Personality disorders are a group of a 10 mental health conditions that involve long-lasting, disruptive patterns of thinking, behavior, mood and relating to others. People with personality disorders often don’t realize their thoughts and behaviors are problematic.
A personality disorder is a mental health condition that involves long-lasting, all-encompassing, disruptive patterns of thinking, behavior, mood and relating to others. These patterns cause a person significant distress and/or impair their ability to function.
There are 10 types of personality disorders, each with different characteristics and symptoms.
Personality is vital to defining who we are as individuals. It involves a unique blend of traits — including attitudes, thoughts and behaviors — as well as how we express these traits in our interactions with others and with the world around us.
Personality disorders may cause distorted perceptions of reality, abnormal behaviors and distress across various aspects of life, including work, relationships and social functioning. Additionally, people with a personality disorder may not recognize their troubling behaviors or the negative effect they have on others.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the standard reference publication for recognized mental illnesses, organizes the 10 types of personality disorders into three main clusters (categories). Each cluster has different symptoms in common.
Cluster A personality disorders involve unusual and eccentric thinking or behaviors. These include:
Cluster B personality disorders involve dramatic and erratic behaviors. People with these types of conditions display intense, unstable emotions and impulsive behaviors. Cluster B personality disorders include:
Cluster C personality disorders involve severe anxiety and fear. They include:
This is a separate condition from obsessive-compulsive disorder (OCD), which is classified as an anxiety disorder. While people with OCD usually are aware that OCD is causing their behavior and accept they need to change, people with OCPD usually have little, if any, self-awareness of their behaviors.
People might have mixed symptoms of more than one personality disorder.
Anyone can have a personality disorder. But different types of personality disorders affect people differently.
Most personality disorders begin in the teen years when your personality further develops and matures. As a result, almost all people diagnosed with personality disorders are above the age of 18. One exception to this is antisocial personality disorder — approximately 80% of people with this disorder will have started to show symptoms by the age of 11.
Antisocial personality disorders are more likely to affect people assigned male at birth. Borderline, histrionic and dependent personality disorders are more likely to affect people assigned female at birth.
Approximately 9% of adults in the U.S. have some type of personality disorder, and about 6% of the global population has a personality disorder.
Borderline personality disorder (BPD) and antisocial personality disorder are the most frequently diagnosed personality disorders.
Personality disorders are among the least understood mental health conditions. Scientists are still trying to figure out the cause of them.
So far, they believe the following factors may contribute to the development of personality disorders:
Each of the 10 types of personality disorders has its own specific signs and symptoms.
But, in general, personality disorders involve problems with:
Another distinguishing sign of personality disorders is that most people who have one often have little to no insight or self-awareness of how their thoughts and behaviors are problematic.
You can’t know for sure if someone has a personality disorder unless they receive a professional, medical diagnosis.
It’s important to understand the difference between personality types and personality disorders. A person who is shy or likes to spend time alone doesn’t necessarily have an avoidant or schizoid personality disorder.
The difference between personality style and a personality disorder can often be determined by assessing how the person’s personality affects different parts of their life, including:
Some general signs of people with a personality disorder include:
Personality disorders can be difficult to diagnose since most people with a personality disorder don’t think there’s a problem with their behavior or way of thinking.
Because of this, people with a personality disorder typically don’t seek help or a diagnosis for their condition. Instead, their loved ones or a social agency may refer them to a mental health professional because their behavior causes difficulty for others.
When they do seek help, it’s often due to conditions such as anxiety, depression or substance use, or because of the problems created by their personality disorder, such as divorce or unemployment, not the disorder itself.
Healthcare providers base the diagnosis of a specific personality disorder on criteria provided in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.
When a mental health professional, like a psychologist or psychiatrist, suspects someone might have a personality disorder, they often ask broad, general questions that won’t create a defensive response or hostile environment. They ask questions that will shed light on:
Because a person suspected of having a personality disorder may lack insight into their behaviors, mental health professionals often work with the person’s family, friends and/or parole officers to collect more insight about their behaviors and history.
Personality disorders are generally underdiagnosed because providers sometimes focus on the symptoms of anxiety or depression, which are much more common in the general population than personality disorders. These symptoms may overshadow the features of any underlying personality disorder.
Personality disorders are some of the most difficult disorders to treat in psychiatry. This is mainly because people with personality disorders don’t think their behavior is problematic, so they don’t often seek treatment.
And even if a person with a personality disorder seeks treatment, modern medicine is still lacking in available treatment options — there are no medications currently approved to treat any personality disorder. But there are medications that can help with symptoms of anxiety and depression, which are common in people with a personality disorder.
But psychotherapy (talk therapy) can help manage personality disorders. Psychotherapy is a term for a variety of treatment techniques that aim to help you identify and change troubling emotions, thoughts and behaviors. Working with a mental health professional, like a psychologist or psychiatrist, can provide support, education and guidance to you and your family.
The main goals of psychotherapy for treating personality disorders include:
There are several different types of psychotherapy, and each personality disorder requires different types.
For example, studies show that dialectical behavior therapy (DBT) is effective for treating those with borderline personality disorder, and people with histrionic personality disorder often benefit from cognitive-behavioral therapy (CBT).
At this time, there’s no known way to prevent personality disorders, but many of the related problems might be lessened with treatment. Seeking help as soon as symptoms appear can help decrease the disruption to the person’s life, family and friendships.
Since people with personality disorders often don’t seek proper medical attention, the overall prognosis for personality disorders is poor.
Untreated personality disorders may result in:
Studies show that personality disorders are associated with elevated rates of:
In addition, people with personality disorders are more likely to visit the emergency room (ER), experience traumatic accidents and have early deaths by suicide.
Although the outlook is dire, studies show that collaborative care management can greatly improve outcomes for people with personality disorders if they stay committed to treatment.
If you know someone who has or may have a personality disorder, try to persuade them to seek treatment. It’s also important to educate yourself about the nature of the specific personality disorder so you can better understand what to expect.
A note from Cleveland Clinic
It’s important to remember that personality disorders are mental health conditions. As with all mental health conditions, seeking help as soon as symptoms appear can help decrease the disruptions to your life. Mental health professionals can offer treatment plans that can help you manage your thoughts and behaviors.
The family members of people with personality disorders often experience stress, depression, grief and isolation. It’s important to take care of your mental health and seek help if you’re experiencing these symptoms.
Last reviewed by a Cleveland Clinic medical professional on 04/16/2022.
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