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What is Schizoid Personality Disorder?

Schizoid personality disorder (SPD) is a chronic and pervasive condition characterized by social isolation and feelings of indifference toward other people. Those who live with this disorder are often described as distant or withdrawn and tend to avoid social situations that involve interaction with other people. However, people with this mental health disorder are able to function fairly well in society.

A schizoid personality disorder isn’t the same as schizophrenia. This is a common misconception. They’re actually two different mental health conditions. The main difference between the two conditions is that people who have schizophrenia have persistent symptoms of psychosis, like hallucinations (seeing or hearing something that others don’t) or delusions (false beliefs). People with schizoid personality disorder don’t experience distortions of reality.

A schizoid personality disorder is one of three disorders that make up cluster A personality disorder. Cluster A includes paranoid, schizoid, and schizotypal personality disorders. The adjective “schizoid” was originally coined to describe the prodromal seclusiveness and isolation observed in schizophrenia. The schizoid personality type was made official in DSM III in 1980, to describe persons experiencing significant ineptitude in forming meaningful social relationships.

Schizoid Personality Disorder
A schizoid personality disorder is frequently found to be co-morbid with substance abuse. Substance use may mask some symptoms of schizoid or, on the other hand, intensify them.

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What Causes Schizoid Personality Disorder? 

A schizoid personality disorder is a chronic lifelong behavior pattern, stemming from childhood. As stated before, there is a suggested heritability to the disorder, but specific genetic causes have not been identified. Specific anatomic abnormalities (localized brain lobe lesions) and biochemical or neurotransmitter-associated diseases are suggested in the literature to have a role in the development of this disorder; however, these are purely speculative at this point.

If you’ve received a diagnosis of schizoid personality disorder, you may be wondering about the reasons why you have a schizoid personality disorder. There’s actually no consensus within the medical community regarding what really causes a personality disorder. It’s commonly believed that it may be a combination of these factors:

  • Environmental influences
  • Genetics and biology
  • Cultural and social influences
  • Childhood relationships
  • Early life experiences

In the case of schizoid personality disorder, there might be a tendency to develop the disorder if there’s a first-degree relative who’s received a diagnosis of:

  • Schizoid personality disorder
  • Schizophrenia
  • Schizotypal personality disorder

But this doesn’t mean it happens every time. Other research suggests that severe loneliness and depression during the early years of life are associated with the development of schizoid personality disorder. This could be related to experiences of:

  • Rejection

Basically, there’s not enough analysis on schizoid personality disorder specifically to fully establish or understand its causes and risk factors.

How Common is Schizoid Personality Disorder?

It’s estimated that about 7.5% of the global population has a schizoid personality disorder. This mental condition affects up to 5% of people in the United States, making it a common personality disorder. It’s twice as common among males than females. People who have relatives with schizophrenia or schizotypal personality disorder are at an increased risk for schizoid personality disorder.

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Do I Have Schizoid Personality Disorder?

Think You Might Have Schizoid Personality Disorder? Perhaps you find it challenging to express yourself emotionally and build relationships with others — through you truly want to connect. You deeply believe you can’t trust anyone but yourself. Fearing what might happen if you get too close, you spend a lot of time lost in your own thoughts.

These key traits of schizoid personality disorder show up internally. So people around you may simply decide you’re a quiet, private person, or assume interpersonal relationships are not your strong point.

The general lack of awareness surrounding this personality disorder means even you may not realize the underlying causes of the behaviors you’ve adopted to protect yourself. You only know they create distress.

That said, if you have come across any information about the condition, you may realize some signs reflect your inner experience. Learning more about schizoid personality disorder can help you take steps toward getting the right kind of support.

Here’s a more sign of what living with a schizoid personality disorder may feel like:

You avoid close relationships

This avoidance stems from an overarching need for safety. You might want an intimate relationship, but your need to feel safe remains more important. Since you consider other people a potential source of danger, you find bonding with others extremely difficult.

You prefer solitary activities and pastimes

Living with schizoid personality disorder tends to mean you’re extremely independent and mostly keep to yourself. 

You have little interest in sex

When you find it difficult to trust others and usually feel unsafe in social situations, it’s only natural you’d lack interest in physical intimacy. Healthy relationships require trust, after all. So when having sex, you might feel somewhat detached and disconnected rather than enjoy the experience.

Schizoid Personality Disorder
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You don’t often feel excited

People with schizoid personality disorder generally learn to dissociate from situations when they feel unsafe or stressed. Over time, this dissociation can become a reflex, leaving you feeling detached and disconnected more often than not.

You have very few friends or confidants

To you, people are either safe or unsafe. Unsafe people (usually the vast majority) are best avoided. Believing you can’t trust others can, understandably, make it hard to confide in anyone. This avoidance, however, often prompts an overwhelming sense of loneliness. People with schizoid personality disorder often develop a close bond with one “safety person,” This friend or family member doesn’t feel threatening, so you find it possible to let them in, to some extent.

You keep your emotions to yourself

With schizoid personality disorder, you certainly experience emotions. But dissociation and detachment can leave you feeling cut off from them. Emotions reflect another layer of vulnerability. Sharing feelings with others means trusting them with your concerns and difficulties — something that could threaten your sense of safety further. Instead of risking pain, you shut down completely in order to protect yourself.

Social Anxiety Disorder vs Schizoid Personality Disorder

Individuals with schizoid personality disorder are not interested in relationships, at least on a conscious level, and they mostly prefer their solitude. Their avoidance is not a result of fear, but rather has to do with social indifference and a need for personal space.

This leaves us with social anxiety disorder, a mental condition in which fear plays a major role. People suffering from social anxiety experience overwhelming feelings of self-consciousness and anxiousness when dealing with social interactions due to fear of humiliation and embarrassment. They usually react to the anxiety they experience.

Schizoid Personality Disorder vs Schizophrenia

While schizoid personality disorder is considered one of the schizophrenia spectrum disorders and shares some common symptoms with schizophrenia and schizotypal personality disorder, there are important distinctions that separate schizoid personality disorder from those two disorders.

Those with schizoid personality disorder rarely experience paranoia or hallucinations. Also, while they may seem aloof and distant during conversations, they do make sense when they speak, which differs from the difficult-to-follow speech patterns that are often demonstrated by people with schizophrenia.

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How is Schizoid Personality Disorder Diagnosed? 

If you are concerned about your symptoms, you may start by consulting your doctor. Your doctor will evaluate your symptoms and check for any underlying medical conditions that might be contributing to your symptoms. In most cases, you will likely then be referred to a mental health professional. The DSM-5 diagnostic criteria state that people must display at least four of the following symptoms in order to be diagnosed with schizoid personality disorder:

  • Always chooses solitary activities
  • Emotional detachment and lack of emotional expression
  • Experiences little pleasure from activities
  • Indifference to criticism or praise
  • Lack of desire or enjoyment for close personal relationships
  • Little or no interest in sex with other people
  • No close friends other than immediate family

A schizoid personality disorder is most often diagnosed by a psychiatrist or another mental health professional who is trained to diagnose and treat personality disorders. General practitioners often lack the training to make this type of diagnosis, especially since the condition is so uncommon and is often confused with other mental disorders. People who have schizoid personality disorder rarely seek out treatment on their own. It is often only after the condition has severely interrupted multiple areas of a person’s life that treatment is sought. 

How is Schizoid Personality Disorder Treated?

If your doctor diagnoses you with schizoid personality disorder, your doctor may prescribe medication or therapy to treat it. No medications are designed to treat schizoid personality disorder specifically. However, some individuals with this condition benefit from taking antidepressants or antipsychotic drugs if they’re experiencing symptoms that their doctor thinks to be improved with these medications.

Several types of therapy can help treat schizoid personality disorder. Talk therapy or psychotherapy can help you learn how to form relationships. You can get this type of therapy along with social skills training to help you feel more comfortable in social situations.

Cognitive-behavioral therapy (CBT) can help you address some of the behaviors associated with your condition. Your therapist can help you learn how to act in social situations and respond to social cues. They can also help you learn to recognize unusual or harmful thoughts and change them. Family therapy may be helpful, especially if you live with others. It can help you strengthen your relationships with family members. It may also help you to feel more supported by your family.

Schizoid Personality Disorder and Substance Abuse

People with schizoid personality disorder seem to be at greater risk of developing schizotypal personality disorder or schizophrenia, as well as anxiety or depression, but addiction is not specifically listed as a complication. However, anxiety and depression can all too often lead to a substance use disorder. Addiction recovery can be a unique challenge for people with schizoid personality disorder because treatment environments can press certain social requirements.

People with schizoid personality disorder are far less likely to seek treatment in the first place because it means meeting and interacting with other people. Since the primary treatment – as it is with all personality disorders – is therapy, that means not only interacting with another person, but interacting on a deep, honest, emotional level – something people with schizoid personality disorder avoid to as great a degree as possible.

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Dual Diagnosis Treatment

To determine the most effective ways to treat schizoid personality disorder and substance abuse, it’s crucial to first get an accurate assessment of all the symptoms. When the symptoms have been evaluated by a mental health professional, it may be determined that another form of depression is present and needs a particular type of treatment. Very often, some combination of psychotherapy, medication, and/or lifestyle changes are effective for coping with functional.

Medically-Assisted Detox

Detox is often considered the first stage of treatment. It will help you navigate the complicated process of alcohol withdrawal, but it doesn’t address patterns of thought and behavior that contribute to alcohol use. Various treatment approaches and settings can help provide the ongoing support necessary to maintain long-term sobriety after you complete detox.

Cravings are very common during detox and can be challenging to overcome. This often leads to relapse. Constant medical care provided during inpatient treatment helps prevent relapse. Clinicians can provide necessary medication and medical expertise to lessen cravings and the effects of alcohol withdrawals.

Psychotherapy for Depression

Several different modalities of psychotherapy have been used in the treatment of depression including:

  • Cognitive Behavioral Therapy (CBT) – an effective treatment that involves making changes in both the patterns of negative thoughts and the behavioral routines which are affecting the daily life of the depressed person for various forms of depression.
  • Person Centered Therapy – a strategy that allows and encourages clients to understand and resolve their concerns in a safe, support environment.
  • Solution Focused Therapy – an approach interested in solutions which can be quickly implemented with a simple first step leading to further positive consequences.

Dual Diagnosis Treatment

Alcoholism and mental health disorders often co-occur. In many cases, traumatic experiences can result in a mental health disorder and substance abuse. Dual diagnosis rehabilitation treats both of these issues together. The best approach for the treatment of dual diagnosis is an integrated system. In this strategy, both the substance abuse problem and the mental disorder are treated simultaneously. Regardless of which diagnosis (mental health or substance abuse problem) came first, long-term recovery will depend largely on the treatment for both disorders done by the same team or provider.

Medication-Assisted Treatments

Medication-Assisted Treatments (MAT) for alcohol use disorder and mental health disorder are commonly used in conjunction with one another. This includes the use of medications and other medical procedures. During your rehab, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. Sometimes, the pressures and problems in your life lead you to rely on substances to help you forget about them momentarily.

If you or a loved one are struggling with long-term substance abuse and a co-occurring mental health condition such as depression, contact one of our helpful treatment specialists today. We Level Up NJ can provide information on dual diagnosis and detox programs that may fit your specific needs.

Schizoid personality disorder
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Sources:

[1] NCBI – https://www.ncbi.nlm.nih.gov/books/NBK559234/

[2] NCBI – https://pubmed.ncbi.nlm.nih.gov/12095001/