Personality disorders: Types, causes, and treatments
Reviewed by Theresa Fry
Written bytherapist.com team
Last updated: 10/13/2022
Your personality consists of the individual way you think, feel, behave, and interact with others. It’s informed by your genetics, environment, culture, family, and past experiences. A healthy personality allows you to be yourself while still responding to stress and change in helpful ways.
A personality disorder is a form of mental illness characterized by a pervasive and enduring pattern of thinking, feeling, and behaving that leads to significant distress or impairment in a person’s life. These traits are exacerbated by stress and change.
Not every personality disorder is the same. Psychologists have identified three main types of personality disorders, categorized as clusters. The disorders listed in each cluster share certain characteristics but require separate diagnoses.
Cluster A personality disorders are characterized by eccentricity and suspicion. People with cluster A personality disorders may have odd or paranoid thoughts, cold or inappropriate feelings, or hostile or distrustful behaviors. Cluster A personality disorders include:
- Paranoid personality disorder: Unfounded or unjustified suspicion of others that interferes with a person’s ability to function and maintain relationships
- Schizoid personality disorder: Emotional and social detachment and a preference for isolation
- Schizotypal personality disorder: Peculiar ideas and behaviors that make it difficult to relate to others; often characterized by “magical thinking,” such as the belief in telepathy and clairvoyance
Cluster B personality disorders are characterized by erratic, unpredictable, or overly emotional ways of thinking and behaving. People with cluster B personality disorders may disregard the emotional needs of others in an attempt to satisfy their own. This can lead to manipulation, lack of empathy, and irresponsible behavior. Cluster B personality disorders include:
- Antisocial personality disorder (ASPD): Lack of remorse and disregard for other people’s rights and feelings; may also include a diagnosis of psychopathy or sociopathy
- Borderline personality disorder (BPD): Extreme moods, unstable relationships, and risky behaviors that may endanger yourself or others
- Histrionic personality disorder: Excessive or exaggerated emotional expression for the purposes of receiving attention
- Narcissistic personality disorder: A debilitating level of self-importance, arrogance, and selfishness, along with a lack of empathy for others
Cluster C personality disorders are characterized by high levels of anxiety and fearfulness. The specific fears that characterize each cluster C disorder differ widely and may include the fear of rejection, the fear of being alone, and the fear that things won’t be done correctly. Cluster C personality disorders include:
- Avoidant personality disorder: Excessive shyness, sensitivity to criticism, and low self-esteem
- Dependent personality disorder: Lack of self-confidence and extreme dependence on others to the point of excusing or tolerating abuse
- Obsessive-compulsive personality disorder (OCPD): Excessive preoccupation with perfectionism, order, rules, and a need for control; different from obsessive-compulsive disorder (OCD), which is characterized by compulsive rituals and obsessions and is not a personality disorder
Beyond the three main clusters of personality disorders, there are two other diagnoses you may receive:
- Other specified personality disorder: When a person has symptoms of one or more personality disorders but not enough to warrant a specific diagnosis; is followed by a specifier (e.g., “with mixed personality features”) that describes the rationale for this diagnosis
- Unspecified personality disorder: Similar to other specified personality disorder, this diagnosis is made when a person has symptoms of one or more personality disorders but not enough to warrant a specific diagnosis, but in this case, the clinician does not know (or chooses not to specify) the reason for a more specific diagnosis
Potentially. Although there is no specific, single cause for personality disorders, genetics are thought to play a major part. According to the Merck Manuals, personality disorders have an estimated 50% heritability level, which is similar to other mental health disorders.
Although your genetic history may affect your likelihood for developing certain personality disorders, it isn’t the only factor at play. Other factors may increase your risk for personality disorders, such as:
- Biochemistry: There’s evidence to suggest that brain structure and the balance of chemicals in the brain may increase a person’s risk for personality disorders.
- Abusive or traumatic childhood: Your environment has a significant effect on your mental health, especially in childhood. If you grew up in an abusive, traumatic, neglectful, or unpredictable household, you may be at a greater risk for developing a personality disorder.
- Childhood mental illnesses: Being diagnosed with conduct disorder or oppositional defiant disorder (ODD) as a child increases your risk for being diagnosed with certain personality disorders later in life, particularly antisocial personality disorder.
Is a Personality Disorder a Mental Illness?
Yes, personality disorders are a type of mental illness. “Mental illness” is an umbrella term covering a variety of mental health conditions, such as mood disorders, developmental disorders, trauma-related disorders, anxiety disorders, and psychotic disorders—to name a few.
It’s important not to self-diagnose your distress. Learning about personality disorders and other mental health conditions can only take you so far. In order to be certain what is causing your symptoms, you will need to receive a diagnosis from a mental health professional. Click here to find a therapist near you.
Personality disorders cannot be cured, but they can be treated. People with personality disorders often don’t recognize that their thoughts, feelings, and behaviors are causing distress or impairment. However, they may seek treatment if their condition significantly impairs their ability to function. For example, people with personality disorders may seek treatment if their behavior jeopardizes their job or their relationships.
The good news is that there are many effective options for treating various personality disorders, such as:
The efficacy of a certain therapy will likely depend on the specific type of personality disorder you’ve been diagnosed with. Click here to find a therapist near you and get a diagnosis so you can get started with treatment.
Medicine may be an additional component added to your treatment plan alongside therapy. There is no medication that treats personality disorders specifically; however, certain medications may alleviate some symptoms. Common medications prescribed for people with personality disorders include:
- Antidepressants: Alleviate symptoms of depression, low mood, irritability, and anger
- Mood stabilizers: Stabilize severe mood swings and reduce impulsive anger and aggression
- Antipsychotics: Reduce impulsive aggression and address difficulties associated with losing touch with reality
- Anti-anxiety medications: Alleviate symptoms of anxiety and agitation
Personality disorders are often difficult to treat because they affect an intrinsic part of who we are: our personalities. It is difficult to change what is fundamentally a core feature of our being. In addition, personality disorders are ego-syntonic, meaning that the person with the disorder is often unaware that they have a problem. Instead, they may view others as the problem, which can limit their motivation for treatment.
However, just because personality disorders are difficult to treat, that doesn’t mean that treatment and improvement is impossible. The therapies and medications listed above can be effective for those who seek help. Click here to find a personality disorder therapist near you so you can get started on getting better.
Multiple personality disorder, known today as dissociative identity disorder (DID), is real—but not in the way you may think. The Hollywood depiction of DID as multiple people inhabiting one body is false. Instead, the personalities existing within a person with DID are in fact different facets of the same identity. In addition, DID is considered a dissociative disorder, not a personality disorder.
Autism spectrum disorder (ASD) is a developmental disorder characterized by social and communication challenges as well as repetitive behaviors. It is not a personality disorder.
Depression is a mood disorder, not a personality disorder. However, people with personality disorders may experience symptoms of depression from time to time.
About the author
The editorial team at therapist.com works with the world’s leading clinical experts to bring you accessible, insightful information about mental health topics and trends.