Personality disorders are a group of mental health conditions that are characterized by inflexible and unhealthy patterns of thinking, feeling, and behaving. These inner experiences and behaviors often differ from the expectations of the culture in which someone lives.
People with personality disorders usually have a hard time getting along with others and dealing with everyday problems in the ways that are expected by a cultural group. They commonly believe that their way of thinking and behaving is completely normal. However, they tend to have a view of the world that is quite different than others. As a result, they may find it difficult to participate in social, educational, and family activities. They also place blame on others for their challenges. These behaviors and attitudes often cause problems and limitations in relationships, social encounters, and work or school settings. They may also make people with personality disorders feel isolated, which can contribute to depression and anxiety.
The cause of personality disorders isn’t known. However, it is believed that they may be triggered by genetic and environmental influences, most prominently childhood trauma.
Personality disorders tend to emerge in the teenage years or early adulthood. The symptoms vary depending on the specific type of personality disorder. Treatment typically includes talk therapy and medication.
There are numerous different types of personality disorders. They are grouped into three clusters based on similar characteristics and symptoms. Some people may have signs and symptoms of multiple personality disorders.
Cluster A: Suspicious
- Paranoid personality disorder: People with paranoid personality disorder are very distrustful of others and suspicious of their motives. They also tend to hold grudges.
- Schizoid personality disorder: People with this type of disorder display little interest in forming personal relationships or partaking in social interactions. They usually don’t pick up on normal social cues, so they can seem emotionally cold.
- Schizotypal personality disorder: In schizotypal personality disorder, people believe they can influence other people or events with their thoughts. They often misinterpret behaviors. This causes them to have inappropriate emotional responses. They may consistently avoid having intimate relationships.
Cluster B: Emotional and Impulsive
- Antisocial personality disorder: People with antisocial personality disorder tend to manipulate or treat others harshly without expressing remorse for their actions. They may lie, steal, or abuse alcohol or drugs.
- Borderline personality disorder: People with this type of disorder often feel empty and abandoned, regardless of family or community support. They may have difficulty dealing with stressful events. They may have episodes of paranoia. They also tend to engage in risky and impulsive behavior, such as unsafe sex, binge drinking, and gambling.
- Histrionic personality disorder: In histrionic personality disorder, people frequently try to gain more attention by being overly dramatic or sexually provocative. They are easily influenced by other people and are extremely sensitive to criticism or disapproval.
- Narcissistic personality disorder: People with narcissistic personality disorder believe that they are more important than others. They tend to exaggerate their achievements and may brag about their attractiveness or success. They have a deep need for admiration, but lack empathy for other people.
Cluster C: Anxious
- Avoidant personality disorder: People with this type of disorder often experience feelings of inadequacy, inferiority or unattractiveness. They usually dwell on criticism from others and avoid participating in new activities or making new friends.
- Dependent personality disorder: In dependent personality disorder, people heavily depend on other people to meet their emotional and physical needs. They usually avoid being alone. They regularly need reassurance when making decisions. They may also be likely to tolerate physical and verbal abuse.
- Obsessive-compulsive personality disorder: People with obsessive-compulsive personality disorder have an overwhelming need for order. They strongly adhere to rules and regulations. They feel extremely uncomfortable when perfection isn’t achieved. They may even neglect personal relationships to focus on making a project perfect.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is a reference doctors and mental health professionals use to help diagnose mental health conditions. Each personality disorder has criteria that must be met for a diagnosis. A primary care or mental health provider will ask you questions based on these criteria to determine the type of personality disorder. In order for a diagnosis to be made, the behaviors and feelings must be consistent across many life circumstances. They should also cause significant distress and impairment in at least two of the following areas:
- the way you perceive or interpret yourself and other people
- the way you act when dealing with other people
- the appropriateness of your emotional responses
- how well you can control your impulses
In some cases, your primary care or mental health provider may perform blood tests to determine whether a medical problem is causing your symptoms. They may also order a screening test for alcohol and drugs.
Treatment can vary depending on the type and severity of your personality disorder. It may include psychotherapy and medications.
Psychotherapy, or talk therapy, may help in managing personality disorders. During psychotherapy, you and a therapist can discuss your condition, as well as your feelings and thoughts. This can provide you with insight on how to manage your symptoms and behaviors that interfere with your daily life.
There are many different types of psychotherapy. Dialectical behavior therapy can include group and individual sessions where people learn how to tolerate stress and improve relationships. Cognitive behavioral therapy aims to teach people how to change negative thinking patterns so they can better cope with everyday challenges.
There aren’t any drugs approved for the treatment of personality disorders. However, certain types of prescription medications might be helpful in reducing various personality disorder symptoms:
- antidepressants, which can help improve a depressed mood, anger, or impulsivity
- mood stabilizers, which prevent mood swings and reduce irritability and aggression
- antipsychotic medications, also known as neuroleptics, which may be beneficial for people who often lose touch with reality
- anti-anxiety medications, which help relieve anxiety, agitation, and insomnia
The most important aspect of treating a personality disorder is the recognition that the problem exists in the first place. People with these types of disorders believe that their personality traits are normal, so they can become quite upset when someone suggests that they may have a personality disorder.
If someone recognizes that they have a personality disorder and engages in treatment, they should see an improvement in their symptoms. It’s beneficial for friends or family members to be involved in their therapy sessions as well. It’s also important for someone with a personality disorder to avoid drinking alcohol and using illicit drugs. These substances can have a negative impact on emotions and interfere with treatment.
Coping and Support
If you are close to someone you suspect might have a personality disorder, you should encourage them to seek help. They may get angry or defensive, but it’s important to avoid arguing with them. Instead, focus on expressing your feelings and voicing your concerns about their behaviors.
Call 911 if you ever feel that the other person intends to cause harm to themselves or others. It is also beneficial to tell your friend or loved one about the National Suicide Prevention Lifeline. This free, 24-hour phone line takes calls from anyone feeling depressed or anxious. A friendly, supportive voice can help them work through a difficult time or crisis.