When someone suffers from mental illness, there is a deprivation of the joy and emotional wealth that’s present when there is ideal mental health. Mental illness can drain our joie de vivre, and make for a muddy emotional existence. Relationships with loved ones tend to be difficult, and there tends to be a propensity for loneliness and isolation. Worse yet, when mental illness is left untreated, the toll it can take on the one suffering and their loved ones can be taxing and sometimes devastating.
Some types of mental illness are more straightforward in their treatment: anxiety and depression, for example, are often treated with various modalities of psychotherapy and balanced with medication. Personality disorders are complex and there are some instances where the patient doesn’t recognize their illness despite their deep suffering. The work involved in treating all mental illness requires a nexus of therapeutic support and a desire for positive change from the patient themselves. The question many have is, Why are personality disorders so challenging?
Personality disorders are grouped into three clusters:
- Cluster A personality disorders are “characterized by odd, eccentric thinking or behavior.” The disorders that fall into this category are: paranoid personality disorder, schizoid personality disorder and schizotypal personality disorder
- Cluster B personality disorders are “characterized by dramatic, overly emotional or unpredictable thinking or behavior.” The disorders that fall into this category are: antisocial personality disorder, borderline personality disorder, histrionic personality disorder and narcissistic personality disorder.
- Cluster C personality disorders are “characterized by anxious, fearful thinking or behavior.” The disorders that fall into this category are: avoidant personality disorder, dependent personality disorder and obsessive-compulsive personality disorder.
Psychotherapy is the most common treatment for all types of mental illness; the most efficacious modality is determined by the needs of the client. Findings show that DBT (Dialectical Behavioral Therapy) in particular is the most effective therapeutic treatment for personality disorders and bipolar disorders. Other effective tools used in treatment may include:
- Individual psychotherapy
- MBSR (Mindfulness Based Stress Reduction)
- Somatic Experiencing
To date, the FDA hasn’t approved of any medications to treat personality disorders. However, medications are often used to treat symptoms that are detrimental to the individual’s recovery. Medications like:
- Antidepressents: for depressed mood, anger, irritability, mood swings, impulsivity and hopelessness.
- Mood stabilizers: to even out mood swings, and to reduce impulsivity, irritability and aggression.
- Antipsychotic medications (also known as neuroleptics): if symptoms include losing touch with reality (psychosis), and sometimes anxiety and difficulty with anger
- Anti-anxiety medications: For anxiety, agitation or insomnia. Note, in some cases, they may increase impulsive behavior and are avoided with some personality disorders.
Treating mental illness requires the cultivation of balance. Participation from the client, a cohesive treatment team, and the correct combination of medication can create the desired environment of mental health. It takes work, dedication, and a willingness to unveil one’s difficulties in order to create a healthy shift toward mental health. I have experienced the shadow side of untreated mental illness with family members who are unwilling to get help. It does, in fact, take a toll on everyone involved. I have learned that one of the key pieces for my own recovery is developing clear communication skills, creating firm, compassionate boundaries, and building consistent program of self-care. Families struggling with mental illness need to ensure that their own wells are filled, that they are getting their own needs met, and that they have a community of support around them.