally a fan of the fight against stigma. I do not hesitate to talk about the fact that I have mental illness, all my colleagues and friends know this. At conferences within the company, I read reports on mental illness, try to educate as much as possible more people. In particular, this is why I am giving this interview in order to remove the stigma of the disease. I want people who know me as a successful person, or do not know me, but in principle understand that I am a successful person - I work in a large company, I get good money, I live in a separate apartment - to realize that people with mental illnesses can achieve a lot, it's not the end of life.

- What will be difficult in a relationship for a partner of a person with BPD?

I say without embellishment: everything will be difficult: from household trifles to relationships in general. It's hard for me to talk about this topic, as I have not had a successful long-term relationship, except for the only one, and it was a relationship with a narcissist that lasted 2.5 years. A person with narcissistic personality disorder is always attracted to a person with BPD. Our disorders very harmoniously complemented each other. And unfortunately, they tortured us both. But as a fact, it was the longest union. I have never been able to do this with healthy people. Therefore, I cannot give any advice here and, to be honest, I would like to receive it myself.

- One symptom is an identity disorder. How does it feel?

It feels like you have no personality, no habits of your own. Until I was 25, I didn't even know that I liked to eat. Living with a person, I adjusted to his eating habits and daily routine. If I live with an owl, then I lie down and get up like an owl, and vice versa. Now I live alone, and it is very difficult for me. It often happens that I can not occupy myself with anything. Panic begins, because I can’t be alone, alone with myself I just feel bad. In this regard, I have many friends and acquaintances with whom I spend time.

- Are you trying to fill yourself with other people?

Not other people, but parts of the personalities of others. You just don't have your own personality and you're tearing pieces off everyone. Therefore, I often adapt to people, behave in such a way that they are pleased. In fact, this is unconscious manipulation. Now I work a lot with a psychotherapist and I understand better when I manipulate. And I stop it.

- Can you find positive sides at PRL?

No ( laughs). There is definitely nothing good in this. Everyone thinks it's so cool because you're so eccentric and different. But it's terrible and makes you suffer. And seeing how others suffer because of you, you suffer even more. Living with BPD is possible, but it's hard. You definitely need psychotherapy. Medications do not help here, except that they will calm in moments of exacerbations.

Anya (not her real name), 22, Russia

- What is your mental state at the moment?

Now the state is suspended. Anxiety takes over. But sometimes it is possible to look "from the outside", then things do not look so bad.

- Are you afraid of stigmatization, have you experienced it?

Yes. Since childhood, I have felt alienated. I still do not accept my impulsiveness and sudden aggression, but I grew up in a constant sense of guilt. When I am frank with people and share my experiences, I turn out to be soft-bodied, lazy for them, as if I had invented something for myself in order to arouse pity. It looks like this from the outside, and it causes even more self-hatred.

- When did you realize that something was wrong? How was the official diagnosis made?

After school. Before that, there was a dark period: I did not know where to put myself, I was looking for danger intentionally, I contacted bad people, walked alone at night - if only something happened to me. I was just lost.

But one day I got to the lecture "The Phenomenon of Suicide in Philosophy and Psychology", which was read by a practicing psychotherapist. The topic was close to me. I often thought about suicide during exacerbations. After the lecture, I decided to go to the doctor, but I could not find the right words - I cried, but at the same time I felt that this particular person knew what was happening to me. He understood everything and handed me a business card, asking me to contact him without fail. I was moved by his responsiveness.

It was not possible to make an appointment with him right away - a tight schedule. I, full of feelings of shame for myself and self-hatred, went to another "specialist". At the very first appointment, he pointed out to me how, according to him, I was behaving inappropriately, and in general was arrogant. I was not surprised then, because I was already used to being guilty. But now I am wildly angry that such people exacerbate the situation of patients who have hardly decided on frankness. I am not talking now about his skills as a specialist, because it was he who diagnosed me, but emotional pressure is unacceptable here. The diagnosis helped me to be more attentive to my condition.

- How does your disorder affect your interactions with people?

Oh, I am one of those quiet "border guards" who have all their experiences inside. In appearance I am affable and friendly, everyone is used to seeing me cheerful. This makes it even harder for me, but the fear of being alone leads to complete confusion. It’s like I’m nobody if there’s no one around, and it doesn’t matter who this “someone” is: he may not be close to me at all. Therefore, in my circle there are many friends who are not similar to each other. And so I allow myself to be treated with disdain.

My emotional state changes easily. The morning can start with depressive thoughts, then I get distracted and find joy, then - in an instant - I fall into a rage, do not control myself, behave defiantly, loudly, climb on the rampage.

People are pleasant to me, they arouse my sincere interest. At a distance, I can be happy for them, I accept everyone as they are. This is what attracts people to me. But if you want to get to know me better, it will take time for trust to develop between us. Because by default I see others as offenders, I think out nasty things for them, I am extremely suspicious. And that's what I hate about myself too.

- Have you done selfharm?

Auto-aggression is also some form of self-harm. There was also alcohol, drugs, a deliberately destructive lifestyle, connections with people who torment you. I hit myself on the head, hit the walls to punish myself.

- How do you adapt? Are you going through therapy?

In a difficult period, I went to a psychotherapist, he said that we would just talk. Along the way, I took tests, tracked my condition, shared my secrets and found support, for which I am very grateful to him. He recommended literature on my subject, and by studying it, I gained hope for recovery.

Now I do not go to the reception, but I already know how to cope with what used to inspire horror. Step by step I go to the transformation.

- What is the most important thing for you in working with PRL?

The ability to separate their destructive feelings from reality. Understanding that my perception is limited and often hurts me. I just started, there is still a lot to learn. Because it’s very difficult to distinguish this, you won’t read this in a book and you won’t understand: “Oh, that’s how it is, now I’ll know.”

- How will you know that you have recovered?

The moments when I felt like myself, felt uplifted and energized, were the highest happiness for me. Therefore, when I accept myself and express myself freely, I will understand that I have coped.

Specialist comment:

Yuri Kalmykov, psychotherapist, candidate of medical sciences

Borderline personality disorder is not a sentence. This can rarely be said about mental illnesses, it is always realistic to provide minimal support to people with them. It all depends on the severity of the disorder: in mild cases, people learn to live with it themselves, adapt intuitively or by reading special literature, and provide self-help. In severe cases, you can not do without the intervention of a specialist.

The main constructive skill for patients with BPD is the ability to see the halftones of life, to see compromises, and not just extremes. The romantic partner of a person with BPD may be advised to be more tolerant of their partner's personal boundaries. It is important not to take on the role of a specialist, but simply to be there, especially in difficult moments.

How to recognize a schizoid in a crowd?

Do you often notice people who do not like close contact, withdraw into themselves and try not to advertise their emotions? Such people have a schizoid personality type, as they suffer from disorders of the same name. Their manners are somewhat different from the behavior of healthy people. Psychiatrists classify such a disorder not as schizophrenia, because schizoid personalities do not suffer from neurosis.

Schizoids surrounded by people

People with a schizoid personality type make up no more than 1-2%. They often scare those around them with their strange behavior because they don't want to make emotional or personal contact. They hide feelings, are in a closed state, but are used to the fact that the public considers them "not like that."

Schizoid personalities try to step back so as not to be team members. They engage in activities that do not require multiple opponents, as they are loners.

They are interested in philosophy, meditation, painting and other creativity. They live in their fantasy world and always keep their distance from others. They prefer the company of children and animals.

In childhood, a child with a schizoid type disorder is very sensitive, he perceives too deeply sound, light, any objects that healthy children may not notice, such as a prickly label on clothes. Very often, infants are fed formula instead of breast milk, because they understand the latter as an invasion of their lives, even the mother's breast is a threat to their identity. If you take such a child in your arms, then he will not hug you and kiss you, but will start to push you away and break out.

Causes of the disorder

Personality includes the totality of thoughts, emotions and behavior. Thanks to a certain type of personality, each person becomes unique. These elements begin to form in childhood, including heredity and environmental factors. Brain function and genetic predisposition play a key role in shaping personality. It is not known exactly what factors violate its formation, perhaps these are social aspects. If a person in the family had relatives with any personality disorders, then he falls into the risk group.

Experts still do not have a common opinion about the causes of the disease. But most doctors agree that personality disorder is caused by causal relationships, calling such a model of behavior biopsychosocial. Among the causes of the appearance of schizoid disorder, it is impossible to single out one factor, since the formation of a certain type of personality depends on a combination of reasons. Here one can highlight social sign, for example, the relationship of the child with family members, psychological - temperament and character in the event of stressful situations, biological - deviations in the brain. Experts managed to find out that personality disorder is transmitted from parents to children.

Causes of personality disorder:

1. Mental trauma at any stage of development. For example, future mom wants to get rid of the child by abortion or the newborn was immediately taken away from the mother and he felt lonely.
2. Improper upbringing in the family: lack of tenderness, conflicts, overprotection by parents.
3. Constant stress, such as problems at school.
4. Emotional abuse: parental pressure on the child, changeable and unpredictable mood of mom and dad.

So, a child who does not have friends in the person of his parents is looking for a patron in himself, gaining and hiding individuality so that it is not crushed.

Symptoms of the disease

Schizoid personality disorder is caused by isolation, detachment in society, limitation of expression of emotions.

The schizoid personality type manifests itself already with early childhood at 3-4 years old. In kindergarten, you can see a child who plays alone, does not try to make contact with other children, he is not attracted to team games, he prefers to spend time alone or in the company of adults, shows a love of reading with age.

In school years, the situation does not change: the child does not try to find friends for himself, he does not care about the opinions of others. Often children with a schizoid personality type enter only into intellectual discussions, they love mathematics, physics and literature.

When communicating with such a child, it is difficult to understand what he feels, because he does not show joy, sadness or anger. Children do not tolerate caresses and tenderness, they never hug or kiss their parents, they are unpleasantly affectionate towards themselves. Children with a personality disorder become outcasts and an occasion for ridicule for classmates. They will never take on the role of leader.

The teenage period for a child with a schizoid personality type is very difficult, since the teenager is intellectually superior to his peers, but the inability to establish contact with people rejects him from the team. Self-esteem during this period can change very much: from feelings of worthlessness to megalomania.

Parents, when invading a child's personal space, may receive a harsh rebuff from his side. For example, if they enter a room without permission, they take any things, ask personal life or study.

Adult schizoids have an already established character. They have a lot of contradictions in their souls: they want to move away, but at the same time they strive for intimacy, they are loners, but they need a person, they can be very absent-minded and attentive at the same time, they don’t look sexy, but they have a rich intimate fantasy. The main signs of schizoid personality disorder:

unwillingness to establish close contacts, start a family;

the desire to retire;

lack of interests and hobbies;

indifference to the opinions of others;

emotional calm;

constant social tension;

practically complete absence emotions;

violation of emotional contact.

With age, the signs of the disorder are expressed more intensely, so the most striking symptoms of the disease appear in 40-50 years.

As a rule, the disease is diagnosed by a psychiatrist or psychologist. Quite often, people with schizoid-type disorder do not seek treatment because they are afraid to open up, thereby making their lives much more difficult. But the specialist will not put pressure on the patient, but on the contrary, a conversation with the doctor will help alleviate the condition of an unusual person.

Treatment of the disease includes:

Medications that do not relieve the patient of the disorder but help relieve symptoms of anxiety and depression, such as antidepressants and antipsychotics.

Psychotherapy consists of cognitive behavioral treatment, with the help of which the patient learns to adequately respond to circumstances and cope with the excitement caused by the inevitable communication with people.

Group therapy is aimed at supporting the patient and increasing social motivation.

Family therapy is especially useful for patients who live with other people, as it can strengthen family relationships.

Psychological counseling is about forming the right relationship that will make a person feel comfortable in the current situation.

There is no definite way to prevent schizoid disorder personality, but early diagnosis and the help of a qualified specialist will allow an unusual person to feel comfortable.

dramatic personality disorder

Are your acquaintances trying to lead a life that is out of character for their lifestyle, normal behavior, work, etc.? They constantly attract attention, scream, dress brightly, show unusual activity for them and very quickly change their minds from one to another. Such people behave provocatively. They are capable of vivid sexual provocations. In addition, quite often, patients with the behavior described above manipulate people, yell at them, splash out aggression and anger. If the personality disorder matches all of these symptoms, then the diagnosis will sound like "dramatic personality disorder."

How to make a diagnosis? Of course, you can make a diagnosis yourself, because the symptoms are on the face, but it is better to contact a psychotherapist for this purpose. The diagnosis is made on the basis of the collected anamnesis.

Dramatic personality disorder is treatable through psychotherapy.

Etiology of the disease

Theatrical or dramatic personality disorder refers to common disorders of the sense of personality as such. Such a violation is classified as unpredictable. Similar symptoms have a narcissistic personality disorder.

The risk group for developing dramatic personality disorder most often includes women.

Previously, this diagnosis in psychotherapy sounded very often, especially if women showed their emotions in the form of tantrums and antisocial behavior in society. By the way, in Europe, about 5% of people officially have such a diagnosis, and it is found there, both in men and women.

As a rule, dramatic personality disorder occurs in childhood and accompanies a person throughout his life.

Dramatic personality disorder begins in a person in childhood, when he is in the family circle. As a rule, children with such disorders are brought up by dictatorial parents - strong, powerful. Such parents do not relate to their child in terms of gender self-identification. They raise children without gender (boy/girl) as such.

Children with dramatic personality disorder are afraid of being rejected, both in the family and in society. They dramatize everything that happens in their everyday life - at school, on the street while walking, in the family. Becoming teenagers, such children show open sexual aggression. The obsession with bullying, insulting, humiliating people of the opposite sex on the face and acts as a symptom of the disease.

Self-analysis, thinking in persons with a dramatic personality disorder is absent. They develop egocentrism, aggression, emotionality.

It can be clearly noted that patients with a personality disorder are completely immersed in themselves, they are not interested in the world around them and the events taking place in it. Moreover, individuals with dramatic personality disorder do not consider and do not perceive the opinions of the people around them. As a rule, children adopt this personality disorder from parents who have it.

Patients with dramatic personality disorder ostentatiously draw attention to themselves, they cannot do without people turning their eyes on them (even if they are judgmental).

Such patients have certain social skills (they communicate, find a common language with people), but in the process of communication there is a surge of aggression towards the interlocutor.

Interest in the people around them can be described as unstable superficial. Behavioral patients live on emotions, not common sense. They do not have their own opinion, and if it appears, then after a while it immediately disappears. People with dramatic personality disorder need constant attention to them, to be supported even in minor situations, and also to approve of all the actions that they take.

If a person has a dramatic personality disorder, then he will constantly strive for the rays of glory. All their actions are overly provocative - they put on explicit sexual clothes, flirt with the opposite sex, and may have promiscuous sex. At the same time, patients do not tolerate criticism from others, and if this takes place, then this plunges patients into depression and provokes aggression.

Patients with dramatic personality disorder cannot bear the monotony and boredom in their lives. Also, it is very difficult for them to focus on one object - both work and love.

General psychological characteristics of patients with dramatic personality disorder: vain, spiteful, deceitful, aggressive, liberated. They tend to exaggerate everything.

If something in life does not work out for patients with dramatic personality disorder, then they have a tendency to commit suicide and inflict bodily harm on themselves.

Such patients constantly attract attention to themselves: with sex, aggression, rage.

Surprisingly, patients with dramatic personality disorder are very attentive to their appearance. They follow fashion, dress very extravagantly and catchy. Their sex life very active.

Diagnosis and treatment

The diagnosis is established by a psychotherapist based on the patient's life history, his typical behavior in everyday life, complaints made, and also as a result of psychological testing.

Main and effective method treatment for dramatic personality disorder is psychotherapy on an individual basis. At the second stage of treatment, group methods take place. It should be noted that this therapy is long - for several years. Moreover, it is impossible to completely cure the violation of personality formation, it is only corrected in the course of therapy to the extent that the patient can fully live and function in society.

Children with borderline personality disorder - a cheat sheet for parents.

Borderline personality disorder in children is not uncommon. It is much rarer to find parents who know that their child has borderline personality disorder. Even rarer are such parents who know how to build relationships with a child "border guard". Borderline disorder is a serious mental health disorder in children. No matter how old the child is, it is quite difficult to maintain a relationship with him. This disorder is difficult to diagnose, especially at an early age, for this reason, parents, most often, do not correlate the behavioral problems of their child with any deviation in the development of his psyche.

Meanwhile, the symptoms, personality disorders in a child, appear from a fairly early age, by about four years, you can already notice a certain kind of distortion; self-image, fear of rejection, extreme and sudden mood swings, tumultuous relationships, relationship difficulties combined with gullibility and naivete. While the child is small, parents consider some oddities in his behavior as age-related features. You can often hear that a child from birth was with a special character. When the child gets older, his behavioral features are more noticeable, but the parents still, the child's character traits do not belong to any personality development disorder. But the real problems often don't start until early adulthood.

Under "border mental disorders» imply a set of mental disorders that is far from homogeneous in its manifestations and mechanism of origin, which occupies, as it were, an intermediate position between " mental illness» /«psychosis»/ and «mental health». Moreover, borderline disorders are not considered as a “bridge” between mental illness and mental health, but as a kind of group of non-specific symptom complexes, similar in severity of their manifestations and limited to the “neurotic level” (“neurotic register”) of mental disorders (Aleksandrovsky Yu.A. , Gannushkin P.B., Gurevich M.O. and others). The group of borderline disorders in children and adolescents usually includes neurotic and pathocharacterological reactions, neuroses and pathocharacterological developments, psychopathy, neurosis-like and psychopathic states, as well as borderline forms of intellectual insufficiency and other less common disorders.

Children with borderline disorder tend to be unable to communicate.

They express their emotional pain by screaming.

They do not know how to regulate their emotional reactions.

A child with borderline personality disorder is always in conflict - with himself, with family members, with classmates.

The behavior of a child with borderline disorder is always a cause for emotional problems, both for the child and for his parents.

When a child becomes an adult, helping him learn how to manage the symptoms of a mental health disorder is much more difficult. Behavioral and emotional problems, affects not only those who have a similar diagnosis, but also has a profound impact on the lives of people around them. Parents of children with borderline personality disorder often feel helpless because they do not know how to help their child, do not know how to communicate with them, do not know how to properly educate them, how to teach them how to interact with other people, help them learn how to manage their symptoms of the disorder and live more successful life.

Trying to help an adult child with borderline personality disorder is no easy task. He, as a rule, refuses any help offered by his parents, as he does not see the need for it. Helping a child or teenager is much easier than helping an adult with borderline personality disorder.

Some parents claim that they noticed signs of borderline disorder in their child as early as infancy. The infant was restless, in senior preschool and primary school age, they faced learning difficulties, numerous episodes of frustration and aggression, and behavioral problems.

Children and adolescents go through many developmental changes, and it can sometimes feel like the symptoms of one disorder can turn into something else entirely. Behavioral problems may be a sign of a deeper disorder, or they may simply be a particular phase of growing up that children outgrow.

Signs of borderline disorder in your child.

These are some of the signs to look out for if you suspect your child may be suffering from borderline personality disorder, including:

• Difficulty in determining psychological readiness for school.
• Intense fear of rejection.
• Not restful sleep.
• It's hard to calm him down.
• Difficulties in adaptation.
• Demanding.
• Depressive state.
• Sensitivity to criticism.
• Easily disappointed.
• Eating problems.
• Heavy tantrums.
• Unstable mood and intense emotions.
• Impulsiveness.
• Deficiencies in reasoning and thinking.
• Learning difficulties.
• Unstable attitude.
• Self-harm.
• Unstable expression of emotional attachment.
• Tendency to bouts of anger and aggression.

Some of the most distinctive features of borderline personality disorder in children include problems with personal relationships and extreme and unjustified fear of rejection and rejection. This may lead to the fact that the child has to change schools, as it is difficult for him to manage his emotions. In communication with other children, there is an idealization of relationships, and a quick disappointment in them. Identity confusion often occurs, and in adolescents this may manifest as gender confusion or take other forms.

One of the indicators of borderline personality disorder in children is manipulation. With the help of manipulation, children try to control everything and everyone .. Usually this is not realized by them. It is important to learn to recognize when a child with borderline personality disorder is manipulating you and to learn how to avoid falling into the trap.

The best way to avoid being manipulated is to give yourself permission to refuse the manipulator's requests. You don't have to do what they want, how they want. It is not easy. To start saying no to someone with borderline personality disorder is to see the full spectrum of your child's emotional responses. But this is the only way to avoid manipulation. Children with borderline personality disorder often get angry and provoke conflict. This in itself can be seen as a form of manipulation. If you avoid saying or doing certain things out of fear that your actions will anger the child, this in itself is manipulation.

How to help a child with borderline personality disorder.

If you suspect that your child suffers from borderline personality disorder, you are tired of the challenges you face on a daily basis, you want to help your child and, last but not least, yourself. Professional psychologist can help you figure this out, offer psychotherapy to help your child understand their feelings, thoughts, positively change them, manage the disorder, give them the necessary life skills and tools to become self-sufficient adults. The family as a whole also needs advice that will help them learn how to respond correctly to the manifestations of your child's disorder, understand the essence of his problem, the reasons for his behavior.

Previously, it was believed that borderline personality disorder could not be corrected, today psychological support for families with children with borderline personality disorder is a necessity, and psychotherapy for children with borderline personality disorder is possible, and this is the key to a guaranteed improvement in the quality of their future life.

About 10% of people suffer from personality disorders (in other words, constitutional psychopathy). Pathologies of this kind are outwardly manifested by persistent behavioral disorders that adversely affect the life of the patient himself and his environment. Of course, not every person who behaves eccentrically or unusually for others is a psychopath. Deviations in behavior and character are considered pathological if they are traced from adolescence, extend to several aspects of life and lead to personal and social problems.

Source: depositphotos.com

paranoid disorder

A person with paranoid personality disorder does not trust anyone or anything. He painfully perceives any contacts, suspects everyone of malevolence and hostile intentions, negatively interprets any actions of other people. We can say that he considers himself the object of a worldwide villainous conspiracy.

Such a patient is constantly dissatisfied or afraid of something. At the same time, he is aggressive: he actively accuses those around him of exploiting him, offending him, deceiving him, etc. Most of these accusations are not only unfounded, but also directly contradict the real state of affairs. A person suffering from a paranoid disorder is very vindictive: he can remember his real or imaginary grievances for years and settle scores with "offenders".

Obsessive Compulsive Disorder

An obsessive-compulsive personality is prone to absolute pedantry and perfectionism. Such a person does everything with exaggerated accuracy, strives to subordinate his life once and for all to established schemes. Any little thing, such as changing the arrangement of dishes on the table, can infuriate him or cause a tantrum.

A person suffering from obsessive-compulsive disorder considers his lifestyle to be absolutely correct and the only acceptable one, therefore he aggressively imposes such rules on others. At work, he interferes with his colleagues with constant nit-picking, and in the family he often becomes a real tyrant, not forgiving his loved ones even the slightest deviation from his ideal.

antisocial disorder

Antisocial personality disorder is characterized by the rejection of any rules of behavior. Such a person does not study well because of a lack of ability: he simply does not complete the tasks of the teacher and does not go to classes, because this is a prerequisite for learning. For the same reason, he does not come to work on time and ignores the instructions of his superiors.

The behavior of the antisocial type is not protest: a person violates all the norms in a row, and not just those that seem wrong to him. And he very quickly comes into conflict with the law, starting with petty hooliganism and damage or misappropriation of other people's property. Offenses usually have no real motivation: a person beats a passerby for no reason and takes his wallet without needing money. Those who suffer from antisocial disorder are not kept even in criminal communities - after all, they also have their own rules of conduct, which the patient is unable to follow.

Schizoid disorder

The schizoid personality type is characterized by a refusal to communicate. The person seems unfriendly, cold, detached to others. He usually does not have friends, does not contact anyone except his closest relatives, he chooses his work in such a way as to do it alone, without meeting people.

The schizoid shows little emotion, is equally indifferent to criticism and praise, and is practically not interested in sex. It is difficult to please a person of this type with something: he is almost always indifferent or dissatisfied.

schizotypal disorder

Like schizoids, people with schizotypal personality disorder avoid making friendships and family ties, preferring to be alone, but they have a different initial message. Individuals with schizotypal deviations are extravagant. They often share the most ridiculous superstitions, consider themselves psychics or magicians, can dress strangely and express their views in detail, artistically.

People with schizotypal disorder have a variety of fantasies, visual or auditory illusions that are almost unrelated to reality. Patients present themselves as the protagonists of events that have nothing to do with them.

hysteroid disorder

A person suffering from hysteroid personality disorder believes that he is deprived of the attention of others. He is ready to do anything to be noticed. At the same time, the hysteroid does not see a significant difference between real achievements worthy of recognition and scandalous antics. Such a person perceives criticism painfully: if he is condemned, he falls into rage and despair.

The hysteroid personality is prone to theatricality, pretentiousness of behavior, exaggerated demonstration of emotions. Such people are very dependent on other people's opinions, selfish and very indulgent to their own shortcomings. Usually they seek to manipulate loved ones, blackmail and scandals to get them to fulfill any of their whims.

narcissistic disorder

Narcissism manifests itself in the belief in unconditional superiority over other people. A person suffering from this disorder is confident in his right to universal admiration and demands worship from everyone he comes across. He is incapable of understanding other people's interests, empathy and a critical attitude towards himself.

Persons prone to narcissism constantly brag about their achievements (even if in reality they don’t do anything special), demonstrate themselves. The narcissist explains his any failure with envy of his success, with the fact that others are unable to appreciate him.

borderline disorder

This pathology is manifested in the extreme instability of the emotional state. A person instantly goes from joy to despair, from stubbornness to gullibility, from calmness to anxiety, and all this without real reasons. He often changes his political and religious beliefs, constantly offends his loved ones, as if deliberately pushing them away from him, and at the same time he is terribly afraid of being left without their support.

Borderline disorder means that the person will periodically become depressed. Such individuals are prone to repeated suicide attempts. Trying to console themselves, they often fall into drug or alcohol addiction.

avoidant disorder

A person suffering from avoidant disorder considers himself completely worthless, unattractive and unlucky. At the same time, he is very afraid that others will confirm this opinion, and as a result he avoids any communication (except for contacts with people who are guaranteed not to express a negative opinion), in fact, he hides from life: he does not meet anyone, tries not to take on new business, fearing that nothing will work out.

dependent disorder

A person with dependent personality disorder suffers from a completely unfounded belief in his own helplessness. It seems to him that without the advice and constant support of loved ones, he will not survive.

The patient completely subordinates his life to the requirements (real or imaginary) of those persons whose help he seems to need. In the worst case, a person cannot remain alone at all. He refuses to make independent decisions, requires advice and recommendations, even on trifles. In a situation where he is forced to show independence, the patient panics and begins to follow any advice, regardless of what result they may lead to.

Psychologists believe that the origins of personality disorders lie in childhood and youthful impressions, in the circumstances that accompanied a person for the first 18 years of his life. Over the years, the condition of such patients almost does not change. Personality disorders are not corrected with medication. These patients are treated using psychotherapeutic methods (family, group and individual sessions) and methods such as environmental therapy (living in special communities). However, the likelihood of improvement in the majority of patients is low: 3 out of every 4 people with personality disorders do not consider themselves sick and refuse to be diagnosed and treated by specialists.

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