Dependent personality disorder or chronic feelings of self-doubt and anxiety

Personality disorder or psychopathy is a disorder of a person’s mental activity, characterized by disharmony in the development of certain aspects of the personality. The first inconsistencies with generally accepted norms in behavior can be visible already at an early age. They become more noticeable during puberty, and over the years the symptoms become more pronounced.

Psychopathy is considered a kind of borderline state, bordering between health and disease. It is seen as a painful deviation from the norm, but is not a mental illness. Personality disorders have many types and forms, so treatment is selected individually, taking into account clinical characteristics.

Causes

According to statistics, about 12% of the population suffers from personality disorders. The reasons for their occurrence are ambiguous in most cases. The main predisposing factors to the development of mental disorders are of a genetic nature - the presence of mental illnesses, alcoholism, personality disorders in parents or close relatives.

In addition, the development of personality disorders can occur as a result of traumatic brain damage before the age of 3-4 years. Also, social factors can play a leading role in the emergence of this kind of pathology - inadequate upbringing of a child in the event of the loss of parents or in a family suffering from alcoholism. Violations arise against the background of inflicted psychological trauma - intimate abuse, manifestations of sadism, moral cruelty towards a child.

At first, the manifestations of the pathology have a clear picture, but with age, the symptoms have no specific boundaries and are reflected in all areas of life.

Causes of cognitive disorders

Cognitive impairments are functional and organic in nature. Functional disorders in the cognitive sphere are formed in the absence of direct brain damage. Overwork, stress and constant overexertion, negative emotions - all this can be the cause of functional cognitive disorders. Functional cognitive disorders can develop at any age. Such disorders are not considered dangerous and always disappear or their manifestations are significantly reduced after the cause of the disorders is eliminated. However, in some cases, drug therapy may be required.

Organic conditions in the cognitive domain arise from brain damage resulting from disease. They are more often observed in older people and usually have more stable features. However, proper therapy even in these cases helps to achieve improvement in the condition and prevents the increase in disorders in the future.

The most common causes of organic pathologies in the cognitive sphere are: insufficient blood supply to the brain and age-related decrease in brain mass or atrophy.

Insufficient blood supply to the brain can occur due to hypertension, cardiovascular pathology and strokes. Therefore, timely diagnosis of these diseases and their correct treatment are very important. Otherwise, serious complications may occur. Blood pressure, maintaining normal blood sugar and cholesterol levels should be given special attention. There are also vascular cognitive disorders that develop as a result of chronic cerebral ischemia, repeated strokes, or a combination thereof. Such pathologies are divided into two options: disorders arising as a result of pathology of small vessels, and disorders resulting from pathology of large vessels. Neuropsychological features of the detected conditions, reflecting their relationship with disruption of the frontal lobes of the brain, will indicate the vascular etiology of cognitive disorders.

Vascular cognitive personality disorders are quite common today in the practice of neurological pathologies.

With brain atrophy, due to age-related changes, more pronounced pathologies of cognitive functions are formed. This pathological condition is called Alzheimer's disease and is considered a progressive disease. However, the rate of growth of pathologies in the cognitive sphere can vary significantly. Mostly, symptoms are characterized by a slow increase, as a result of which patients can maintain independence and independence for many years. Adequate therapy is of great importance for such patients. Modern methods of therapy help to achieve improvement in the patient’s condition and long-term stabilization of symptoms.

Pathologies in the cognitive sphere can also be caused by other brain diseases, cardiovascular failure, diseases of internal organs, metabolic disorders, alcohol abuse or other poisoning.

Symptoms

Personality disorder is characterized by alternating periods of social compensation and decompensation.

Compensation is manifested by the individual’s temporary adaptation to society. During this period, a person does not have problems communicating with people around him, and personal deviations are hardly noticeable. During decompensation, pathological personality traits become pronounced, which contributes to a significant disruption of the adaptive capabilities of social interaction.

This period can take either a short period of time or last for a long time.

Personality disorders during exacerbation may be accompanied by symptoms such as:

• distortion of perception of reality;
• a feeling of emptiness and meaninglessness of existence;
• hypertrophied reaction to external stimuli;
• inability to establish relationships with other people;
• asociality;
• depression;
• feeling of uselessness, increased anxiety, aggression.

The diagnosis of “Personality disorder” can be made only if there is a triad of Gannushkin-Kerbikov criteria for psychopathy, which includes the totality of personality disorders, the severity of the pathology, as well as the relative stability of the individual’s condition.

Symptoms of cognitive disorders

Cognitive dysfunction is characterized by specific symptoms, which depend on the severity of the pathological process and which parts of the brain it affects. Damage to individual areas causes impairment of individual cognitive functions, but disorders of several or all functions at once are still more common.

A disorder of cognitive functions causes a decrease in mental performance, memory impairment, difficulty expressing one’s own thoughts or understanding someone else’s speech, and deterioration in concentration. With severe disorders, patients may not complain about anything due to a loss of criticality towards their own condition.

Among cognitive pathologies, the most common symptom is memory impairment. Initially, progressive disturbances arise in remembering recent events, and gradually, distant events. Along with this, mental activity may decrease, thinking may be impaired, as a result of which the individual cannot correctly evaluate information, and the ability to generalize data and draw conclusions deteriorates. Another equally common manifestation of cognitive impairment is deterioration in concentration. Individuals with such manifestations find it difficult to maintain vigorous mental activity and concentrate on specific tasks.

The term moderate cognitive personality disorder usually means a disruption of one or more cognitive processes that goes beyond the boundaries of the age norm, but does not reach the severity of dementia. Moderate cognitive impairment is mainly considered a pathological condition, the result of which transformations at this stage are not limited to age-related involutive processes.

According to a number of studies, mild cognitive impairment syndrome is observed in 20% of individuals over 65 years of age. Research also shows that dementia develops in 60% of individuals with this pathology within five years.

Moderate cognitive impairment in 20-30% of cases is stable or slowly progressive, in other words, it does not transform into dementia. Such disorders can go unnoticed by individuals for quite a long time. However, if several symptoms are detected in a short period of time, then it is worth contacting specialists for advice.

The presence of a cognitive disorder is indicated by the following symptoms: difficulties in performing ordinary counting operations, difficulties in repeating information just received, disorientation in an unfamiliar area, difficulties in remembering the names of people new to the environment, obvious difficulties in finding words during normal conversation.

Moderate cognitive disorders, identified in the early phases of their development, can be quite successfully corrected with the help of medications and various psychological techniques.

In order to assess the severity of cognitive impairment, special neuropsychological testing is used, which consists of answering a number of questions and performing certain tasks by the patient. In accordance with the test results, it becomes possible to determine the presence of deviations in certain cognitive functions, as well as their severity. Test tasks can be in the form of simple mathematical operations, such as adding or subtracting, writing something on paper, repeating a few words, identifying objects shown, etc.

Schizoid personality disorder

Persons suffering from this type of pathology are characterized by excessive isolation, emotional detachment, and sociopathic tendencies. They do not need contact with people, prefer a solitary lifestyle, and most often choose work with the possibility of minimal communication.

When interacting with others, such people experience internal discomfort, a feeling of uncertainty, tension, and therefore avoid establishing trusting relationships and do not have close friends.

Patients with this diagnosis show interest in everything unusual, have non-standard views on things and well-developed logical thinking. They are also characterized by a passion for various philosophical problems, ideas for improving life, and exact sciences.

People suffering from this type of disorder often achieve excellence in mathematics or theoretical physics, have musical talent, and also the ability to establish unexpected patterns.

What is cognitive impairment

Cognitive functions are perception, intelligence, the ability to get acquainted with new information and remember it, attention, speech, orientation in space and time, motor skills. Over time, a person begins to experience disturbances in everyday behavior due to disruptions in cognitive functions. Isolated cases of forgetfulness are not a reason to worry, but if a person begins to regularly forget events, names or names of objects, then this may indicate disturbances in brain activity, then the patient needs the help of a neurologist.

Paranoid disorder

Personality disorder of the paranoid type is characterized by increased distrust, pathological suspicion, and an exaggerated perception of injustice towards one’s own person. Patients with this diagnosis tend to see negative intent in everything, constantly feel a threat from the outside, and attribute negative intentions to others.

A paranoid person is characterized by increased confidence in his own importance, does not recognize that others are right, and is convinced of his own infallibility. Such a person is extremely sensitive to criticism addressed to him and interprets any actions and words of others in a negative way.

In a state of decompensation, the clinical picture is complemented by pathological jealousy, a craving for constant disputes and proceedings, and aggression.

Dissocial disorder

Pathology is manifested by an indifferent attitude towards the feelings of others, irresponsible behavior, and disregard for social rules and responsibilities. Individuals with this diagnosis are characterized by behavioral non-compliance with social norms; they are characterized by open confrontation with the outside world and a criminal predisposition.

In childhood, the characteristic features of such individuals are increased conflict, lack of desire to learn, and opposition to any established rules. During puberty, persons suffering from this pathology show a tendency to theft, hooliganism, and frequent running away from home.

An adult with a dissocial disorder has no spiritual values, is unable to experience warm feelings, and blames everyone but himself. Such people assert themselves at the expense of the weak, do not feel pity, have sadistic tendencies, and are aggressive in bed.

Hysterical disorder

This kind of disorder occurs in 2-3% of the population, most often in females. This type of mental disorder is characterized by theatrical manifestation of emotions, frequent mood swings, shallow perception of phenomena, and inconsistency in attachments. Such people love increased attention to their person, so they try in every possible way to achieve this.

Patients with hysterical disorder are overly concerned with their appearance, strive for ostentatious external brilliance, and need constant confirmation of their irresistibility.

When building personal relationships, individuals with this diagnosis put their own interests first and try to achieve their goals at the expense of others through manipulation. They are painfully aware of the indifferent attitude of others.

Diagnostics

Diagnosis of cognitive impairment

To diagnose a cognitive disorder and the degree of its development, it is necessary to collect the medical history of the patient and his relatives. It is necessary to take into account genetic predisposition, previous injuries, bad habits, the psycho-emotional state of the patient, and uncontrolled use of medications by a doctor.

Diagnostics includes the following activities:

• a neurologist conducts an examination for the presence of an underlying disease, the symptoms of which may be neurological in nature;
• a psychiatrist assesses the patient’s mental health using neuropsychological tests as diagnostics - these are special exercises when it is necessary to reproduce pictures and words, solve certain problems, perform some movements, and so on, that is, cognitive-behavioral additional therapy is carried out;
• the use of the MMSE scale - certain questions with which the doctor assesses the patient’s speech and memory, time orientation, etc., will indicate the effectiveness of treatment.

In patients with acquired cognitive disorder, additional laboratory tests are taken to determine the biochemical composition of the blood, the level of thyroid-stimulating hormones, and lipid profile readings.

The following instrumental studies are carried out:

• CT scan;
• Magnetic resonance imaging;
• dopplerography;
• electroencephalogram.

In some cases, differential diagnosis is carried out.

Obsessive-compulsive disorder

This type of disorder is characterized by increased caution, a tendency to doubt, a desire to keep everything under control, and obsessive thinking. People suffering from this type of personality disorder strive for perfection in everything, which greatly interferes with the completion of the task itself. They are overly conscientious, scrupulous, too pedantic and demanding of themselves and others.

Such patients are convinced that only their lifestyle and concepts are correct, and therefore demand that others conform to their ideas. Often, these individuals develop obsessive thoughts and peculiar rituals, expressed in the constant need to count objects, repeatedly check whether household appliances are turned off, whether the entrance doors are closed.

The financial side of life plays a special role for such people. They are overly frugal in spending, which they also demand from others; money is perceived as something that needs to be put aside in case of a global catastrophe.

During the period of compensation, individuals with this diagnosis are distinguished by reliability, pedantry, and correctness in communication. During decompensation, they are bothered by a growing feeling of anxiety, due to which the patient becomes irritable, remains in a gloomy state, and has hypochondriacal tendencies.

Symptoms of disorders by type

Each type of disorder has its own symptoms:

Passive-aggressive

Patients are irritable, envious, rather angry, threaten to commit suicide, but, as a rule, do not do this. The condition is aggravated by constant depression due to alcoholism, as well as various somatic disorders.

Narcissistic

There is a significant exaggeration of one's own talents and merits, multiple fantasies on various topics. They love admiration for themselves, envy the successful people around them and demand unwavering submission to their own demands.

Dependent

People with this syndrome often have very low self-esteem, they show self-doubt and try to avoid responsibility. A special problem in this case is the fundamental difficulties of making important decisions; people with such a personality disorder easily endure insults and humiliation, and are afraid of loneliness.

Alarming

Manifests itself in fear of various environmental factors. They are afraid to speak publicly, have a number of social phobias, are very sensitive to criticism, and require constant support and approval from society.

Anancast

There is excessive shyness, impressionability, and lack of confidence in oneself and one’s strengths. Such patients are often overcome by doubts, they are afraid of responsible work, and sometimes they are overcome by obsessive thoughts.

Histrionic

They crave constant attention and are very impulsive to the point of hysteria. Extremely changeable moods will often change. People try to stand out in the most extravagant way, often lying and making up various stories about themselves in order to gain more significance from society. They often behave openly and friendly in public, but in families they are tyrants.

Emotionally unstable

They are very excitable and respond to any events very violently, openly expressing anger, dissatisfaction, and irritation. The outbursts of such people often lead to open violence if they meet resistance/criticism from other people. Their mood is very changeable, unpredictable, and they have a great tendency to act impulsively.

Dissocial

Tendency to ill-considered and impulsive actions, disregard for moral standards, indifference and aversion to responsibilities. Such people do not regret their actions, they often lie, manipulate others, and they do not have anxiety or depression.

Schizoid personality disorder

Such people strive for isolated life activities; they do not want close relationships and ordinary contacts with others. Patients are indifferent to praise or criticism, show very little interest in sexual relations, but they often become attached to animals. The predetermining factor is the maximum possible isolation from the surrounding society.

Paranoid

They almost always experience unfounded suspicions about deception, exploitation, or other actions on the part of society. Patients are unable to forgive other people; they believe that they are always right and understand only the authority of power and authority. In extreme forms they can be dangerous, especially if they intend to pursue or take revenge on their imaginary enemies and offenders.

Anxiety disorder

This type of pathology is accompanied by a constant feeling of anxiety, unpleasant premonitions, and low self-esteem. Such people try to avoid any contact with people, considering themselves socially inferior and personally unattractive. They are too shy, indecisive, and often lead a reclusive lifestyle.

Individuals with an anxiety disorder are pathologically afraid of criticism in their direction; they are hypersensitive to any negative assessments, and therefore try to avoid social and professional activities.

As a rule, people with this diagnosis adapt well to society, since in most cases the environment is sympathetic to the problem of such a person.

Diagnosis and treatment

When diagnosing, a person’s lifestyle is taken into account, as well as diseases that close relatives have. The patient will have to undergo various tests such as blood test, MRI and CT , various mental tests and a lapidogram should also be done. Based on the results, it will be possible to separate the disease from others, as well as determine which disease caused cognitive impairment.

You will definitely need to undergo therapy, which will be prescribed based on the results of the examinations completed. The doctor will decide what medications the person will need. For example, in case of persistent brain damage, a specialist may prescribe Galatamine, Dnepezil and Nicergoline.

If there are moderate cognitive impairments, then a specialist may prescribe medications that will help improve blood circulation. Neuroprotectors are also often used. For example, a specialist may recommend Glycine, Ceraxn, Mexidol and Nootropil.

In addition to medications, a person will have to follow a special diet. A person will need to give up fatty foods, eat fresh fruits and vegetables, and seafood. In this case, you will have to take B vitamins to maintain the body.

A person should not give up his usual lifestyle; he needs to maintain social communication, remain active, and try to avoid stress. You will need to see a doctor regularly so that you can adjust your treatment regimen and monitor your condition.

Narcissistic disorder

A clear manifestation of this kind of disorder occurs in adolescence. Patients experience an increased need for admiration from others, exaggerate their own importance in society, and do not accept critical judgments.

The main character traits of such individuals are complete conviction of their own greatness and the need to indulge all their whims. They are convinced of their superiority over other people, have an inflated opinion of their talents and achievements, and are absorbed in fantasies about their successes. They need increased attention and are focused exclusively on themselves.

Narcissistic individuals are clever exploiters and manipulators, thanks to which they achieve the fulfillment of their desires at the expense of others. Such people prefer a certain social circle that meets their high standards. They do not accept criticism and comparisons with “ordinary” people.

The inner world of these individuals is quite fragile and vulnerable, the emotional state is unstable and completely depends on external circumstances. Arrogance and arrogance are a protective mask that hides excessive sensitivity to rejection and criticism.

Dependent personality disorder

People suffering from this type of disorder are characterized by shifting responsibility for solving most life issues. The pathology is accompanied by a feeling of helplessness, pathological fear due to the inability to independently manage one’s own life.

As a rule, dependent people try to find a kind of patron with the help of whom they can at least somehow realize themselves in society. Such individuals need constant encouragement, advice, and approval of actions. Patients with this diagnosis are fearful, timid, unsure of their own abilities, unable to live without constant guidance.

The period of decompensation begins in the event of the loss of a patron, when life tasks must be performed independently, without prior agreement with him. The clinical picture during this period worsens significantly, which can lead to severe panic attacks without any particular reason.

The essence of the disorder

Dependent disorder is a personality disorder in which a person believes in his own helplessness and weakness. “I can never do anything well” and “I never succeed in anything” are the two main mental attitudes of a person with a dependent disorder. An alternative name for the disorder is asthenic (from the Greek “powerlessness”) psychopathy.

Asthenics do not recognize their achievements, consider themselves incompetent and worthless. Moreover, they can achieve success, but attribute it to someone else. Devaluation of oneself and one’s merits is the main feature of asthenics.

As the name suggests, such people are prone to addictions, especially psychological and in relationships. They have a strong need for intimacy. But in relationships they take the position of a victim, easily shifting all the responsibility and all the laurels to the partner. For the sake of recognition and support from asthenics, they are ready to humiliate themselves, agree with others, while actually disagreeing, and downplay their abilities and capabilities. Asthenics are capable of long-term relationships, but the nature of the relationship can only be dependent.

An anxiety disorder often develops as a result of an addictive disorder. In addition, asthenics are prone to panic in situations of uncertainty, for example, when changing their place of residence or changing their usual living conditions, changing responsibilities at work (although more often such people do not work and are financially dependent on a partner), criticism from others.

Asthenic psychopathy is often complicated by psychosomatic diseases and addictions. Fear of independent life forces a person to look for options for escaping reality (alcoholism, drug addiction, taking medications, overeating, smoking).

Treatment

Treatment tactics depend on the causes of the pathology, the form and characteristics of the clinical picture. Only a psychiatrist can diagnose a personality disorder, and only a specialist should prescribe treatment measures. Self-prescribed therapy may not only not bring the desired results, but can also significantly aggravate the situation.

In a state of compensation, the patient does not need drug treatment. The basis of treatment measures in this case will be group or individual psychotherapy aimed at smoothing out pathological character traits. This method will allow the patient to learn how to respond correctly to certain life situations, which in turn will help him fully adapt to society.

During the period of decompensation, a person is considered disabled; if it lasts for a long period of time, there is a possibility of disability. Therefore, this condition requires immediate treatment. In this case, in addition to psychotherapeutic influences, drug therapy is prescribed to help relieve the symptomatic manifestations of the disorder.

To reduce anxiety, depression and other painful symptoms, selective serotonin reuptake inhibitors are usually prescribed. Anticonvulsants may be prescribed to control impulsivity and temper tantrums. To combat depersonalization and depression, drugs such as risperidone Risperdal are used.

The main goal of treatment is to eliminate the stressful state and isolate the patient from the external stimulus that caused the exacerbation of symptoms. This helps to reduce the severity of clinical manifestations - anxiety decreases, the feeling of hopelessness disappears, and depression is eliminated.

Classification

Pathology is divided into several types. According to the severity of the clinical picture:

• moderate cognitive impairment;
• mild cognitive impairment.

These are conditions in which dementia, that is, dementia, is not observed, especially if it is a mild cognitive developmental disorder. But if the problem is not detected in time and adequate treatment is not started, the patient may become weak-minded.

If the pathological process is not treated, dementia develops. The causes of the pathology are different - diseases, poisoning and injuries. But this always leads to the manifestation of a violation of human cognitive functions. Initially, memory deteriorates, the patient does not recognize relatives, does not understand where he is.

It is up to the doctor to determine whether it is a mild cognitive disorder or another type of disease during diagnostic procedures.

Personality disorder in children

In order to start treatment on time and prevent the pathological condition from worsening, you should be attentive to the psychological health of the child. As a rule, dependent and anxious personality disorders are the most common in childhood. Most often, the development of pathology is associated with a negative home or school environment, where moral as well as physical humiliation predominates.

The anxiety type of disorder is manifested by the following symptoms:

• low self-esteem;
• tendency to awkwardness;
• hypertrophied perception of problems;
• defensive behavior;
• reluctance to communicate with peers;
• increased anxiety.

If you have an addictive disorder, you may experience symptoms such as:

• victim behavior;
• excessive sensitivity to criticism;
• shifting responsibility to others;
• feeling of loneliness;
• reluctance to make decisions independently;
• lack of confidence in one's own strength;
• unstable emotional state.

If any symptoms appear, it is advisable to contact a qualified professional. Treatment for mental disorders in children is selected as carefully as possible. As a rule, therapeutic measures are based on the use of gentle drug therapy, long-term work with a psychologist, and constant monitoring by a psychiatrist.

Mild cognitive impairment

The pre-dementia condition is a mild cognitive impairment. In other words, mild impairments of cognitive functions are pathologies of higher brain functions, which are characterized primarily by vascular dementia, which goes through a series of stages in its development, determined by a consistent increase in symptoms - starting with mild impairments of the functions of the cognitive sphere, mainly memory, and ending with severe impairments - dementia.

According to the recommendations of the international classification of diseases, a diagnosis of mild cognitive disorder is possible in the presence of the following symptoms: deterioration in memory function, attention or decreased learning ability,

When performing mental work, high fatigue is observed. At the same time, memory impairment and disruption of other brain functions do not lead to atrophic dementia and are not associated with delirium. The listed disorders are of cerebrovascular origin.

The clinical manifestations of this disorder correspond to a stable cerebrasthenic syndrome, which essentially refers to psychopathological conditions reflecting disorders of various areas of the psyche, including cognitive functions. However, despite this, cerebrasthenic syndrome is characterized by the external safety of patients, the absence of severe impairments of mental, critical and prognostic processes, the illusion of instability, patency of asthenic disorders.

Diagnosis of this disorder is based on the results of clinical examinations and the findings of experimental psychological research.

Mild cognitive disorder is differentiated from organic disorders by the fact that disturbances in the functioning of the cognitive sphere do not occur in conjunction with emotional (affective instability), productive (! paranoia) and behavioral disorders (inadequacy).

General prevention

Unfortunately, there is no specific standard for the prevention of various personality disorders, since each person is individual. However, it is still possible to prevent the development of mental disorders in a child. For this purpose, many mental health programs have been developed today to help parents and children solve family problems.

These types of programs are mainly educational in nature - they involve lectures and discussions aimed at understanding developmental psychology.

Adults suffering from a personality disorder should not neglect the services of a psychiatrist. If you are unable to control your emotions and reactions, it is advisable to consult with a competent specialist who will prescribe appropriate therapy.

Despite the fact that this kind of personality disorder is not a mental illness, during the period of decompensation a person is not able to independently overcome painful symptoms. Therefore, to avoid undesirable consequences, you should definitely seek medical help.

Diagnostic methods

To confirm the presence of a personality disorder, a thorough diagnostic examination is required . Most often, specialists make a diagnosis by identifying three symptoms from the following signs of the disease:

1. Decreased ability to work and productivity in the professional sphere.
2. Changes in behavior patterns affecting various areas of life.
3. Prolonged stay in a state of stress, which has a chronic form.
4. Physiological problems caused by stress.
5. Changes in behavioral model and personal position, expressed by a negative perception of the surrounding world.

Mental personality disorders are divided into three categories, which have their own characteristic features:

1. Group “A” - paranoid, schizoid and schizotypal personality disorders are included in the cluster of specific disorders.
2. Group "B" - disinhibited, unspecified, borderline, histrionic, narcissistic and antisocial disorders are included in the cluster of theatrical or emotional disorders.
3. Group “C” - avoidant, obsessive-compulsive and dependent disorders are included in the cluster of panic and anxiety pathologies.

Today, in Russia, an international system is used to classify diseases. Before the adoption of this system, the diagnosis of mental illness was based on the system of the Russian psychiatrist P. B. Gannushkin. This system, developed at the beginning of the twentieth century, divided personality disorders into asthenic, psychasthenic, schizoid, paranoid, excitable, hysterical, affective and unstable types.