Schizoid personality disorder is an uncommon condition in which people avoid social activities and consistently shy away from interaction with others. It affects more males than females. If you have schizoid personality disorder, you may be seen as a loner, and you may lack the desire or skill to form close personal relationships.
To others, you may appear somewhat dull or humorless. Because you don't tend to show emotion, you may appear as though you don't care about what's going on around you. Although you may seem aloof, you may actually feel lonely, even if it's hard for you to acknowledge. Or you may feel much more at ease being alone, and feel comfortable with your life.
The cause of schizoid personality disorder is unknown. Therapy and — in some cases — medications can help.
People with schizoid personality disorder are loners. If you have this condition, you're likely to:
Prefer being alone and usually choose solitary activities
Prize independence and have few close friendships
Feel confused about how to respond to normal social cues and generally have little to say
Feel little if any desire for sexual relationships
Feel unable to experience pleasure
Come off as dull, indifferent or emotionally cold
Feel unmotivated and tend to underperform at school or work
Personality disorders begin in early adulthood, at the latest. Some of these tendencies may have first become noticeable during your childhood. They also occur across a range of social and personal situations. They may either cause you to have trouble functioning well in a job, socially or in other areas of life. However, you may do reasonably well in your job if you mostly work alone.
If you have schizoid personality disorder, you may not know how to form friendships, or you may feel too anxious around other people to try, so you simply give up and turn inward.
Schizoid personality disorder is considered part of the schizophrenic spectrum of disorders, which includes schizotypal personality disorder and schizophrenia. These conditions all have similar symptoms, such as a severely limited ability to make social connections along with a lack of emotional expression.
However, unlike schizotypal personality disorder and schizophrenia, people with schizoid personality disorder:
Are in touch with reality — they're unlikely to experience paranoia or hallucinations
Make sense when they speak, although the tone may not be animated — in contrast to conversational patterns of someone with schizotypal personality disorder or schizophrenia, which are typically strange and hard to follow
Classes of personality disorders
Another way of understanding personality disorders has been to group them into classes. Schizoid personality disorder, along with schizotypal and paranoid personality disorders, are grouped together as Class A personality disorders. Class A disorders refer to odd or eccentric behaviors. They differ from Class B — dramatic and emotional behaviors — and Class C — anxious and fearful behaviors.
When to see a doctor
Treatment for schizoid personality disorder is usually sought by people who are bothered by an associated problem, such as depression. In cases where the isolation is bothersome or the other symptoms are distressing, psychotherapy may be helpful.
If someone close to you has urged you to seek help for symptoms common to schizoid personality disorder, make an appointment, starting with a primary care physician 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 with him or her to the first appointment.
The exact causes of schizoid personality disorder are unknown, although a combination of genetic and environmental factors — particularly in early childhood — are thought to increase the risk of developing the disorder.
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 or unresponsive to emotional needs
Being hypersensitive or thin-skinned in your early teen years and having these needs treated with annoyance or scorn
Suffering child abuse, neglect or other mistreatment
People with schizoid personality disorder are at increased risk of:
Developing schizotypal personality disorder, schizophrenia or another delusional disorder
Diagnosing schizoid personality disorder is usually based on an in-depth interview with your doctor about your symptoms as well as your medical and personal history. Your doctor may perform a physical exam to rule out other conditions that may be causing or contributing to your symptoms. If your initial visit is with a primary care doctor, you'll likely be referred to a mental health professional for further evaluation.
To be diagnosed with schizoid personality disorder, you must meet criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. Diagnosis of schizoid personality disorder includes four or more of these characteristics:
You neither desire nor enjoy close relationships, including being part of a family.
You almost always choose solitary activities.
You have little, if any, interest in sexual experiences with another person.
You take pleasure in few, if any, activities.
You don't have any close friends or confidants other than first-degree relatives.
You seem not to care about praise or criticism.
You seem emotionally cold, detached or unexpressive.
For schizoid personality disorder to be diagnosed, doctors need to rule out conditions with similar symptoms.
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 professional help from a therapist who's experienced in treating schizoid personality disorder can have a major positive impact. Treatment options include:
Medications. Although there's no specific drug to treat schizoid personality disorder, certain drugs can help with symptoms. For example, if you have symptoms of anxiety or depression, you doctor may prescribe a selective serotonin reuptake inhibitor (SSRI). Or while antipsychotics are not a routine part of treatment, they may be used to help with flattened emotions and social problems.
Talk therapy (psychotherapy). If you feel that you would like to have closer relationships, a modified form of cognitive behavioral therapy may help you change the beliefs and behaviors that are problems for you. A therapist with experience treating schizoid personality disorder is likely to understand your need for personal space and how difficult it is for you to open up about your inner life. He or she can continue reaching out to 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 increase your social motivation.
With appropriate treatment and a skilled therapist, you can make significant progress and improve your quality of life.