Overview of Personality Disorders
Personality Disorders is a general term for a group of mental illnesses that are characterized by long term patterns of maladaptive thoughts and behavior. These unhealthy and abnormal traits can put a serious strain on people’s personal relationships, impair their ability to function normally in society, alienate them from others and decrease their satisfaction with life.1 While the exact causes for these disorders are not well known, scientists believe that they are the result of both genetic and environmental factors. Some of the most common personality disorders include the following:
Antisocial Personality Disorder
Histrionic Personality Disorder
Narcissistic Personality Disorder
Avoidant Personality Disorder
Dependent Personality Disorder
Schizoid Personality Disorder
Paranoid Personality Disorders
Obsessive-Compulsive Personality Disorder
Schizotypal Personality Disorder
These personality disorders are each characterized by uniquely maladaptive patterns of behavior, especially in relation to sexual expression. The two disorders from the previous list that will be discussed further in this article are Antisocial Personality Disorder and Borderline Personality Disorder.
Antisocial Personality Disorder
People with Antisocial Personality Disorder are those who are commonly referred to as psychopaths or sociopaths. However, it is important to understand that sociopaths and psychopaths are not actually the same. Sociopaths differ from psychopaths because their personalities are shaped mostly by their environment, whereas psychopaths are born with a maladaptive brain disorder. People with this disorder are incapable of feeling guilt or remorse so they continually violate the rights of others, using manipulation and compulsive lying without any regard for how their behavior affects others. Many people with this disorder engage in unusually early aggressive or sexual behavior and many of them struggle to have loving, lifelong, monogamous relationships.
Borderline Personality Disorder
People with Borderline Personality Disorder (BPD) have issues regulating their emotions and thoughts, and they often experience unstable, chaotic, and intense relationships. These people tend to fall madly in love within only a few days and then have extremely dramatic breakups. They will often engage in impulsive, reckless, self-damaging behavior including alcohol and drug use, overeating, excessive spending sprees, rebound sex, and self-mutilation or cutting. People with this disorder also tend to have deep abandonment depression, separation anxiety, and an intolerance of being alone. Many of their symptoms are similar to those of Bipolar Disorder including idealization/devaluation in which there is a pattern of intense and stormy relationships with family, friends, and loved ones, often shifting from extreme closeness and love (idealization) to extreme dislike or anger (devaluation).2
Borderline Personality Disorder affects sex in several ways:
BPD and Attitudes About Sex – women with BPD report more negative attitudes about sex and more general sexual dissatisfaction 3
BPD and Relationship Quality – people with BPD experience a great deal of conflict in their relationships, which naturally leads to negative experience or feelings towards sex 3
BPD and Reckless Sex – people with BPD often engage in impulsive behaviors, partly due to their intense emotional responses (anger, fear, love, loneliness, jealousy, emptiness) People with BPD are also more likely to engage in casual sex and have multiple sexual partners 3
Treatments for Personality Disorders
As with all forms of mental illness, personality disorders can be difficult to treat. Finding a treatment that works for an individual patient involves a lot of communication between patients and their doctors. Both medication and various forms of therapy can help people cope with these disorders and doctors often suggest a combination of medication and therapy for the most effectiveness.
Medication for personality disorders can be very complex, but generally the type of medication someone receives is dependent upon the symptoms they are experiencing. People with any of these personality disorders may be prescribed antimanics (for symptoms of mania), antidepressants (for symptoms of depression), anxiolytics (for symptoms of anxiety), or antipsychotics (for symptoms of psychosis). While medication may be beneficial for people with certain disorders, it is often used to help alleviate more short term symptoms that are severe or life threatening. Once a person is out of any immediate danger, their doctor will add therapy to their treatment regimen; therapy often proves to be more effective for long term maintenance of a disorder.
Therapy can be incredibly effective at helping patients learn to regulate their emotions as well as improve the quantity and quality of their interpersonal relationships. Various forms of therapy can be administered in either a one-on-one setting between the therapist and patient or in a group setting. Additionally, it may be beneficial for the family, friends, or loved ones of the patient to participate in the therapy sessions as well. Studies show that including family members in therapy can improve both the patient’s treatment and the family members’ ability to cope with and support the patient.2 Psychotherapy is usually the first treatment for people with personality disorders.
Psychotherapy can include various practice such as Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT). CBT involves identifying and changing core beliefs and/or behaviors that underlie inaccurate perceptions of themselves and of others, as well as problems interacting with others.2 DBT teaches skills to control intense emotions, reduces self-destructive behaviors, and improves relationships. This therapy often incorporates elements of mindfulness training, and it differs from CBT in that it seeks a balance between both changing and accepting beliefs/behaviors.2
Therapists will meet with a patient and develop a personalized plan for them, adapting various forms of psychotherapy to meet the needs of the specific patient. Oftentimes, therapists will mix techniques from different types of therapy or use some combination of therapies, depending on what they think will be most beneficial to the patient’s particular case.
Treatments’ Effects on Sex Life
Medication used to treat personality disorders may have negative side effects, some of which can affect the person’s sex life. As mentioned above, the types of medication used to treat personality disorders can include antimanics, antidepressants, anxiolytics, or antipsychotics. Antidepressants can cause sexual problems. Anti-anxiety medication can cause changes in sex drive or ability to perform in a sexual situation. Antipsychotics can have sexual dysfunction side effects such as erectile dysfunction.4
While some specific medications can have negative sexual side effects, the benefits of treatment far outweigh the costs. Managing someone’s personality disorder through medication and therapy can improve their relationships with others, their ability to communicate with their loved ones, and their overall life satisfaction.
1. "Personality Disorders." MedlinePlus. U.S. National Library of Medicine, 10 May 2016. Web. 18 May 2016. <https://www.nlm.nih.gov/medlineplus/personalitydisorders.html>.
2. "Borderline Personality Disorder." National Institute of Mental Health. National Institutes of Health, n.d. Web. 18 May 2016. <http://www.nimh.nih.gov/health/topics/borderline- personality-disorder/index.shtml>.
3. Bouchard S, Godbout N, Sabourin S. (2009). “Sexual Attitudes and Activities in Women with Borderline Personality Disorder Involved in Romantic Relationships.” Journal of Sex & Marital Therapy, 35:106-121, 2009.
4. "Mental Health Medications." National Institute of Mental Health. National Institutes of Health, Jan. 2016. Web. 18 May 2016. <http://www.nimh.nih.gov/health/topics/mental- health-medications/index.shtml>.
Last Updated 18 May 2016.