Personality disorders: A detailed guide for understanding and managing personality disorders

What Are Personality Disorders?

Personality disorders are a group of mental health conditions, characterized by unhealthy thoughts, and behaviors that cause distress and/or interfere with one’s ability to function normally. These thoughts and behaviors are significantly different from what is expected or considered “normal.”

Personality disorders typically arise in adolescence or early adulthood and can be long-lasting, especially without proper treatment. These disorders affect two or more of the following:

• How someone thinks about themself or others
• How the individual reacts and responds emotionally
• How someone relates to other people
• How the individual controls their behavior

What Causes Personality Disorders?

As with many other mental health conditions, there isn’t a single, straightforward cause of personality disorders. Instead, there are multiple factors that can contribute, including:

1. 1. Genetics: Research has found that certain genes may be associated with certain personality disorders. For example, a specific gene mutation may play a role in the development of obsessive-compulsive personality disorder (OCPD).
   2. Personality traits: Personality traits like anger or aggression, fear, and anxiety can also play a role in the development of personality disorders. For example, someone with anxiety may be more likely to develop certain personality disorders like avoidant personality disorder (which is characterized by extreme shyness).
   3. Trauma: Traumatic experiences in one’s childhood, such as physical or verbal abuse, are also linked to the development of personality disorders. 

What Are the Three Types of Personality Disorders?

Each personality disorder belongs to one of three subcategories or “clusters”:

Cluster A Personality Disorders

These are characterized by odd or eccentric thinking and behavioral patterns. Cluster A personality disorders include paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder.

Cluster B Personality Disorders 

These are characterized by dramatic, unpredictable, or overly emotional thinking or behavioral patterns. Cluster B personality disorders include narcissistic personality disorder, antisocial personality disorder, borderline personality disorder, and histrionic personality disorder.

Cluster C Personality Disorders

These are characterized by anxious thinking or behavioral patterns. Cluster C personality disorders include dependent personality disorder, avoidance personality disorder, and obsessive-compulsive personality disorder.

How Many Personality Disorders Are There? What Are They?

There are 10 personality disorders in total. Here’s some basic information about each, starting with cluster A personality disorders and then onto Clusters B and C:

1. Paranoid personality disorder is characterized by a pattern of being paranoid and suspicious of others. Individuals with this disorder assume that other people are out to get them and are wary of trusting others.
2. Schizoid personality disorder is characterized by a detachment from relationships and showing very little emotion. Those with this disorder typically prefer to be alone and don’t seek close relationships with others.
3. Schizotypal personality disorder is characterized by discomfort in close relationships and peculiar beliefs or behaviors. These individuals might also have extreme social anxiety.
4. Narcissistic personality disorder is characterized by the need for praise or admiration and indifference toward others’ feelings. Individuals with this disorder may feel entitled and take advantage of other people.
5. Antisocial personality disorder is characterized by a disregard for others. Those with this disorder might refuse to conform to social norms, regularly deceive others, or engage in impulsive behavior.
6. Borderline personality disorder is characterized by instability in one’s relationships, plus impulsivity and heightened emotions. Those with this disorder may engage in risky behavior, experience up and down moods, and harbor an intense fear of being alone or abandoned.
7. Histrionic personality disorder is characterized by attention-seeking behavior. Those with this disorder will go to extremes to gain the attention they seek, are easily influenced, and have rapidly changing emotions.
8. Dependent personality disorder is characterized by dependence on others. Individuals with this disorder feel that they need to be taken care of and cling to their loved ones. They lack self-confidence and require excessive reassurance from others.
9. Avoidant personality disorder is characterized by a sensitivity to criticism or rejection. Those with this disorder feel inadequate or inferior to others. They are extremely shy and have an intense fear of disapproval or embarrassment.
10. Obsessive-compulsive personality disorder (OCPD) is characterized by an obsession with perfection and control. Individuals with this disorder have a preoccupation with details and rules — they desire to control situations and people.

What Is the Most Common Type of Personality Disorder?

The most commonly diagnosed personality disorder is OCPD. As detailed above, this disorder is characterized by an obsession with control and the desire for everything to be perfect. It’s important to note that OCPD is different from obsessive-compulsive disorder (OCD). The latter is classified as a serious anxiety disorder, characterized by excessive thoughts that lead to repetitive behaviors. 

While OCPD is the most commonly diagnosed personality disorder, it’s also difficult to diagnose and many people with the disorder don’t receive treatment because they think their perfectionism and desire for control are normal. 

How Do Personality Disorders Differ from the Personality Characteristics of Typical People?

Personality disorders are characterized by thinking and behavioral patterns that differ from cultural norms or expectations. They also cause the individual distress and get in the way of their ability to live a normal life. 

How Can You Tell If Someone Has a Personality Disorder?

Only a mental health professional can diagnose a personality disorder, following specific criteria set forth by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, there are specific signs that can indicate a personality disorder:

Paranoid Personality Disorder

• Suspicion and distrust of others
• The belief that others are out to get you
• Refusal or hesitancy to confide in others
• The assumption that innocent remarks are actually insults
• Angry or hostile behavior toward perceived insults

Schizoid Personality Disorder

• Disinterest in relationships
• Preference for being alone
• Limited to no emotional expression
• Indifference toward others
• Inability to pick up on social cues

Schizotypal Personality Disorder

• Eccentric thinking, beliefs, and behaviors
• Lack of emotions and relationships
• Feeling indifferent toward or suspicious of others
• Believing you can influence other people and events with your thoughts
• Believing certain events have hidden messages intended for you

Antisocial Personality Disorder

• Apathy toward others’ thoughts and feelings
• Tendency to con others (lie, steal, etc.)
• Impulsive behavior 
• Lack of remorse for any harm done
• Lack of responsibility

Borderline Personality Disorder

• Risky and impulsive behavior
• Poor self-image
• Unhealthy relationships
• Drastic mood swings
• Intense angry behavior

Histrionic Personality Disorder

• Attention-seeking
• Provocative behaviors to gain attention
• Strong opinions with little to no facts to back them up
• Rapidly-changing mood swings
• Perceives relationships with others to be closer than they are

Narcissistic Personality Disorder

• Inflated self-importance and arrogance
• Failure to recognize others’ feelings
• Desire and expectation for constant praise
• Exaggeration of your accomplishments or abilities
• Taking advantage of others

Avoidant Personality Disorder

• Sensitivity to rejection and/or criticism
• Feelings of inadequacy
• Extreme shyness around others
• Fear of being ridiculed or embarrassed
• Avoidance of interactions with others

Dependent Personality Disorder

• Dependence on others
• Clingy behavior
• Fear of having to fend for yourself
• Lack of self-confidence
• Tolerance of abuse

Obsessive-Compulsive Personality Disorder

• Preoccupation with perfection
• Distress when perfection isn’t achieved
• Desire to be in control of people and situations
• Excessive commitment to work or projects
• Stubbornness

How Are Personality Disorders Treated?

There are several effective treatments for personality disorders. The treatment that’s best for you or someone else will depend on the specific personality disorder, its severity, and your lifestyle. Often, you’ll consult with several professionals about your diagnosis and treatment plan, including your primary care doctor, a psychiatrist, a psychologist or therapist, and/or a pharmacist. 

That said, psychotherapy is the primary form of treatment for personality disorders, which allows you to talk about your symptoms, better understand your disorder, and learn how to manage it well. Depending on your situation, you may benefit from individual therapy, group therapy, family therapy, or all of the above.

Medication is another common and effective form of treatment for personality disorders. Certain psychiatric medications can help with your symptoms, including: 

• Antidepressants, if you’re struggling with a depressed mood, irritability, impulsive behavior, and/or anger
• Mood stabilizers, if you’re dealing with mood swings, aggressive behavior, irritability, or impulsivity
• Antipsychotics, or neuroleptics, if you feel disconnected from reality (psychosis)
• Anti-anxiety medication, if you’re struggling with anxiety

Your care team can help you determine which treatment is right for you, whether that’s therapy, medication, or in many instances, a combination of both.