Personality Disorders

A personality disorder is a mental health condition that is determined by certain distinct personality traits and behaviors. These behaviors often differ from the norm and influence how individuals think about themselves and others, how they interact and respond emotionally, how they relate to peers, and the level of control they have over their behaviors.

Personality is a collection of traits or characteristics that determine who someone is and how they respond to others. A personality disorder is when those traits disrupt life.

Personality develops during late adolescence and early adulthood, leaving many to wonder if unwanted behavioral traits can be improved. While the therapeutic process for personality disorders can be lengthy, there are techniques available that have proven effective in improving symptoms.

What Are Personality Disorders?

The DSM-5 recognizes ten personality disorders, categorized into three clusters, each of which shares similar behaviors. It is not uncommon for individuals to have traits in different clusters, leading to a mixed personality disorder.

Cluster A Personality Disorders

Cluster A personality disorders make up behaviors that are odd and eccentric. Individuals with cluster A personalities tend to have the following:

  • Suspicious of other’s motives
  • Difficult and conflicted relationships
  • Thinking errors or eccentric behavior that seems odd to others
  • Social anxiety

Cluster A personality disorders include:

Schizoid Personality Disorder

Schizoid personality disorder describes individuals who have limited social skills that affect their ability to develop relationships. Individuals with a schizoid personality disorder often have a hard time expressing or understanding emotions and often detach or avoid close relationships with others.

Schizotypal Personality Disorder

Schizotypal personality disorder describes individuals who are uncomfortable in close relationships. They often have eccentric or odd beliefs and may not fully understand how their behaviors impact others. Individuals with schizotypal personality disorder may also hear voices, and they may be suspicious of others.

Paranoid Personality Disorder

Paranoid personality disorder describes individuals who are suspicious and untrusting in their relationships. They often believe that the people in their lives are out to get them and may avoid sharing information about themselves. If they do form relationships, they are often full of conflict and lack trust.

Cluster B Personality Disorder

Cluster B personality disorders describe people who are typically overly dramatic and erratic.  Individuals with Cluster B personalities tend to:

  • Have difficulty maintaining relationships

  • Express negative reactions to criticism

  • Focus on their own self goals and needs

  • Behave in a way that is dramatic and unpredictable

Histrionic Personality Disorder

Histrionic personality disorder often leads individuals to believe that their needs and wants are most important. They often seek new ways to get the attention of those around them and may feel uncomfortable when they do not have it. They may shift emotions often and respond in an overly emotional way.

Borderline Personality Disorder

Borderline personality disorder describes individuals who act in a way to avoid abandonment from others. Described as impulsive, they may have outbursts of anger and frustration. They also often have low self-esteem and may have conflicted relationships because of the ongoing need for reassurance.

Narcissistic Personality Disorder

Narcissistic personality disorder presents with behaviors of inflated self-importance. Individuals may be so focused on their own needs, that they ignore the needs of others. They may lack empathy and work toward their goals, without guilt, always focusing on what they want, and not how it will affect others.

Antisocial Personality Disorder

Antisocial personality disorder describes individuals who cannot care about or understand other’s feelings. They are often referred to as sociopaths because they can harm others, steal, lie, or cheat without guilt. Individuals with antisocial personality disorder also lack the ability to identify hurt in others, which can lead to legal troubles.

Cluster C Personality Disorders

Cluster C personality disorders include behaviors that are considered fearful and overly anxious. Individuals with Cluster C personalities tend to:

  • Avoid others

  • View their symptoms as unwanted and feel ashamed of them

  • Be afraid to take risks

Obsessive-Compulsive Personality Disorder

Obsessive-compulsive personality disorder describes a set of behaviors that are orderly and in control. Individuals often believe they need to complete certain rituals or tasks to prevent something terrible from happening. They tend to be preoccupied with certain tasks like cleaning, counting, ordering, or structuring.

Dependent Personality Disorder

Dependent personality disorder describes the debilitating fear of having to take care of, or rely on, yourself. Individuals with dependent personality disorder will often rely on others to make important decisions or complete certain tasks. They may need constant reassurance and often fear what they will do if their partner leaves them.

Avoidant Personality Disorder

Avoidant personality disorder is a series of behaviors that include a fear of being criticized or rejected in a meaningful relationship. In an attempt to protect themselves from this fear, individuals with an avoidant personality disorder may avoid communicating or interacting with certain people. They might also avoid social events.

*It is important to note that obsessive-compulsive personality disorder is not the same as obsessive-compulsive disorder (OCD).

What Treatments are Available for Personality Disorders?

Personality traits are not always easy to overcome. However, there are a variety of techniques that can be effective.

A few of the treatments for personality disorders include:

  • Psychoanalytic therapy
  • Cognitive-behavioral therapy (CBT)
  • Dialectical behavioral therapy (DBT)
  • Psychoeducation

Treatment of personality disorders often includes:

  • Education of personality disorders
  • Setting and tracking progress toward goals
  • Diagnosing and treating any co-occurring disorders
  • Developing relationship/communication skills
  • Identifying irrational thoughts and learning to overcome them
  • Evaluating how certain behaviors affect others
  • Learning new coping mechanisms
  • Improving self-esteem

While medications are not a treatment for personality disorders, they may be used to deal with the symptoms of co-occurring disorders. Medications like antidepressants or antipsychotics might be used in combination with psychotherapy. This multi-modal treatment can be an effective option for harder-to-treat personality disorders.

Some psychotherapists may also recommend including family in the treatment of personality disorder symptoms. Personality disorders often affect the entire family, either through difficult relationships or poor conflict resolution techniques. By involving the family in the treatment process, both the client and their family can better understand and set treatment goals together.

Personality disorders can affect many aspects of an individual’s life. With awareness and a treatment plan, it is possible to work toward the improvement of certain behaviors. While treatment depends on the symptoms and the specific disorder, individuals can learn how to have new and healthy relationships and coping skills.