A number of barriers make personality disorders among the most challenging mental health conditions to treat. People with these conditions are likely to have difficulty opening up to or retaining closeness with therapists. Perceived criticism may cause them to react angrily and break off therapy. Those who seek treatment on their own and who are motivated to stick with therapy over many years are the most likely to succeed.

Treatment for most personality disorders is a combination of therapy and medications.

Therapy

Types of therapy that can help people with personality disorders include:

Psychodynamic psychotherapy

This approach entails talking about your condition and related issues with a mental health professional. Psychotherapy can help people with personality disorders recognize how they’re responsible for the turmoil in their lives and learn healthier ways of reacting to people and problems. Individual, group and family therapy can all be helpful.

Cognitive behavior therapy

This form of psychological treatment involves actively retraining the way you think about problems, which in turn improves your emotions and behaviors.

Dialectical behavior therapy

This type of cognitive behavior therapy focuses on coping skills — learning how to take better control of behaviors and emotions with techniques such as mindfulness, which helps you observe your feelings without reacting. It is most often used to treat borderline personality disorder. Doctors are studying the effectiveness of this type of therapy with all types of personality disorders.

Medications

People with personality disorders often experience serious mental and emotional strain, cusing additional mental health problems, such as depression, phobia and panic. Medications may help alleviate these related conditions, but they can’t cure the underlying disorder. Therapy aimed at building new coping mechanisms must be the cornerstone of treatment.
Medications that may offer support during therapy include:

Antidepressants

Doctors commonly prescribe selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac, Sarafem), sertraline (Zoloft), citalopram (Celexa), paroxetine (Paxil), nefazodone, and escitalopram (Lexapro), or the related antidepressant venlafaxine (Effexor) to help relieve depression and anxiety in people with personality disorders. Less often, monoamine oxidase inhibitors such as phenelzine (Nardil) and tranylcypromine (Parnate) may be used.

Anticonvulsants

These medications may help suppress impulsive and aggressive behavior. Your doctor may prescribe carbamazepine (Carbatrol, Tegretol) or valproic acid (Depakote). Your doctor may also prescribe topiramate (Topamax), an anticonvulsant that’s being studied as an aid in managing impulse-control problems.

Antipsychotics

People with borderline and schizotypal personality disorders are at risk of losing touch with reality. Antipsychotic medications such as risperidone (Risperdal) and olanzapine (Zyprexa) can help improve distorted thinking. For severe behavior problems, doctors may prescribe haloperidol (Haldol).

Other medications

Doctors sometimes prescribe anti-anxiety medications such as alprazolam (Xanax) and clonazepam (Klonopin) and mood stabilizers such as lithium (Eskalith, Lithobid) to relieve symptoms associated with personality disorders.

Sources: Healthy Genius

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