Personality disorders (sometimes referred to as PDs) are not something you can label people with just for having one or two negative personality traits; rather, personality disorders fall under specific criteria in the DSM-V. They can range from mild to severe.
Research suggests that about 10% of adults could probably be diagnosed with a personality disorder, making it difficult or impossible for them to have “sustained, meaningful, and rewarding relationships with others.”
Personality disorders, in general, are marked by an obsessive concern for the self, rigid and uncompromising attitudes, and an inability or unwillingness to adapt to the needs and desires of others. They function as a cover for deep-seated self-esteem issues, representing a form of overcompensation for feelings of insecurity and inferiority. – Bridgestone Recovery
Some people with personality disorders recognize that their thinking and behavior patterns are unhealthy, while others may consider themselves normal and may not realize that they need help for a personality disorder. They or their loved ones often seek help because of relationship problems.
Some of the more well-known of the ten personality disorder types are narcissistic, borderline, and antisocial. A few of the lesser-known personality disorders are histrionic, avoidant, and dependent. It’s important to be informed that someone with these traits may have a personality disorder, whether the traits are found in you or someone else.
Personality disorders are divided by the DSM-V into three categories:
- Cluster A (odd/eccentric) disorders include paranoid, schizoid, and schizotypal.
- Cluster B (dramatic/emotional/erratic) disorders include borderline, narcissistic, antisocial, and histrionic.
- Cluster C (anxious/fearful) disorders include avoidant, dependent, and obsessive-compulsive personality.
In this article, we’ve chosen to highlight three of the lesser-known personality disorders: histrionic, avoidant, and dependent personality disorder. Although these conditions are not as well-known as BPD (Borderline Personality Disorder), NPD (Narcissistic Personality Disorder), or antisocial (the condition of sociopaths), they can be equally destructive to lives and relationships.
It’s important to note that a person who exhibits some characteristics of a personality disorder does not necessarily qualify for a mental health diagnosis. Everyone has some characteristics that are found in one or more personality disorders. If someone has only one or two traits of a specific disorder, this is not enough to qualify them for a diagnosis (e.g., someone with narcissistic personality traits doesn’t necessarily have NPD.)
So, it’s important to remember that people who exhibit histrionic, avoidant, or dependent traits may not have a personality disorder. But, being informed about the traits of PDs can be helpful in the effort to have healthier relationships. Whether or not certain unhealthy traits are part of a personality disorder, they can still be disruptive to healthy relationships.
Let’s talk in detail about each of these three lesser-known personality disorders, and about how Christian counseling can be a helpful step in addressing them.
Histrionic Personality Disorder
Histrionic personality disorder (HPD) falls under the cluster B or the emotional/impulsive section of personality disorders in the DSM-V—the same category as borderline, narcissistic, and antisocial personality disorders.
Someone with HPD may seem to have high self-esteem because they tend to be loud, dramatic, and seem overconfident. In reality, their self-esteem is overly dependent on others’ approval of them. They have an unusually high need to be noticed and to be the center of attention. They will manipulate situations and people so that they can remain the center of attention.
Histrionic personality disorder involves high levels of emotionality and attention-seeking behavior. It is four times more common in women than in men, and it is estimated that HPD affects less than 2% of adults in the United States, making it one of the least common PDs.
Here are some more specific signs and symptoms of histrionic personality disorder:
- Discomfort without being the center of attention
- Displays of inappropriately seductive or flirtatious behavior/dress
- Rapidly changing emotion
- Exaggerated but insincere behavior
- Constant seeking of approval
- An inordinate concern with physical appearance
- Excessive sensitivity to criticism
- Boredom with routine
- Rash decision-making
- Lack of empathy for others
Many people with HPD have at least one co-occurring disorder, including another cluster B disorder or depression, anxiety, an eating disorder, etc.
Avoidant Personality Disorder
Avoidant personality disorder (APD) falls under the cluster C or anxious section, along with dependent and obsessive/compulsive personality disorders.
A person with APD has extremely low self-esteem coupled with an intense fear of being judged or rejected. Because of their fear and a low sense of self-worth, they avoid social situations whenever they can.
Someone with APD is highly sensitive to scrutiny and constantly fears to be “on display.” They may still be able to function in everyday life but will have a strong pattern of avoiding situations where they are uncomfortable.
Having APD is not the same as having Social Anxiety Disorder (SAD), although the conditions do overlap. APD is a more deeply-rooted type of anxiety. It is thought that 1.5-2% of adults have APD.
Here are the signs and symptoms of avoidant personality disorder:
- Extreme sensitivity
- Few close friends
- Social anxiety
- Poor self-image
- Paranoia about what others are thinking
- Physical symptoms of anxiety and fear in social situations
- Avoidance of conflict
Depression is often correlated with APD, and so are substance use disorders.
Dependent Personality Disorder
Dependent Personality Disorder (DPD) is another one of the cluster C or anxiety disorders. Someone who has DPD is extremely dependent or clingy because of their intense fear of separation. This disorder is thought to be one of the most straightforward PDs to diagnose.
It is interesting to note that the symptoms of DPD are similar to the symptoms of borderline personality disorder. In both cases, the person with the disorder has a fear of being abandoned.
While someone with BPD responds to this fear with emotions of emptiness and anger, a person with dependent personality disorder submits to their fear and clings to a relationship to avoid the fear coming true.
About 2.5% of adults are thought to have DPD, which can be described as “a chronic and obsessive need to be cared for or supported by others, which leads to behavior that loved ones may classify as clingy or overly needy.”
Here are the signs and symptoms of Dependent Personality Disorder:
- Inability to make neutral decisions without input
- Avoidance of adult responsibilities
- Intense fear of abandonment
- Oversensitivity to criticism
- Lack of self-confidence
- Difficulty expressing dissenting opinions for fear of criticism
- Deferring to others to take responsibility
It is thought that most people with DPD also have at least one other mental health condition, such as depression, anxiety, substance use disorder, etc.
Treatment for Personality Disorders
What are the treatment options if you or someone you love seems to be exhibiting symptoms of a personality disorder?
The first thing a doctor or psychologist will probably do with a possible diagnosis of a personality disorder is to rule out any underlying medical causes for the behavior. Someone whose behavior is dependent, avoidant, antisocial, erratic, etc. may have an underlying medical cause.
Once a medical cause has been ruled out and if there is a personality disorder diagnosis, a mental health professional can screen for co-occurring disorders such as anxiety or depression, which can be treated with medication if necessary. Treatment of any co-occurring disorders will improve the quality of life for the patient, making it easier to address the underlying issues of the personality disorder.
Medication is not an effective choice simply for the personality disorder itself. Psychotherapy (also known as talk therapy) and counseling are frequently used to help patients deal with the fallout of their unhealthy relationship patterns and learn new and healthier ways of approaching life and relationships.
The goals of therapy for personality disorders may include emotional regulation and changing core beliefs that contribute to the disorder.
Christian Counseling for Personality Disorders
Christian counseling makes use of valid forms of talk therapy employed by skilled, experienced professionals who use biblically informed, professional methods to treat personality disorders in the therapeutic setting. If you are interested in talking to a Christian counselor about issues caused by a personality disorder in your own life or someone else’s, please do not hesitate to reach out today.