Passive Aggressive Personality Disorder

What is passive aggressive personality disorder?

People who have passive aggressive personality disorder (PAPD) seem to go along with what people want even though it upsets them. They tend to see others as nosy, demanding, and pushy. They do not express feelings directly, but instead find indirect ways to try to punish or control others.

How does it occur?

This disorder usually starts in the early adult years. The causes are unknown. Experts think it may be caused by differences in the brain or nervous system. It might also be related to problems in the family such as abuse, financial stresses, death of loved ones, or mental illness.

What are the symptoms?

People who have this disorder:

• tend to be sullen and contrary without actually disagreeing
• put things off or deliberately do them wrong
• avoid responsibility by blaming others or claiming that they forgot
• are easily offended and complain regularly
• may be enthused for a short time, but then go back to being dissatisfied, critical, and envious
• are often resentful
• feel angry often but do not express it openly
• may appear to be pleasantly social but then make critical or cruel comments
• resist suggestions or help from others.

How is it diagnosed?

Your healthcare provider will ask about your symptoms, relationships, and medical history. You may have lab tests to rule out medical problems. You may be referred to a mental health therapist to rule out depression or other mental health problems. You may be asked to complete a personality test.

How is it treated?

Psychotherapy can help you see yourself more clearly. It helps you understand the reasons for your behavior and to recognize the effects of your behavior on others. This can help you change behaviors that get in the way of living a satisfying life. Several kinds of therapy may be helpful:

• group therapy
• psychodynamic therapy
• behavior therapy
• cognitive therapy
• cognitive-behavior therapy (CBT).

Cognitive behavioral therapy (CBT) is a way to help you identify and change thoughts you have that are not realistic. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new thought and behavior patterns.

Medicine is not used to treat this disorder, but may help if you also have problems with anxiety or depression. You may be hospitalized if you are suicidal.

When should I seek help?

If your symptoms are seriously interfering with your daily life, seek help from your healthcare provider or a mental health professional. Treatment can make a big difference in the quality of your life. Without treatment this disorder will be lifelong.

For more information, contact the National Alliance for the Mentally Ill (NAMI) or the National Mental Health Association (NMHA).

• NAMI's toll-free number is 1-800-950-NAMI. The Web site address is http://www.nami.org.
• NMHA's toll-free Information Center number is 1-800-969-NMHA. The Web site address is http://www.NMHA.org.