Personality disorders are types of mental health conditions. They can lead to consistent, long-term, and unhealthy patterns of thinking, feeling, and behaving.
There are three main clusters of personality disorders: cluster A, cluster B, cluster C.
Each cluster has several unique traits that are used to categorize the symptoms. Grouped within the three clusters are 10 personality disorders. There are four personality disorders in cluster B, including:
- antisocial personality disorder
- borderline personality disorder
- histrionic personality disorder
- narcissistic personality disorder
It’s possible to be diagnosed with personality disorders from different clusters.
Each personality disorder has its own unique symptoms or traits. According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), symptoms must:
- have an onset in adolescence or early adulthood
- be stable over time
- lead to distress or impairment for the individual
Antisocial personality disorder
People with antisocial personality disorder demonstrate a pattern of disregard for and the violation of rights of others. Deceitfulness and manipulation are used for personal gain. They may treat other people harshly, or lie or cheat to reap these personal benefits. They may also be more likely to engage in theft. However, they generally have no remorse for what they have done.
People with antisocial personality disorder also have an increased risk for drug or alcohol addiction.
Borderline personality disorder
People with borderline personality disorder often have unstable personal relationships. It can also affect the way you view yourself. Symptoms include:
- impulsive behavior
- chronic feelings of emptiness
- chronic feelings of abandonment
- intense episodes of anger
- reckless behavior
People with this disorder may also display suicidal behaviors.
Histrionic personality disorder
People with histrionic personality disorder often strive to be the center of attention. They may use various attention-seeking behaviors, often in socially inappropriate situations. These behaviors may include:
- provocative interactions
- theatrical expressions
- a false sense of intimacy
People with this disorder are at increased risk for suicidal gestures.
Narcissistic personality disorder
People with this personality disorder believe they are superior to others. Symptoms include:
- extremely negative reactions to criticism
- elevated sense of self-importance
- preoccupation with grandiose thoughts of success
- excessive need for admiration
- strong sense of entitlement
People with this disorder often show a lack of empathy and may exploit personal relationships to elevate their self-image.
Causes and risk factors
Personality disorders are likely caused by a combination of genetics and environmental factors.
One study found a strong correlation between borderline personality disorder and history of sexual trauma. Another study found a link between children who were verbally abused by their mothers and various personality disorders, including borderline and narcissistic personality disorders.
A recent review also found similarities in the anatomic features of the brains of people with cluster B personality. This suggests that brain development may also contribute to these disorders.
Research has found a significant link between cluster B personality disorders and family history as well. Having a parent or sibling with a personality disorder increases your risk for developing the disorder.
It’s important not to diagnose yourself or others if you see the signs of a personality disorder. A personality disorder diagnosis should only be made by a trained mental health professional.
Mental health professionals use the DSM-5 to diagnose personality disorders and other mental health conditions. To be diagnosed, individuals must meet the criteria listed for that particular disorder.
You’ll likely need to meet with a therapist for several sessions before an official diagnosis is made. During your appointments, they’ll ask various questions about your life, many of which may feel very personal. It’s important to be open and honest with your mental health professional. That will help them make an accurate diagnosis.
According to the DSM-5, you’ll need to meet the following requirements to receive a cluster B personality disorder diagnose:
- Symptoms first appeared by early adulthood.
- If you’re under 18, symptoms must have been present for a minimum of one year.
- Symptoms must not be due to other disorders or specific stressful situations.
Your doctor may also want to talk to family members to get a better understanding of your symptoms. That’s because it may be difficult to recognize symptoms in yourself. Your doctor will not share things you’ve said to them with members of your family, nor will they share things with you that your family members have shared.
Treatment will likely involve various methods and require commitment on your part. Your doctor may recommend trying new things during the course of your treatment. And you may need to continue meeting with your doctor long term, even after your symptoms have improved.
Psychotherapy is typically a key part of any treatment plan. It’s also sometimes called talk therapy.
During psychotherapy, you’ll have the opportunity to express your thoughts and feelings in a judgement-free, supportive environment. People with cluster B personality disorders may find it difficult to establish a comfortable relationship with a therapist. You shouldn’t take that as a sign that therapy isn’t working.
Your doctor may also recommend dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT).
DBT is used to help teach new skills and encourage change. It may include group or individual sessions.
CBT focuses on problem solving and teaches the skills to identify problematic thoughts and beliefs.
There are no medications approved by the U.S. Food and Drug Administration for the treatment of personality disorders. Some medications may be helpful when used by your prescriber to manage some symptoms or to treat co-occurring psychiatric or mental health disorders. Commonly used medications include:
- mood stabilizers
- antianxiety medication
Talk to your doctor about potential side effects, and let them know if your symptoms aren’t improving or are getting worse. You should also avoid using drugs or alcohol while taking these medications as they can increase your risk for side effects.
Helping a loved one
If a family member or friend has been diagnosed with a personality disorder, be supportive and transparent. Let them know in a nonjudgmental way when they’re violating your boundaries. They may not always pick up on social cues, but gently guiding them can help them identify behaviors that may be affected by their condition.
If you believe someone with cluster B symptoms is a danger to themselves or others, call your local emergency services.
Individuals with cluster B personality disorders often have difficulties maintaining healthy relationships, and may display emotional and impulsive symptoms. Managing this condition is possible with treatment, though you may need to use a combination of treatments, including therapy and, in some cases, medication.
If you think someone is at immediate risk of self-harm or hurting another person:
- Call 911 or your local emergency number.
- Stay with the person until help arrives.
- Remove any guns, knives, medications, or other things that may cause harm.
- Listen, but don’t judge, argue, threaten, or yell.
If you think someone is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.