Schizoid personality disorder (SPD) is a chronic and pervasive condition characterized by social isolation and feelings of indifference toward other people.
They find it difficult to express emotions and lack the desire to form close personal relationships. This type of personality disorder is believed to be relatively rare and tends to affect more men than women. People with schizoid personality disorder are also at risk of experiencing depression.
Schizoid Personality Disorder Symptoms
People with schizoid personality disorder typically experience:
- A preoccupation with introspection and fantasy
- A sense of indifference to praise and affirmation, as well as to criticism or rejection
- Detachment from other people
- Little or no desire to form close relationships with others
- Indifference to social norms and expectations
- Infrequent participation in activities for fun or pleasure
- Not enjoying social or family relationships
- Often described as cold, uninterested, withdrawn, and aloof
Typical Onset
The disorder is often first noticeable during childhood and is usually apparent by early adulthood. The symptoms of the disorder can have an impact on multiple life domains including family relationships, school, and work.
The DSM-5 defines schizoid personality disorder as a "pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity to form close relationships as well as by cognitive or perceptual distortions and eccentricities of behaviour, beginning by early adulthood and present in a variety of contexts."
Work-Life Impact
Those with this disorder also tend to have few friendships, date rarely, and often do not marry. The symptoms of the disorder may also make it difficult to work in positions that require a lot of social interaction or people skills. People with a schizoid personality disorder may do better in jobs that involve working in solitude.
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 SPD from those two disorders.
Those with SPD 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 often demonstrated by people with schizophrenia.
Causes
The causes of schizoid personality disorder are not known, although it is believed that a combination of genetic and environmental factors play a role. Personality is shaped by a wide variety of factors including inherited traits and tendencies, childhood experiences, parenting, education, and social interactions. All of these factors may play some part in contributing to the development of SPD.
Diagnosis
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 SPD:
- 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
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.
Treatment
Schizoid personality disorder can be challenging to treat. Those with the disorder rarely seek treatment and may struggle with psychotherapy because they find it difficult to develop working relationships with a therapist. The social isolation that characterizes schizoid personality disorder also makes it difficult to find support and assistance.
Medications may be used to treat some of the symptoms of schizoid personality disorder such as anxiety and depression. Such medications are usually used in conjunction with other treatment options such as cognitive behavioral therapy (CBT) or group therapy.
CBT can help people with SPD identify problematic thoughts and behaviors and develop new coping skills. Group therapy may help people practice interpersonal skills.
One-on-one therapy can seem intimidating for people with this condition because it requires a great deal of social interaction. Such treatments may be most effective when mental health professionals are careful to avoid pushing too hard and clients are not faced with excessive pressure and emotional demands.
Coping
Because of the nature of the condition, you might feel that it is simply easier to keep to yourself rather than seek out professional help. Even if you generally prefer solitude, people with schizoid personality disorder do experience loneliness and isolation. There are things that you can do to seek out support.
Consider joining a work or hobby-related social group. Because emotional intimacy can be challenging for people with schizoid personality disorder, you might find it easier to socialize with others in the context of an occupational or recreational pursuit. This can be a great way to develop social connections without overwhelming yourself.
If you have a loved one with this condition, you can help by avoiding judgment, being patient, and encouraging the individual to seek treatment. Avoid trying to push the individual into activities or relationships that make them feel uncomfortable or pressured. Instead, look for activities that you can do together that don't require a great deal of emotional investment.
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