Personality disorders are mental disorders characterized by unhealthy patterns of behavior, thought, and/or daily function. Because these patterns deviate from what is considered the societal norm, individuals with personality disorders often experience internal and social problems. (1)
There are 10 personality disorders divided into three clusters: A, B, and C. Cluster A includes paranoid personality disorder, schizotypal personality disorder, and schizoid personality disorder. Cluster B personality disorders include histrionic, narcissistic, borderline, and antisocial. Finally, cluster C includes obsessive-compulsive, dependent, and avoidant personality disorders.
Treatment for personality disorders can include intensive, long-term psychotherapy. Sometimes, medication can help. Anyone with signs or symptoms of a personality disorder should speak with a primary care provider or mental health professional to determine their risk factors and medical history. Without treatment, personality disorders have the potential to cause disruptions in patients' and their loved ones’ lives and could lead to social isolation, drug or alcohol abuse, or other social or medical problems. (1)
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There is no single cause that leads to personality disorders. Factors that may contribute to the development of personality disorders include: (2)
Genetic and external factors may play a role in the onset of personality disorders, with early environmental influences being one consideration. (3) Some personality disorders are less common in certain parts of the world and more prominent in others.
Researchers believe that genetic deviations may impact the development of obsessive-compulsive disorder, while stressful experiences and trauma may factor into other types of personal disorders. (4) For example, one study determined that subjects with borderline personality disorder had higher-than-usual rates of childhood sexual trauma. (5) Those with paranoid personality disorder had higher rates of verbal abuse in the past. (6)
It's likely that most personality disorders are the result of a combination of internal and external factors, and researchers continue to investigate potential causes.
Since most personality disorders emerge or become symptomatic in the teen years or early adulthood, it's crucial for individuals and their families to be aware of common personality disorder symptoms and know when to get professional support.
The symptoms will depend on the personality disorder but may include: (2)
People with personality disorders can have difficulty forming bonds and stable relationships with others because of troubling and otherwise non-typical behaviors. Some individuals with personality disorders may seek excessive attention or have too few boundaries. They may have a hard time understanding how their behaviors or thought patterns are dangerous or upsetting. People living with personality disorders may have poor self-esteem, excessive self-esteem, or a muddled image of themselves. Additionally, while not all people with personality disorders are dangerous or abusive, some may have abusive tendencies toward themselves or others.
To determine if a loved one has a personality disorder, they will require an assessment from a qualified healthcare professional.
Speaking to a professional is the best way to get a formal personality disorder diagnosis. There are 10 personality disorders in the DSM-5-TR (7), each with its own hallmarks. Using the DSM-5-TR as a guide, mental health professionals and specialists check to see if patients' symptoms or behaviors match the specific criteria required for diagnosis.
Healthcare professionals look at a patient’s long-term health history, patterns of behavior, physical functions, and persistent symptoms. Those under 18 may not receive a formal personality disorder diagnosis because they are still growing and developing. (7)
The right personality disorder treatment depends on the diagnosis and severity of the condition. Psychotherapy is the most common treatment, and it comes in forms such as: (7)(11)
Dialectical behavior therapy helps patients get to know their emotions and behaviors for better emotional regulation. Cognitive-behavioral therapy encourages people to recognize their thought patterns and work to change them in a positive way. Psychoanalytic therapy is a type of talk therapy that helps patients gain insight into their behaviors, while group therapy helps peers get to know each other and find support while living with similar conditions. Psychoeducation teaches about these and other possible treatment options. (12)
Medications for personality disorders aren't usually the first treatment approach, but mood stabilizing, anti-anxiety, or antidepressant medications may address some symptoms, such as mood swings or depression. In some cases, a patient may work with a team including social workers, psychologists, psychiatrists, family members, primary care physicians, and other specialists, to address care from a multitude of angles. (7)
A person with a personality disorder diagnosis can live productively. Some steps patients can take to live well after diagnosis include: (7)(8)(9)
Support groups and mental health professionals can provide additional support to discuss symptoms and experiences to help patients cope.
Family members and friends of those with personality disorders can help by being patient and trying not to judge their loved one. Setting boundaries and planning for triggers can help reduce conflicts.
It’s also essential for friends and family to avoid labeling their loved ones or assuming how the condition may impact them. Learning about the disorder can be beneficial for all involved. (10) Family therapy or couples therapy can also be helpful when symptoms of a personality disorder impact the family or relationship dynamic.
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