Personality disorders
- Borderline Personality Disorder
Borderline personality disorder involves intense, rapidly shifting emotions, unstable relationships, fear of abandonment, impulsivity and often self-harm. The primary treatment is structured psychotherapy, especially dialectical behavior therapy (DBT), with medication used to target specific symptoms such as mood instability or impulsivity. Most people improve substantially, and the majority achieve remission over time. - Narcissistic Personality Disorder
Narcissistic personality disorder is a persistent pattern of grandiosity, need for admiration and limited empathy, usually concealing fragile self-esteem. Long-term psychotherapy such as transference-focused, schema or mentalization-based therapy is the primary treatment. No medication treats NPD itself; medication targets co-occurring depression, anxiety or mood instability. Progress is gradual, but motivated patients improve in relationships and emotional stability over one to three years. - Antisocial Personality Disorder
Antisocial personality disorder is a persistent pattern of disregard for others' rights, with deceit, impulsivity, aggression and lack of remorse, preceded by conduct disorder in youth. Treatment is primarily structured psychotherapy focused on consequences and impulse control, with medication for aggression, mood instability and co-occurring substance use, ADHD or depression. No medication treats the disorder itself, and outcomes depend heavily on motivation and treatment of addiction. - Avoidant Personality Disorder
Avoidant personality disorder is a pervasive pattern of social inhibition, feelings of inadequacy and hypersensitivity to rejection that leads to avoiding relationships and opportunities. Psychotherapy, including schema therapy, CBT with graded exposure and social skills training, is the primary treatment over months to years. SSRIs help the social anxiety and depression that usually coexist. Most motivated patients make meaningful gains within a year.
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