Personality disorders are often some of the more stigmatised, less discussed and most misunderstood mental health disorders. They are mental health conditions that affect how someone thinks, perceives, feels or relates to others.
Types of personality disorder
In current diagnostic criteria, there are three main groups of personality disorder:
Folks living with personality disorders in this group can struggle to relate to others, with their behaviour often perceived as eccentric or odd. These disorders include:
Paranoid personality disorder
This disorder revolves around feelings of paranoia or distrust.
Feelings with paranoia can cause you to:
- difficulty in trusting or confiding in others in fear of them taking advantage of you
- difficulty relaxing
- have extreme fear and anxiety around danger that is not evident to others
Schizoid personality disorder
With this personality disorder, it is not usually associated with symptoms of psychosis, but instead is associated with:
- difficulty forming close relationships with others
- prefer to be alone
- not experiencing pleasure from many activities
- lack of interest in sex or intimacy
- difficulty relating to others
Schizotypal personality disorder
People diagnosed with schizotypal personality disorder often struggle with making or maintaining relationships with other people.
They might experience:
- strange or distorted thoughts
- displaying feelings inappropriately
- anxious and tension with others who do not share their views
People living with personality disorders from group B can struggle with emotional regulation. These disorders include:
Antisocial personality disorder
Antisocial personality disorder is a particularly challenging type of personality disorder characterised by impulsive, irresponsible and reckless behaviour.
People with this diagnosis may:
- put themselves in risky situations with disregard for consequences to themselves/others
- behave in ways that negatively affect others
- behave illegally or participate in criminal activity
- feel easily bored or impulsive
- struggle with empathy towards other people
Note: this disorder is regularly discussed amongst professionals, and originated from stigmatising terms such as psychopathy and sociopathy
Borderline personality disorder
Also known as Emotionally Unstable Personality Disorder (EUPD), Borderline personality disorder may be diagnosed using the following signs:
- strong feelings about being abandoned, which may result in behaviour to stop that happening or push people away
- intense, changeable emotions
- struggling with a sense of who you are, with varying ideas and aspirations
- struggling with longer-term personal relationships
- impulsive and damaging behaviour
- suicidal thoughts
- other mental health diagnoses including anxiety, depression, PTSD
and occasionally under times of intense stress:
- psychotic experiences
Histrionic personality disorder
This disorder is described by the American Psychiatric Association as a disorder categorized by a pattern of excessive attention-seeking behaviours, often beginning in early adulthood. This may include:
- feeling uncomfortable when not the centre of attention
- feeling responsible for entertaining those around you
- impulsive decision-making
- the need for approval from others
- easily influenced by those around you
Narcissistic personality disorder
Narcissistic personality disorder can mean you have an unusually high sense of self-importance, focusing on desiring success, admiration and attention.
People with this disorder may:
- seek constant approval or recognition
- be very sensitive to criticism or feedback
- feel more entitled to things than other people
- be more unwilling to acknowledge the feelings or needs of others
Fear and anxiety are common themes within the personality disorders in group C. These are:
Dependent personality disorder
This disorder is defined by allowing people around you to take responsibility over aspects of your life. Those with dependent personality disorder may:
- struggle with self-confidence and independence
- put their own needs behind everyone else’s
- feel hopeless, or fear abandonment
- allow others to make decisions for you
Avoidant personality disorder
People with avoidant personality disorder may:
- feel anxious, insecure or inferior to other people, leading to feeling uncomfortable in social situations
- avoid social activities where you have to be around other people
- avoid relationships with other people
- fear rejection or public humiliation
- be overly self-critical and are sensitive to criticism
Obsessive-compulsive personality disorder
Often mixed up with Obsessive Compulsive Disorder (which is a form of behaviour rather than personality), OCPD is also focused around problems with perfectionism, need for control and rigidity. People with this disorder may:
- need everything to be under control/done a certain way
- have unrealistic expectations for yourself and others
- struggle to accept new ways of doing things
- have anxiety over things being perfect, or making mistakes.
Treatment for a personality disorder
Treatment for a personality disorder usually involves a talking therapy. This is where the person talks to a therapist to get a better understanding of their own thoughts, feelings and behaviours.
It will last for at least 3 months, but can often last longer depending on the severity of the condition and other problems the person may have.
As well as listening and discussing important issues with the person, the therapist may identify strategies to resolve problems and, if necessary, help them change their attitudes and behaviour.
Some other treatments include:
Therapeutic communities – (TCs) are an intensive form of group therapy in which the experience of having a personality disorder is explored in depth. TCs have been shown to be effective for mild to moderate personality disorders, but require a high level of commitment.
Medicine – Medicine may be prescribed to treat problems associated with a personality disorder, such as depression, anxiety or psychotic symptoms. For example, moderate to severe symptoms of depression might be treated with a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI). Read more about the treatment for borderline personality disorder and antisocial personality disorder.
It’s not clear exactly what causes personality disorders, but they’re thought to result from a combination of the genes a person inherits and early environmental influences – for example, a distressing childhood experience (such as abuse or neglect).
Support for people living with a personality disorder
Having a personality disorder can have a big effect on the person’s life, as well as their family and friends, but support is available.
Many people with personality disorders do not ‘fit neatly’ into one specific category or diagnosis; there are mixed diagnoses of one or more types of disorder. Terminology around personality disorders is still debated amongst clinicians, people with lived experience and mental health professionals. However you identify or choose to describe your diagnoses (or lack thereof), there is support available to you.
If you’d like support for yourself or someone you know, you may find the following links useful: