Because of the stigma associated with mental health issues, the diagnostic phrase Schizoid Personality Disorder (SPD) is likely to evoke images of someone in serious mental distress.
In fact, this type of personality disorder is characterized by a person who’s fully in touch with reality, but prefers to spend time alone rather than to socialize with others. He or she is likely to be considered a “loner” by others.
That’s not to say that SPD is easy to live with. Along with craving social isolation, this personality disorder makes it difficult for a person to express emotion, even when they’re experiencing it.
If they do eventually open up, it is generally in a very restricted manner, communicated in what may appear to sound like a flat monotone voice that can be confusing to others.
This can be frustrating and make it doubly hard to create or maintain a meaningful connection with other people.
Very often, though, people with schizoid personality disorder are not interested in developing deeper relationships, even intimate, sexual ones, and will go out of their way to avoid them.
It is not uncommon, however, for a person with this disorder to have a deep, emotional connection to a pet.
People with this personality disorder are likely to be high functioning and can even thrive in jobs that require a lot of solitary time.
However, employment that requires a lot of interpersonal interaction can be problematic because their individual behavior and way of communicating may appear to lack social-nuance or seem culturally out of place.
What are the Symptoms of Schizoid Personality Disorder?
Schizoid personality disorder falls in a psychiatric category known as Cluster A personality disorders.
According to the Mayo Clinic, these are conditions that exhibit “odd, eccentric thinking or behavior” in people diagnosed with them.
The Diagnostic and Statistical Manual of Mental Health (DSM-5), often referred to as the “Bible of psychiatry,” lists the following symptoms of schizoid personality disorder:
- Appears aloof and detached
- Shows emotional coldness, detachment or flattened affect
- Does not enjoy or desire close relationships
- Avoids social activities that involve significant contact with others
- Prefers solitary activities
- Has little to no interest in sexual experiences with others
- Is indifferent to praise or criticism
- Displays little observable change in mood
- Finds very few activities pleasurable
- Has very few, if any, friends outside of immediate relatives
Because normal social interaction is so difficult for people with SPD, coupled with their lack of interest in maintaining deep connections or sexual intimacy, they are unlikely to date and very often never marry.
What Causes of Schizoid Personality Disorder?
Like other personality disorders, the short answer is that the root cause of Schizoid Personality Disorder is unknown.
Most researchers believe SPD is a combination of many factors, such as:
- Family history
- Childhood interactions
- And even a person’s ability to cope with normal levels of stress
Though the condition may start to develop early in childhood, it isn’t generally diagnosed until a person is well into young-adulthood, around the late 20s.
Part of the reason for this is because children’s personalities are still developing and changes and patterns of behavior have not necessarily taken hold.
To complicate matters, children go through dramatic changes during the teenage years that make it challenging to pinpoint if their behavior is an outgrowth of their true personality or simply part of being an adolescent.
It is difficult to know the prevalence of schizoid personality disorder in the United States because most people with this condition do not seek treatment and are likely to believe there is nothing wrong with them.
Most estimates believe that around 3.1 to 4.9 percent of people in the U.S. have schizoid personality disorder, with men being more likely than women to develop the condition.
A diagnosis of SPD should be made by a mental health professional, a psychiatrist or psychologist, who will assess a patient’s symptoms and life history before making their judgment.
Family practice physicians or general practitioners are unlikely to have the necessary training to spot and diagnose the disorder, let alone to offer treatment or therapy.
Treatment for Schizoid Personality Disorder
People with Schizoid Personality Disorder do not generally seek treatment unless their disorder starts to impair their life in one form or another.
Usually if they do seek some form of treatment or professional help, it is because they have reached a limit on their ability to cope with particular stressors that often create anxiety or depression.
Though substance use disorders are not considered a symptom of schizoid personality disorder, there is always some risk with mental illness that a person self-medicates symptoms of depression or anxiety with drugs or alcohol.
If this happens, it can lead to a dual diagnosis, which is the presence of a substance use disorder and a mental illness together and requires specialized treatment.
There are not any Food and Drug Administration (FDA) approved medications for schizoid personality disorder, though a psychiatrist may prescribe antidepressants or anti-anxiety drugs if those symptoms are present.
The primary method of treatment for personality disorders is psychotherapy, though this can be challenging in regard to schizoid personality disorder because a patient is required to maintain social interaction.
It is possible to build trust over a long period if a patient continues with therapy. Once the therapist and patient trust builds, it might be possible to continue on to other methods of treatment such as Cognitive Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT).
Group therapy would be beneficial, although many people with SPD have a hard time simply getting through a one on one session.
There isn’t any evidence to show the efficacy of Motivational Enhancement Therapy (MET), but a few therapists have speculated it may work for some to open up about their issues and to engage in treatment.
MET is a treatment modality that is built on trust, and while it is almost always only used for treating addiction, the primary focus is to empower the client’s motivation to make positive behavioral changes. For this reason, there are some who think it might be appropriate.