Psychiatry
The Department of Psychiatry at the Meitra Hospital offers complete diagnostic and medical management of mental health problems. Our vision is to provide mental healthcare across all ages and to focus on promoting positive mental health, early detection, treatment and rehabilitation of various mental health and related issues. Our services caters to child and adolescent behavioural problems, geriatric mental health issues, maternal and re productive mental health, general adult psychiatry, de-addiction services, stress management. We also provide behavioural and psychotherapeutic management of mental health issues across all ages.

Personality Disorder

Personality disorders are a long-term pattern of thoughts and behaviours that are unhealthy. It is a type of mental illness in which you have rigid ways of thinking and behaviour that results in significant problems in relationships with others and often cause distress for the individual who experiences them. Thoughts and behaviours of an individual with personality disorder tend to be inflexible, rigid and unable to respond to changes and demands of life. There are many types of personality disorders which are broadly classified into three clusters based on similar characteristics and symptoms.

  • Cluster A: odd or eccentric behaviour
  • Cluster B: dramatic, over emotional, erratic or unpredictable behaviour
  • Cluster C: anxious and fearful behaviour
Causes

There are no clear reasons for personality disorders. They are thought to occur due to a combination of:

  • Environmental factors
  • Social circumstances
  • Genetic factors
  • Early life experiences
Symptoms

Symptoms of personality disorders vary depending on the type. 

Cluster A Personality Disorder:

  • Paranoid personality disorder
    • Suspicious of others without any proper reasons
    • Pervasive distrust in others
    • Feel that people are trying to harm you
    • Feel easily rejected
    • Holding grudges
    • Anger to perceived insults
    • Unjustified suspicion that your spouse is being unfaithful.
  • Schizoid personality disorder
    • You prefer to be alone
    • You may have only few social relationships
    • Inability to take pleasure in most activities
    • You might appear removed from situations
    • Appearance of being cold or indifferent to others
    • Lack of libido (sex drive)
  • Schizotypal personality disorder
    • Problems in relationship with other people
    • Strange thoughts
    • Have odd behaviour or appearance
    • Peculiar thinking, beliefs, speech or behaviour
    • Inappropriate display of feelings or emotions
    • Inappropriate response to others

Cluster B Personality Disorder

  • Antisocial personality disorder
    • Aggressive, impulsive, violent and reckless behaviour
    • You may lie or steal often to satisfy your needs
    • Blame others for problems you have
    • Disregard for others needs, feelings or safety
    • Disregard safety of yourself
    • Consistently irresponsible
  • Borderline personality disorder
    • Strong emotions, mood swings and feelings you cannot cope with
    • Fear of being abandoned
    • Anxious and distressed mostly
    • Problems with how you see yourself 
    • Unstable and intense relationships
    • Suicidal thoughts, self harm or use drugs and alcohol
    • Impulsive and risky behaviours
  • Histrionic personality disorder
    • Seeks attentions constantly
    • Want to be noticed
    • Easily influenced by others
    • Feel anxious about being ignored
    • Lively and over dramatic
    • Become bored with normal routines
    • Rapidly changing emotions
    • More concern about appearance
  • Narcissistic personality disorder
    • High sense of self importance
    • Fantasise about unlimited success, power and attractiveness
    • Expects attention and admiration
    • Act selfishly to gain success
    • Unwilling to acknowledge others needs or feelings
    • Exaggeration of achievements or talents
    • Arrogant behaviour

Cluster C Personality Disorder

  • Dependent personality disorder
    • Excessively dependent on others
    • You may not have self confidence
    • Unable to do things alone
    • Fears disapproval
    • Put your own needs after the needs of others
    • Feel hopeless
    • Fear being alone or abandoned
  • Avoidant personality disorder
    • Fear of being judged negatively
    • Feel uncomfortable in social situations
    • Don’t like or too sensitive to criticism and rejections
    • Have low self esteem
    • Feeling unattractive or inadequate 
  • Obsessive compulsive personality disorder
    • Anxious about things that seem unorganised
    • Extreme perfectionism
    • Rigid, inflexible and stubborn
    • Cautious about things
    • Think a lot about small details
    • Problems completing tasks due to your own high standards
    • Inability to delegate tasks
    • Tight control over spending money
    • Neglect of enjoyable activities due to over commitment to a work
Diagnosis

Diagnosis of personality disorders include:

  • Physical exam
  • Psychiatric evaluation
  • DSM-5 (Diagnostic Statistical Manual of Mental Disorders – fifth edition) criteria for personality disorders may be used by a psychologist or your mental health professional.

 

Prevention

There are no known ways to prevent personality disorders. Problems can be lessened or controlled with proper treatment.

Treatment

A team approach is usually required for personality disorders. Treatment for the condition may require a longer period. Treatment measures for personality disorders include the following: 

  • Medications: drugs such as antidepressants, anti-anxiety drugs and mood stabilisers may be prescribed by your doctor.
  • Psychotherapy is also part of treatment for personality disorders. It is the use of psychological methods to treat mental and emotional difficulties.
  • Therapeutic communities: living in a therapeutic community can be very helpful in dealing with relationships
  • Dialectical behavioural therapy: it is a type of cognitive behaviour therapy which focuses on teaching people how to live in the moment, develop healthy ways to cope with stress and other problems and to improve their relationships.
  • Cognitive analytical therapy: this form of therapy allows you to identify your current difficulties and develop new methods to cope with it and avoid reoccurrence of the problem in future.
  • Mentalisation based therapy:  it is long term therapy which helps in making sense of our thoughts, feelings and to link these to our actions and behaviours.
  • Mentalization: focus on developing an understanding of yourself and how others feel
  • Art therapies:  art, music and dance therapies help you to express how you are feeling. 
  • Group therapy:  useful for people who avoid social situations or who is too dependent on others.

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