Cluster A Personality Disorders and Traits

Cluster A personality disorders include:

• paranoid personality disorder
• schizoid personality disorder
• schizotypal personality disorder

While they’re separate conditions, they all tend to involve thinking and behavior that appears unusual or eccentric to others. This often leads to social problems.

Paranoid personality disorder

Paranoid personality disorder causes patterns of distrustful behavior. People with this personality disorder often feel suspicious about the motives of others or fear that others intend to harm them.

Other traits of paranoid personality disorder include:

• difficulty trusting others
• unjustified suspicion that others are being disloyal without reason
• reluctance to confide in others out of fear they’ll use the information against you
• perception of innocent remarks as threatening or insulting
• anger at perceived attacks
• tendency to hold a grudge
• unjustified fear that a spouse or romantic partner is being unfaithful

Schizoid personality disorder

Schizoid personality disorder is an uncommon condition that causes people to avoid social activities and have trouble displaying emotion. To others, people with schizoid personality disorder may seem humorless or cold.

Other traits of schizoid personality disorder include:

• preferring to be alone
• not wanting or enjoying close friendships
• feeling unable to experience pleasure from anything
• having difficulty expressing emotions
• having difficulty reacting appropriately to emotional situations
• feeling little or no desire for sexual relationships

Schizotypal personality disorder

People with schizotypal personality disorder are often described as having unusual personalities. They tend to have few intimate relationships, distrust others, and experience a great deal of social anxiety.

Other traits of schizotypal personality disorder include:

• using a peculiar style of speech or unusual speaking patterns
• lacking close friends
• dressing in unusual ways
• believing they have unusual powers, such as the ability to influence events with their thoughts
• experiencing unusual sensations, such as hearing a voice that isn’t there
• having unusual beliefs, behaviors, or mannerisms
• being suspicious of others without reason
• having inappropriate reactions

Personality disorders are often harder for doctors to diagnose than other mental health conditions, such as anxiety or depression. Everyone has a unique personality that shapes the way they think about and interact with the world.

If you think you or someone close to you may have a personality disorder, it’s important to start with an evaluation by a mental health professional. This is usually done by either a psychiatrist or psychologist.

To diagnose personality disorders, doctors often start by asking a series of questions about:

• the way you perceive yourself, others, and events
• the appropriateness of your emotional responses
• how you deal with other people, especially in close relationships
• how you control your impulses

They might ask you these questions in a conversation or have you fill out a questionnaire. Depending on your symptoms, they may also ask for permission to talk to someone who knows you well, such as a close family member or spouse.

This is completely optional, but allowing your doctor to speak to someone close to you can be very helpful for making an accurate diagnosis in some cases.

Once your doctor gathers enough information, they’ll likely refer to the new edition of the Diagnostic and Statistical Manual of Mental Disorders. It’s published by the American Psychiatric Association. The manual lists diagnostic criteria, including symptom duration and severity, for each of the 10 personality disorders.

Keep in mind that the symptoms of different personality disorders often overlap, especially across disorders within the same cluster.

There are a variety of treatments available for personality disorders. For many, a combination of treatments works best. When recommending a treatment plan, your doctor will take into account the type of personality disorder you have and how severely in interferes with your daily life.

You might need to try a few different treatments before you find what works best for you. This may be a very frustrating process, but try to keep the end result — more control over your thoughts, feelings, and behavior — in the front of your mind.

Psychotherapy

Psychotherapy refers to talk therapy. It involves meeting with a therapist to discuss your thoughts, feelings, and behaviors. There are many types of psychotherapy that take place in a variety of settings.

Talk therapy can take place on an individual, family, or group level. Individual sessions involve working one-on-one with a therapist. During a family session, your therapist will have a close friend or family member who’s been affected by your condition join the session.

Group therapy involves a therapist leading a conversation among a group of people with similar conditions and symptoms. This can be a great way to connect with others going through similar issues and talk about what has or hasn’t worked.

Other types of therapy that might help include:

• Cognitive behavioral therapy. This is a type of talk therapy that focuses on making you more aware of your thought patterns, allowing you to better control them.
• Dialectical behavioral therapy. This type of therapy is closely related to cognitive behavioral therapy. It often involves a combination of individual talk therapy and group sessions to learn skills for how to manage your symptoms.
• Psychoanalytic therapy. This is a type of talk therapy that focuses on uncovering and resolving unconscious or buried emotions and memories.
• Psychoeducation. This type of therapy focuses on helping you better understand your condition and what it involves.

Medication

There are no medications specifically approved to treat personality disorders. There are, however, certain medications that your prescriber may use “off label” to help you with certain symptoms.

Additionally, some people with personality disorders may have another mental health disorder which can be the focus of clinical attention. The best medications for you will depend on individual circumstances, such as the severity of your symptoms and the presence of co-occurring mental disorders.

Medications include:

• Antidepressants. Antidepressants help treat symptoms of depression, but they can also reduce impulsive behavior or feelings or anger and frustration.
• Anti-anxiety medications. Medications for anxiety can help manage symptoms of dread or perfectionism.
• Mood stabilizers. Mood stabilizers help prevent mood swings and reduce irritability and aggression.
• Antipsychotics. Medications used to treat psychosis can be helpful for people who easily lose touch with reality or see and hear things that aren’t there.

Make sure to tell your doctor about any medications you’ve tried in the past. This can help them better determine how you’ll respond to different options.

If you try a new medication, let your doctor know if you experience uncomfortable side effects. They can either adjust your dosage or give you tips for managing side effects.

Keep in mind that medication side effects often subside once your body gets used to the mediation.

If someone close to you may have a personality disorder, there are a few things you can do to help them feel comfortable. This is important: People with personality disorders might be unaware of their condition or think they don’t need treatment.

If they haven’t received a diagnosis, consider encouraging them to see their primary care doctor, who can refer them to a psychiatrist. People are sometimes more willing to follow advice from a doctor than from a family member or friend.

If they’ve received a diagnosis with a personality disorder, here are a few tips to help them through the treatment process:

• Be patient. Sometimes people need to take a few steps back before they can move forward. Try to allow space for them to do this. Avoid taking their behavior personally.
• Be practical. Offer practical support, such as scheduling therapy appointments and making sure they have a reliable way to get there.
• Be available. Let them know if you’d be open to joining them in a therapy session if it would help.
• Be vocal. Tell them how much you appreciate their efforts to get better.
• Be mindful of your language. Use “I” statements instead of “you” statements. For example, rather than saying “You scared me when…,” try saying “I felt scared when you…”
• Be kind to yourself. Make time to care for yourself and your needs. It’s hard to offer support when you’re burned out or stressed.

If you’re feeling overwhelmed and don’t know where to start, consider starting with the National Alliance on Mental Illness’ guide to finding support. You’ll find information about finding a therapist, getting financial help, understanding your insurance plan, and more.

You can also create a free account to participate on their online discussion groups.