An Overview of Personality Disorders

Personality traits are patterns of perceiving, thinking, relating, and reacting that remain relatively stable over time. In personality disorders, these traits become pronounced, maladaptive, and rigid to the point that they impair relationships with others. People with these mental health conditions often are not aware of their maladaptive behaviors because they have a distorted perception of the world around them that makes their behavior seem appropriate.

Symptoms of personality disorders usually appear in late adolescence or young adulthood, but they can begin to appear in childhood. Each type has specific symptoms, which are covered below.

Personality disorders are grouped into three clusters. Cluster A personality disorders involve suspicion of or a lack of interest in others, while cluster B disorders have a pattern of unpredictable behavior and overly emotional thinking. People with cluster C personality disorders display anxious behaviors or thinking.

Cluster A personality disorders feature odd, eccentric behaviors or patterns of thinking. There are three personality disorders in this cluster.

• Paranoid Personality Disorder: People with paranoid personality disorder are suspicious of others and may believe that other people are trying to hurt them. They may take innocent comments or situations as personal insults and have a habit of holding grudges.
• Schizoid Personality Disorder: Those with schizoid personality disorder may choose to be alone and appear cold and uninterested in others. They have a limited ability to express emotions and do not take pleasure in most activities.
• Schizotypal Personality Disorder: Schizotypal personality disorder features unusual beliefs, thoughts, behavior, or speech. People with this condition may experience social anxiety and have flat or unusual emotional responses. They may engage in magical thinking, like believing their thoughts can affect others or that things and events around them have hidden messages.

Four personality disorders are classified under cluster B. They are:

• Borderline Personality Disorder: Those with borderline personality disorder have a fear of being abandoned or alone. They have unstable relationships and mood swings, and they are often angry. People with this personality disorder frequently engage in risky behavior, and they are more prone to self-harm and suicide.
• Narcissistic Personality Disorder: This personality disorder causes people to believe that they are special or more important than others. People with narcissistic personality disorder can have fantasies about being successful, powerful, or attractive and may embellish their accomplishments and talents. They do not understand the needs and feelings of others and may take advantage of them for personal gain.
• Antisocial Personality Disorder: People with antisocial personality disorder can be aggressive or violent. They have little, if any, concern for the feelings of others and often lie and steal. People with this personality disorder often violate the rights of others, and they may have frequent run-ins with the law. They also have little regret for how their behavior affects the people around them.
• Histrionic Personality Disorder: People with histrionic personality disorder are attention-seeking, emotional, and dramatic. They may rely on their sex appeal to get attention. They are concerned with their physical appearance and may be easily influenced by others.

Group C personality disorders feature patterns of anxious thoughts and behavior. The following three conditions are classified under this group:

• Avoidant Personality Disorder: People with avoidant personality disorder are sensitive to criticism and may not feel good enough. They are extremely shy in social settings, do not try new activities because they do not like meeting new people, and fear being made fun of or embarrassed.
• Dependent Personality Disorder: Those who have dependent personality disorder lack confidence in their abilities and need a lot of advice and consoling from others to make decisions. They generally rely on others too much and feel like they need to be taken care of, which can lead to them being clingy or submissive. People with this personality disorder may tolerate abuse and may need to start a new relationship immediately after one ends.
• Obsessive-Compulsive Personality Disorder: This personality disorder causes people to focus too much on rules and order to the point that they cannot finish projects. They need everything to be perfect, which is impossible. Those with this condition need to be in control of people and situations. They can be inflexible and stubborn about ethics, morality, and values and may ignore loved ones because they are so focused on work or completing a project.

Experts are not completely sure what causes personality disorders but believe that they may result from a combination of factors, including genetics and environment.

Risk factors for personality disorders include childhood abuse and trauma, including sexual abuse and verbal abuse, and high sensitivity to stimuli, like noise, light, and texture.

Experts have identified some protective factors, too, like having positive relationships with peers and having a strong relationship with even a single person, like a friend, teacher, or relative.

Personality disorders can have significant complications, especially if left untreated. These can include substance use disorder, relationship difficulties, job instability, and an increased risk of self-harm.

Personality disorders are underdiagnosed as many people with them often do not realize that they are exhibiting problematic behavior. When they do seek treatment, it is usually because they are experiencing signs of anxiety or depression rather than looking for support for their personality disorder.

Some people with personality disorders may seek treatment with the assistance of a close friend or family member. If you have someone in your life who you think may be exhibiting symptoms of a personality disorder, encourage them to seek help. If you believe that you may be experiencing symptoms of one of these conditions, connect with a mental health professional for support.

Treatment for personality disorders is usually talk therapy. In talk therapy, people with these conditions work with a mental health professional to learn how to control their emotions, manage stress, and relate to other people.

There are no approved medications for treating personality disorders, but some people with personality disorder may have other mental health conditions, too, like mood or anxiety disorders. Medication can help manage symptoms of comorbid conditions, which can make the person better able to manage and respond to psychotherapy.