Personality Disorders in the Age of COVID-19: Challenges and Coping Strategies

According to most experts, COVID-19 has had a significant impact on many aspects of life, including mental health. Not only were mental health outcomes observed in people affected by COVID-19, but also in everybody who had to comply with the restrictive measures that were set. In particular, high rates of anxiety, depression, post-traumatic symptoms, and insomnia were witnessed during the initial stage of the outbreak. In addition, research has shown that outcomes such as behavioral disorders will persist and actually peak well after the pandemic is over. With that being said, the following article will explore the impact the pandemic had on people with personality disorders, and how they dealt with it.

For people within the category of cluster A personality disorders, the tendency to want to be alone is actually key in why they adhered to strict lockdown measures, but that in turn worsened their already existing social withdrawal. According to the results of multiple studies, people with antisocial traits, such as lack of empathy and disregard for the rights of others, tended to not comply with the restrictive measures placed during the pandemic. 

In regard to the cluster B personality disorders, studies done showed that being impulsive and having an inflated self-esteem were actually risk factors for not complying with pandemic measures. In addition, people with borderline personality disorder (BPD) were found to have an even more intense fear of abandonment as well as the inability to properly regulate their emotions. Another study conducted on patients with BPD during quarantine correlated living alone with a worsened clinical outcome. Interestingly, another study done on patients with BPD placed in isolation showed a significant decrease in fear, shame, guilt, binge-eating behaviors, and overall tension felt by these patients, but an increase in their distress. One study conducted showed that people with narcissistic personality disorders are more likely to suffer from PTSD as a result of the pandemic.

For patients with cluster C personality disorders, their anxiety about being affected by COVID-19 drives them to comply with the strict measures placed; however, in OCPD, their inflexibility and reluctance to change might lead them to do the opposite.

A study had shown that people with either paranoid, schizoid or narcissistic personality disorder were more prone to believe the conspiracy theories surrounding COVID-19. In addition, one study reported that people who tend to be extroverted and open minded had lower levels of depression and anxiety in response to the pandemic, and people who were not dependent on others were able to adapt much better to the pandemic than those who were. Moreover, it was found that anxious, cyclothymic, and depressive temperaments were associated with predicting moderate to severe psychological stress. In a study conducted on nurses working at the hospital, it was determined that those with an agreeable personality trait, as in being cooperative and friendly, were more prone to developing anxiety symptoms in response to the pandemic. Interestingly, it was reported that patients with personality disorders had lower rates of referrals and admissions during lockdown; that might be attributed to the fear of catching COVID or the introduction of telemedicine.

Moreover, regarding the treatment of personality disorders during the pandemic, the only option was an online intervention. With that being said, studies conducted showed that in order for it to be efficient it would have to include psychoeducation which consists of presenting evidence-based information about the disorder in order for the person to better understand their struggle; in addition, it would also include a structured module designed to follow a patient’s progress over time.  

In conclusion, it’s safe to say that the pandemic had multiple negative effects on people with personality disorders, and not enough research was provided on how to properly manage such effects. Moreover, the common consensus amongst all studies was that dysfunctional personality traits were directly related to negative outcomes in coping with the pandemic, and functional personality traits provided better coping skills for those affected.