Schizoid Personality Disorder

Schizoid personality disorder is a mental illness characterized by a lack of engagement in social relationships and limited expression of emotions.^[1] People with schizoid personality disorder prefer to spend time alone, living and working independently if they can.

What is schizoid personality disorder?

Schizoid personality disorder is a mental health problem that can begin as early as childhood.^[1] It is characterized by an apparent lack of emotion and an indifference to personal and social relationships. People with schizoid personality disorder are solitary, preferring to live and work alone and avoid social activities altogether. This means the condition can occasionally be misdiagnosed as avoidant personality disorder or paranoid personality disorder.

People with schizoid personality disorder can live well without treatment, mainly because the symptoms in themselves aren’t necessarily distressing.^[2] A person with schizoid personality disorder may not be aware that there is a problem, especially if they live alone, find a job that allows them to work autonomously and generally have minimal interaction with others. Because of this, it is often unlikely that someone with this condition will try to get psychiatric help of their own volition. ^[3]

Symptoms of schizoid personality disorder

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) ^[1], used by mental health professionals in the U.S. to diagnose mental health problems, the symptoms of schizoid personality disorder include:

• A lack of desire for or enjoyment of close interpersonal relationships with others, including family members
• A tendency toward solitude and solitary activities
• Little to no interest in sexual activity
• A lack of pleasure in most activities
• An absence of close personal relationships, except perhaps immediate family members
• A lack of interest in what other people might think of them
• lack of emotional expression, emotional coldness, and emotional detachment

The International Classification of Diseases ^[4], the other primary diagnostic manual created by the World Health Organization, also includes ‘an excessive preoccupation with fantasy and introspection’ in its list of symptoms. This might mean a tendency to daydream or a complex ‘inner life.’

Symptoms can start as early as childhood, presenting as a lack of friends, difficulty at school and a preference for being alone.^[1] Personality disorders are generally not diagnosed until adulthood, despite earlier symptoms, partly because our personalities take time to develop through childhood and adolescence.

Some people with schizoid personality disorder may develop delusional disorder, schizophrenia or major depressive disorder.^[1]

Causes of schizoid personality disorder

The causes of schizoid personality disorder are not well understood. However, as with other personality disorders, it is believed there is a genetic link.^[1] Some studies show that schizoid personality disorder appears more prevalent in people whose relatives have schizophrenia or schizotypal personality disorder.

Diagnosing schizoid personality disorder

There is no test for schizoid personality disorder, and most people with the condition don’t seek a diagnosis or treatment. This is because the symptoms of schizoid personality disorder may not present a problem to someone with the condition. They may, however, seek help for an associated problem such as depression.

According to the DSM-5, a mental health professional may diagnose schizoid personality disorder if a person has four or more of the abovementioned symptoms. Other conditions that may explain symptoms, such as schizophrenia or autism spectrum disorder, should be considered when diagnosing.^[1]

Treatment for schizoid personality disorder

As most people with schizoid personality disorder don’t seek help, treatment options are not very developed. In addition, therapy, one of the main treatments for personality disorders and mental health problems, can be difficult for someone with schizoid personality disorder – the nature of the condition makes it hard to develop a relationship with a therapist.

Group therapy can help with developing social skills. Cognitive behavioral therapy may be useful in exploring a person’s preconceptions about social relationships and whether any value can be found in them.

More often, someone with schizoid personality disorder might seek help for an associated problem such as depression. In these circumstances, healthcare providers may prescribe medication such as antidepressants.

The DSM-5 does not list suicidal thoughts as a symptom of schizoid personality disorder, but recent research suggests suicidal thoughts may be more common than previously thought.^[2] Treatment, such as therapy or medication, can be prescribed to help someone cope with suicidal thoughts.

Self-care for schizoid personality disorder

If you have schizoid personality disorder and find your condition difficult to deal with, the most important thing to do is seek help. This might not be easy, but as with any mental health condition, it is the first step to getting the support you need. Visit your doctor or a mental health professional for expert advice.

If isolation or difficulties forming social relationships is causing a problem, developing connections with a hobby or common interest as a foundation can be an easier way to form friendships. Join a group that interests you and use that as a basis to meet people with similar hobbies.^[5]

If you are under pressure from your family to behave in a way that is not natural for you, encourage them to learn about schizoid personality disorder. Family therapy, where you and your family member(s) meet with a therapist, may help them understand your needs better so they can support you correctly.^[3]

Helping someone with schizoid personality disorder

Having a loved one with a mental illness can be challenging. If you are close to someone with schizoid personality disorder, you may struggle to understand how they live and may worry that they are not okay. You may also struggle because they don’t seem particularly interested in having a close relationship with you.

There are many things you can do to support your loved one:

• Look after yourself. It can be too easy to neglect ourselves when trying to support someone else, but it’s important to ensure you look after your physical and mental well-being. Take time for yourself, do things you enjoy, eat healthily, stay active and get good sleep. If you are struggling with your mental health, seek help.
• Read up. Learn as much as possible about schizoid personality disorder and how it affects people.
• Don’t judge. Schizoid personality disorder can greatly impact someone’s life, but it’s important to remember that many people with the condition can live perfectly well. For example, suppose they are not distressed by their circumstances, and it does not significantly impact their ability to live and work peacefully. In that case, it may be that the best thing you can do to support them is to accept that they approach life differently than you.
• Find safe ways to connect. People with schizoid personality disorder find social relationships difficult and unappealing, but you may have more success if you focus on a shared hobby or interest. In addition, finding a way to build a relationship that focuses less on emotional intimacy and more on an intellectual or practical foundation may give you a way to spend quality time together.
• If necessary, encourage them to seek help. If they are not ready to seek help, you need to accept that as their individual choice. But if they are willing, you can offer to research sources of support and go to appointments with them, for example.
• Know what to do in a crisis. Research how to support someone who is suicidal or self-harming so you know what to expect and how to react. If you are concerned that they pose an immediate risk to themselves or someone else, call your local crisis mental health service.

FAQs about schizoid personality disorder

How common is schizoid personality disorder?

Because people with schizoid personality disorder often don’t seek help, it’s difficult to understand how common it is. The DSM-5 cites studies suggest between 3.1% and 4.9% of the population are affected.^[1]

Schizoid personality disorder vs. Autism – What is the difference?

Many of the symptoms of schizoid personality disorder are similar to those of people with autism spectrum disorder (ASD). For this reason, it can be difficult even for doctors to tell the difference.^[1] ASD includes a broad spectrum of symptoms and experiences, but people with ASD can be emotionally detached and socially withdrawn, which is also true of people with schizoid personality disorder. Both conditions can also affect how a person speaks, thinks and perceives the world in ways that might seem the same to the untrained eye.^[6]

A recent study looked into the seemingly common symptoms between ASD and schizoid personality disorder in detail. A key fundamental difference between people with ASD and schizoid personality disorder appears to be rooted in intention. The symptoms of schizoid personality disorder stem from a lack of interest, motivation or desire to have a social connection. In contrast, someone with ASD is likely to want close relationships but experiences barriers in developing them effectively.^[7]

Is schizoid personality disorder the same as schizophrenia, schizoaffective disorder or schizotypal personality disorder?

No. Despite sounding similar, these are different conditions.^[1]

Schizophrenia and schizoaffective disorder both involve experiences of psychosis – seeing things that aren’t there or hearing voices, for example. While someone with schizoid personality disorder may experience short periods of psychosis under extreme stress, it is not a core or common part of the condition.

People with schizotypal personality disorder have significantly different symptoms from people with schizoid personality disorder, including paranoia and unusual beliefs. While they struggle with social relationships, this stems from social anxiety caused by paranoid fears, not from a lack of motivation or interest.