North Carolina Mental Health Intervention Experts
Are you losing someone you love to a Mental Health Crisis? Whether your person of concern is suffering from Bipolar Disorder (manic, depressive disorder), a Dual Diagnosis Condition, Co Occurring Disorder, Behavioral Disorder, Substance Abuse (drugs, alcohol) Depression or other Mental Health problem, a North Carolina Mental Health Intervention Specialist can help.
It is our philosophy that when someone is in a crisis, wisdom compels us to take proactive measures to help them before something inevitably worse happens. So whether you are planning to stage an alcohol intervention, drug addiction intervention, mental health disorder intervention, eating disorder intervention or behavioral health intervention, learn how an experienced North Carolina Intervention Specialist can help guide you through the process.
For immediate assistance or to receive a private consultation call: 800-980-3927
If someone you care about is telling you no, I won’t go to treatment, I don’t need help, the problem isn’t that bad – or acknowledges they need help, but doesn’t follow up on getting it – you are in the right place. Without competent assistance, dealing with destructive behaviors can leave families discouraged or convinced that nothing can be done. Fortunately, these are the exact type of difficulties we are trained to deal with when encountering alcohol abuse, drug addiction, mental health disorders and behavioral concerns.
Our experienced Intervention Specialists provide knowledgable support and guidance every step of the way. The techniques we’ve developed have improved current intervention methods used throughout the industry today. Our evidenced-based model has significantly reduce further damage from occurring to already strained relationships, while substantially increasing the odds of getting those suffering from alcoholism, drug addiction and other related co occurring disorders successfully into a treatment setting.
In fact, every family that has sought our assistance has told us they were either met with resistance, excuses, denial or minimization when they approached their loved one with getting help. Meanwhile, almost every one of these same families were later told by their loved one, “okay, I’m willing to go to treatment” after allowing us to stage and facilitate their loved one’s intervention.
By focusing our attention on interrupting the powerful hold taking place within the limbic system (complex area of the brain that supports a variety of functions; including emotion, behavior, motivation and long-term memory), we specifically address what’s preventing someone from accepting professional care. Our experienced Intervention Specialists are adept at pinpointing the blocks, breaking through denial and systematically dealing with the irrational thinking that affects a person’s decision making abilities.
When a person’s thoughts and decision making abilities are impaired, wisdom compels us to take proactive measures – despite their resistance or implausible excuses about receiving help. The harm being caused to their brain’s structure, along with other risk-factors may one day have irreparable repercussions, so doing nothing is not the answer.
We know from our own personal accounts how distressing it is for families to watch their loved one struggle with alcoholism, drug addiction and/or a mental disorder. We also know how debilitating it is to be the one consumed by a chronic illness. This insightful vantage point has allowed us to truly understand the pain, suffering and desperation each side undergoes.
Prior to staging an intervention, we meet with the intervention participants and provide them with clear instructions on what to say and do. Any foreseeable errors or distractions are carefully examined during this pre-intervention or dress rehearsal meeting. After our strategy is formulated, we then meet with your loved one and present them with a dignified solution to treating their medical condition.
In our initial phone interview, we will discuss relevant issues in order to do a thorough evaluation. Once a comprehensive profile is factored in, a strategy will be developed that is tailored around your loved one’s particular situation. Cost, logistics, time frame and any other questions or concerns you have will also be answered.
Finding the right intervention specialist is the most important first step to ensuring the person you care about receives proper health care. Families, friends, employers colleagues and co-workers are encouraged to reach out to us. Trying to manage destructive behaviors and/or mental health related conditions without professional assistance can potentially be fatal. Addiction and mental health disorders are complex, and often pose challenges when it comes to the person accepting help, being properly diagnosed and following treatment plans. Aligning yourself to a qualified professional who understands the serious nature of drug addictions and the mental health related components many sufferers experience is critical.
If someone you care about needs help, take the next step… Move forward – because without change – it will not get better.
Begin the healing process today and let us provide you with a confidential consultation today: 800-980-3927
Principles of Effective North Carolina Mental Health and Behavioral Health Treatment:
1. No single treatment is appropriate for all individuals. Matching treatment settings, interventions, and services to each individual’s particular problems and needs is critical to his or her ultimate success in returning to productive functioning in the family, workplace, and society.
2. Treatment needs to be readily available. Because individuals who are addicted to drugs may be uncertain about entering treatment, taking advantage of opportunities when they are ready for treatment is crucial. Potential treatment applicants can be lost if treatment is not immediately available or is not readily accessible.
3. Effective treatment attends to multiple needs of the individual, not just his or her drug use. To be effective, treatment must address the individual’s drug use and any associated medical, psychological, social, vocational, and legal problems.
4. An individual’s treatment and services plan must be assessed continually and modified as necessary to ensure that the plan meets the person’s changing needs. A patient may require varying combinations of services and treatment components during the course of treatment and recovery. In addition to counseling or psychotherapy, a patient at times may require medication, other medical services, family therapy, parenting instruction, vocational rehabilitation, and social and legal services. It is critical that the treatment approach be appropriate to the individual’s age, gender, ethnicity, and culture.
5. Remaining in treatment for an adequate period of time is critical for treatment effectiveness. The appropriate duration for an individual depends on his or her problems and needs. Research indicates that for most patients, the threshold of significant improvement is reached at about 3 months in treatment. After this threshold is reached, additional treatment can produce further progress toward recovery. Because people often leave treatment prematurely, programs should include strategies to engage and keep patients in treatment.
6. Counseling (individual and/or group) and other behavioral therapies are critical components of effective treatment for addiction. In therapy, patients address issues of motivation, build skills to resist drug use, replace drug-using activities with constructive and rewarding non-drug-using activities, and improve problem-solving abilities. Behavioral therapy also facilitates interpersonal relationships and the individual’s ability to function in the family and community.
7. Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies. For patients with mental disorders, both behavioral treatments and medications can be critically important.
8. Addicted or drug-abusing individuals with coexisting mental disorders should have both disorders treated in an integrated way. Because addictive disorders and mental disorders often occur in the same individual, patients presenting for either condition should be assessed and treated for the co-occurrence of the other type of disorder.
9. Medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use. Medical detoxification safely manages the acute physical symptoms of withdrawal associated with stopping drug use. While detoxification alone is rarely sufficient to help addicts achieve long-term abstinence, for some individuals it is a strongly indicated precursor to effective drug addiction treatment.
10.Treatment does not need to be voluntary to be effective. Strong motivation can facilitate the treatment process. Sanctions or enticements in the family, employment setting, or criminal justice system can increase significantly both treatment entry and retention rates and the success of drug treatment interventions.
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Dual Diagnosis Intervention, Co Occurring Disorder Intervention, Mood Disorder Intervention, Depression Intervention, Major Depressive Disorder Intervention, Dysthymic Disorder Intervention, Bipolar Disorder Intervention, Suicidal Tendencies Intervention, Schizophrenia Interventions, Anxiety Disorders Intervention, Panic Disorder Interventions, Obsessive-Compulsive Disorder (OCD) Intervention, Post-Traumatic Stress Disorder (PTSD) Intervention, Generalized Anxiety Disorder (GAD) Interventions, Social Phobia Intervention, Agoraphobia Intervention, Specific Phobia Intervention, Eating Disorders Intervention, Attention Deficit Hyperactivity Disorder (ADHD) Intervention, Autism Intervention, Personality Disorders Intervention, Antisocial Personality Disorder Intervention, Avoidant Personality Disorder Intervention, Borderline Personality Disorder Intervention, Alcohol Intervention, Drug Addiction Intervention, Heroin Addiction Intervention, Crystal Meth Addiction Intervention, Pain Pill Addiction Intervention, Prescription Pill Addiction Intervention, Prescription Medication Addiction Intervention, Prescription Drug Abuse Intervention, Adderall Addiction Intervention, Ativan Addiction Intervention, Amphetamine Addiction Intervention, Ambien Addiction Intervention, Opiate Addiction Intervention, Valium Addiction Intervention, Percocet Addiction Intervention, Hydrocodone Addiction Intervention, Oxycodone Addiction Intervention, Oxycontin Addiction Intervention, MS Contin Addiction Intervention, Opioid Addiction Intervention, Suboxone Addiction Intervention, Benzodiazepine Addiction Intervention, Xanax Addiction Intervention, Klonopin Addiction Intervention, Ecstasy Addiction Intervention, Molly Addiction Intervention, MDMA Addiction Intervention, GHB Addiction Intervention, Cocaine Addiction Intervention, Crack Cocaine Addiction Intervention, Vicodin Addiction Intervention, Percocet Addiction Intervention, Hydrocodone Addiction Intervention, Methadone Addiction Intervention, Codeine Addiction Intervention, Ketamine Addiction Intervention, Fentanyl Addiction Intervention, Morphine Addiction Intervention, Opium Addiction Intervention, Subutex Addiction Intervention, Spice Addiction Intervention, Soma Addiction Intervention, Roxicodone Addiction Intervention, K2 Addiction Intervention, Halcion Addiction Intervention, Lunesta Addiction Intervention, Librium Addiction Intervention, Percodan Addiction Intervention, Marijuana Addiction Intervention, Inhalants addiction Intervention, Hallucinogens Addiction Intervention, Demerol Addiction Intervention, Hydrochloride Addiction Intervention, Dilaudid Addiction Intervention, Lortab Addiction Intervention, Lorcet Addiction Intervention, Darvon Addiction Intervention, Darvocet Addiction Intervention, Biphetamine Addiction Intervention, Dexedrine Addiction Intervention, Ritalin Addiction Intervention, Desoxyn Addiction Intervention, Ultram Addiction Intervention, Tramadol Addiction Intervention, Anabolic Steroid Addiction Intervention, Family Intervention, Adolescent Intervention, Teen Addiction Intervention, Young Adult Intervention, Senior Citizen Intervention, Christian Intervention, Christian Family Intervention, Faith Based Intervention, Executive Intervention, Sex Addiction Intervention, Gambling Addiction Intervention, Intervention Specialist, Intervention Services, Intervention Help
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Mental disorder, any illness with significant psychological or behavioral manifestations that is associated with either a painful or distressing symptom or an impairment in one or more important areas of functioning.
Mental disorders, in particular their consequences and their treatment, are of more concern and receive more attention now than in the past. Mental disorders have become a more prominent subject of attention for several reasons. They have always been common, but, with the eradication or successful treatment of many of the serious physical illnesses that formerly afflicted humans, mental illness has become a more noticeable cause of suffering and accounts for a higher proportion of those disabled by disease. Moreover, the public has come to expect the medical and mental health professions to help it obtain an improved quality of life in its mental as well as physical functioning. And indeed, there has been a proliferation of both pharmacological and psychotherapeutic treatments. The transfer of many psychiatric patients, some still showing conspicuous symptoms, from mental hospitals into the community has also increased the public’s awareness of the importance and prevalence of mental illness.
There is no simple definition of mental disorder that is universally satisfactory. This is partly because mental states or behaviour that are viewed as abnormal in one culture may be regarded as normal or acceptable in another, and in any case it is difficult to draw a line clearly demarcating healthy from abnormal mental functioning.
A narrow definition of mental illness would insist upon the presence of organic disease of the brain, either structural or biochemical. An overly broad definition would define mental illness as simply being the lack or absence of mental health—that is to say, a condition of mental well-being, balance, and resilience in which the individual can successfully work and function and in which the individual can both withstand and learn to cope with the conflicts and stresses encountered in life. A more generally useful definition ascribes mental disorder to psychological, social, biochemical, or genetic dysfunctions or disturbances in the individual.
A mental illness can have an effect on every aspect of a person’s life, including thinking, feeling, mood, and outlook and such areas of external activity as family and marital life, sexual activity, work, recreation, and management of material affairs. Most mental disorders negatively affect how individuals feel about themselves and impair their capacity for participating in mutually rewarding relationships.
Psychoses are major mental illnesses that are characterized by severe symptoms such as delusions, hallucinations, disturbances of the thinking process, and defects of judgment and insight. Persons with psychoses exhibit a disturbance or disorganization of thought, emotion, and behaviour so profound that they are often unable to function in everyday life and may be incapacitated or disabled. Such individuals are often unable to realize that their subjective perceptions and feelings do not correlate with objective reality, a phenomenon evinced by persons with psychoses who do not know or will not believe that they are ill despite the distress they feel and their obvious confusion concerning the outside world. Traditionally, the psychoses have been broadly divided into organic and functional psychoses. Organic psychoses were believed to result from a physical defect of or damage to the brain. Functional psychoses were believed to have no physical brain disease evident upon clinical examination. Much research suggests that this distinction between organic and functional is probably inaccurate. Most psychoses are now believed to result from some structural or biochemical change in the brain.
Substance abuse disorders
Substance abuse and substance dependence are two distinct disorders associated with the regular nonmedical use of psychoactive drugs. Substance abuse implies a sustained pattern of use resulting in impairment of the person’s social or occupational functioning. Substance dependence implies that a significant portion of a person’s activities are focused on the use of a particular drug or alcohol. Substance dependence likely leads to tolerance, in which markedly increased amounts of a drug (or other addictive substance) must be taken to achieve the same effect. Dependence is also characterized by withdrawal symptoms such as tremors, nausea, and anxiety, any of which might follow decreases in the dose of the substance or the cessation of drug use. (See chemical dependency.)
A variety of psychiatric conditions can result from the use of alcohol or other drugs. Mental states resulting from the ingestion of alcohol include intoxication, withdrawal, hallucinations, and amnesia. Similar syndromes may occur following the use of other drugs that affect the central nervous system (see drug use). Other drugs commonly used nonmedically to alter mood are barbiturates, opioids (e.g., heroin), cocaine, amphetamines, hallucinogens such as LSD (lysergic acid diethylamide), marijuana, and tobacco. Treatment is directed at alleviating symptoms and preventing the patient’s further abuse of the substance.
The term schizophrenia was introduced by Swiss psychiatrist Eugen Bleuler in 1911 to describe what he considered to be a group of severe mental illnesses with related characteristics; it eventually replaced the earlier term dementia praecox, which the German psychiatrist Emil Kraepelin had first used in 1899 to distinguish the disease from what is now called bipolar disorder. Individuals with schizophrenia exhibit a wide variety of symptoms; thus, although different experts may agree that a particular individual suffers from the condition, they might disagree about which symptoms are essential in clinically defining schizophrenia.
Mood disorders include characteristics of either depression or mania or both, often in a fluctuating pattern. In their severer forms, these disorders include the bipolar disorders and major depressive disorder.
Major mood disorders
In general, two major, or severe, mood disorders are recognized: bipolar disorder and major depression.
Bipolar disorder (previously known as manic-depressive disorder) is characterized by an elated or euphoric mood, quickened thought and accelerated, loud, or voluble speech, overoptimism and heightened enthusiasm and confidence, inflated self-esteem, heightened motor activity, irritability, excitement, and a decreased need for sleep. Depressive mood swings typically occur more often and last longer than manic ones, though there are persons who have episodes only of mania. Individuals with bipolar disorder frequently also show psychotic symptoms such as delusions, hallucinations, paranoia, or grossly bizarre behaviour. These symptoms are generally experienced as discrete episodes of depression and then of mania that last for a few weeks or months, with intervening periods of complete normality. The sequence of depression and mania can vary widely from person to person and within a single individual, with either mood abnormality predominating in duration and intensity. Manic individuals may injure themselves, commit illegal acts, or suffer financial losses because of the poor judgment and risk-taking behaviour they display when in the manic state.
There are two types of bipolar disorders. The first, commonly known as bipolar 1, has several variations but is characterized primarily by mania, with or without depression. Its most common form involves recurrent episodes of mania and depression, often separated by relatively asymptomatic periods. The second type of bipolar disorder, typically called bipolar 2 (bipolar II), is characterized primarily by depression accompanied—often right before or right after an episode of depression—by a condition known as hypomania, which is a milder form of mania that is less likely to interfere with routine activities.
The lifetime risk for developing bipolar disorder is about 1 percent and is about the same for men and women. The onset of the illness often occurs at about age 30, and the illness persists over a long period. The predisposition to develop bipolar disorder is partly genetically inherited. Antipsychotic medications are used for the treatment of acute or psychotic mania. Mood-stabilizing agents such as lithium and several antiepileptic medications have proved effective in both treating and preventing recurrent attacks of mania.
Major depressive disorder is characterized by depression without manic symptoms. Episodes of depression in this disorder may or may not be recurrent. In addition, the depression can take on a number of different characteristics in different people, such as catatonic features, which include unusual motor or vocal behaviour, or melancholic features, which include profound lack of responsiveness to pleasure. People with major depression are considered to be at high risk of suicide.
Symptoms of major depressive disorder include a sad or hopeless mood, pessimistic thinking, a loss of enjoyment and interest in one’s usual activities and pastimes, reduced energy and vitality, increased fatigue, slowness of thought and action, change of appetite, and disturbed sleep. Depression must be distinguished from the grief and low spirits felt in reaction to the death of a loved one or some other unfortunate circumstance. The most dangerous consequence of severe depression is suicide. Depression is a much more common illness than mania, and there are indeed many sufferers from depression who have never experienced mania.
Major depressive disorder may occur as a single episode, or it may be recurrent. It may also exist with or without melancholia and with or without psychotic features. Melancholia implies the biological symptoms of depression: early-morning waking, daily variations of mood with depression most severe in the morning, loss of appetite and weight, constipation, and loss of interest in love and sex. Melancholia is a particular depressive syndrome that is relatively more responsive to somatic treatments such as antidepressant medications and electroconvulsive therapy (ECT).
It is estimated that women experience depression about twice as often as men. While the incidence of major depression in men increases with age, the peak for women is between ages 35 and 45. There is a serious risk of suicide with the illness; of those who have a severe depressive disorder, about one-sixth eventually kill themselves. Childhood traumas or deprivations, such as the loss of one’s parents while young, can increase a person’s vulnerability to depression later in life, and stressful life events, especially where some type of loss is involved, are, in general, potent precipitating causes. Both psychosocial and biochemical mechanisms can be causative factors in depression. The best-supported hypotheses, however, suggest that the basic cause is faulty regulation of the release of one or more neurotransmitters (e.g., serotonin, dopamine, and norepinephrine), with a deficiency of neurotransmitters resulting in depression and an excess causing mania. The treatment of major depressive episodes usually requires antidepressant medications. Electroconvulsive therapy may also be helpful, as may cognitive, behavioral, and interpersonal psychotherapies.
The characteristic symptoms and patterns of depression differ with age. Depression may appear at any age, but its most common period of onset is in young adulthood. Bipolar disorders also tend to appear first in young adulthood.
Anxiety has been defined as a feeling of fear, dread, or apprehension that arises without a clear or appropriate justification. It thus differs from true fear, which is experienced in response to an actual threat or danger. Anxiety may arise in response to apparently innocuous situations or may be out of proportion to the actual degree of the external stress. Anxiety also frequently arises as a result of subjective emotional conflicts of whose nature the affected person may be unaware. Generally, intense, persistent, or chronic anxiety that is not justified in response to real-life stresses and that interferes with the individual’s functioning is regarded as a manifestation of mental disorder. Although anxiety is a symptom of many mental disorders (including schizophrenia, obsessive-compulsive disorder, and post-traumatic stress disorder), in the anxiety disorders proper it is the primary and frequently the only symptom.
The symptoms of anxiety disorders are emotional, cognitive, behavioral, and psychophysiological. Anxiety disorder can manifest itself in a distinctive set of physiological signs that arise from overactivity of the sympathetic nervous system or from tension in skeletal muscles. The sufferer experiences palpitations, dry mouth, dilatation of the pupils, shortness of breath, sweating, abdominal pain, tightness in the throat, trembling, and dizziness. Aside from the actual feelings of dread and apprehension, the emotional and cognitive symptoms include irritability, worry, poor concentration, and restlessness. Anxiety may also be manifested in avoidance behaviour.
Anxiety disorders are distinguished primarily in terms of how they are experienced and to what type of anxiety they respond. For example, panic disorder is characterized by the occurrence of panic attacks, which are brief periods of intense anxiety. Panic disorder may occur with agoraphobia, which is a fear of being in certain public locations from which it could be difficult to escape.
Specific phobias are unreasonable fears of specific stimuli; common examples are a fear of heights and a fear of dogs. Social phobia is an unreasonable fear of being in social situations or in situations in which one’s behaviour is likely to be evaluated, such as in public speaking.
Obsessive-compulsive disorder is characterized by the presence of obsessions, compulsions, or both. Obsessions are persistent unwanted thoughts that produce distress. Compulsions are repetitive rule-bound behaviours that the individual feels must be performed in order to ward off distressing situations. Obsessions and compulsions are often linked; for example, obsessions about contamination may be accompanied by compulsive washing.
Post-traumatic stress disorder is characterized by a set of symptoms that are experienced persistently following one’s involvement, either as a participant or as a witness, in an intensely negative event, usually experienced as a threat to life or well-being. Some of these symptoms include reexperiencing of the event, avoidance of stimuli associated with the event, emotional numbing, and hyperarousal. Finally, generalized anxiety disorder involves a pervasive sense of worry accompanied by other symptoms of anxiety.
In general, anxiety, like depression, is one of the most common psychological problems people experience and for which they seek treatment. While panic disorder and some phobias, such as agoraphobia, are diagnosed much more commonly in women than in men, there is little gender difference for the other anxiety disorders. The anxiety disorders tend to appear relatively early in life (i.e., in childhood, adolescence, or young adulthood). As with the mood disorders, a variety of psychopharmacological and psychotherapeutic treatments can be used to help resolve anxiety disorders.
Two of the major classifications of eating disorders involve not only abnormalities of eating behaviour but also distortions in body perception. Anorexia nervosa consists of a considerable loss in body weight, refusal to gain weight, and a fear of becoming overweight that is dramatically at odds with reality. People with anorexia often become shockingly thin in the eyes of everyone but themselves, and they manifest the physical symptoms of starvation. Bulimia nervosa is characterized by either impulsive or “binge” eating (eating a significantly large amount of food during a given period of time), alternating with maladaptive (and often ineffective) efforts to lose weight, such as by purging (e.g., self-induced vomiting or misuse of laxatives, diuretics, or enemas) or fasting. People with bulimia are also preoccupied with body weight and shape, but they do not exhibit the extreme weight loss apparent in anorexia patients. As many as 40–60 percent of anorexia patients also engage in binge eating as well as purging; however, they remain significantly underweight.
At least half of all people diagnosed with an eating disorder do not meet the full criteria for either of the two main categories described above. The diagnosis of eating disorder, not otherwise specified, or EDNOS, is given to those with clinically significant eating disturbances that meet some, but not all, of the diagnostic criteria for either anorexia nervosa or bulimia nervosa. Examples of such include binge eating disorder (episodes of binge eating with the absence of compensatory weight-loss behaviours) and purging disorder (episodes of self-induced vomiting or misuse of laxatives that follow a normal or below normal amount of food consumption). Patients with anorexia nervosa engage in excessive control over their eating behaviour, although subjectively they may report feeling little to no control over their bodies with regard to weight gain. Those with bulimia also report a loss of control when engaging in episodes of binge eating, occasionally attempting to compensate for this at later times. According to the U.S. National Institute of Mental Health, approximately 0.5–3.7 percent of females will be diagnosed with anorexia nervosa in their lifetime. Lifetime prevalence for bulimia nervosa is about 0.6 percent among U.S. adults. The typical age of onset for anorexia is between the ages of 12 and 25. Both disorders are diagnosed far more frequently in girls than in boys. Prevalence rates for EDNOS are greater than for both anorexia and bulimia combined.
Misperceptions of one’s appearance can also be manifested as body dysmorphic disorder, in which an individual magnifies the negative aspects of a perceived flaw to such a degree that the person shuns social settings or embarks compulsively upon a series of appearance-augmenting procedures, such as dermatological treatments and plastic surgery, in an attempt to remove the perceived defect.
Personality is the characteristic way in which an individual thinks, feels, and behaves; it accounts for the ingrained behaviour patterns of the individual and is the basis for predicting how the individual will act in particular circumstances. Personality embraces a person’s moods, attitudes, and opinions and is most clearly expressed in interactions with other people. A personality disorder is a pervasive, enduring, maladaptive, and inflexible pattern of thinking, feeling, and behaving that either significantly impairs an individual’s social or occupational functioning or causes the person distress.
Theories of personality disorder, including their descriptive features, etiology, and development, are as various as theories of personality itself. For example, in trait theory (an approach toward the study of personality formation), personality disorders are viewed as rigid exaggerations of particular traits. Psychoanalytic theorists (Freudian psychologists) explain the genesis of the disorders in terms of markedly negative childhood experiences, such as abuse, that significantly alter the course of normal personality development. Still others in fields such as social learning and sociobiology focus on the maladaptive coping and interactional strategies embodied in the disorders.
A number of different personality disorders are recognized, some of which are discussed below. It is important to note that the mere presence of the trait, even having it to an abnormal extent, is not enough to constitute disorder; rather, the abnormality must also cause disturbance to the individual or to society. It is also common for personality disorders to co-occur with other psychological symptoms, including those of depression, anxiety, and substance use disorders. Because personality traits are by definition virtually permanent, these disorders are only partially, if at all, amenable to treatment. The most effective treatment combines various types of group, behavioral, and cognitive psychotherapy. The behavioral manifestations of personality disorders often tend to diminish in their intensity in middle and old age.
Borderline personality disorder
Borderline personality disorder is characterized by an extraordinarily unstable mood and self-image. Individuals with this disorder may exhibit intense episodes of anger, depression, or anxiety. This is a disorder of personality instability—such as unstable emotionality, unstable interpersonal relationships, unstable sense of self—as well as impulsivity. People with this disorder often have “emotional roller-coaster” relationships, in which they experience a desperate fear of abandonment and exhibit alternating extremes of positive and negative affect toward the other person. They may engage in a variety of reckless behaviours, including sexual risk-taking, substance abuse, self-mutilation, and attempts at suicide. They may exhibit cognitive problems as well, particularly regarding their physical and psychological sense of self. The disorder, which occurs more commonly in women, often appears in early adulthood and tends to fade by middle age.
A person with this disorder shows prominent overscrupulous, perfectionistic traits that are expressed in feelings of insecurity, self-doubt, meticulous conscientiousness, indecisiveness, excessive orderliness, and rigidity of behaviour. The person is preoccupied with rules and procedures as ends in themselves. Such persons tend to show a great concern for efficiency, are overly devoted to work and productivity, and are usually deficient in the ability to express warm or tender emotions. They may also exhibit a high degree of moral rigidity that is not explained by upbringing alone. This disorder is more common in men and is in many ways the antithesis of antisocial personality disorder.
The causes of personality disorders are obscure and, in many cases, difficult to study empirically. There is, however, a constitutional and therefore hereditary element in determining personality characteristics generally and so in determining personality disorders as well. Psychological and environmental factors are also important in causation. For example, many authorities believe there is a link between childhood sexual abuse and the development of borderline personality disorder or between harsh, inconsistent punishment in childhood and the development of antisocial personality disorder. However, it is extremely difficult to establish the validity of these links through systematic scientific inquiry, and, in any case, such environmental factors are not always associated with the disorders.
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