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PERSONALITY DISORDERS TREATMENTS |
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At one time psychiatrists thought that
personality disorders did not respond very well to treatment. This
opinion was derived from the notion that human personality is fixed
for life once it has been molded in childhood, and from the belief
among people with personality disorders that their own views and
behaviors are correct, and that others are the ones at fault. More
recently, however, doctors have recognized that humans can continue
to grow and change throughout life. Most patients with personality
disorders are now considered to be treatable, although the degree of
improvement may vary. The type of treatment recommended depends on
the personality characteristics associated with the specific
disorder. Hospitalization Inpatient treatment is rarely required for patients with personality disorders, with two major exceptions: borderline patients who are threatening suicide or suffering from drug or alcohol withdrawal; and patients with paranoid personality disorder who are having psychotic symptoms. Psychotherapy Psychoanalytic psychotherapy is suggested for patients who can benefit from insight-oriented treatment. These patients typically include those with dependent, obsessive-compulsive, and avoidant personality disorders. Doctors usually recommend individual psychotherapy for narcissistic and borderline patients, but often refer these patients to therapists with specialized training in these disorders. Psychotherapeutic treatment for personality disorders may take as long as three to five years. Insight-oriented approaches are not recommended for patients with paranoid or antisocial personality disorders. These patients are likely to resent the therapist and see him or her as trying to control or dominate them. Supportive therapy is regarded as the most helpful form of psychotherapy for patients with schizoid personality disorder. Cognitive-behavioral therapy Cognitive-behavioral approaches are often recommended for patients with avoidant or dependent personality disorders. Patients in these groups typically have mistaken beliefs about their competence or likableness. These assumptions can be successfully challenged by cognitive-behavioral methods. Group therapy Group therapy is frequently useful for patients with schizoid or avoidant personality disorders because it helps them to break out of their social isolation. It has also been recommended for patients with histrionic and antisocial personality disorders. These patients tend to act out, and pressure from peers in group treatment can motivate them to change. Because patients with antisocial personality disorder can destabilize groups that include people with other disorders, it is usually best if these people meet exclusively with others who have APD (in "homogeneous" groups). Family therapy Family therapy may be suggested for patients whose personality disorders cause serious problems for members of their families. It is also sometimes recommended for borderline patients from overinvolved or possessive families. Medications Medications may be prescribed for patients with specific personality disorders. The type of medication depends on the disorder. Antipsychotic drugs Antipsychotic drugs, such as haloperidol (Haldol), may be given to patients with paranoid personality disorder if they are having brief psychotic episodes. Patients with borderline or schizotypal personality disorder are sometimes given antipsychotic drugs in low doses; however, the efficacy of these drugs in treating personality disorder is less clear than in schizophrenia. Mood stabilizers Carbamazepine (Tegretol) is a drug that is commonly used to treat seizures, but is also helpful for borderline patients with rage outbursts and similar behavioral problems. Lithium and valproate may also be used as mood stabilizers, especially among people with borderline personality disorder. Antidepressants and anti-anxiety medications Medications in these categories are sometimes prescribed for patients with schizoid personality disorder to help them manage anxiety symptoms while they are in psychotherapy. Antidepressants are also commonly used to treat people with borderline personality disorder. Treatment with medications is not recommended for patients with avoidant, histrionic, dependent, or narcissistic personality disorders. The use of potentially addictive medications should be avoided in people with borderline or antisocial personality disorders. However, some avoidant patients who also have social phobia may benefit from monoamine oxidase inhibitors (MAO inhibitors), a particular class of antidepressant. |
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| PERSONALITY DISORDERS RELATED ITEMS | ||
