Schizoid Personality Disorder: Symptoms, Causes, and Treatment

What is schizoid personality disorder?

Schizoid personality disorder (sometimes abbreviated to SZPD, SPD, or ScPD) is a mental health condition defined by detachment from social relationships and difficulty expressing emotions. It’s a cluster A personality disorder, meaning it involves behaving or thinking in odd or eccentric ways.

If a person has schizoid personality disorder, they have little desire to establish or maintain personal relationships and may structure their life in a way that allows them to minimize contact with others. They might avoid dating, for example, and look for jobs that allow them to work from home or in isolation. In social situations, they may feel emotionally cut off from others or see themselves as an observer rather than a participant. While some people with SZPD may be able to tolerate a certain degree of physical intimacy, others find themselves automatically dissociating when around others.

Overt vs covert schizoid personality disorder

If someone has overt schizoid personality disorder, they outwardly appear to be a loner. They may seem to always be daydreaming or simply disinterested in other people. They may also have a restricted emotional range, rarely smiling, laughing, or even showing anger. Often, not even compliments or high praise seem to budge their mood.

On the other hand, people with covert schizoid personality disorder may seem as sociable as the average person. They’re better able to “mask” their symptoms when necessary, such as in the workplace. But beneath that mask, they still have a hard time building emotional attachments and rarely share their feelings.

The effects of schizoid personality disorder and isolation

Even when someone doesn’t desire to socialize, a solitary lifestyle can have health consequences, including negative effects on the brain’s functioning. Some research suggests that lack of social stimulation can reduce cognitive abilities, such as memory, and ultimately lead to cognitive decline. There’s also some evidence that isolation increases inflammation, which can lead to problems throughout the body, such as poor cardiovascular health.

The solitary lifestyle associated with schizoid personality disorder can also negatively impact social skills. This can make it difficult to “read between the lines,” for example, pick up on subtle nonverbal cues such as shrugs or eye rolls, and make socializing feel even more burdensome, pushing the person further into isolation. It can also make it harder to function at work or in important social situations.

Whatever you or your loved one’s experience with schizoid personality disorder, it is possible to find help and improve your life. Of course, a willingness to seek treatment is necessary first. However, once a change is desired, professional treatment and self-help steps are available. The first step is to recognize the symptoms of the disorder.

Schizoid personality disorder symptoms

In the United States, SZPD is estimated to occur in somewhere between 3.1 to 4.9 percent of the population. According to the DSM-5, if you have schizoid personality disorder, your social detachment will result in four or more of the following symptoms by early adulthood:

• Gaining no enjoyment from personal relationships and having little desire to pursue them.
• Showing an apathetic attitude towards praise or criticism.
• Consistently choosing solitary activities rather than social ones.
• Lacking close friends.
• Having little to no interest in physical intimacy with others.
• Finding little to no pleasure in most activities.
• Appearing emotionally detached or cold.

A healthcare provider will need to rule out other potential causes of these symptoms. For example, conditions such as depression can also make it hard to feel pleasure or find the motivation to form relationships.

There are often several barriers to a diagnosis. Many people with this disorder are able to adapt well enough to hide their symptoms or they simply don’t believe they have a problem. They’re also unlikely to seek a diagnosis on their own since the process involves interacting with others. When a person with SZPD does seek out help, it’s often because they feel limited and dissatisfied with their life.

Similar and co-occurring disorders

Schizoid personality disorder can sometimes be hard to diagnose because its symptoms can overlap with other personality disorders, including:

Schizotypal personality disorder. People with schizotypal personality disorder often experience reclusiveness and have few close connections. However, they’re more likely to display odd thoughts and behaviors, such as unusual speech patterns, tangents, paranoia, or magical thinking. These symptoms may make them feel like outcasts and lead to social anxiety.

Paranoid personality disorder (PPD). Because they are wary of others, a person with paranoid personality disorder may have difficulty opening up to others. They may even aim to completely isolate themselves. They’re more likely to show hostility and anger than those with schizoid personality disorder.

Avoidant personality disorder (AVPD). People with AVPD also tend to isolate themselves. However, their avoidance of social interaction stems from low self-esteem and fear of rejection rather than a lack of desire to socialize.

[Read: Avoidant Personality Disorder (AVPD]

Obsessive-compulsive personality disorder (OCPD). People with OCPD have an obsession with control and orderliness. Their rigidity and fixation on work can make them seem detached and neglectful of relationships, similar to people with schizoid personality disorder.

It’s possible for a person with SZPD to simultaneously be diagnosed with one or more of the above personality disorders. They’re also prone to developing issues such as anxiety and depression. In people with SZPD, these conditions might stem from early childhood experiences, such as abandonment or abuse.

Schizoid, schizotypal, and schizophrenia: how they differ

Although they have similar names, these are three different conditions:

Schizophrenia is the most challenging of the three. Symptoms of schizophrenia can include delusions and hallucinations as well as disorganized speech and behavior. It can also include “negative symptoms,” meaning an absence of normal behaviors. For instance, a person with schizophrenia might have a lack of pleasure, motivation, or emotional responses.

Schizoid personality disorder can make a person seem emotionally cold and indifferent to others. Despite their unusual desire to be socially withdrawn, people with this disorder don’t experience hallucinations or delusions.

Schizotypal personality disorder falls somewhere between the other two conditions. Its symptoms don’t include hallucinations, but eccentric thinking and odd behavior may be apparent. People with this disorder can also be socially withdrawn.

What causes schizoid personality disorder?

The exact causes of schizoid personality disorder are unknown. However, current research points to a few possibilities:

Genetics. The disorder may be passed down through family genes. Studies of twins suggest that there is some degree of heritability to schizoid personality disorder. Having a family member who has schizophrenia also seems to increase a person’s risk of developing this personality disorder.

Childhood experiences may cause or contribute to schizoid personality disorder. Having a neglectful caregiver or experiencing traumatic situations, such as sexual or emotional abuse, can lead to trust issues, low self-esteem, and social withdrawal.

Disease, lesions, or other abnormalities in the brain may increase the risk of developing SZPD. Traumatic brain injury may also be another risk factor. This type of injury can affect parts of the brain that handle social functioning or emotional processing and perception.

Development issues, such as premature birth, low birth weight, and malnutrition, are also potential risk factors.

How to help someone with SZPD

If someone close to you has schizoid personality disorder, it’s easy to feel frustrated or hurt by their unwillingness to open up and engage with you or other family members. If it’s your child with SZPD, you might worry that the disorder will limit their ability to function in society when they grow up.

Here are a few ways you can help your loved one while also taking care of yourself:

Listen without judgment. Accept that your loved one likely has a very different outlook than you. Although we all occasionally want space from other people, someone with SZPD spends most of their time craving solitude. Instead of lecturing them on how they should feel or act, ask them about their experiences and take the time to really understand them.

Encourage your loved one to seek treatment. Lay out concrete ways in which you believe their condition is limiting them or affecting their well-being. For example, you could point out that friends can offer practical benefits as well as emotional support. They can be there when you need help moving, for example, or need care when recovering from an injury or illness.

Recognize when you’re not getting through. If your loved one is not willing to accept they have a disorder, set aside the idea that arguing will change their opinion. Instead, spend more time listening to them and empathizing with how they feel, even if you don’t agree with everything they say. You can’t help your loved one if you position yourself as an adversary, so aim to be an ally.

[Read: How to Help Someone with Mental Illness Accept Treatment]

Search for common ground. Even if your loved one won’t admit they have SZPD or that the condition is causing them problems, they might be willing to admit they’re feeling depressed or something is missing from their life. Encouraging them to seek treatment for this different condition can still be a positive step forward.

Be mindful of their preferences. Extend invitations to your loved one, even if they regularly turn down your offers. Aim to be considerate of the types of interactions they seem to enjoy most. You might find that they’re more likely to join you on a peaceful nature walk, for example, but can’t tolerate big social gatherings. When they do decline to join you, don’t take it personally.

Take care of yourself. You might feel a sense of despair or heartache over how difficult it is to connect with a loved one with schizoid personality disorder. Even as you try to support them, it’s important to maintain your own social connections and self-care practices. Spend time with other people, engage in hobbies you love, and take care of your physical health.

Manage social expectations. Change can come slowly, and you’ll need to set realistic expectations on how much change is possible. Don’t expect your loved one’s social desires and behaviors to change overnight or assume they’ll someday turn into a social butterfly who loves going to parties.

Expect setbacks. Don’t beat yourself up when your loved one seems to retreat or push you away. Instead, take time to appreciate any small signs of improvement. When a person has SZPD, even something as simple as making a new acquaintance or deciding to call a friend can be an important step forward.

Professional treatment

People with cluster A personality disorders often shy away from professional treatment, so it’s difficult for researchers to determine which treatments are most effective. However, working with a therapist can help identify and change the distressing thought patterns and behaviors that accompany schizoid personality disorder.

[Read: Online Therapy: Is it Right for You?]

Rather than relying on a standardized treatment plan, a therapist will work with the individual to come up with a personalized approach to managing the disorder. One person with SZPD may want to develop strategies to reduce dissociating, for example, while another may want to examine and adjust their beliefs about interpersonal relationships.

While an aversion to socializing can make it difficult for someone with SZPD to consider, group therapy can also be beneficial. These sessions allow the person to practice being more open with others and reading verbal and nonverbal cues.

Medication

While there aren’t any medications that will cure SZPD, certain medications can help a person manage comorbid issues:

• Anti-anxiety drugs can help control anxiousness surrounding social interactions.
• Antidepressants such as selective serotonin reuptake inhibitors may help reduce depression symptoms.
• Antipsychotics can help if the person struggles with distorted thoughts.

If you recognize SZPD in yourself

While people with schizoid personality disorder are often unlikely to reach out for help, they’re not always blind to their issues. If you have this personality disorder, you might still feel isolated or some degree of loneliness. Even if you don’t think of it as “loneliness,” you might feel deeply unfulfilled or as if something is missing from your life. A small part of you might long for an emotional connection or to be understood by others.

You may feel understimulated and bored when you go too long without social interaction, or envious when you see other people making connections. Even if the thought of socializing seems like a daunting task or something you simply can’t get excited about, you can still feel like you’re letting friends and family members down by not reaching out.

It can be tempting to think, “This is the way I’ve always been, and this is the way I’ll always be.” But that’s not necessarily true. The following tips can help you adjust your lifestyle and improve your sense of well-being. (And if it’s a loved one with SZPD rather than you, it can also help to encourage them to adopt some of these strategies.)

Tip 1: Develop self-soothing practices

People often turn to each other for physical and emotional comfort. In fact, social support has been shown to ease psychological distress, even when it comes to conditions like burnout and post-traumatic stress disorder (PTSD). However, since you have a decreased desire to socialize, it’s important to develop other stress-reduction techniques.

Practice mindful breathing. Long, deep breaths can have a calming effect on your central nervous system. As you engage in breathing exercises, you’ll notice increased feelings of comfort and relaxation. Consider making deep breathing meditation a regular part of your day, or use mindful breathing to manage anxiety in the moment.

Be active. It’s not always easy to find the motivation to exercise, especially if you already struggle to find pleasure in life. But, if you push yourself to get in some physical activity—even something as simple as a daily walk or bike ride by yourself—you can benefit from the reduced stress hormones and increased mood-boosting hormones.

[Read: The Mental Health Benefits of Exercise]

Prioritize sleep. Most adults need seven to nine hours of sleep a night. Sleep deprivation can lead to fatigue, a drop in motivation, increased blood pressure, and various other issues. To get better sleep and reduce overall stress, try to maintain a consistent sleep-wake cycle, wind down before bed, and limit napping throughout the day.

Tip 2: Improve social skills

If isolation is the norm, you might have a harder time recognizing and sending more subtle verbal and non-verbal cues. Practicing these skills can help you avoid miscommunication and make you more comfortable in social situations.

Try to be curious. If you can’t seem to move beyond small talk in a conversation, aim to learn more about the other person. Go beyond simple “yes” and “no” questions, like “Do you enjoy reading books?” Questions like “What books have you enjoyed lately?” can lead to more interesting conversations and foster deeper connections.

Ground yourself. Dissociation is a feeling of numbness or disconnection from the world around you. You might find yourself dissociating when you’re alone, but it can also happen during social situations, pulling you out of the moment. Practice using your senses to keep yourself grounded in the present. For example, focus on the sound of the other person’s voice. Dissociation is sometimes linked to past trauma, so you may need to work with a therapist to treat the issue.

Build nonverbal skills. When your nonverbal cues complement your words, your message becomes clearer and more authentic to others. On the other hand, if there’s a disconnect between your verbal and nonverbal messages, you might confuse other people. For instance, if you fail to smile while you deliver good news, the listener might question your sincerity. To improve nonverbal communication skills, learn to be more present, build your emotional awareness, and practice reading other people’s body language.

Tip 3: Make socializing more accessible

When you have schizoid personality disorder, maintaining a social life can be taxing. If it feels like too much work, you can experiment with strategies that make the process less exhausting.

Use texting. Although it shouldn’t be a total substitute for face-to-face interactions, texting can be a useful communication tool. It allows you to respond at your own pace and use emojis to express yourself better.

Pursue interests that require light socializing. Engage in activities that allow you to be around other people, even if you’re not socializing the entire time. For example, you can explore the outdoors with a hiking group or go to an indoor climbing gym. If already have solitary hobbies that you enjoy, think of ways to appreciate them with other people. This could involve anything from joining a book club to playing video games with other people online.

Schedule social tasks. Try following a routine, such as texting people around the same time each day. Scheduling face-to-face meetups ahead of time will also give you time to mentally prepare for each interaction. As you begin to include social tasks on your calendar, try to strike a comfortable balance between time spent alone and time spent with others.

Don’t force it. If you’re constantly forcing yourself to spend hours socializing, it’ll quickly begin to feel like an overwhelming chore. You might also feel disingenuous if you try to give other people the impression that you’re an extravert. Instead, be gentle with yourself. Decline invitations if you think you’ll truly dislike being at a social event. And don’t be afraid to end interactions early if negative emotions or fatigue begin to wear you down.