Schizoid personality disorder: symptoms, causes and treatment

Rethink describes the experience as having few social relationships, preferring to be alone and not enjoying or wanting to be part of close relationships, including family. Others may see a person as quiet, private or emotionally distant in social situations. Some people with these traits are content with solitude, and a preference for being alone is not in itself a problem; it is the lasting pattern and its impact on life that matters.

The NHS notes that someone with a personality disorder may also have other mental health problems, such as depression and drug addiction, and NHS inform lists symptoms across personality disorders including avoiding other people, being overwhelmed by feelings like anxiety or distress, and difficulty maintaining stable close relationships. Rethink adds that distress can lead to problems such as depression or anxiety, and some people use alcohol or drugs to cope.

Everyone has a personality made up of ways of thinking, feeling and behaving. Rethink Mental Illness describes these as traits sitting along a scale, and says that if traits cause significant problems for you and others you may be diagnosed with a personality disorder. The NHS puts it as a person who thinks, feels, behaves or relates to others very differently from the average person.

NHS inform lists schizoid personality disorder among the types, alongside paranoid and schizotypal personality disorders, which are grouped together as group A. Rethink says people with group A conditions can find it hard to relate to other people and their behaviour might seem unusual or eccentric. The core features of schizoid personality disorder are a lasting preference for solitude and a limited interest in close relationships.

The word schizoid is easily confused with schizophrenia, but they are different. Schizoid personality disorder is not a psychotic illness; it describes an enduring way of relating to other people, rather than episodes of delusions or hallucinations.

It is not clear exactly what causes personality disorders. The NHS says they are thought to result from a combination of the genes a person inherits and early environmental influences, such as a distressing childhood experience like abuse or neglect. NHS inform adds that severe distress or fear during childhood can also contribute.

Rethink states that many people diagnosed with a personality disorder have experienced trauma, but that this does not mean everyone who experiences trauma will develop one. Research it cites suggests around 1 in 20 people live with a personality disorder.

Rethink says only a psychiatrist can diagnose a personality disorder, and that you can see your GP to begin with, who might refer you to an NHS personality disorder team or community mental health team. NHS inform says diagnoses are made by specialist mental health services after a referral from a GP.

The assessment covers symptoms and experiences, feelings, thoughts and actions, physical health, relationships, use of drugs or alcohol and past experiences. It is not a test or exam. Rethink explains that psychiatrists use ICD-11 or DSM-5 and look at whether physical health problems could be causing symptoms. The ICD-11 no longer diagnoses separate types, instead grading severity as mild, moderate or severe, while the DSM-5 continues to identify 10 types in 3 groups. Rethink also points out that diagnosis can be difficult because of overlap with other conditions, such as complex post-traumatic stress disorder or bipolar disorder.

Rethink says personality disorders are usually treated with psychological treatments or talking therapies, and that therapy is usually long term and often involves group therapy. The NHS says treatment can last several months or years, depending on severity and any other problems, and that therapeutic communities may be offered to some people.

There is no recommended medication for personality disorders, according to Rethink, although a doctor may offer medicine for anxiety, low mood or psychosis. The NHS notes that recovery is common: many people with a personality disorder recover over time, psychological or medical treatment is often helpful, and sometimes support is all that is needed. Treatment should be tailored to the individual.

Most people with a personality disorder are not in crisis, but a mental health emergency should be taken as seriously as a physical one. The NHS says to get advice from 111 or ask for an urgent GP appointment if you need urgent help for your mental health, and that with 111 you can select the mental health option and may be able to speak to a trained mental health professional over the phone.

The NHS says to call 999 or go to A&E now if someone's life is at risk, for example if they have seriously injured themselves or taken an overdose, or if you do not feel you can keep yourself or someone else safe. It says you will not be wasting anyone's time. Rethink also notes that distress can lead to problems such as depression or anxiety, and that some people use alcohol or drugs, or self-harm, to cope, which is a reason to speak to a GP early.

Some people with schizoid traits lead stable lives, particularly where work or study allows independence. Support may be most useful if loneliness, depression or anxiety develop, or if relationships and work are affected.

Rethink notes that specialist NHS personality disorder services are not in every area. If there is none locally you should still be offered treatment for your personality disorder by NHS mental health services, and you can ask your GP about applying for treatment in another area. Families and carers can get support too: Rethink points to Carers UK and Carers Trust, and the NHS points to Mind and Rethink for guidance on supporting someone with a personality disorder.

NHS routes are through a GP to a community mental health team or personality disorder service. Waiting times and the availability of long-term therapy vary across the UK.

Some people choose a private psychiatric assessment or psychotherapy for faster access. Check the clinician's registration and experience of personality disorders, and keep your GP informed so that any diagnosis and treatment are recorded consistently.