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Attention-deficit hyperactivity disorder (ADHD) is one of the most common reasons children are referred for mental health services. It affects as many as one in every 20 children. Although boys are three to four times more likely than girls to experience ADHD, the disorder affects both boys and girls.While the condition is most often associated with children, there has been a more recent understanding that Attention Deficit Disorders (ADD, ADHD) continue into adulthood for many individuals. Symptoms such as inattention, impulsivity, and overactivity are now known to continue into adulthood for a significant percentage of children with ADD. Unfortunately, relatively few adults are diagnosed or treated for ADD.
The prevalence of ADD in adults is unknown; very few have been studied. In the few treatment studies of adults, there does not appear to be a significant sex difference. About two-thirds of the children who are diagnosed in or before elementary school with ADD continue to have behavioral symptoms in adolescence. During this time period, associated behavioral, learning, and emotional problems also manifest themselves. Approximately one-third to one-half of these adolescents continue to have symptoms of ADD during their adult years.
ADHD is nobody’s fault. Researchers believe that biology and genes play a large role in the development of ADHD. In fact, 30 to 40 percent of children diagnosed with ADHD have relatives with the same disorder. Brain scans reveal that the brains of children with ADHD differ from those of children without the disorder. Children with ADHD are thought to have problems with the part of the brain that controls the organization and direction of thought and behavior.
The exact cause or causes of ADD are not conclusively known. Scientific evidence suggests that in many cases the disorder is genetically transmitted and is caused by an imbalance or deficiency in certain chemicals that regulate the efficiency with which the brain controls behavior. A 1990 study at the National Institute of Mental Health correlated ADD with a series of metabolic abnormalities in the brain, providing further evidence that ADD is a neurobiological disorder.
There is little scientific evidence to suggest that environmental factors, dietary factors such as food dyes or sugar, inner-ear problems or “visual motor” difficulties are the underlying cause of ADD.
There are three main types of ADHD. One type is characterized by inattentiveness, one type is characterized by hyperactive or impulsive behavior, and the third type is combined—when children exhibit signs of both types. Symptoms are often unnoticed until a child enters school. To be diagnosed with ADHD, a child must show symptoms in at least two settings, such as home and school, and the symptoms must interfere with the child’s ability to function at home or school for at least six months. Specialists have agreed that at least six symptoms from the following lists must be present for an accurate diagnosis, and symptoms must begin by age 7.
Signs of inattentive behavior:
- Has difficulty following instructions
- Has difficulty focusing on tasks
- Loses things at school and at home
- Forgets things often
- Becomes easily distracted or has difficulty listening
- Lacks attention to detail, makes careless mistakes or is disorganized
- Fails to complete homework or tasks
Signs of hyperactive behavior:
- Is fidgety
- Leaves seat when they shouldn’t
- Runs or climbs inappropriately
- Talks excessively
- Has difficulty playing quietly
- Always on the go
- Blurts out answers
- Has trouble waiting their turn
The presence of some symptoms, however, does not confirm a diagnosis of ADHD. Just because a child has a lot of energy or difficulty paying attention in school does not mean the child has ADHD. An accurate diagnosis relies on the presence of a range of symptoms and difficulties that prevent the child from performing at an appropriate level for his or her age and intelligence level. Teachers often first observe these issues, and their input should be considered seriously.
Adults who are living with the condition, and especially those who are undiagnosed and untreated, may be experiencing a number of problems, some of which stem directly from the disorder and others that are the result of associated adjustment patterns.
Current symptoms of an adult with ADD may include:
- Chronic lateness
- Chronic boredom
- Low self-esteem
- Mood swing
- Employment problems
- Substance abuse or addictions
- Relationship problems
The symptoms of ADD can be variable and situational, or constant. Some people with ADD can concentrate if they are interested or excited, while others have difficulty concentrating under any circumstances. Some avidly seek stimulation, while others avoid it. Some become oppositional, ill-behaved and, later, antisocial; others may become ardent people-pleasers. Some are outgoing, and others, withdrawn.
Most people experience feelings of anxiety before an important event such as a big exam, business presentation or first date. Anxiety disorders, however, are illnesses that cause people to feel frightened, distressed and uneasy for no apparent reason. Left untreated, these disorders can dramatically reduce productivity and significantly diminish an individual’s quality of life.
Anxiety disorders are among the most common mental illnesses in America; over 21% of adults (42.5 million) are affected by these debilitating illnesses each year.
Stress is a normal, proportional reaction to a stressful situation or external pressures. It’s normal to feel stressed about a final exam or job interview. Anxiety in anxiety disorders is characterized by feelings of apprehension or unexplained thoughts of impending doom.
While most individuals will experience some form of anxiety in their lives, there is still research being done on the causes of anxiety disorders. New research shows that anxiety disorders run in families, and that they have a biological basis, much like allergies or diabetes and other disorders. Anxiety disorders may develop from a complex set of risk factors, including genetics, brain chemistry, personality, and life events.
For people who experience trauma, anxiety is a way that the brain and body has reacted to the traumatic experience – sometimes as a protective measure. When we’re feeling attacked it makes sense to be on guard and not trust others. For people who have been through trauma, those thoughts and protective behaviors can continue even when danger is gone. Finding ways to feel safe, re-teach your body and mind to readjust to feelings of safety, and working through bad experiences can help.
- Feeling restless
- Feeling tired
- Difficulty concentrating or losing their train of thought
- Muscle pain, tightness, or soreness
- Difficulty sleeping – both falling asleep or staying asleep
(Obsessive-compulsive disorder (OCD))
People with obsessive-compulsive disorder (OCD) suffer intensely from recurrent unwanted thoughts (obsessions) or rituals (compulsions), which they feel they cannot control. Rituals, such as handwashing, counting, checking or cleaning, are often performed in hope of preventing obsessive thoughts or making them go away. Performing these rituals, however, provides only temporary relief, and not performing them increases anxiety. Left untreated, obsessions and the need to perform rituals can take over a person’s life. OCD is often a chronic, relapsing illness.
Obsessions are thoughts, images or impulses that occur repeatedly. The person does not want to have these ideas, finds them disturbing and intrusive and, usually, recognizes that they really don’t make sense. Obsessions are accompanied by uncomfortable feelings, such as fear, disgust or doubt. Common obsessions include contamination fears, imagining having harmed self or others, imagining losing control of aggressive urges, intrusive sexual thoughts or urges, excessive religious or moral doubt, or a need to tell, ask or confess.
People with OCD typically try to make their obsessions go away by performing compulsions. Compulsions are acts the person repeatedly performs, often according to certain “rules.” These rituals are performed to obtain relief from the discomfort caused by the obsessions. Examples of compulsions are washing, repeating, checking, touching, counting, ordering/arranging, hoarding or saving, and praying.
In some instances, a person may suffer from only obsessions or only compulsions.
OCD symptoms cause distress, take up a lot of time (more than an hour a day), or significantly interfere with the person’s work, social life or relationships.
Most individuals with OCD recognize that their obsessions are not just excessive worries about real problems and that the compulsions they perform are excessive or unreasonable. The extent to which a person with OCD realizes that his or her beliefs and actions are unreasonable is called his or her “insight.”
There is growing evidence that OCD has a biological basis. OCD is no longer attributed to family problems or to attitudes learned in childhood. Instead, the search for causes now focuses on the interaction between biological factors and environmental influences.
Research suggests that OCD involves problems in communication between parts of the brain. These problems may be caused by insufficient levels of certain brain chemicals, called neurotransmitters. Drugs that increase the brain concentration of these chemicals often help improve OCD symptoms.
Basic Facts About Depression
Major depression is one of the most common mental illnesses, affecting 6.7% (more than 16 million) of American adults each year and 3.2% of children aged 3-17 years (approximately 1.9 million).
Depression causes people to lose pleasure from daily life, can complicate other medical conditions, and can even be serious enough to lead to suicide.
Depression can occur to anyone, at any age, and to people of any race or ethnic group. Depression is never a “normal” part of life, no matter what your age, gender or health situation.
While the majority of individuals with depression have a full remission of the disorder with effective treatment,only about a third (35.3%) of those suffering from severe depression seek treatment from a mental health professional. Too many people resist treatment because they believe depression isn’t serious, that they can treat it themselves or that it is a personal weakness rather than a serious medical illness.
Many things can contribute to clinical depression. For some people, a number of factors seem to be involved, while for others a single factor can cause the illness. Oftentimes, people become depressed for no apparent reason.
Biological – People with depression may have too little or too much of certain brain chemicals, called “neurotransmitters.” Changes in these brain chemicals may cause or contribute to depression.
Cognitive – People with negative thinking patterns and low self-esteem are more likely to develop clinical depression.
Gender – More women experience depression than men. While the reasons for this are still unclear, they may include the hormonal changes women go through during menstruation, pregnancy, childbirth and menopause. Other reasons may include the stress caused by the multiple responsibilities that women have.
Co-occurrence – Depression is more likely to occur along with certain illnesses, such as heart disease, cancer, Parkinson’s disease, diabetes, Alzheimer’s disease, Multiple Sclerosis and hormonal disorders.
Medications – Side effects of some medications can bring about depression.
Genetic – A family history of depression increases the risk for developing the illness. Some studies also suggest that a combination of genes and environmental factors work together to increase risk for depression.
Situational – Difficult life events, including divorce, financial problems or the death of a loved one can contribute to depression.
Persistent sad, anxious or “empty” mood
Sleeping too much or too little, middle of the night or early morning waking
Reduced appetite and weight loss, or increased appetite and weight gain
Loss of pleasure and interest in activities once enjoyed
Persistent physical symptoms that do not respond to treatment (such as chronic pain or digestive disorders)
Difficulty concentrating, remembering or making decisions
Fatigue or loss of energy
Feeling guilty, hopeless or worthless
Thoughts of suicide or death
Eating disorders are real, complex medical and psychiatric illnesses that can have serious consequences for health, productivity and relationships.
Eating disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder and OSFED (other specified feeding or eating disorder), are bio-psycho-social diseases– not fads, phases or lifestyle choices.
People struggling with an eating disorder often become obsessed with food, body image and/or weight. These disorders can be life-threatening if not recognized and treated appropriately. The earlier a person receives treatment, the greater the likelihood of full recovery.
Disordered eating and dangerous weight loss behaviors have unfortunately become normalized in our culture. Dieting, “clean eating” and compulsive exercise are often precursors to full-blown eating disorders. There is a common misconception that symptoms must be severe in order to seek professional help, but any symptom is cause for concern and it is best to intervene early. When disordered eating has a negative impact on quality of life, it’s time to seek help.
Eating disorders – such as anorexia, bulimia, and binge eating disorder – include extreme emotions, attitudes and behaviors surrounding weight and food issues. Eating disorders are serious emotional and physical problems that can have life-threatening consequences for females and males.
Anyone can develop an eating disorder regardless of their gender, age, race, ethnicity, culture, size, socioeconomic status or sexual orientation.
In the United States, 20 million women and 10 million men suffer from a clinically significant eating disorder at some time in their life, including anorexia nervosa, bulimia nervosa, binge eating disorder or EDNOS (EDNOS is now recognized as OSFED, other specified feeding or eating disorder, per the DSM-5).
As with most mental illnesses, eating disorders are not caused by just one factor but by a combination of sociocultural, psychological and biological factors.
Sociocultural and psychological factors:
Pressures to be thin (i.e., pressure to lose weight from family and friends)
Cultural norms of attractiveness as promoted by magazines and popular culture
Use of food as way of coping with negative emotions
Rigid, “black or white” thinking (e.g., “being fat is bad” and “being thin is good”)
Over-controlling parents who do not allow expression of emotion
History of sexual abuse
Genetic predisposition to eating disorders, depression, and anxiety
Certain personality styles, for example obsessive-compulsive personality type
Deficiency or excess of certain brain chemicals called neurotransmitters
Trauma Related Disorder (Such as PTSD)
If you have gone through a traumatic experience, it is normal to feel a multitude of emotions, such as distress, fear, helplessness, guilt, shame or anger. You may start to feel better after days or weeks, but sometimes, these feelings don’t go away. If the symptoms last for more than a month, you may have post-traumatic stress disorder or PTSD.
“Post traumatic Stress Disorder (PTSD) is an anxiety disorder that can occur following the experience or witnessing of a traumatic event.
PTSD is a real problem and can happen at any age. If you have PTSD, you are not alone. It affects over 12 million American adults (3.7% of the adult population) in any given year.
Who Can Get PTSD?
Anyone who was a victim, witnessed or has been exposed to a life-threatening situation.
Survivors of violent acts, such as domestic violence, rape, sexual, physical and/or verbal abuse or physical attacks.
Survivors of unexpected dangerous events, such as a car accident, natural disaster, or terrorist attack.
Combat veterans or civilians exposed to war.
People who have learned of or experienced an unexpected and sudden death of a friend or relative.
Emergency responders who help victims during traumatic events.
Children who are neglected and/or abused (physically, sexually or verbally).
For many people, symptoms begin almost right away after the trauma happens. For others, the symptoms may not begin or may not become a problem until years later. To meet criteria for PTSD, you have to have been exposed to some trauma that results in the following symptoms.
Reexperiencing the trauma in ways that make you feel distressed. Repeatedly thinking about the trauma. You may find that thoughts about the trauma come to mind even when you don’t want them to. Having nightmares about the memories and/or flashbacks about the trauma
Avoiding reminders of the trauma. You may not want to talk about the event or be around people or places that remind you of the event.
Having memory problems and negative thoughts about the world and self. Feeling like you’re to blame for the trauma. Feeling depressed and isolated. Having difficulty relating or interacting with others.
Feeling irritable, angry, constantly alert or on guard. Feeling jumpy or easily startled along with difficulty sleeping and concentrating.
PTSD is a problem when it gets in the way of living the life you want to live. It can affect work, school, and relationships. There may be problems in daily living such as having problems functioning in your job, at school, or in social interactions.
These are other symptoms of PTSD:
Physical symptoms: chronic pain, headaches, stomach pain, diarrhea, tightness or burning in the chest, muscle cramps or low back pain.
Substance abuse: using drugs or alcohol to cope with the emotional pain.
Relationship problems: having problems with intimacy, or feeling detached from your family and friends.
Depression: persistent sad, anxious or empty mood; loss of interest in once-enjoyed activities; feelings of guilt and shame; or hopelessness about the future. Other symptoms of depression may also develop.
Suicidal thoughts: thoughts about taking one’s own life. If you or someone you know is thinking about suicide, chat online at http://www.suicidepreventionlifeline.org or call 1-800-273-TALK
Substance Abuse Disorders
There are many reasons why people decide to drink and use drugs. Using drugs and drinking excessively can come with serious risk and devastating consequences.
Substance abuse affects an estimated 25 million Americans. In terms of people who are affected indirectly such as families of abusers and those injured or killed by intoxicated drivers, an additional 40 million people are affected. The monetary cost to society and the economy because of reduced productivity, property damage, accidents, and health care are astounding. Alcoholism (heavy drinking) afflicts 16 million adults and almost 300,000 children annually. An estimated 21.6 million Americans (age 12 and older) are addicted to other drugs such as sedative-hypnotics or barbiturates, opiates, sedatives, hallucinogens and psychostimulants.
What’s the Difference Between Regular Use and Addiction?
For many individuals, consuming low or infrequent doses of substances is not uncommon. Sometimes individuals use substances experimentally or casually. If this is the case, serious negative effects may not occur.
If using substances starts to have a negative effect on life, it’s a sign of possible addiction. There are many symptoms and warning signs of substance abuse and dependence including:
Continuously using drugs or alcohol even while experiencing negative side effects
Finding out that you are using more and more drugs or alcohol to get the same “good feeling”
Trying to stop but finding it very difficult
Emotionally feeling like you need to use drugs or drink to feel normal
Physically feeling like you need to use drugs or drink to feel normal
Finding that you’re spending more and more time trying to find ways to get drugs or alcohol
Feeling sick (withdrawal symptoms) including – trembling, hallucinations, sweating and/or high blood pressure when you stop using drugs or drinking
When doing drugs or drinking interferes with work, school, or relationships
Bipolar disorder is a mental health disorder characterized by extreme highs and lows in mood and energy. While everyone experiences ups and downs, the severe shifts that happen in bipolar disorder can have a serious impact on a person’s life. More than 3.3 million American adults (1.7%) suffer from bipolar disorder in a given year. An estimated 4.4% of U.S. adults experience bipolar disorder at some time in their lives.
Contrary to how it is sometimes used in conversation, a diagnosis of bipolar disorder does not mean a person is highly emotional but rather refers to someone who experiences extended periods of mood and energy that are excessively high and or/irritable to sad and hopeless, with periods of normal mood in between.
It typically begins in adolescence or early adulthood and continues throughout life. It is often not recognized as an illness and people who have it may suffer needlessly for years.
Bipolar disorder can be extremely distressing and disruptive for those who have this disease, their spouses, family members, friends, and employers. Although there is no known cure, bipolar disorder is treatable, and recovery is possible. Individuals with bipolar disorder can and do have successful relationships and meaningful jobs. The combination of medication, therapy, healthy lifestyle, and support helps the vast majority of people return to productive, fulfilling lives.
Although a specific genetic link to bipolar disorder has not been pinpointed, research shows that bipolar disorder tends to run in families.
People may inherit a tendency to develop the illness, which can then be triggered by environmental factors such as distressing life events.
Brain development, structure and chemicals called neurotransmitters, which act as messengers between nerve cells, are also thought to play a role in the development of bipolar disorder.
Bipolar disorder is often difficult to recognize and diagnose. It can cause a person to have a high level of energy, unrealistically expansive thoughts or ideas, and impulsive or reckless behavior. These symptoms may feel good to a person, which may lead to denial that there is a problem.
Another reason bipolar disorder is difficult to diagnose is that its symptoms may appear to be part of another illness or attributed to other problems
such as substance abuse, poor school performance, or trouble in the workplace.
Symptoms of bipolar disorder fall into two categories: mania and depression.
Mania: The symptoms of mania, which can last up to three months if untreated include:
Excessive energy, activity, restlessness, racing thoughts and rapid talking (also called “pressured speech”).
Extreme “high” or euphoric feelings—a person may feel “on top of the world” and even bad news or tragic events can’t change this.
Being easily irritated or distracted.
Decreased need for sleep—an individual may go days with little or no sleep without feeling tired.
Unrealistic beliefs in one’s ability and powers—a person may experience feelings of exaggerated self-confidence or unwarranted optimism. This can lead to over ambitious work plans and the belief that nothing can stop him or her from accomplishing any task.
Uncharacteristically poor judgment—a person may make poor decisions which may lead to unrealistic involvement in activities, meetings and deadlines, reckless driving, spending sprees, and/or foolish business ventures.
Unusual sex drive or abuse of drugs (particularly cocaine, alcohol or sleeping medications).
Provocative, intrusive, or aggressive behavior—a person may become enraged or paranoid if his or her grand ideas are stopped, or extreme social plans are refused.
An episode of depression can come before or after a manic, hypomanic, or normal period of mood. Symptoms include:
Persistent sad, anxious or empty mood.
Changes in sleep such as, getting too much or too little, or waking in the middle-of-the-night or unusually early in the morning
Reduced appetite and weight loss, or increased appetite accompanied by weight gain.
Irritability or restlessness
Difficulty concentrating, remembering or making decisions. These may often impact a person’s ability to fulfill work, school or other life obligations.
Fatigue or loss of energy.
Persistent physical symptoms that don’t respond to treatment, such as chronic pain or digestive issues (like upset stomach or diarrhea).
Feeling guilty, hopeless or worthless.
Thoughts of death or suicide, including suicide attempts.
Psychotic Disorders (Such as Schizophrenia)
Schizophrenia is a serious disorder which affects how a person thinks, feels and acts. Someone with schizophrenia may have difficulty distinguishing between what is real and what is imaginary; may be unresponsive or withdrawn; and may have difficulty expressing normal emotions in social situations.
Contrary to public perception, schizophrenia is not split personality or multiple personality. The vast majority of people with schizophrenia are not violent and do not pose a danger to others. Schizophrenia is not caused by childhood experiences, poor parenting or lack of willpower, nor are the symptoms identical for each person.
The cause of schizophrenia is still unclear. Some theories about the cause of this disease include: genetics (heredity), biology (abnormalities in the brain’s chemistry or structure); and/or possible viral infections and immune disorders.
Genetics (Heredity): Scientists recognize that the disorder tends to run in families and that a person inherits a tendency to develop the disease. Similar to some other genetically-related illnesses, schizophrenia may appear when the body undergoes hormonal and physical changes (like those that occur during puberty in the teen and young adult years) or after dealing with highly stressful situations.
Chemistry: Scientists believe that people with schizophrenia have an imbalance of the brain chemicals or neurotransmitters: dopamine, glutamate and serotonin. These neurotransmitters allow nerve cells in the brain to send messages to each other. The imbalance of these chemicals affects the way a person’s brain reacts to stimuli–which explains why a person with schizophrenia may be overwhelmed by sensory information (loud music or bright lights) which other people can easily handle. This problem in processing different sounds, sights, smells and tastes can also lead to hallucinations or delusions.
Structure: Some research suggests that problems with the development of connections and pathways in the brain while in the womb may later lead to schizophrenia.
Viral Infections and Immune Disorders: Schizophrenia may also be triggered by environmental events, such as viral infections or immune disorders. For instance, babies whose mothers get the flu while they are pregnant are at higher risk of developing schizophrenia later in life. People who are hospitalized for severe infections are also at higher risk.
Early Warning Signs
The signs of schizophrenia are different for everyone. Symptoms may develop slowly over months or years, or may appear very abruptly. The disease may come and go in cycles of relapse and remission.
Behaviors that are early warning signs of schizophrenia include:
Hearing or seeing something that isn’t there
A constant feeling of being watched
Peculiar or nonsensical way of speaking or writing
Strange body positioning
Feeling indifferent to very important situations
Deterioration of academic or work performance
A change in personal hygiene and appearance
A change in personality
Increasing withdrawal from social situations
Irrational, angry or fearful response to loved ones
Inability to sleep or concentrate
Inappropriate or bizarre behavior
Extreme preoccupation with religion or the occult
Anyone who experiences several of these symptoms for more than two weeks should seek help immediately.
A medical or mental health professional may use the following terms when discussing the symptoms of schizophrenia.
Positive symptoms are disturbances that are “added” to the person’s personality.
Delusions – false ideas – individuals may believe that someone is spying on him or her, or that they are someone famous (or a religious figure).
Hallucinations – seeing, feeling, tasting, hearing or smelling something that doesn’t really exist. The most common experience is hearing imaginary voices that give commands or comments to the individual.
Disordered thinking and speech – moving from one topic to another, in a nonsensical fashion. Individuals may also make up their own words or sounds, rhyme in a way that doesn’t make sense, or repeat words and ideas.
Disorganized behavior – this can range from having problems with routine behaviors like hygiene or choosing appropriate clothing for the weather, to unprovoked outbursts, to impulsive and uninhibited actions. A person may also have movements that seem anxious, agitated, tense or constant without any apparent reason.
Negative symptoms are capabilities that are “lost” from the person’s personality.
Extreme apathy (lack of interest or enthusiasm)
Lack of drive or initiative
Those who struggle with a personality disorder have great difficulty dealing with other people. They tend to be inflexible, rigid, and unable to respond to the changes and demands of life. People with personality disorders tend to have a narrow view of the world and find it difficult to participate in social activities.
What is “Personality”?
Personality refers to a distinctive set of traits, behavior styles, and patterns that make up our character or individuality. How we perceive the world, our attitudes, thoughts, and feelings are all part of our personality. People with healthy personalities are able to cope with normal stresses and have no trouble forming relationships with family, friends, and co-workers.
Some experts believe that events occurring in early childhood exert a powerful influence upon behavior later in life. Others indicate that people are genetically predisposed to personality disorders. In some cases, however, environmental factors may cause a person who is already genetically vulnerable to develop a personality disorder.
A personality disorder must fulfill several criteria. A deeply ingrained, inflexible pattern of relating, perceiving, and thinking serious enough to cause distress or impaired functioning is a personality disorder. Personality disorders are usually recognizable by adolescence or earlier, continue throughout adulthood, and become less obvious throughout middle age.
Types of Personality Disorders
There are many formally identified personality disorders, each with their own set of behaviors and symptoms. Many of these fall into three different categories or clusters:
Cluster A: Odd or eccentric behavior
Cluster B: Dramatic, emotional or erratic behavior
Cluster C: Anxious fearful behavior
Since there are too many identified types of personality disorders to explain in this context, we will only review a few in each cluster.
Schizoid Personality Disorder: Schizoid personalities are introverted, withdrawn, solitary, emotionally cold, and distant. They are often absorbed with their own thoughts and feelings and are fearful of closeness and intimacy with others. For example, a person suffering from schizoid personality is more of a daydreamer than a practical action taker.
Paranoid Personality Disorder: The essential feature for this type of personality disorder is interpreting the actions of others as deliberately threatening or demeaning. People with paranoid personality disorder are untrusting, unforgiving, and prone to angry or aggressive outbursts without justification because they perceive others as unfaithful, disloyal, condescending or deceitful. This type of person may also be jealous, guarded, secretive, and scheming, and may appear to be emotionally “cold” or excessively serious.
Schizotypal Personality Disorder: A pattern of peculiarities best describes those with schizotypal personality disorder. People may have odd or eccentric manners of speaking or dressing. Strange, outlandish or paranoid beliefs and thoughts are common. People with schizotypal personality disorder have difficulties forming relationships and experience extreme anxiety in social situations. They may react inappropriately or not react at all during a conversation or they may talk to themselves. They also display signs of “magical thinking” by saying they can see into the future or read other people’s minds.
Antisocial Personality Disorder: People with antisocial personality disorder characteristically act out their conflicts and ignore normal rules of social behavior. These individuals are impulsive, irresponsible, and callous. Typically, the antisocial personality has a history of legal difficulties, belligerent and irresponsible behavior, aggressive and even violent relationships. They show no respect for other people and feel no remorse about the effects of their behavior on others. These people are at high risk for substance abuse, especially alcoholism, since it helps them to relieve tension, irritability and boredom.
Borderline Personality Disorder: People with borderline personality disorder are unstable in several areas, including interpersonal relationships, behavior, mood, and self-image. Abrupt and extreme mood changes, stormy interpersonal relationships, an unstable and fluctuating self-image, unpredictable and self-destructive actions characterize the person with borderline personality disorder. These individuals generally have great difficulty with their own sense of identity. They often experience the world in extremes, viewing others as either “all good” or “all bad.” A person with borderline personality may form an intense personal attachment with someone only to quickly dissolve it over a perceived slight. Fears of abandonment may lead to an excessive dependency on others. Self-mutilation or recurrent suicidal gestures may be used to get attention or manipulate others. Impulsive actions, chronic feelings of boredom or emptiness, and bouts of intense inappropriate anger are other traits of this disorder, which is more common among females.
Narcissistic Personality Disorder: People with narcissistic personality have an exaggerated sense of self-importance, are absorbed by fantasies of unlimited success, and seek constant attention. The narcissistic personality is oversensitive to failure and often complains of multiple somatic symptoms. Prone to extreme mood swings between self-admiration and insecurity, these people tend to exploit interpersonal relationships.
Avoidant Personality Disorder: Avoidant personalities are often hypersensitive to rejection and are unwilling to become involved with others unless they are sure of being liked. Excessive social discomfort, timidity, fear of criticism, avoidance of social or work activities that involve interpersonal contact are characteristic of the avoidant personality. They are fearful of saying something considered foolish by others; worry they will blush or cry in front of others; and are very hurt by any disapproval by others. People with avoidant personality disorder may have no close relationships outside of their family circle, although they would like to, and are upset at their inability to relate well to others.
Dependent Personality Disorder: People with dependent personality disorder may exhibit a pattern of dependent and submissive behavior, relying on others to make decisions for them. They require excessive reassurance and advice, and are easily hurt by criticism or disapproval. They feel uncomfortable and helpless if they are alone, and can be devastated when a close relationship ends. They have a strong fear of rejection. Typically lacking in self-confidence, the dependent personality rarely initiates projects or does things independently. This disorder usually begins by early adulthood and is diagnosed more frequently in females than males.
Obsessive-Compulsive Personality Disorder: Compulsive personalities are conscientious and have high levels of aspiration, but they also strive for perfection. Never satisfied with their achievements, people with compulsive personality disorder take on more and more responsibilities. They are reliable, dependable, orderly, and methodical, but their inflexibility often makes them incapable of adapting to changed circumstances. People with compulsive personalities are highly cautious, weigh all aspects of a problem, and pay attention to every detail, making it difficult for them to make decisions and complete tasks. When their feelings are not under strict control, events are unpredictable, or they must rely on others, compulsive personalities often feel a sense of isolation and helplessness.