Schizoid personality disorder

A person suffering from schizoid personality disorder may demonstrate the following symptoms:

• You like being alone and prefer going through your daily routine and activities alone
• You do not desire or enjoy being in close relationships
• You have none or very little sexual desires (Read more: Sexual anorexia)
• You always feel like you cannot be happy or experience any sort of pleasure
• You have difficulties in talking about your feelings and emotions
• You are not able to react appropriately to social situations and cues
• You do not enjoy humour 
• People have described you as being indifferent and emotionally cold or unavailable to them
• You feel ambitionless and have no motivation to achieve your goals
• You aren’t bothered about positive or negative remarks about you

Schizoid personality disorder is usually expected to begin during the early years of adulthood and some of the above mentioned clinical features could also be observed during childhood. The condition might affect one’s ability to perform their duties and activities of daily living at school, work or in other social settings. Patients who work alone are able to perform their jobs perfectly.

Patients who suffer from schizoid personality disorder may also have some similarities with those suffering from schizophrenia and schizotypal personality disorder. These similarities may include the inability to form social connections and an inability to express themselves emotionally. Patients of all three conditions are often considered to be odd, strange and unconventional.

Your personality is an amalgamation of your own thoughts, behaviours and emotions—these make each individual different and decide the way a person assesses, interprets and relates to the world around them. Science suggests that your personality is developed during your childhood and is influenced by a combination of inherited traits and the environment around you.

The exact reason behind the development of schizoid personality disorder is unknown. During normal development, children pick up skills to accurately understand social scenarios and react to them appropriately. Most patients develop this disorder in early childhood, depending on the genetic and environmental factors that may play a huge role in influencing their personality.

The factors that may increase the risk of developing schizoid personality disorder include: 

• Having family members who have a history of suffering from personality disorders like schizoid personality disorder, schizophrenia and schizotypal personality disorder. Studies conducted on twins were suggestive of the fact that this disorder is inherited and has a constitutional basis. 
• Some patients may have had one or both parents who were dismissive, cold and unresponsive to their child’s emotional requirements. 
• Scientific research done on various groups of patients suffering from schizoid personality disorder suggests that there is an association between being underweight and developing personality disorders, including schizoid personality disorders. 
• Poor calorie intake during pregnancy can result in numerous mental disorders, which also includes personality disorders. 
• Premature babies are more likely to develop personality disorders. (Read more: Caring for a premature baby)
• Patients who experience a traumatic brain injury may also be at risk of developing this condition.
• Low birth weight may also be a contributing factor in the development of schizoid personality disorder. (Read more: Tips to increase your baby’s weight)

While there may be some similarities between schizophrenia and schizoid personality disorder, there are also distinct differences. 

• Patients who suffer from schizoid personality disorder are aware of the reality around them and do not experience paranoia and hallucinations whereas schizophrenic patients experience vivid hallucinations (mainly auditory hallucinations that may be first person, second person or third person hallucinations). 

• Patients with schizoid personality disorder speak sensibly. Their way of talking may not be lively but it would make perfect sense. Whereas schizophrenic patients have strange and difficult to understand conversational methods. People with schizophrenia have a disorganized speech that occurs due to disturbances in their thought process. Doctors may observe that their speech is incoherent, they repeat words constantly and they switch between unrelated topics or stop speaking suddenly. 

• Schizophrenic patients have numerous forms of delusions. Delusions are defined as false and firm beliefs which may include persecutory or grandiose delusions or delusions of reference. Schizophrenic patients are likely to experience strange and bizarre delusions that have no basis and do not arise out of their daily life experiences. Some patients may feel that their body has been possessed. They may also claim that various thoughts are being planted in their mind. (Read more: Delusional Disorder)

• Patients with schizoid personality disorders usually do not have any form of negative symptoms that are severely harmful. Schizophrenic patients experience a wide variety of negative symptoms that may include flat affect, lack of motivation in engaging in any form of social interaction, inability to feel pleasure (anhedonia) and lack of motivation (avolition).

This personality disorder can be associated with a wide range of disorders. These may include the following : 

• Suicidal tendencies: Patients of schizoid personality disorder may have suicidal thoughts when they are upset and depressed or when all their social connections have been cut off. People with this condition know why they wish to die and this thought cements itself in their head. These patients are likely to hide these intentions. 
• Asperger syndrome: Children with Asperger’s are very likely to develop schizoid personality disorder during early adulthood. Asperger syndrome is a part of the autism spectrum disorder. It is a developmental disorder that is described by difficulties in social interaction along with repetitive behavioural patterns and interests. 
• Low body weight: Observational studies performed on patients with schizoid personality disorders and Asperger syndrome show that their body mass index (BMI) is considerably lower than that of the general population. These patients usually have abnormal eating patterns and only eat when they are alone. They may also restrict their diet and fear that they may acquire illnesses by eating certain kinds of food. Patients with schizoid personality disorders may describe that they do not enjoy eating and rarely feel hungry.

(Read more: Eating disorders)

Patients suffering from this personality disorder conventionally only visit the hospital for certain related complications like depression. 

If you feel that a family member is affected by this illness, you may want to suggest that this person visit a doctor. It would be better if you can accompany them for the first visit. 

The doctor will take a complete and comprehensive history of the patient and will perform a thorough physical examination to rule out other medical conditions. You may be referred to a psychiatrist. 

The diagnosis of schizoid personality disorder is usually based on your clinical profile, your personal history and the symptoms described in the diagnostic and statistical manual of mental disorders (DSM-5), which is followed by the American Psychiatric Association. 

The DSM-5 is a manual that aids in the diagnosis of mental illnesses. As per the DSM-5 criteria, a patient of schizoid personality disorder is indicated by at least four of the following symptoms: 

• Neither desires nor enjoys close relationships, including being part of a family
• Almost always chooses solitary activities
• Has little, if any, interest in having sexual experiences with another person
• Takes pleasure in few, if any, activities
• Lacks close friends or confidants other than first-degree relatives
• Appears indifferent to the praise or criticism of others
• Shows emotional coldness, detachment or flattened affectivity

The DSM-5 describes schizoid personality disorder (SPD) as a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood.

If you suffer from this illness, you have two options. The first option is that you can continue to avoid any form of social interactions and live a life without any emotional connections. Your second choice is to seek treatment from a psychiatrist or other mental health professionals. Treatment for this condition is known to affect the lives of patients in a positive manner.

There are numerous treatment options that are available, including the following: 

• Psychotherapy: This may also be referred to as talk therapy. This modality of treatment can be extremely useful. It can help you to form meaningful and close social connections. Cognitive behavioural therapy is used to modify your opinions and behaviour that are responsible for your condition. Your therapist would understand your difficulties in sharing your own personal space and feelings and provide suitable ways to achieve the ability to open up about your inner life and forming relationships with others. This method of treatment provides patients with emotional comfort but it is time-consuming and difficult to perform. The reason behind this is that patients with schizoid personality disorders are not very involved in these conversations due to difficulties in establishing any sort of interest and motivation for treatment. Another issue with cognitive behavioural therapy is that it is based on the identification of thoughts. But schizoid patients may lack any automatic thoughts making it very difficult to perform. 

• Group therapy: It allows patients with schizoid personality disorders to interact with others who are affected by the same or related personality disorders. This helps them in developing interpersonal skills. This form of treatment also provides patients with a support structure and teaches them numerous methods that help them respond to social cues. 

• Medical treatment: There is no medication that is used directly for the treatment of schizoid personality disorder. Certain drugs help in reducing the severity of the symptoms of the illness and other mental illnesses seen in combination with SPD. Previously, a group of drugs called atypical antipsychotics such as olanzapine and risperidone were said to help with social deficits. But studies suggest that these medications are not useful for treating any form of personality disorders. Bupropion helps in the treatment of certain symptoms like anhedonia (inability to feel pleasure). Some drugs such as lamotrigine, selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs) and MAO inhibitors (MAOI) help patients with social anxiety.  

With early diagnosis and adequate treatment, patients suffering from schizoid personality disorder can lead a happy and meaningful life. 

(Consult doctor online)

People who have this condition are at a higher risk of developing some complications. These may include the following: 

• Schizophrenia 
• Schizotypal personality disorder
• Severe depression
• Anxiety disorders
• Panic attacks