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 a difficult character, as the people say, whose behavior does not fit into generally accepted norms and often causes condemnation. Today we look at mixed personality disorder: the limitations that this ailment entails, its symptoms and treatments.
If a person's behavior deviates from the norm, bordering on inadequacy, psychologists and psychiatrists consider it 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. In fact, this term is appropriate to use in cases where the doctor cannotclassify the patient's behavior into a particular 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 he althy 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 17-18 years oldpersonality is being formed. 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 can 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 a personality disorder due to mixed diseases (for example, 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 great. 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.
A worsened personality disorder can lead to serious consequences, including physical harm to others.
Causes of personality disorder
Personality disorders, both mixed and specific, usually occur against the background of brain injuries inas 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, social play a leading role.
First of all, this is the wrong parenting - 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 too 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 comorbid psychological problems - they see 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 do not depend on them and are beyond their control.
So, people diagnosed with mixed personality disorder have the following symptoms:
- building problemsfamily and work relationships, as noted above;
- emotional shutdown, in which a person feels emotionally empty and avoids communication;
- difficulties in managing their own negative emotions, which leads to conflicts and often even ends in physical assault;
- periodic loss of contact with reality.
Sick people are dissatisfied with their lives, it seems to them that everyone around is guilty of their failures. Previously, it was 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 take a closer look at these types.
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 emotionallythat they are not capable of showing either love or hatred towards 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 think 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.
Emotionally unstable disorder. 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 tension, 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 ordinarylife problems. At the same time, they are confident in their own importance, which others do not perceive, treating them with prejudice, as patients are sure.
Hysterical breakdown. Hysterics are prone to increased emotional excitability, 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. By adulthood, 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.
Anancaste disorder. It is expressed in constant doubts, excessive caution and increased attention to detail. 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, fearfulness, 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 alone. These people are afraid of offending others. At the same time, they are quite well adapted to life in society, as society treats them with sympathy.
The state of decompensation is expressed in poor he alth - lack of air, rapid heartbeat, nausea or even vomiting and diarrhea.
Dependent (unstable) personality disorder. People with this diagnosis are characterized by passive behavior. They shift all responsibility for making decisions and even for their own lives to 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 is manifested in the complete inability to control one's life with the loss"leader", confusion, bad mood.
If a 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. Such people often develop schizophrenia in the future.
What are the consequences of mixed personality disorder?
- Such mental disorders can lead to a tendency to alcoholism, drug addiction, suicidal tendencies, inappropriate sexual behavior, hypochondria.
- Improper upbringing of children due to mental disorders (excessive emotionality, cruelty, lack of a sense of responsibility) leads to mental disorders in children.
- Possible mental breakdowns while performing normal daily activities.
- Personality disorder leads to other psychological disorders - depression, anxiety, psychosis.
- The impossibility of full contact with a doctor or therapist due to distrust or lack of responsibility for one's actions.
Mixed personality disorder in children and adolescents
Typically, personality disorder 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.
A big role in the development of pathology is played not only bygenetic factors, how much upbringing and social environment. For example, hysterical disorder can occur against the background of insufficient attention and participation in the life of the child from the parents. As a result, about 40% of children with conduct disorders continue to suffer from it.
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 to join the army.
Treatment for personality disorder
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 tosociety and feel 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.
Drugs 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 to change the character that 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 develop drug dependence very quickly.
Neuroleptics 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.
- Valproic acid - a mood stabilizer - successfully copeswith depression and anger.
- "Lamotrigine" and "Topiromate" reduce impulsiveness, anger, anxiety.
- Amitriptine also treats depression.
In 2010, doctors were researching 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 He alth 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 the treatment of 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 achieved a stable remission within 2-6 years, which lasted at least two years.
DBT (dialectical behavior therapy) is a technique that was developed by Marsha Linehan in the 90s. It is aimed primarily at the treatment of patients who have experienced psychological trauma and cannot recover from it. According to the doctor, pain cannot be prevented, but suffering can. Specialists help their patients develop a different line of thinking and behavior. This will help to avoid stressful situations in the future and prevent decompensation.
Psychotherapy, including family therapy, is aimed at changing interpersonalrelationship 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 belongs to personality disorders, are recommended a three-year psychoanalysis.
Personality disorder and driver's license
Are "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 don't interfere at all.
Restrictions in the patient's life
Problems with employment in the speci alty in patients usually do not arise, 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 rough edges and live like a completely he althy person.
