What Is Schizoid Personality Disorder? Here's What Experts Say
Getting close to someone with this condition is challenging.
Despite what the name might sound like, schizoid personality disorder is not a form of schizophrenia, a mental disorder that causes someone to experience hallucination or delusions and a disconnect from reality.
Instead, schizoid personality disorder is fully tethered in reality. It's an uncommon disorder in which someone lacks the desire to be socially or intimately connected to others; they may also appear withdrawn or indifferent.
"The key feature of schizoid personality disorder is a feeling of alienation and disconnection from others," clinical psychologist Scott Wetzler, PhD, a professor in the department of psychiatry and behavioral sciences at Albert Einstein College of Medicine in New York City, tells Health. Those who have this personality disorder have a difficult time relating to and understanding other people, in part due to a lack of compassion or empathy, he says.
If you're interacting with someone with schizoid personality disorder, you may view them as being "cold, unemotional, aloof, and uninterested," says Wetzler. This aloofness can spring from an inability to read and relate to others. At the same time, though, it doesn't mean that they don't care.
What is schizoid personality disorder?
First, it helps to know what a personality disorder is. While your personality might make you unique as a human, a disorder is characterized by "thinking, feeling, and behaving that deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time," according to the American Psychiatric Association (APA).
But not all personality disorders are the same. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies mental disorders for clinicians and groups personality disorders into three clusters based on similarities they share. Belonging to Cluster A is paranoid, schizoid, and schizotypal personality disorders. These are grouped together because they are considered "odd" or "eccentric." (Schizotypal personality disorder is more about having eccentric ideas-even more magical thinking.)
How common is schizoid personality disorder?
Still, it's a frequently misdiagnosed disorder, Daniel Winarick, PhD, a licensed clinical psychologist in New York City, tells Health. "If someone comes to me with the diagnosis, I encourage them to get a second opinion, as it's hard to meet the diagnostic criteria," he says. Other disorders may look like schizoid personality disorder, such as avoidant personality disorder (where someone avoids contact with others out of fear of rejection), says Winarick.
What are the behavior traits of schizoid personality disorder?
In order to be diagnosed with schizoid personality disorder, someone will persistently show detachment and disinterest in social relationships and won't show emotions when interacting with others. These behavior and personality traits start when a person is young.
According to Merck Manual, the DSM-5 also says they must have at least four of the following traits:
- No desire for or enjoyment of close relationships, including those with family members
- Strong preference for solitary activities
- Little, if any, interest in sexual activity with another person
- Enjoyment of few, if any, activities
- Lack of close friends or confidants, except possibly first-degree relatives
- Apparent indifference to the praise or criticism of others
- Emotional coldness, detachment, or flattened affect
"A person with schizoid personality disorder can function fine in society, but they appear and feel like loners. They prefer solitary activities," says Winarick. At the same time, though, many people with this personality disorder still want to relate to people. They might not seem like they care about social rejection-but they might.
People who have depression can also become socially withdrawn, which might make it harder to distinguish between depression and schizoid personality disorder. But "schizoid personality disorder is being socially withdrawn all the time. Someone who is depressed may appear socially withdrawn during periods of depression," says Wetzler.
Someone with schizoid personality disorder may have always has these traits. "It's a disconnected temperament that's there almost from the beginning," says Wetzler. Because it starts early-you may notice they had these traits or preference to be alone as a child-a child with schizoid personality disorder can become socially ostracized at school, and that disconnection becomes ingrained as they don't develop social relationships.
How is schizoid personality disorder treated?
Schizoid personality disorder may be most frustrating for loved ones who want to connect and relate to the person but find it extremely hard to do so. "The person with schizoid personality disorder is usually okay with being this way," says Winarick.
That said, there may be ramifications-like issues moving up in their career or generally feeling like an outsider-that may push someone to accept help.
And help comes in the form of talk therapy. Finding the right therapist can be challenging, and a patient needs to stick with it. "The therapist needs to be respectful of their space and not be too challenging or get into really emotional topics," adds Winarick. Ultimately, the goal is to help draw the person out a little more or help them stretch to relate to others and find motivation to socialize.
Therapy isn't always a success because the traits associated with schizoid personality disorder are ingrained in the individual.
"One challenge with personality disorders is that in general, they are inflexible, pervasive, and resistant to change," Michael Roeske, PsyD, licensed clinical psychologist with Newport Academy and adjunct professor with the University of San Francisco, tells Health. So the goal of treatment is not a significant personality change. "It's unlikely that someone with schizoid personality disorder will become completely comfortable in the natural flow and give-and-take of relationships that most people enjoy. But they can learn to recognize how they're experienced by others and develop coping skills so that they're not alienating themselves," he says.
How to connect with someone who has schizoid personality disorder
Wetzler adds that many people with schizoid personality disorder spend a lot of time engaged in video games, as they find comfort in escaping into a fantasy world that offers a sense of control and an opportunity to engage with others in a structured, less intense way. If you'd like to connect to a friend or loved one who has schizoid personality disorder, you can start by engaging them in conversation about something they enjoy, like video games or another hobby or interest.
For loved ones, join them in their interests but don't expect-or push for-a lot of intimacy immediately. "Be available but not intrusive. Love without expecting an overt showing of love. And realize that you're probably more important to the person than they show," says Winarick.
To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter