A personality disorder is present in a person when certain characteristics have been present for many years, usually since the patient's youth.
Both genetic and environmental influences are possible causes. Examples of this are people who are so overly anxious that they are barely able to manage their daily lives without outside help. Other personality disorders are, for example, characterized by strong coercive actions, excessive self-insecurity, pronounced childlike behavior and much more.
Within certain limits, these disorders can be improved by long-term, intensive psychotherapy, mostly in a psychoanalytic setting, and people can be helped to cope better with their everyday life and social environment. To what extent therapy makes sense and is possible must be assessed individually.
In contrast to neurosis, which aderives from unprocessed conflicts, the diseases treated in this section belong to disorders in which the causes of the problems are more complex. All clinical patterns discussed so far belong to the neurotic disorders.
Psychosis is a disorder of perceiving the environment and processing emotions. Patients develop fears and feelings of persecution (paranoia) in a more or less pronounced way. These feelings are partly accompanied by delusions, which means that the sufferer perceives things that are not real. Usually, they cannot be convinced that their perceptions are wrong.
For example, these people are convinced that advertising posters or television programmes contain special, secret messages addressed only to them. Sometimes they feel influenced by radio waves or other things.
These patients should immediately be treated by neurologists or psychiatrists. Modern medicines can quickly alleviate the patient's suffering. Especially in the case of suicide threats, which are always to be taken seriously, a hospital stay is absolutely necessary.
Psychoses are disorders in the perception of the environment and in the processing of emotions. Patients develop fear and feelings of persecution (paranoia) in a more or less pronounced way. These feelings are partly accompanied by delusions, which means that these people perceive things that are not real. Nor can they be convinced that their perceptions are wrong.
For example, people suffering from this type of disease are convinced that advertising posters or television programmes contain special, secret messages that are addressed only to them. Sometimes they feel influenced by radio waves and much more.
These patients immediately belong in the treatment of neurologists or psychiatrists, who can nowadays quickly improve these diseases with modern drugs or alleviate the suffering of the patient. Especially in the case of suicide threats, which are always to be taken seriously, a stay in hospital is absolutely necessary.
Schizophrenia is a form of psychosis. Juvenile schizophrenia in particular often occurs, which usually develops in the mid-20s, but then often heals at a later age.
Borderline disorders occupy a special position. These patients are often very inhibited by intense feelings of fear and anger. To relieve these emotions, patients tend to behave bizarrely, inappropriately, rebelliously and unpredictably.
Many forms of extreme behaviour are also associated with drugs, alcohol and other addictive substances. The anxiety can be so strong that it resembles the symptoms of psychosis. Borderline patients often have paranoid thoughts, but are less often exposed to delusions.
Sometimes such borderline disorders also occur in patients who have experienced severe trauma. However, this is not conditional. Unfortunately, mentally unstable people are also more easily victims of abuse and violence.
All these disorders tend to be more severely impairing than the disorders discussed above, with the exception of abuse and violence.
As a rule, these patients tend to be best care for in clinics, neurologists and psychiatrists. A stay in a modern psychiatric hospital can also make sense. In any case, patients in internal distress and great fear can always turn to the emergency rooms in their place of residence.
Of course, people who suffer from psychosis also often have various conflicts, for example within their families or at work. In all these conflicts, conventional psychotherapy is also an option, provided the underlying disease is recognised and treated.
Depending on the severity of the disorder, treatment can take several years with interruptions. Diagnosis, prognosis and therapy of psychoses is a complex topic that can only be briefly addressed here. In outpatient psychotherapy, patients are usually only treated after an acute phase. The subject of treatment are the the often very severe problems in social behaviour and relationships.
The conflicts mentioned above, which occur at the same time as the underlying disease, can also be treated with behavioral therapy, deep psychological therapy, and analytical therapy (covered by the insurance company). All forms of humanistic psychotherapy, such as talk therapy, but also psychodrama (all not covered by insurance) can be considered if they are tailored to the specific problem of the patient.
Currently, particularly specialized approaches with a mixture of behavioral therapy and cognitive training are being researched. Salutogenesis approaches are also an option. In any case, the basis for successful treatment is a particularly trusting relationship between patient and therapist as well as the therapist's experience with the subject.
For certain disorders, low-frequency psychotherapy can have a supportive and preventive effect that can prevent hospitalisation.
With a mixture of inpatient and outpatient therapy, the treatment can take several years with interruptions.
Health insurance companies, both private and statutory/public, usually cover the costs of treatment.