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Personality disorders

Reviewed by Monika Cope-Ward, LCSW

Cutouts stacked on top of each other showing the outline of a face with different expressions

Your personality consists of the way you think, feel, behave, and interact with others. It’s shaped 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.

When a person has a personality disorder, it means they have deeply rooted patterns of thoughts, feelings, and behaviors that have caused them distress and impacted their life over a long period of time. These traits are worsened by stress or change and cause the person to act in ways that are different than what’s expected.1

Types of personality disorders

There are many kinds of personality disorders. For the most part, they’re split into three “clusters.” The disorders in these clusters share certain qualities, but each one also has distinct characteristics.

Cluster A personality disorders

Cluster A personality disorders involve suspicion of or disinterest in others. People with these disorders may have paranoid thoughts, cold or inappropriate feelings, or hostile or distrustful behaviors.

  • Paranoid personality disorder: Involves unfounded suspicion of others that makes it hard to trust people and maintain relationships
  • Schizoid personality disorder: Features emotional and social detachment, as well as a preference for isolation
  • Schizotypal personality disorder: Unusual ideas and behaviors make it hard to relate to others; often involves “magical thinking,” where a person believes they can affect someone else just by thinking about them

Cluster B personality disorders

Cluster B personality disorders involve erratic or overly emotional ways of thinking and behaving. People with these disorders may disregard the emotional needs of others in order to satisfy their own, which can lead to manipulation, lack of empathy, and irresponsible behavior.

  • Antisocial personality disorder (ASPD): A pattern of disregarding other people’s rights and feelings, with no remorse for those actions
  • Borderline personality disorder (BPD): Characterized by extreme moods, unstable relationships, impulsive behaviors, and an unstable sense of self
  • Histrionic personality disorder: Features excessive, exaggerated, and quickly changing expressions of emotion, usually with the goal of gaining attention
  • Narcissistic personality disorder: An overblown sense of self-importance, arrogance, and selfishness, along with a lack of empathy for others

Cluster C personality disorders

Cluster C personality disorders involve high levels of anxiety or fearfulness, though the specific fears that characterize each disorder can differ widely.

  • Avoidant personality disorder: Someone is excessively shy and sensitive to criticism, and they have low self-esteem
  • Dependent personality disorder: Involves a lack of self-confidence and extreme dependence on others, even to the point of tolerating mistreatment or abuse
  • Obsessive-compulsive personality disorder (OCPD): Characterized by an extreme focus on perfectionism, order, rules, and control—note that this differs from obsessive-compulsive disorder (OCD), which is an anxiety disorder

Personality disorder—trait specified

It’s possible to have the distinguishing features of a personality disorder but not fit neatly into one of the 10 specific disorders described above. If someone fits this description, they may receive the diagnosis “personality disorder—trait specified.”2

Is multiple personality disorder real?

Multiple personality disorder is now called dissociative identity disorder (DID), and it is a real diagnosis. However, it’s very different from the sensationalized version often shown in movies and on television. DID is a type of dissociative disorder, not a personality disorder.

What causes personality disorders?

There’s no single cause of personality disorders, but genetics are believed to play a strong role.3 However, they aren’t the only factor that can affect your likelihood of developing certain personality disorders. Other risk factors include:

  • Biochemistry: Because brain structure and chemical balances vary from person to person, some people are at greater risk than others.
  • Abusive or traumatic childhood: Your environment, especially during childhood, has a significant effect on your mental health. Growing up in an abusive, traumatic, neglectful, or unpredictable household may increase your risk.
  • Childhood mental health struggles: Being diagnosed with certain mental health disorders as a child, such as oppositional defiant disorder (ODD) or attention-deficit/hyperactivity disorder (ADHD), may increase your risk of being diagnosed with particular personality disorders later in life.4

Are personality disorders mental illnesses?

“Mental illness” is an umbrella term used to describe a variety of mental health conditions, including mood disorders, anxiety disorders, and trauma-related conditions. It’s difficult to say decisively whether personality disorders are mental illnesses due to a lack of clinical clarity in defining them.5 Many clinicians don’t consider people who have personality disorders to be mentally ill because those people generally know right from wrong and can control their behavior. People with mental illnesses, on the other hand, tend to have a hard time controlling their behavior on their own.

Can you tell if you have a personality disorder?

It’s important not to self-diagnose a mental health condition. Reading and learning about personality disorders and other conditions can be helpful, but working with a mental health professional is the only way to find out what’s driving your symptoms.

Treatment for personality disorders

Personality disorders can’t be cured, but they can be treated. People with these disorders often don’t realize that their thoughts, feelings, and behaviors are causing distress or damaging their relationships. However, they may decide to seek treatment if their condition impacts their everyday life: For example, if their behavior causes them to lose their job or if loved ones tell them repeatedly that there’s an issue.

Effective therapies

Therapeutic options for treating personality disorders include:

The effectiveness of any type of therapy will likely depend on what type of personality disorder you’ve been diagnosed with. Find a therapist near you to get a diagnosis and begin treatment.

Medications

Alongside therapy, medicine may be a part of your treatment plan. While no medication has been approved by the Food and Drug Administration (FDA) specifically to treat personality disorders, certain medications may help ease symptoms:6

  • Antidepressants can lessen symptoms of depression, including low mood, irritability, and anger.
  • Mood stabilizers can reduce severe mood swings, impulsive anger, and aggression.
  • Antipsychotics can reduce impulsive aggression and lessen the likelihood of losing touch with reality.
  • Anti-anxiety medications can ease symptoms of anxiety and agitation.

Why are personality disorders difficult to treat?

These disorders are often hard to treat because people’s personalities are such a deeply held piece of who they are. It’s hard to change core features of our being.

In addition, personality disorders are “egosyntonic,” meaning that people who have them are often unaware they have a problem. Instead, they tend to view others as the problem and therefore don’t believe they need treatment.

Personality disorders are difficult to treat, but that doesn’t mean treatment and improvement are impossible. The therapies and medications listed above can be effective for those who seek help. Search our provider directory to find a mental health professional in your area.

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.

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