What are personality disorders?
Personality disorders are persistent and unhealthy patterns of thinking, feeling, and behaving. They usually become evident in early adulthood or adolescence and remain consistent throughout life, especially if undiagnosed or untreated.
Personality disorders can affect a person’s quality of life. They can cause emotional distress, prevent you from completing daily tasks, and make it difficult to maintain healthy relationships with others. Although a personality disorder can’t be “cured,” someone with a personality disorder can still live a happy and meaningful life by increasing self-awareness and learning coping skills.
Types of personality disorders
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), currently recognizes 10 personality disorders. These disorders are grouped into three categories (or “clusters”) based on their similarities.
Someone can have multiple personality disorders from different clusters.
Cluster A personality disorders
Cluster A personality disorders are conditions marked by eccentric behavior, limited emotional expression, and social withdrawal.
Cluster B personality disorders
Cluster B personality disorders are characterized by very emotional, dramatic, or erratic behavior.
Cluster C personality disorders
Cluster C personality disorders are characterized by anxiety and fearful thoughts and behavior.
Symptoms and causes of personality disorders
Although each personality disorder has its own specific symptoms, some common signs exist.
Common symptoms of personality disorders
- Difficulty in relationships. This is often one of the most noticeable symptoms. Someone with a personality disorder might struggle to maintain healthy social connections due to their inflexibility, emotional reactions, or odd behavior. They might frequently see themselves as misunderstood and either push people away or feel pushed away.
- Unstable emotions. Some personality disorders are defined by disruptive mood swings or emotional outbursts. Beneath these emotions are deeply rooted issues like an intense desire for approval or fear of abandonment. Other personality disorders feature an inability to express emotions or feel empathy for others.
- Extreme or unusual behavior. People with personality disorders might exhibit controlling behavior, impulsive decision-making, unusual speech patterns, or marked avoidance of others. They might not see an issue with their own behavior, even as it disrupts their daily functioning and relationships.
- Distorted view of self, others, or events. A personality disorder can involve an unstable sense of self, which can lead to sudden shifts in goals and values. Someone with a personality disorder might also misinterpret other people’s words and actions. For example, they might take a slight criticism as a personal attack.
Causes and risk factors
The exact causes of personality disorders are unknown. However, research suggests a combination of genetic and neurological factors as well as environmental factors play a role.
- Genetics. Some research, such as studies on twin siblings, shows that certain personality disorders can run in families. For example, if your parents have a particular personality disorder, you might be more at risk of developing it. Certain inheritable genes also influence brain chemicals, such as serotonin and dopamine. These chemicals regulate aspects of personality like mood, empathy, aggression, and impulsivity, so imbalances might result in personality disorders.
- Neurological factors. Other differences in brain structures and activity might also cause personality disorders. For instance, brain imaging studies show that people with cluster B personality disorders may have abnormalities in their amygdala, the part of the brain that processes emotions like fear. These differences in the brain may also be genetic.
- Environmental factors. Certain life experiences may contribute to the development of personality disorders. Childhood abuse and neglect, in particular, are strong risk factors for these disorders.
- Insecure attachment styles—which are the result of early interactions with an emotionally unavailable or inconsistent caregiver—may increase the risk of personality disorders. For example, dependent, histrionic, and borderline personality disorders all seem to be associated with anxious attachment. On the other hand, schizoid and avoidant personality disorders seem to be associated with avoidant attachment.
- Stressors in adulthood, such as divorce, job loss, sexual assault, and traumatic combat experiences, may also play a role in the development of personality disorders.
Treatment for personality disorders
Although they may be stubborn, the symptoms of personality disorders can be treated and managed.
Psychotherapy (talk therapy)
Psychotherapy is considered the most effective treatment option for personality disorders. The exact type of therapy and structure of treatment will vary based on the specific condition.
- Cognitive behavioral therapy (CBT): CBT involves learning to identify and adjust unhelpful thought patterns and behaviors. This might be helpful for people with personality disorders who find themselves caught in a cycle of automatic negative thoughts and self-defeating actions.
- Dialectical behavior therapy (DBT): Based on CBT, DBT focuses on developing mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation skills. It’s considered an evidence-based treatment option for borderline personality disorder, with some research even indicating that it leads to detectable changes in brain activity.
- Schema-focused therapy (SFT). SFT focuses on uncovering how negative thought patterns, perceptions, and behaviors are formed in childhood and how to overcome them. SFT employs a more flexible approach than CBT, perhaps making it more useful for people with personality disorders.
Medication options
Currently, there’s no medication that’s been proven to treat or cure a personality disorder. However, certain drugs might be prescribed to manage symptoms, such as aggression or impulsivity, or treat co-occurring conditions like depression and anxiety. Some examples include:
Personality disorder support and resources
Whether you or a loved one is struggling with a personality disorder, finding the right support can be a life-changing step. Don’t hesitate to turn to helplines, support groups, and other resources for coping.
