What is the difference between schizotypal and schizoid personality disorder?

Schizoid personality disorder and schizotypal personality disorder both impact social relationships, self-esteem, and overall functioning. While some people may use the terms interchangeably, they are very different.

What is a Personality Disorder?

Personality disorders can be difficult to understand for people who aren’t experiencing them. They are chronic, long-lasting, and usually develop in the teenage years or early adulthood. 

A personality disorder is a type of mental disorder consisting of a different, rigid way of thinking. Although this thinking may feel normal to the person struggling, these thoughts do not align with the way everyone else thinks. 

This clash often causes issues in relationships, social situations, and work or school. It’s difficult to relate to others and to perceive things the way others do. 

The ten different personality disorders are:

Experts agree that personality disorders result from a combination of both genetic and environmental influences. Genetic links associated with anxiety, fear, and aggression can predispose personality disorders. Similarly, various environmental factors can increase the risk, including: 

• Having a family history of personality disorders.
• Having a family history of mental illness.
• Physical, emotional, or sexual trauma. 
• An abusive, unstable, or chaotic family environment in childhood.
• A diagnosis of childhood conduct disorder.
• Variations in brain chemistry and structure.

To better understand the ten personality disorders, psychologists have broken them down into three distinct categories. 

The Three Clusters of Personality Disorders

Cluster A

• Displays odd and eccentric behavior and thinking. Subsequently, people may find them “weird.” These individuals often struggle to have closer relationships with others. 
• Includes paranoid, schizoid, and schizotypal personality disorders.

Cluster B

• Displays dramatic, erratic, and unpredictable behavior. They may struggle with tremendous impulse control, suicidal thoughts, and other dangerous or irrational behaviors. 
• Includes antisocial, borderline, histrionic, and narcissistic personality disorders.

Cluster C

• Displays fearful and anxious thinking. They rarely feel safe in their environments or even with themselves. 
• Includes avoidant, dependent, and obsessive-compulsive disorders. 

Many people are familiar with the personality disorders that fit under Clusters B and C. For example, the symptoms of borderline personality disorder (Cluster B). People with borderline personality disorder experience intense mood swings and shifting interests and values. They often perceive everything in extremes of “black and white,” and they exhibit reckless behavior. Similarly, many people know someone with Cluster C symptoms. For example, obsessive-compulsive personality disorder is characterized by extreme perfectionism and order. These people often impose their way of thinking onto their environments, which makes it difficult for them to form relationships. 

Schizoid Personality Disorder Symptoms 

To understand the difference between schizoid and schizotypal, let’s look at some of the symptoms associated with schizoid personality disorder.

People with schizoid personality disorder are often perceived as cold, detached, or flat. They may have a restricted range of expressed emotion. As a result, they don’t usually show many facial expressions. Moreover, they don’t want or enjoy being engaged in close relationships. While they might be social with others, they don’t desire emotional connection. Other symptoms of schizoid personality disorder include:

• Having little to no interest in building relationships.
• Being perceived as a loner by others.
• Having decreased pleasure from activities that usually bring others pleasure.
• Appearing indifferent to praise, pleasure, or criticism.
• Choosing solidarity when given the option.
• Exhibiting little- if any- interest in sexual relationships. 
• Lacking close friends.
• Inability or extreme difficulty in expressing anger even when provoked.
• Engaging in passive behaviors and responses around others.
• Lacking the skills needed to appropriately interact with others.
• Working best alone.
• When under stress, experiencing brief psychotic episodes that can last for several minutes to several hours.
• Having no fear of being embarrassed or being found inadequate.
• Underachieving in school or work.

These symptoms show a pattern of detachment from social interactions. For a doctor or mental health professional to diagnose someone with schizoid personality disorder, these behaviors and thoughts must be present in a variety of contexts. For example, some people prefer to be alone at work. But if they like socializing with friends or at parties, they would not meet the criteria for this personality disorder. 

People with schizoid personality disorder act similarly in all situations. Likewise, they don’t just become more comfortable with people or in new situations as time goes on. Their symptoms cause significant impairment in functioning- they may miss opportunities at work or school, and they may also pull away when others try to connect with them. 

Treatment for Schizoid Personality Disorder

There is very little research on effective treatment for schizoid personality disorder. It should be noted that many people with this condition aren’t actually upset over it. In fact, people consider themselves content. They simply don’t feel the need for socializing and connecting with others.

 If they’re not a harm to themselves or others, it’s best for family not to push treatment on them. Doing so could cause them to retreat into themselves even more.  

That said, some people do benefit from entering therapy for schizoid personality disorder. For example, these individuals may struggle with other issues, like depression, anxiety, or substance use. Often, if they do enter therapy, they may focus on those issues. 

Building rapport with these clients can be difficult for therapists. Many times, these individuals only offer limited information in their interactions. Because they don’t feel the need for human connection, they don’t depend on their therapists for support or empathy. Instead, they tend to seek straightforward advice and solutions.

Some clients may want to improve their schizoid personality disorder symptoms. If this is the case, therapy can help clients learn how to develop closer relationships. Cognitive-behavioral therapy offers helpful tools in examining negative distortions about the self and others. It also provides practical guidance in teaching new ways of coping with distress. 

In some cases, family therapy can be beneficial. Family therapy may support loved ones who need an understanding of the condition. It can also teach everyone healthy boundaries and communication skills to support one another. 

At times, medication can also be helpful. While there are no medications that specifically treat this personality disorder, certain drugs can help alleviate other mental health symptoms. 

Symptoms of Schizotypal Personality Disorder Symptoms

The diagnostic criteria for schizotypal personality disorder differs dramatically from that of schizoid. The signs and symptoms of schizotypal personality include: 

• Presenting as paranoid and highly suspicious of others.
• Lacking close friends and emotional support.
• Significant struggles to adjust or fit in with social gatherings and situations. 
• Excessive social anxiety that does not diminish with familiarity.
• Odd, peculiar, and eccentric behavior.
• Possesses an acute discomfort with close relationships.
• Experiencing hallucinations (seeing or hearing things that others don’t)
• Experiencing grandiose ideas of reference. For example, everything may have an extreme personal relevance attached to it. A random occurrence is labeled as a part of destiny.
• Having odd beliefs that directly influence behavior. For example, people might think they have a sixth sense, telepathy, or possess magical abilities. That said, these beliefs are inconsistent with subcultural norms.
• Having unusual perceptual illusions because you feel everything very intensely.
• Displaying odd thinking and speech.
• Speaking in vague, metaphorical, or circumstantial communication. 
• Displaying inappropriate conduct when out in public, though others may struggle to identify why the behavior seems odd.
• Needing excess social isolation. 
• Holding unconventional beliefs about how the world works. 

Patients with schizotypal personality disorder are more likely to have it if a first-degree relative has it. Similar to schizoid personality disorder, they prefer to be alone. This does not appear exclusively with other mental illnesses, substance use,  or autism. 

Again, this behavior needs to occur across numerous settings. Like with all personality disorders, mental health professionals often diagnose schizotypal after ruling out other conditions like psychosis, delusional disorder, or bipolar disorder. 

Treatment for Schizotypal Personality Disorder

Many times, group therapy is helpful for people struggling with a mental illness. However, this is not the case for treating schizotypal personality disorder is to avoid such groups. These people feel uncomfortable with social interaction. They also may impose their bizarre and irrational behavior onto others- which can result in social conflict.

However, individual therapy can be helpful. Therapists can use cognitive-behavioral techniques to engage in reality testing. They can also provide nonjudgmental, compassionate support- which may be paramount if the person feels like they are alone in their struggles. 

Additionally, social skills workshops may be helpful. These workshops should be exclusively focused on strengthening relationships, active listening, and healthy communication. 

Finally, mood stabilizers and antidepressants may be helpful. That said, it’s not uncommon for people with schizotypal personality disorder to reject medicine. They may believe that the doctor is attempting to poison or harm them. They may also fail to see that they’re struggling with a condition.

Regardless of the chosen treatment method, it’s crucial to remain warm and welcoming. Many of these individuals have immense trust issues- they are used to being closed off from others. Thus, providing compassion remains crucial.

Similarities between Schizoid Personality Disorder and Schizotypal Personality Disorder

There are a few key similarities between schizoid personality disorder and schizotypal personality disorder. These include:

• They might have a close relationship with first-degree family members (but that’s usually the only close relationship in their lives).
• They lack any close friends.
• They don’t adjust to people or situations over time. For them, these social interactions are often uncomfortable and unwanted.
• Don’t force people with either of these disorders into doing something or entering a certain mode of treatment. It’s easy for them to close off and push others away.

Commonly Asked Questions

Can you have both schizoid and schizotypal at the same time?

Yes. This is not unusual. In fact, research shows that many people with severe personality disorders can meet the criteria for five or more conditions.

Do these disorders indicate you might develop schizophrenia?

Not necessarily. There is a low risk that people with one of these disorders will develop schizophrenia. 

Which one is more likely to have schizophrenia?

People with schizotypal personality disorder are more likely to develop schizophrenia. 

My loved one is living with schizoid / schizotypal: what should I do?

Unless they are harming themselves or others, their condition isn’t an acute emergency. If they want to go to therapy to develop their social skills and gain new perspectives, encourage them. Oftent doctors will recommend family therapy. This will help a family navigate the symptoms and support the patient in a healthy and beneficial manner.

Additional Supporter Strategies:

• Don’t be offended by your loved one’s behavior. They don’t mean it personally.
• Don’t force your loved one to talk or go into any uncomfortable situations. You might upset them or make them push you away.
• Remember that many people with these disorders don’t think they have them or don’t see why their way of thinking isn’t normal. 
• Be mindful of your words and specific diction. Discuss how you feel rather than what they did.
  • For example: “I felt scared when you did that.” rather than, “You scared me when you did that.”
• Have patience with them as they navigate social situations.
• Take care of yourself as you work with your loved one through developing their social skills. This can be a long and emotional process.

Personality disorders are long-term mental disorders that typically develop in late adolescence or early adulthood. At times, it can be difficult for people to realize that their way of thinking and acting isn’t congruent with other people. 

Schizoid vs schizotypal, while commonly confused, are actually quite different in their symptoms and behaviors. These symptoms are disruptive to daily life and prevent patients from developing healthy and normal relationships. While some people might accept their circumstances, others may wish to seek therapy to learn social skills and implement a healthier lifestyle. 

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