Personality disorders are a group of mental health conditions that involve long-term patterns of thoughts, feelings, and behaviors that are significantly different from societal expectations. These patterns can interfere with everyday life, work, and relationships. Symptoms typically begin to appear in late adolescence or early adulthood.

It’s estimated that around 11% of people worldwide live with a personality disorder. While there are various types, a common characteristic among them is having thoughts and behaviors that consistently deviate from cultural norms.

Mental health professionals such as psychologists and psychiatrists are qualified to diagnose personality disorders. However, treatment can be challenging, as individuals with personality disorders often do not seek help themselves. When treatment is pursued, psychotherapy and psychiatric medications are the primary tools to manage symptoms.

Types of Personality Disorders

Mental health professionals classify personality disorders into three main clusters based on shared characteristics. Each cluster includes specific disorders:

Cluster A: Eccentric or Odd Behavior

These disorders involve unusual or paranoid thinking and behaviors:

  • Paranoid personality disorder: Characterized by mistrust and suspicion of others without sufficient reason.

  • Schizoid personality disorder: Involves detachment from social relationships and limited emotional expression.

  • Schizotypal personality disorder: Marked by eccentric beliefs, unusual behavior, and difficulty forming close relationships.

Cluster B: Dramatic, Emotional, or Erratic Behavior

Individuals with these disorders display intense, often unpredictable emotions and behaviors:

  • Antisocial personality disorder: Involves disregard for others' rights and feelings, manipulative or deceitful behaviors.

  • Borderline personality disorder: Causes severe mood swings, unstable self-image, and difficulties with emotional regulation.

  • Histrionic personality disorder: Characterized by excessive attention-seeking and intense emotional displays.

  • Narcissistic personality disorder: Includes a grandiose sense of self-importance and a lack of empathy for others.

Cluster C: Anxious or Fearful Behavior

These disorders are marked by excessive anxiety and fear:

  • Avoidant personality disorder: Includes extreme sensitivity to rejection and feelings of inadequacy, leading to social withdrawal.

  • Dependent personality disorder: Characterized by an overreliance on others for decision-making and reassurance.

  • Obsessive-compulsive personality disorder: Involves perfectionism, rigidity, and a need for control. (Note: This is different from obsessive-compulsive disorder, or OCD.)

Common Symptoms of Personality Disorders

Although symptoms vary depending on the specific disorder, many personality disorders share certain traits, including:

  • Inappropriate or unpredictable behavior

  • Poor self-image

  • Difficulty forming or maintaining relationships

  • Lack of awareness that their behavior is unusual

  • Tendency to blame others for their own emotions or actions

  • Mood instability

  • Emotional regulation issues

  • Impulsivity

Causes

The exact causes of personality disorders are complex and not fully understood. However, they likely result from a combination of factors:

  • Genetics: Some personality disorders may be linked to genes, particularly those affecting neurotransmitters in the brain.

  • History of trauma: Childhood abuse, neglect, bullying, or emotional trauma are significant contributing factors.

  • Cultural influence: Cultural background may shape the type and expression of a personality disorder. For instance, some cultures may have higher rates of anxiety-based disorders.

Risk Factors

Research into certain disorders, such as borderline personality disorder, has identified common risk factors:

  • Low socioeconomic status

  • Ineffective or abusive parenting

  • Having a parent with a personality disorder

  • Generational trauma or unstable home environments

  • Traits like impulsiveness, aggression, emotional instability, and negativity

Diagnosis

Diagnosis typically involves a detailed psychological evaluation by a mental health professional. This may include:

  • Discussing symptoms

  • Reviewing medical and psychological history (personal and family)

  • Physical examination

Professionals use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a guideline for diagnosis. Since personality is still developing in children, these disorders are usually not diagnosed before the age of 18.

Many people with personality disorders are unaware that their behavior is problematic, so diagnosis often happens when a loved one intervenes or when a healthcare provider refers them for evaluation.

Treatment Options

Personality disorders can be more difficult to treat than other mental health conditions. Treatment usually includes:

  • Psychotherapy: Common approaches include cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and psychodynamic therapy. These methods help individuals recognize harmful patterns and develop healthier coping mechanisms.

  • Medication: While no medication specifically treats personality disorders, doctors may prescribe antidepressants, anti-anxiety medications, or mood stabilizers to manage related symptoms.

  • Group therapy: Offers emotional support and helps participants build social skills. It’s particularly helpful for cluster B disorders.

  • Social skills training: Especially useful for individuals with avoidant personality disorder to build confidence and improve interactions.

  • Hospitalization: In severe cases involving safety concerns or intense crises, hospital care may be necessary for stabilization and intensive treatment.

Related Conditions

Personality disorders often co-occur with other health or mental health conditions, including:

  • Anxiety and mood disorders

  • Substance use disorder

  • Heart disease

  • Diabetes

  • Arthritis

  • Digestive issues

These disorders can also lead to serious life challenges such as:

  • Difficult interpersonal relationships

  • Divorce or domestic violence

  • Job loss or unemployment

  • Substance abuse

  • Homelessness

  • Self-harm or suicidal behavior

Living With a Personality Disorder

The long-term outlook for people with personality disorders can be poor, especially when they don’t acknowledge the need for treatment. However, those who seek help can learn to manage their condition effectively.

The collaborative care model—where psychiatrists, primary care providers, and nurse managers work together—has shown promising results. Some individuals may improve significantly after just six months of coordinated care.

In addition to treatment, self-care can make a big difference. If you’re living with a personality disorder, consider the following strategies:

  • Educate yourself about the disorder

  • Engage in regular physical activity

  • Avoid drugs and alcohol

  • Use journaling or join support groups to express feelings

  • Practice mindfulness or stress-reduction techniques like yoga or meditation

  • Surround yourself with supportive and understanding people

By following a treatment plan and building a strong support network, many individuals can improve their well-being and quality of life.