Personality Disorders

Personality disorders are long-term patterns of thinking, feeling and behaving that differ from what’s expected. These patterns can make it hard for you to manage emotions, control impulses or maintain healthy relationships. They often cause problems in daily life, including at work, school or home.

“Personality” refers to the unique traits that shape how you respond to people and situations. Everyone has their own mix of characteristics that influence how they see the world, relate to others and handle experiences.

Healthcare providers diagnose personality disorders by looking at your behavior patterns over time. There are 10 types of personality disorders, each with different characteristics and symptoms. Borderline and antisocial personality disorders are among the most frequently diagnosed in clinical settings.

There are different treatments available to help manage symptoms. A healthcare provider can help you find the best options.

Personality disorder types

Experts group personality disorders into three clusters based on shared traits and behaviors. It’s possible to meet the criteria of more than one personality disorder. You may also have traits of different personalities, but not meet the criteria for being diagnosed with that disorder.

Cluster A personality disorders

These involve different ways of thinking and behaving.

• Paranoid personality disorder: Ongoing distrust and suspicion of others
• Schizoid personality disorder: Little interest in relationships and limited emotional expression
• Schizotypal personality disorder: Different beliefs or behaviors that make close relationships challenging

Cluster B personality disorders

These involve intense emotions, impulsive behavior and unpredictable actions.

• Antisocial personality disorder: Disregard for rules and the rights of others
• Borderline personality disorder (BPD): Strong mood swings and difficulty managing emotions and relationships
• Histrionic personality disorder: Strong need for attention and approval from others
• Narcissistic personality disorder: Inflated sense of self-importance and lack of empathy for others

Cluster C personality disorders

These involve anxiety, fear and strong feelings of insecurity.

• Avoidant personality disorder: Avoiding social situations due to fear of rejection
• Dependent personality disorder: Strong need for others to provide care and reassurance
• Obsessive-compulsive personality disorder (OCPD): Extreme focus on order, control and perfectionism

Symptoms of personality disorders

Each of the 10 types has its own specific signs and symptoms. Common symptoms may include:

• Long-term patterns of thinking, feeling and behaving differently that are hard to change
• Difficulty forming or maintaining relationships
• Problems with self-image or identity
• Strong or unmanaged emotional reactions
• Impulsive or risky behavior

You may not realize how your behavior affects others. Because of this, a friend or loved one may notice the signs first.

Causes of personality disorders

Experts don’t know the exact cause of personality disorders. Most develop from a combination of factors, including:

• Genetics: Certain genetic traits that you inherit may influence your personality.
• Brain biology: Differences in how your brain regulates emotions, impulses and stress may contribute.
• Temperament: Natural personality traits that appear early in life might shape how you respond to experiences and relationships as you grow up.
• Stress: Long-term patterns of coping with stress or emotional conflict may contribute to unhealthy behavior patterns over time.

Because the cause isn’t well understood, there’s no known way to prevent it.

Risk factors

These disorders can affect anyone. Several factors might increase the risk, including:

• Having a family history of personality disorders
• Experiencing childhood trauma, abuse or neglect
• Living through continuously stressful situations

Antisocial personality disorders are more likely to affect males. Borderline, histrionic and dependent personality disorders are more likely to affect females.

Complications

As people with personality disorders may not always seek treatment right away, the condition can sometimes affect different areas of life. Without support or treatment, you may experience:

• Relationship challenges
• Difficulty with work or school
• Problems with social functioning or relationships

These may also increase your risk of developing other mental health conditions, like substance use disorder, depression or anxiety. Your risk of suicidal thoughts or self-harm may also be higher.

If you have thoughts of harming yourself, you can call or text the Suicide and Crisis Lifeline at 988 (U.S.). Someone is available 24/7.

How doctors diagnose personality disorders

To make a diagnosis, your provider will offer a mental health evaluation. A psychiatrist, psychologist or other mental health professional will talk with you about your thoughts, behaviors and emotions over time. They’ll also ask about your medical history, family history, relationships and life experiences.

Your provider will compare these patterns to the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) to determine whether they meet criteria for a personality disorder. They’ll also rule out other possible causes, like another mental health condition, substance use or a medical problem that affects your brain. In some cases, they may use other tests to help support the diagnosis.

Providers usually diagnose personality disorders in adults, as traits are still developing during childhood and adolescence.

It’s important to remember that personality disorders can be hard to diagnose. This is because you may not think there’s a problem with your behavior or way of thinking. Sometimes, a family member, friend or social service agency encourages someone to see a mental health professional when their behavior begins to affect others.

If you do seek help, it may be for related concerns, like anxiety, depression, substance use or life challenges, like relationship problems or job difficulties, rather than the personality disorder itself.

Personality disorder treatment

Treatment usually focuses on therapy and support. The goal is to help you better understand your thoughts and behaviors and learn healthier ways to cope. Your provider might suggest:

• Therapy: This is the main treatment. It may help you manage your emotions, improve relationships and change harmful behavior patterns. Common types include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT) and group therapy.
• Medications: These may help with certain symptoms. Your provider might prescribe medicine for conditions like depression, anxiety or mood changes.

When should I see my healthcare provider?

You should see a healthcare provider if long-lasting patterns in how you think, feel or behave begin to affect your daily life. This includes problems with relationships, work, school or managing your emotions.

You should also seek help if you have depression, anxiety or impulsive behavior, or if you have thoughts of self-harm or suicide. Sometimes, your loved ones will be the first to notice these changes. They might recommend that you talk with a mental health professional.

What can I expect if I have a personality disorder?

Living with a personality disorder might feel challenging at times. You may or may not notice patterns in how you think, feel or relate to others that affect your relationships, work or daily life. These patterns often develop over many years, so changing them can take time and effort.

The prognosis varies by type. Some symptoms may improve as you get older, especially with support and treatment. Therapy can help you better understand your behavior, manage emotions and build healthier relationships.

But these disorders are usually long term. Some traits continue over time, and progress may happen slowly. Many people find that learning coping skills, building support systems and staying engaged in treatment helps them manage symptoms.