Personality Disorders

What are Personality Disorders?

Personality disorders are a group of mental health conditions where long-term patterns of thinking, feeling, and behaving differ significantly from what is expected in society. These patterns can cause difficulties with relationships, work, and daily functioning.

Unlike short-term changes in mood or behavior, personality disorders are enduring and often begin in adolescence or early adulthood.

Common Features

  • Rigid patterns of behavior that make it hard to adapt to different situations

  • Difficulties in relationships (conflict, mistrust, or withdrawal)

  • Distorted self-image – either too low, too high, or unstable

  • Problems regulating emotions – intense, unpredictable, or blunted emotions

  • Impact on functioning – struggles at work, in school, or socially

Types of Personality Disorders

Mental health professionals group personality disorders into three clusters:

Cluster A: Odd or Eccentric

  • Paranoid Personality Disorder – distrust and suspicion of others.

  • Schizoid Personality Disorder – detachment from social relationships, limited emotional expression.

  • Schizotypal Personality Disorder – unusual beliefs, eccentric behavior, social anxiety.

Cluster B: Dramatic, Emotional, or Erratic

  • Antisocial Personality Disorder – disregard for others’ rights, impulsivity, lack of empathy.

  • Borderline Personality Disorder (BPD) – unstable relationships, fear of abandonment, emotional intensity, impulsivity.

  • Histrionic Personality Disorder – excessive emotionality, need for attention.

  • Narcissistic Personality Disorder – grandiosity, need for admiration, lack of empathy.

Cluster C: Anxious or Fearful

  • Avoidant Personality Disorder – extreme shyness, fear of rejection, feelings of inadequacy.

  • Dependent Personality Disorder – excessive reliance on others for decisions and care.

  • Obsessive–Compulsive Personality Disorder (OCPD) – perfectionism, control, and rigidity (different from OCD).

Causes and Risk Factors

The exact cause is unknown, but likely involves a mix of:

  • Genetics – family history of personality or mental health conditions.

  • Environment – trauma, neglect, or abuse in childhood.

  • Temperament – innate traits like sensitivity or impulsivity.

  • Social factors – unstable relationships, bullying, or chronic stress.

Diagnosis

  • Made by a psychiatrist or psychologist after detailed interviews.

  • Symptoms must be long-term, inflexible, and pervasive across life areas.

  • Other mental health conditions are often considered (e.g., depression, anxiety, PTSD).

Treatment Options

Personality disorders can be challenging, but treatment helps many people improve relationships, functioning, and wellbeing.

  • Psychotherapy (main treatment)

    • Dialectical Behavior Therapy (DBT) – especially effective for Borderline Personality Disorder.

    • Cognitive Behavioral Therapy (CBT) – helps change unhelpful thoughts and behaviors.

    • Schema Therapy – addresses deeply rooted patterns.

    • Mentalization-Based Therapy (MBT) – improves understanding of emotions and relationships.

  • Medication

    • No single medication treats personality disorders, but antidepressants, mood stabilizers, or antipsychotics may help with specific symptoms.

  • Supportive Approaches

    • Group therapy, peer support, and psychoeducation.

    • Building healthy routines, self-care, and social support networks.

Living With a Personality Disorder

  • Relationships may be challenging, but recovery and personal growth are possible.

  • Many people benefit from learning coping skills, self-awareness, and communication strategies.

  • Progress is often gradual and may involve setbacks, but treatment can significantly improve quality of life.

Supporting Someone With a Personality Disorder

  • Show patience and empathy – avoid judgment.

  • Encourage professional help – therapy is the most effective treatment.

  • Set healthy boundaries – be supportive while protecting your own wellbeing.

  • Learn about the condition – understanding patterns makes it easier to support loved ones.

Getting Help

If you or someone you know may be living with a personality disorder:

  • Reach out to a GP, counselor, or mental health professional.

  • Early support can improve long-term outcomes.

  • In crisis (e.g., suicidal thoughts, self-harm, or violence), call emergency services or crisis hotlines immediately.