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Schizoid personality disorder

Overview

Schizoid personality disorder is an uncommon condition in which people avoid social activities and consistently shy away from interaction with others. They also have a limited range of emotional expression.

If you have schizoid personality disorder, you may be seen as a loner or dismissive of others, and you may lack the desire or skill to form close personal relationships. Because you don't tend to show emotion, you may appear as though you don't care about others or what's going on around you.

The cause of schizoid personality disorder is unknown. Talk therapy, and in some cases medications, can help.

Symptoms

If you have schizoid personality disorder, it's likely that you:

  • Prefer being alone and choose to do activities alone
  • Don't want or enjoy close relationships
  • Feel little if any desire for sexual relationships
  • Feel like you can't experience pleasure
  • Have difficulty expressing emotions and reacting appropriately to situations
  • May seem humorless, indifferent or emotionally cold to others
  • May appear to lack motivation and goals
  • Don't react to praise or critical remarks from others

Schizoid personality disorder usually begins by early adulthood, though some features may be noticeable during childhood. These features may cause you to have trouble functioning well in school, a job, socially or in other areas of life. However, you may do reasonably well in your job if you mostly work alone.

Schizotypal personality disorder and schizophrenia

Although a different disorder, schizoid personality disorder can have some similar symptoms to schizotypal personality disorder and schizophrenia, such as a severely limited ability to make social connections and a lack of emotional expression. People with these disorders may be viewed as odd or eccentric.

Even though the names may sound similar, unlike schizotypal personality disorder and schizophrenia, people with schizoid personality disorder:

  • Are in touch with reality, so they're unlikely to experience paranoia or hallucinations
  • Make sense when they speak (although the tone may not be lively), so they don't have conversational patterns that are strange and hard to follow

When to see a doctor

People with schizoid personality disorder usually only seek treatment for a related problem, such as depression.

If someone close to you has urged you to seek help for symptoms common to schizoid personality disorder, make an appointment with a health care or mental health professional.

If you suspect a loved one may have schizoid personality disorder, gently suggest that the person seek medical attention. It might help to offer to go along to the first appointment.

Causes

Personality is the combination of thoughts, emotions and behaviors that makes you unique. It's the way you view, understand and relate to the outside world, as well as how you see yourself. Personality forms during childhood, shaped through an interaction of inherited tendencies and environmental factors.

In normal development, children learn over time to accurately interpret social cues and respond appropriately. What causes the development of schizoid personality disorder is unknown, although a combination of genetic and environmental factors, particularly in early childhood, may play a role in developing the disorder.

Risk factors

Factors that increase your risk of developing schizoid personality disorder include:

  • Having a parent or other relative who has schizoid personality disorder, schizotypal personality disorder or schizophrenia
  • Having a parent who was cold, neglectful or unresponsive to emotional needs

Complications

People with schizoid personality disorder are at an increased risk of:

  • Developing schizotypal personality disorder, schizophrenia or another delusional disorder
  • Other personality disorders
  • Major depression
  • Anxiety disorders

Diagnosis

After a physical exam to help rule out other medical conditions, your primary care provider may refer you to a mental health professional for further evaluation.

Diagnosis of schizoid personality disorder is typically based on:

  • Thorough discussion of your symptoms
  • Symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association
  • Your medical and personal history

Treatment

If you have schizoid personality disorder, you may prefer to go your own way and avoid interacting with others, including doctors. You may be so used to a life without emotional closeness that you're not sure you want to change — or that you can.

You might agree to start treatment only at the urging of a family member who is concerned about you. But help from a mental health professional who's experienced in treating schizoid personality disorder can have a major positive impact. Treatment options include:

  • Talk therapy (psychotherapy). Psychotherapy can be helpful. If you'd like to develop closer relationships, a modified form of cognitive behavioral therapy may help you change the beliefs and behaviors that are problems. A therapist understands your need for personal space and how difficult it is for you to open up about your inner life. He or she can listen to and help guide you without pushing too hard.
  • Group therapy. A goal of individual treatment may be a group setting in which you can interact with others who are also practicing new interpersonal skills. In time, group therapy may also provide a support structure and improve your social skills.
  • Medications. Although there's no specific drug to treat schizoid personality disorder, certain drugs can help with issues such as anxiety or depression.

With appropriate treatment and a skilled therapist, you can make significant progress and improve your quality of life.

Preparing for an appointment

You're likely to start by seeing your primary care doctor. However, in some cases when you call to set up an appointment, you may be referred directly to a mental health professional.

Take a family member or friend along, if possible. With your permission, someone who has known you for a long time may be able to answer questions or share information with the doctor that you don't think to bring up.

Here's some information to help you prepare for your appointment.

What you can do

Before your appointment, make a list of:

  • Any symptoms you or your family noticed and for how long. Ask friends or relatives if they've felt concerned about your behavior and what they've noticed.
  • Key personal information, including traumatic events in your past and any current, major stressors. Find out about your family's medical history, including any history of mental illness.
  • Your medical information, including other physical or mental health conditions with which you've been diagnosed.
  • All medications you take, including the names and doses of any medications, herbs, vitamins or other supplements.
  • Questions to ask your doctor to make the most of your appointment.

Examples of questions you may want to ask your doctor include:

  • What is likely causing my symptoms or condition?
  • What are other possible causes?
  • Is my condition likely temporary or long term?
  • What treatments are most likely to be effective for me?
  • If you're recommending medications, what are the possible side effects?
  • Is there a generic alternative to the medicine you're prescribing?
  • How much can I expect my symptoms to improve with treatment?
  • I have other health conditions. How can I best manage them together?
  • Are there brochures or other printed materials that I can have? What websites do you recommend?

Don't hesitate to ask any other questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Be ready to answer them to reserve time to go over points you want to focus on. Your doctor may ask:

  • What are the problems or symptoms that concern you?
  • Have you noticed that your symptoms get worse in certain situations? If yes, what are those situations, and how do you handle them?
  • Do you have close friends or family? If not, does it bother you?
  • How would you describe yourself?
  • Do you frequently choose to do things by yourself?
  • Do you confide in anyone who is not in your immediate family?
  • What do you prefer to do in your free time?
  • Have you ever thought about harming yourself or others? Have you ever done so?
  • Have your family members or friends expressed concern about your behavior?
  • Have any of your close relatives been diagnosed with or treated for mental illness?
  • Do you drink alcohol or use drugs? If so, how often?

Last updated: July 12th, 2016

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