Psychotherapy: Short-Term Therapy , Long-Term Results

Individuals get addicted inadvertently and accidentally. They do not set out to make their lives more difficult. It often takes time before they are addicted and even more time before they acknowledge to themselves that they are addicted. They may get addicted to a chemical, for example, alcohol or prescription medications, or an activity, for example, internet pornography or gambling, or both. In addition, individuals with addictions often grapple with other emotional and behavioral issues. They may suffer from depression and social anxiety or have interpersonal issues.

Many individuals suffer from anger problems. Their unhealthy anger could lead them to feel resentful and miserable if they hold their anger in. Their anger could lead to relationship, legal, or job problems if they express their anger outwardly.

Anger is one of the moral emotions. Individuals with unhealthy anger problems often are stuck on some real injustice that has befallen them. They cannot get past the transgressions they have received.

Some individuals with unhealthy anger feel irritable much of the time. Their anger is easily triggered by minor or slight inconveniences. Some individuals with anger find themselves often disappointed in the behavior of others who fail to meet their expectations. Some individuals with anger feel they are embattled with the world and have difficulty with authority or functioning under the direction of others.  Anger episodes can last for days or weeks, taking up much of a person’s conscious thought and devouring their time and energy.

Although there is no diagnosis for anger problems in DSM-5 or the World Health Organizations ICD-10 manual, several disorders reflect enduring and dysfunctional anger. The most common of these are Intermittent Explosive Disorder and Oppositional Defiant Disorder. However, more than 32 disorders listed anger, aggression, or irritability as a symptom.

Research shows that mental health professionals often misdiagnose clients with anger problems and give them a more severe diagnosis than their symptoms indicate.

Often people have anger problems with another emotional problem. Research has shown that the presence of anger with a primary emotional disorder like depression or anxiety results in more severe emotional problems and are more resistant to treatment.

Separation Anxiety Disorder

Separation Anxiety Disorder is a disorder that is characterized by developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by at least three of the following: recurrent and excessive distress about anticipating or being away from home or loved ones; constant, excessive worry about losing a parent or other loved one to an illness or a disaster; constant worry that something bad will happen, such as being lost or kidnapped, causing separation from parents or other loved ones; refusing to be away from home because of fear of separation; not wanting to be home alone and without a parent or other loved one in the house; reluctance or refusing to sleep away from home without a parent or other loved one nearby; repeated nightmares about separation; and/or frequent complaints of headaches, stomachaches or other symptoms when separation from a parent or other loved one is anticipated. The fear, anxiety, or avoidance is persistent, lasting at least 4 weeks in children and adolescents and typically 6 months or more in adults. Separation anxiety disorder may be associated with panic disorder and panic attacks ― repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes. 

Specific Phobias

Specific Phobias are identified by the fear or intense anxiety about a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood). The phobic object or situation almost always provokes immediate fear or anxiety.  Individuals may either actively avoid the object/situation or the phobic stimulus is endured with intense fear or anxiety.  The response is disproportionate to the actual danger posed and to the sociocultural context.  The fear, anxiety, or avoidance typically lasts for six months or more and causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.  

Social Anxiety Disorder

Social Anxiety Disorder is a relatively common problem, characterized by heightened anxiety or fear about being evaluated by others in social situations. The anxiety is considered disproportionate to the actual situation and can be highly distressing. The fear may be related to performance, such as public speaking, or even benign interactions with others, such as speaking with a sales associate or meeting someone new. Some individuals even experience social anxiety while just being watched by others, such as eating in public. Individuals with social anxiety disorder tend to either avoid the feared situation or suffer through it with intense discomfort. Shame and embarrassment are also commonly experienced emotions in individuals with social anxiety. Individuals with social anxiety may also struggle with being assertive.

Panic Disorder

Panic Disorder is characterized by the experience of recurrent and unexpected panic attacks. A panic attack is an abrupt period of intense fear or discomfort that heightens significantly within minutes and is  accompanied by 4 or more of the following systemic symptoms: palpitations, pounding heart, or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath or smothering; a feeling of choking; chest pain or discomfort; nausea or abdominal distress; feeling dizzy, unsteady, lightheaded, or faint; feelings of unreality (derealization) or being detached from oneself (depersonalization); fear of losing control or “going crazy”; fear of dying; numbness or tingling sensations (paresthesias); chills or hot flushes. In addition, at least one panic attack is followed by one month or more of the individual fearing that they will have more attacks, which may cause them to change their behavior and often includes avoiding situations that might induce an attack.

Agoraphobia

Agoraphobia is characterized by a marked, or intense, fear or anxiety triggered by the real or anticipated exposure to a wide range of situations such as use of public transportation, being in open or enclosed spaces, being in crowds or being outside one’s home alone.  Individuals with agoraphobia often avoid these situations due to fears that escape would be difficult or that they may not be able to receive help if they were to experience panic-like symptoms.  The situations almost always provoke fear or anxiety. The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.  

Generalized Anxiety Disorder (GAD)

Generalized Anxiety Disorder (GAD) is among the most common psychological problems. It is characterized by excessive anxiety about numerous situations and is frequently resistant to individuals’ attempts to control the anxiety. Features of GAD are related to mood, thought, and body, including feeling restless, fatigued, irritable, physically tense, and experiencing difficulty with concentration and sleep. Individuals with GAD may also experience other physical symptoms such as sweating, heart palpitations, shortness of breath, and gastrointestinal complaints. GAD tends to cause significant distress at home, work, school, and in relationships, and is often stable throughout an individual’s life. GAD is differentiated from typical worrying by the intense nature of the mood and physical symptoms, consistent preoccupation of the individual’s thoughts, and significant impact in many areas of their life.  

Illness Anxiety Disorder (Hypochondriasis)

Illness Anxiety Disorder (Hypochondriasis) is classified under the category of Somatic Symptom and Related Disorders. It is characterized by an individual’s strong belief and excessive worry that they have a serious or life-threatening illness despite having no, or only mild, symptoms.  Symptoms of Illness Anxiety Disorder (IAD) involve excessive worry over having or getting a serious illness, excessive health-related behaviors (e.g., repeatedly checking body for signs of illness) or abnormal avoidance (e.g., avoiding doctors’ appointments and hospitals), high levels of anxiety and alarm over personal health status, and little to no presence of physical symptoms. Furthermore, signs may include: being preoccupied with having or getting a serious disease or health condition; worrying that minor symptoms or body sensations are indicative of a serious illness; being easily alarmed about a health status; finding little or no reassurance from doctor visits or negative test results; and frequently making medical appointments for reassurance and/or avoiding medical care for fear of being diagnosed with a serious illness. IAD may fluctuate in severity and increase with age or during times of stress.

Bipolar I Disorder

Bipolar I Disorder, once known as Manic Depression, involves one or more manic episodes and one or more depressive episodes. Manic episodes are periods of time with abnormally heightened energy levels, thoughts, and mood. During a manic episode, an individual may feel euphoric, get little or no sleep, experience pressured or racing thoughts and speech, and may engage in self-destructive or impulsive behavior. Severe manic episodes may also include psychotic symptoms such as hallucinations and delusions. Episodes of mania and depression may alternate rapidly, may be separated by periods of normal experience, or may occur simultaneously in a mixed episode.

Bipolar II Disorder

Individuals with Bipolar II Disorder, unlike Bipolar I, have at least one current or past major depressive episode, with persistent depressed mood and/or loss of interest in most activities, and other characteristics of MDD (see description of MDD). Additionally, those with bipolar II disorder had experienced or are currently experiencing a hypomanic episode, that is, a period of elevated mood, typically accompanied by uncharacteristically high energy levels, minimal sleep, restlessness, fast speech, engagement in risky behaviors, and feelings of euphoria. Bipolar II may manifest with a cycle of intermittent major depression and hypomania, with depression often presenting more dominantly.  Individuals with bipolar II disorder may not always fully identify the negative impact of the mood extremes on their daily lives.

Cyclothymic Disorder

Cyclothymic Disorder is characterized by an individual having periods of elevated mood (hypomanic symptoms) and periods of depressive symptoms for at least two years (one year for children and teenagers), with these highs and lows occurring during at least half that time. The fluctuations in mood are not sufficient in number, severity, or duration to meet the full criteria for a hypomanic or depressive episode, however, they are present over fifty percent of the time. Individuals with cyclothymic disorder may be prone to labile mood, emotional dysregulation, and display an overreaction to minor stressors and disappointments. Symptoms of cyclothymic disorder include periods of stable moods usually lasting less than two months; cause distress or significant impairment in social or occupational functioning; cannot be accounted for by substance use or a medical condition; and do not meet the criteria for bipolar disorder, major depression or another mental disorder. Individuals with cyclothymic disorder are never symptom-free for more than two consecutive months.

Social Skills and Assertiveness Deficits

Social skills refer to any skill or ability to facilitate interactions, recognize and reciprocate emotional cues from others, and communicate with others in various social situations. They are more often times than not associated with Autism Spectrum Disorders due to the impaired development in social interaction and communication of these disorders. Teaching social skills has consistently been the focus of many child enrichment programs, both academic and non-academic. In addition, some individuals who may not qualify for a disorder that includes social skills deficits may still encounter challenges and benefit from training. Some of the skills that are focused on during social skills training include, but are not limited to, learning and rehearsing appropriate ways to begin, maintain and end conversations, give and receive compliments, and engage in socially appropriate non-verbal behavior (e.g., eye contact, body posture, etc.). 

Assertiveness training is an effective intervention for individuals who need improvement with social skills. Many individuals have trouble asserting themselves effectively to others. They may rarely speak up to express their needs and viewpoints, or they may express themselves in ways that others perceive as overly confrontational or demanding. Some individuals have little practice stating their perspectives appropriately and may benefit from applying skills training to multiple settings. Others find it relatively easy to assert themselves in certain situations (e.g., with close friends), but have great difficulty in other situations (e.g., with employers). For these individuals, the lack of assertiveness is typically associated with heightened worry about the potential consequences of asserting themselves.

Career and lifestyle changes

Career and lifestyle changes are often some of the most stressful events of a person’s life, leading a person to be filled with the potential for irrational beliefs. Even before the event begins, there is often anxiety about making the decision to do so and what the consequences might be if the “wrong” decision is made. During the adjustment period, there may be anger toward things not going as planned or anxiety about the unfamiliarity of the situation. Once the change has been made, feeling depressed, and/or guilt may occur when a person begins to think that the wrong choice was made. Understandably, this discomfort may last awhile and maybe great in frequency, intensity, and duration. Relief may be established by eventually accepting that a person made the best decision they could at the time, that the consequences of it are not unbearable or awful, and that they are not a failure or a bad person for making a mistake.  

Procrastination

Procrastination is quite common and can adversely affect one’s life in a variety of dimensions. Unfortunately, there is no drug for procrastination nor is it recognized by any insurance company. Where then does procrastination come from and how do we combat it? Two of the world’s leading experts on procrastination, Joseph Ferrari, Ph.D., and Timothy Pychyl, Ph.D., estimate that 20% of individuals identify themselves as chronic procrastinators. According to Ferrari and Pychyl, individuals who procrastinate fall into three major categories:

1. Avoidant procrastination
- Those in this category usually harbor a fear of failure (and in some cases success). These individuals would rather have people think they lack effort rather than ability.
2. Thrill seeker procrastination
- Those in this category get a “rush” from waiting to the last moment in order to triumph over a very difficult predicament.
3. Decisional procrastination
- Those in this group cannot make decisions and/or feel like not making a decision absolves them from responsibility.

Relationship Difficulties

Many people experience relationship difficulties with significant others, colleagues, friends, and family members. Often, such difficulties are exacerbated by anxiety, poor social skills, anger problems, or lack of assertiveness. Individuals in romantic relationships often lack communication skills, empathy, and a general understanding of one another. Couples or marital therapy addresses these issues and assists couples in developing healthier and more satisfying relationships.

Disruptive Mood Dysregulation Disorder

Disruptive Mood Dysregulation Disorder is chronic, severe, and persistent irritability in children and adolescence.  There are two prominent clinical manifestations: frequent temper outbursts and irritation or a persistent angry mood.  Frequent temper outbursts occur three or more times per week usually brought on by frustration.  These outbursts last more than one year and occur in at least two settings.  Persistent irritable or angry mood is present between the severe temper outbursts.  The mood is clearly observable by others (e.g., parents, teachers, or peers).   Onset is before the age of ten years.

Major Depressive Disorder (MDD)

Major Depressive Disorder (MDD) is characterized by a consistently depressed mood and loss of interest or enjoyment in most activities over a period of two weeks or longer. Other symptoms include significant change in appetite/weight, problems with sleep, general fatigue, and feeling slowed down. Individuals with MDD may also experience problems related to thought processes, such as difficulty concentrating and making decisions, and having thoughts of hopelessness, self-worth, and death, dying, or suicide. MDD is typically associated with significant distress or dysfunction in one’s life, and can often be observed by others in a person’s mood and behavior. Individuals with MDD frequently describe feeling numb or having an absence of emotional range, and often no longer care about participating in leisure activities or hobbies they once enjoyed. Many with MDD may also become irritable or angry when encountering minor frustrations. Individuals with MDD tend to ruminate on past failures and engage in negative evaluations about their own worth and their future.

Persistent Depressive Disorder (Dysthymia)

Persistent Depressive Disorder (Dysthymia) is a form of chronic (ongoing) depression. Although symptoms of persistent depressive disorder may be less severe than other types of depression, they are longer-lasting in duration. Persistent Depressive Disorder (PDD) causes continuous feelings of deep sadness and hopelessness. These feelings may affect an individual’s mood and behavior as well as physical functions, including appetite and sleep. As a result, individuals with PDD often lose interest in doing activities they once enjoyed and have difficulty finishing daily tasks. The chronic nature of PDD can also make it more challenging to cope with the symptoms. PDD is primarily characterized by the presence of depressed mood on most days for at least 2 years for adults (at least 1 year for children and adolescents). During this period, individuals are depression-free for no longer than 2 months at a time. The symptoms of PDD include: persistent feelings of sadness and hopelessness; sleep problems; low energy; change in appetite; difficulty concentrating; indecisiveness; a lack of interest in daily activities; decreased productivity; poor self-esteem; negative attitude; and avoidance of social activities.

Oppositional Defiant Disorder (ODD)

Oppositional Defiant Disorder (ODD) is characterized by a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures. This may be evident through frequent loss of temper, persistent arguments with adults, defiance of rules/requests, deliberate annoyance of others, frequent blame of others for one’s mistakes, and frequent displays of anger, resentment, spite, or vindication.

Conduct Disorder (CD)

Conduct Disorder (CD) involves a repetitive and persistent pattern of behavior in which basic rights of others or major age-appropriate societal norms or rules are violated. This may be in the form of aggression to people and animals, destruction of property, deceitfulness or theft, and/or serious violation of rules.

Intermittent Explosive Disorder (IED)

Intermittent Explosive Disorder (IED) is characterized by difficulty controlling aggressive impulses that lead to behavioral outbursts which can be in the form of verbal aggression (e.g., temper tantrums, frequent elevated arguments) or behavioral aggression (e.g., damage to property or physical assault to individuals and/or animals). Outbursts are recurrent, out of proportion to the magnitude of the stressor, cause impairments in functioning, and are not pre-meditated.

Antisocial Personality Disorder

Individuals with Antisocial Personality Disorder are characterized by a pattern of disregard for or violation of other people’s rights since adolescence. They exhibit a tendency to violate social norms, and may engage in behaviors that can lead to run-ins with the law. They may be involved in deception, lying, or conning for personal gain or pleasure. They have a tendency to be impulsive and/or aggressive, leading to physical altercations. They may have little awareness of personal or others’ safety. They lack a sense of responsibility, leading to failure to meet work demands or financial obligations. Furthermore, individuals with Antisocial Personality Disorder lack remorse and may rationalize negative consequences that they may have inflicted on others.

Anorexia Nervosa is characterized by having a significantly low body weight (e.g., body weight that is less than minimally normal); there is an extreme fear of weight gain; disturbance in body weight or shape; and undue influence of body shape or weight on self-evaluation. Individuals suffering from Anorexia Nervosa typically have rigid rules about food (e.g., what not to eat; how much to eat; when to eat). Some individuals with Anorexia Nervosa will engage in binge eating and/or purging (self-induced vomiting, laxatives, or diuretics). There are many serious medical complications with Anorexia Nervosa including cardiac problems, osteoporosis, and endocrine issues.

Bulimia Nervosa is characterized by binge eating (eating an amount of food that is larger than the average person would eat in a discrete period of time coupled with a sense of lack of control over one’s eating) and self-defeating compensatory methods to prevent weight gain (e.g., self-induced vomiting, misuse of laxatives or diuretics, fasting, excessive exercise). Self-evaluation/self-worth is excessively influenced by one’s body shape and weight. In addition, many individuals suffering from Bulimia Nervosa attempt to delay their eating for long periods of time; engage in body checking (pinching parts of one’s body to feel for fatness, repeatedly looking in the mirror); or avoidance (purposely not looking to parts of one’s body believed to be fat or disgusting). Medical complications associated with Bulimia Nervosa include but are not limited to electrolyte imbalance, gastrointestinal issues, dental problems, inflamed throat and swollen glands.

Binge-Eating Disorder is characterized by recurrent episodes of binge eating accompanied with eating quicker than normal; eating until one feels uncomfortably full; eating large amounts of food though not physically hungry; eating alone due to shame; and experiencing disgust, depression, and/or guilt following the binge. There is no inappropriate use of compensatory behavior.

Specified/Unspecified Eating Disorders encompass those individuals who do not meet the full criteria for either Anorexia Nervosa or Bulimia Nervosa.

Attention Deficit/Hyperactivity Disorder (ADHD) is characterized by a persistent pattern of inattention and/or hyperactivity that is present before 12 years of age. Inattention may interfere with social, academic, or occupational performance. In childhood, this often manifests in difficulty completing school-related tasks, messy schoolwork, careless errors, and difficulty following directions. Hyperactivity often involves excessive motor activity. Difficulty remaining seated, frequent running and climbing, and excessive talking are often noted. In addition to inattention and hyperactivity, impulsivity may also be present in the form of frequent intrusion of others’ conversations and difficulty delaying responses (e.g., blurting out answers in class). Ability to socialize and obtain/maintain friendships is often hindered as a result.  Adults with ADHD frequently have difficulty organizing and completing tasks. High levels of distractibility and difficulty focusing and maintaining concentration are evident in both children and adults. 

Learning Disorders are diagnosed when an individual has significant difficulty learning and using academic skills and a particular area is significantly below what is expected for the individual’s age. Learning Disorders may involve one or a combination of the following: impairment in reading, impairment in written expression, and/or impairment in mathematics. These learning problems significantly interfere with academic achievement, occupational functioning, or activities of daily living that involve these skills. 

Autism Spectrum Disorder (ASD) is characterized by persistent deficits in areas of communication skills and social interaction which may include a lack of social-emotional reciprocity, non-verbal communication deficits (e.g., maintaining eye contact, awkward gestures or body language), difficulty in maintaining interpersonal relationships and understanding social cues. Individuals with ASD also engage in repetitive and stereotyped patterns of behavior and activities that may include preoccupation with parts of objects, repetitive motor behaviors (e.g., flapping, twisting), and inflexible adherence to nonfunctional routines and rituals. Inflexibility and rigid thinking patterns are also common. Some individuals with ASD have sensory integration issues where they may be very sensitive to certain sounds, textures, etc. ASD can range in severity, and severity indicators are classified by level of intellectual functioning and language impairment. Mild ASD (e.g., absent or mild intellectual and language impairment) was previously diagnosed as Asperger’s Disorder. 

Intellectual Disability is characterized by deficits in intellectual functioning that can range from mild to profound. It is also accompanied by significant impairments in adaptive functioning (e.g., communication, self-care, social/interpersonal skills, home living, functional academic skills). For a diagnosis of intellectual disability, the onset of intellectual and adaptive deficits occurs in the developmental period (early childhood).

Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD) is a disorder that is characterized by the presence of obsessive thoughts or intrusive images, compulsive behaviors or the combination of obsessions and compulsions. Obsessive thoughts/images/memories are intrusive and inappropriate and cause an individual significant anxiety and distress. Compulsions are repetitive behaviors (e.g., hand washing, putting objects in order, checking) or mental acts (e.g., praying or counting) that a person feels compelled to perform in an attempt to minimize feelings of anxiety and discomfort.

Body Dysmorphic Disorder (BDD)

Body Dysmorphic Disorder (BDD) is a psychological disorder that involves a misperception of one or more body areas. Individuals with BDD perceive a defect or flaw in their appearance that is either very small or nonexistent. Areas of concern often involve flaws of the face or head (e.g., hair thinning, acne, scars, redness, wrinkles, facial asymmetry, size/shape of facial features such as nose, mouth, lips, etc.). Other areas of concern may include but are not limited to genitals, breasts, buttocks, abdomen, hips, and thighs. Individuals suffering from BDD are preoccupied with the perceived defect(s) to a point where it causes clinically significant distress in several areas of functioning. They may spend excessive amounts of time checking their appearance in mirrors, putting on makeup or otherwise masking their appearance, and seeking reassurance. Individuals with BDD will often avoid social situations and romantic relationships. As a result, high levels of anxiety, depression, embarrassment, shame, and self-disgust are frequently present.

Excoriation Disorder

Excoriation Disorder is characterized by repeated picking of the skin, often leaving scabs, scarring, or discoloration. Individuals with excoriation disorder generally feel an urge to correct perceived imperfections in their skin and have difficulty controlling the urge. Urges may also be preceded by physical skin sensations or emotional tension/stress. Although picking at skin abnormalities can be a normative behavior (i.e. cuticles, acne, etc.), it becomes problematic when the frequency or consequences are severe enough to result in significant emotional distress or impairment. People may experience a degree of shame and/or avoid social activities as a result of their appearance, which can, in turn, lead to secondary depression or anxiety. Infections and medical problems related to excoriation disorder are also common.

Hoarding Disorder

Hoarding Disorder is characterized by persistent difficulty discarding or parting with possessions, regardless of their actual value.  The difficulty is due to a perceived need to save the items and to the distress associated with discarding them.  As a result, the accumulation of possessions congests and clutters active living areas, which substantially compromises their intended use.  Hoarding disorder causes clinically significant distress or impairment in social, occupational, or other important areas of functioning (including the ability to maintain a safe environment for self and others).

Trichotillomania

Trichotillomania is characterized by an overwhelming urge to repeatedly pull out one’s own hair, resulting in repetitive hair pulling and subsequent hair loss. Though the hair on the scalp is most often affected; the eyelashes, eyebrows, beard or any other area hair may grow can also be affected. The criteria for a diagnosis include: recurrent pulling out of one’s hair resulting in noticeable hair loss; an increasing sense of tension immediately before pulling out the hair or when attempting to resist the behavior; pleasure, gratification, or relief when pulling out the hair; the disturbance is not better accounted for by another mental disorder and is not due to a general medical conditions (e.g., a dermatologic condition); and the disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Hair pulling may be triggered by or accompanied by a number of emotional states. It can be preceded by anxiety, boredom, stress, or tension, and can result in feelings of gratification, relief, or pleasure following the pulling. Hair pulling can also involve varying degrees of awareness. Specifically, hair pulling can be focused (i.e., pull hair intentionally to relieve tension or distress) or automatic (i.e., pull hair without a realization of the behavior). An individual may do both focused and automatic hair pulling, depending on the situation and mood.

Antisocial Personality Disorder

Individuals with Antisocial Personality Disorder are characterized by a pattern of disregard for or violation of other people’s rights since adolescence. They exhibit a tendency to violate social norms, and may engage in behaviors that can lead to run-ins with the law. They may be involved in deception, lying, or conning for personal gain or pleasure. They have a tendency to be impulsive and/or aggressive, leading to physical altercations. They may have little awareness of personal or others’ safety. They lack a sense of responsibility, leading to failure to meet work demands or financial obligations. Furthermore, individuals with Antisocial Personality Disorder lack remorse and may rationalize negative consequences that they may have inflicted on others.

Avoidant Personality Disorder

The lives of people with Avoidant Personality Disorder are marked by a pattern of social inhibition and hypersensitivity to perceived criticism, which are associated with chronic feelings of personal inadequacy beginning by early adulthood. Believing that they are socially inept or otherwise inferior to others, individuals with this disorder typically avoid activities involving significant interpersonal contact because they are afraid that they will be negatively evaluated or rejected. They are commonly inhibited with regard to initiating relationships or openly expressing themselves within relationships, and may be highly reluctant to take risks due to fear of embarrassment.

Borderline Personality Disorder (BPD)

Borderline Personality Disorder (BPD) is a disorder characterized by chronic, stable patterns of emotional distress, mainly relating to concerns about self-identity and relationships with others. Individuals with BPD report feeling extremely emotional yet empty and cannot bear the thought of being abandoned. Behaviorally, BPD is often accompanied by impulsive behaviors such as frequent sex, substance abuse, shoplifting, and self-injurious cutting or overdosing. Living with someone who has BPD can be difficult as relational dysfunction is a primary symptom of the disorder.

Dependent Personality Disorder

Individuals with dependent personality disorder tend to feel incapable of caring for themselves. They have difficulty making decisions and assuming responsibility without relying on others for advice and reassurance. They may be reluctant to take on projects due to lack of self-confidence. In order to avoid disapproval or being left alone, they may have difficulty expressing disagreement, and may subject themselves to unpleasant activities or abusive relationships. Furthermore, they may be preoccupied with unrealistic fears of being left alone, and may pursue close relationships urgently after one has ended.

General Personality Disorder

General Personality Disorder is a pattern of inner experience and behavior that deviates from the expectations of the individual’s culture and is manifested in at least two of the following areas: cognition (ways of perceiving and interpreting self, other people, and events), affectivity (the range, intensity, lability, and appropriateness of emotional response), interpersonal functioning, or impulse control.  The pattern is inflexible and pervasive across a broad range of personal and social situations and leads to clinically significant distress or impairment in daily functioning.  The patterns are stable and of long duration, and its onset can be traced back to at least adolescence or early adulthood.

Histrionic Personality Disorder

Individuals with Histrionic Personality Disorder often display dramatic and fluctuating emotions. They tend to enjoy being the center of attention and may become uncomfortable otherwise. They may use their appearance, impressionistic speech, or provocative/sexually-seductive behaviors to draw attention to themselves. People with Histrionic Personality Disorder tend to be easily influenced by others. Furthermore, they may deem relationships to be more intimate than generally perceived by others.

Narcissistic Personality Disorder

Individuals with Narcissistic Personality Disorder exhibit a grandiose sense of self-importance, need for excessive admiration, and lack of empathy. They may display a sense of entitlement, believe they are exceptionally unique and can only be understood by or associated with an elite few, and/or be preoccupied with fantasies of unlimited success, power, beauty, intellect, or ideal love. Nonetheless, the appearance of superiority and arrogance actually masks the sensitivity to rejection, criticism, or defeat. Their arrogant attitudes, behaviors, and interpersonal exchanges primarily serve to enhance and maintain self-esteem. This maintenance of self-esteem is often dependent on relationships with others and individuals with Narcissistic Personality Disorder are often interpersonally exploitive such that they will try eliciting admiration from others in service of themselves. Limited empathic responses are characteristic of these individuals and the motive behind any seemingly altruistic behavior is to enhance self-esteem.

Obsessive-Compulsive Personality Disorder (OCPD)

Beginning by early adulthood, individuals with Obsessive-Compulsive Personality Disorder (OCPD) display a persistent preoccupation with themes of order and control. Their perfectionism and focus on organization frequently interferes with their ability to complete tasks effectively or enjoy leisure pursuits. Peers might describe individuals with this disorder as inflexible, stubborn, or closed-minded. Other common features may include “workaholic” tendencies, hoarding, and unwillingness to delegate responsibility to others. OCPD differs from Obsessive-Compulsive Disorder (OCD) because it reflects a general personality style and does not involve specific obsessions or compulsions.

Paranoid Personality Disorder

The primary feature of Paranoid Personality Disorder is a tendency, apparent in multiple contexts, to distrust others and be suspicious of malicious intentions even when there is little evidence to support the suspicions. Because of this attitude, which develops by early adulthood, individuals with this disorder are frequently reluctant to confide in others or worry constantly about the potential disloyalty of romantic partners, friends, or associates. Such individuals are also likely to misinterpret many remarks as threats or insults, and to respond to perceived insults with immediate anger and long-term grudges.

Schizoid Personality Disorder

A defining feature of individuals with Schizoid Personality Disorder is a preference for solitary activities and isolation, reflected by a pattern of detachment and withdrawal, and an indifference to social relationships (including those with family). This preference is not due to anxiety about being in social situations or paranoia but rather stems from an inner emptiness and apathy towards social situations. They generally lack strong emotional experiences and display a restricted range of emotion. In addition to their own lack of emotionality, they also lack an awareness of other people’s feelings and struggle to empathize. Their limited involvement in their relationships with others precludes the development of friendships, and when interacting with others they will exhibit significant social skills deficits, demonstrating long silences and minimal verbal exchanges.

Schizotypal Personality Disorder

Individuals with Schizotypal Personality Disorder present with odd or peculiar beliefs (e.g., ideas of reference or magical thinking), appearance, and behavior. They tend to report unusual perceptual experiences that do not meet threshold for psychosis. Their exocentric beliefs may manifest in unusual speech that is overelaborate or vague. Additionally, they exhibit considerable social anxiety resulting from paranoid fears and suspiciousness, rather than negative self-appraisals. Their tendency to experience interpersonal discomfort and paranoia often leads them to withdraw which subsequently limits opportunities for them to develop social skills or experience interactions that may disconfirm their paranoid beliefs; as a result, they lack close friends other than close relatives. When they do interact with others, they may display constricted or inappropriate emotions and poor psychosocial functioning in general.

Post Traumatic Stress Disorder (PTSD) is characterized by symptoms that include intense fear, helplessness, and/or horror that a person experiences following exposure to a traumatic event. The traumatic event can include an actual or threatened death or a threat to one’s or another person’s physical integrity. Symptoms of PTSD can also emerge when an individual learns about an unexpected or violent death, serious harm, or threatened death that was experienced by a family member or close acquaintance. Individuals who display symptoms of PTSD often re-experience the traumatic event, may experience guilt for surviving, avoid stimuli associated with the event, and are increasingly sensitive to outside stimuli. Many individuals who experience a traumatic event often find themselves re-living it or experiencing fear, as symptoms persist for more than one month and cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.