Therapeutic, Pharmacological, Holistic and Alternative Treatments for Personality Disorders

Personality disorders are enduring patterns of thoughts, beliefs, and behavior that are pervasive, rigid, and can lead to psychological distress and impairment of functioning. There are considered to be ten different types of personality disorders: borderline, antisocial, histrionic, narcissistic, avoidant, dependent, schizoid, paranoid, obsessive-compulsive, and schizotypal. Although these disorders differ in symptomology, etiology, and expression, treatment options are similar and fall into three broad categories. Choosing which treatment is dependent on the individual and the type and severity of their personality disorder. Here, we'll provide a list of treatments for personality disorders, including an overview of how they work and their demonstrated efficacy in previous research. Note that treatments are not mutually exclusive- often the best outcomes are found when a number of treatments are used in combination.

Therapeutic Treatments

Therapy enables the individual with a personality disorder to gain insight and awareness into their maladaptive thoughts and behavior.There are a number of different therapeutic interventions including family and group therapy, cognitive therapy, dialectical behavior therapy, psychoanalysis and psychodynamic therapy. All of these treatments have demonstrated efficacy in treating personality disorder.Research conducted by Perry, Banon and Ianni in the American Journal of Psychiatry, for example, found psychotherapy was associated with a sevenfold increase in the rate of recovery when compared with the natural history of disorders. A meta-analysis conducted by Leichsenring and Leibing in the American Journal of Psychiatry found support that both psychodynamic therapy and cognitive behavior therapy was effective in the treatment of personality disorders. Group therapy was found to significantly improve the self-esteem, symptomatology, and diagnosiability in research conducted by Budman, Demby, Soldz and Merry at Harvard Medical School.

Pharmacological Treatments

Drug treatments include antidepressants such as selective serotonin reuptake inhibitors (SSRIs) for depression and impulsivity, antipsychotics such as halporidol (Haldol) for psychosis, mood stabalizers such as Lithium for behavioral problems such as rage outbursts and anti-anxiety medication. In research conducted by Tyrer and Bateman at the Royal College of Psychiatrists SSRI's and monoamine oxidase inhibitors were found to have some benefit in the treatment of borderline personality disorder. They cautioned, however, that all personality disorders should not be treated with the same drug. It should also be noted that drug therapy does not necessarily remedy the maladaptive traits involved in personality disorders. An individual with dependent personality disorder, for example, may be treated for anxiety and depressive symptoms associated with their disorder but may still have self-esteem problems. Combinations of pharmacological and therapeutic interventions are therefore recommended.

Holistic and Alternative Treatments

Although there has not been a lot of research conducted on these therapies, preliminary research for their efficacy has been positive. One such treatment is mindfulness training, which is a method of relaxation that encourages the individual to become more self aware through continually observing the present without considering the past or the future. Mindfulness training was found to significantly reduce the severity of borderline personality disorder in research conducted by Lineham in 1993. Mindfulness was also found to reduce negative states such as stress and anxiety that may lead to negative outcomes for individuals with personality disorder. Antecdotal evidence also supports treatments such as stress reduction. Stress is identified as a trigger for both the both the development and severity of personality disorders. Activities that reduce stress, such as exercise, meditation and yoga, are therefore likely to be effective as adjunct treatments for personality disorders.

Sources

American Journal of Psychiatry: The Effectiveness of Psychodynamic Therapy and Cognitive Behavior Therapy in the Treatment of Personality Disorders: A Meta-Analysis.

American Journal of Psychiatry: Effectiveness of Psychotherapy for Personality Disorders

Advances in Psychiatric Treatment: Drug Treatment for Personality Disorders

Pubmed.gov: Time-Limited Group Psychotherapy for Patients with Personality Disorders: Outcomes and Dropouts

Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.