Personality disorder treatments?

[mrscjh12]

My mum has a severe personality disorder "histrionic" she is a big attention seeker, to the extent she can reck lives just for attention. No medication helps her, and needs to be treated for her behaviour problems. What treatment can help with personsilty disorders?

 

[dib4uk]

Well hello and welcome!

Has your mum been put on the waiting lists for therapy? She might be able to have pyschodynamic therapy but i'm not to sure what else is avaliable for that.

Sorry i'm not much help but for other personality disorders theres a treatment called DBT i believe.

 

[Wonky]

Sorry,dib4uk, I'm going to contradict you a bit.

DBT has only shown some effectiveness with Borderline PD, specifically in reducing negative behaviours like self-harm. As far as all the other PDs go I haven't seen anything that says there is any strong evidence that any form of psychotherapy or psychological treatment is clearly effective for PD. Psychotherapy as a treament for PD still needs a lot more investigation and greater and clearer proof.

From the psychotherapy viewpoint the only real options are a "therapeutic community" or an intensive psychotherapy unit. Attendance at a therapeutic community is usually for two years.

mrscjh12, you need to find out what your local MH Trust offers. And first of all your mum needs to be a patient of that Trust under a Consultant Psychiatrist. No GP can handle a severe PD case.

There may be some meds that can help a bit. There is no specific drug treatment for any form of PD, but some meds may help with specific things like anxiety or mood swings. But medication really needs to be looked at by a Consultant Psychiatrist.

 

[Wonky]

I realise my reply to mrscjh12's question was a bit bleak and short.

The thing about psychotherapy and PD is that at the moment that seems the most promising path, but as I said it seems that a lot more evidence is needed before it can be confidently classed as a generally effective treatment.

Most work so far on PD and psychotherapy seems to be with regard to Anti-Social PD (ASPD) and Borderline PD. These are, I am afraid, the PDs that get the most attention because they impact more greatly on services - ASPD often coming via the criminal justice system and BPD having a high suicidal and self-harm profile.

Having said that I am not saying that people with ASPD or BPD (perhaps especially BPD) have an easy time getting help. The interesting thing about services for PD is that in 2003 the Department of Health published a document called 'Personality Disorder No Longer a Diagnosis of Exxlusion.." This doc obviously acknowledged that a PD diagnosis was used as a way to exclude people from MH services, on the grounds that PD was untreatable. The doc urged greater optimism about treating PD etc. And what has been the result? Well for one thing a well-known and respected specialist PD centre, the Henderson Hospital, closed in 2007. I very much doubt that nationally there has been any expansion of services for PD. And I very much think that psychiatrists still use it as a way of getting rid of patients.

"Therapeutic communities" are specialist units where people attend several times a week for about two years and where they are encouraged to get involved with the running of the "community". e.g. making lunch, and various activities, e.g. creative writing, as well as having some sort of psychotherapy. I don't know much about intensive psychotherapy units but I should think they are what they say they are and they don't have the "community" and more wide-ranging character of therapeutic communities.

 

[*Sapphire*]

I believe histrionic and emotionally unstable personality disorders are other (perhaps mistakenly used) names used for Borderline Personality Disorder. Although it can be a separate diagnosis in its own right so you would need to check that out.

There are many types of therapies available that may be of help to your mum either alone or combined. It largely depends on her condition and her behaviours and what funding/therapy is available in your area.

What I will say is that whatever treatment she undertakes please don't expect an overnight cure. Personality disorders are very complex and sometimes it takes more than one therapy and some time to help. I know what she will need is lots of support from her family and friends.

I hope things are going okay?

 

[Wonky]

I have never heard of emotionally unstable PD before - that must be a new term - but histrionic definitely used to be a completely separate PD from Borderline.

I think this obviously is an issue where someone like mrscjh12 needs to find creditable official/academic sources because there seems to be a lot of difference in what lay people know and it can be become rather confusing and even (unintentionally) misleading.

 

[trombone_babe]

I found this page really useful, and from a creditable source too.

http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/personalitydisorders/pd.aspx