Schizoid personality disorder (SPD) is a mental health condition that causes a person to have little or no interest in connecting with others. People with SPD may seem distant, aloof, or passive.

SPD is a rare condition, affecting only around 1% of the population.

People with SPD may not experience very strong emotions, sexual desire, or pleasure in many activities. As with other personality disorders, they may also not realize they have the condition.

However, for those who have SPD and who would like to seek treatment to better understand their condition, learn how to manage their feelings, and improve their quality of life or social relationships, a therapist can help.

This article will explore SPD, its symptoms, causes, diagnosis, and treatment options.

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Schizoid personality disorder (SPD) is a condition that causes little to no interest in forming close relationships. People with SPD can seem distant or detached from others, and appear indifferent to praise or criticism. They do not often feel strong emotions, and they may choose solitary activities and career paths.

In SPD, this ambivalence towards relationships is not the result of other conditions, such as depression, nor is it due to a personal preference. It is a lifelong pattern of behavior that begins in childhood, and applies to all aspects of life.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th revised edition (DSM-5-TR), a person may have SPD if they are detached from others, and express a limited range of emotions when socializing. The symptoms must be present from at least early adulthood, and occur in a variety of situations.

They must also have four of the following:

  • no desire for, or enjoyment of, close relationships
  • chooses solitary activities
  • little or no interest in sexual experiences
  • gets pleasure from few activities
  • lacks close friends
  • seems detached or has a lack of emotion

For the condition to be SPD, these symptoms must not occur due to another condition, such as depression or autism. They must also be unusual within the culture a person belongs to.

For example, if a person comes from a culture where having fewer friends is typical, them having one or two close connections may not be a sign of SPD. But if they have no close relationships, no interest in forming them, and this is unusual in their culture, this could be SPD.

Doctors do not know what causes SPD. Genetics may be a factor, because if one family member has SPD, others are also more likely to develop it. However, scientists have not identified any specific genes associated with the condition.

Having cold or neglectful parents or caregivers may also contribute to SPD by teaching children that personal relationships are not satisfying. An older 2006 study of 593 families found a link between low parental affection and a higher risk of SPD.

Brain injuries or differences in brain structure could also play a role. A small older study found an association between experiencing a traumatic brain injury (TBI) and numerous personality disorders.

Of the 60 people in the study, 14 had at least 1 personality disorder, and 6.7% developed SPD. Larger studies on the causes of SPD are necessary to fully understand the causes.

There is no specific test for diagnosing SPD. As a result, mental health professionals rely on self-reported symptoms from the patient, observations about their behavior, and tests to rule out other explanations.

A mental health professional may start by looking at the individual’s medical history. They may ask questions about symptoms, talk with them over one or more interviews, and may perform assessments for other causes, such as autism, if appropriate.

However, it may take time to reach the right diagnosis. Personality disorders can be challenging to identify because many people who have them do not realize there is something atypical about their behavior.

People with SPD typically seek medical help only when they develop another condition, such as anxiety or depression, or when family members encourage them.

For this reason, doctors may also work with a person’s loved ones to collect more evidence to help with the diagnosis.

To date, there has not been much research on the treatments that work most effectively for SPD specifically. Treatment tends to be similar to the treatment for other personality disorders. The main approach is talk therapy or psychotherapy.

Talking therapies may help a person with SPD learn more about how to be aware of their emotions and thoughts. Therapy can also help develop social and cognitive skills, making it easier to create relationships with other people.

Medications may ease symptoms of coexisting conditions, such as anxiety or depression. However, doctors rarely prescribe drugs to treat SPD on its own.

Anyone who is concerned they may have SPD, or any other mental health condition, can speak with a professional for advice. People can contact a doctor or a mental health helpline to ask questions confidentially.

That said, it is unlikely that people who are worried about a lack of relationships or sexual desire have SPD. People with this condition tend to be unaware there is anything unusual about this, or if they are, they do not feel strongly about it.

Those who do find these experiences distressing may have another condition that is affecting their mood, social engagement, or sex drive. A therapist can help with this, too.

Anyone experiencing thoughts of self-harm or suicide should seek help as soon as possible.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Schizoid personality disorder (SPD) is a rare mental health condition that causes indifference or a lack of enjoyment in social situations. People with SPD have few relationships, seem not to care about what others think, and they may have no interest in sex.

People with SPD may not realize they have a mental health condition, nor feel the need to treat it. However, people with SPD can also experience anxiety, depression, and sometimes, loneliness. It is important that anyone experiencing these symptoms seeks professional support.