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A personality disorder is a type of mental disorder in which you have a rigid and unhealthy pattern of thinking, functioning and behaving. A person with a personality disorder has trouble perceiving and relating to situations and people. This causes significant problems and limitations in relationships, social activities, work and school.
In some cases, you may not realize that you have a personality disorder because your way of thinking and behaving seems natural to you. And you may blame others for the challenges you face.
Personality disorders usually begin in the teenage years or early adulthood. There are many types of personality disorders. Some types may become less obvious throughout middle age.
Personality disorders are a group of mental health conditions that are characterized by inflexible and unhealthy patterns of thinking, feeling, and behaving. These inner experiences and behaviors often differ from the expectations of the culture in which someone lives.
People with personality disorders usually have a hard time getting along with others and dealing with everyday problems in the ways that are expected by a cultural group. They commonly believe that their way of thinking and behaving is completely normal. However, they tend to have a view of the world that is quite different than others. As a result, they may find it difficult to participate in social, educational, and family activities. They also place blame on others for their challenges. These behaviors and attitudes often cause problems and limitations in relationships, social encounters, and work or school settings. They may also make people with personality disorders feel isolated, which can contribute to depression and anxiety.
The cause of personality disorders isn’t known. However, it is believed that they may be triggered by genetic and environmental influences, most prominently childhood trauma.
Personality disorders tend to emerge in the teenage years or early adulthood. The symptoms vary depending on the specific type of personality disorder. Treatment typically includes talk therapy and medication.
What Are the Different Types of Personality Disorders?
There are numerous different types of personality disorders. They are grouped into three clusters based on similar characteristics and symptoms. Some people may have signs and symptoms of multiple personality disorders.
Cluster A: Suspicious
- Paranoid personality disorder: People with paranoid personality disorder are very distrustful of others and suspicious of their motives. They also tend to hold grudges.
- Schizoid personality disorder: People with this type of disorder display little interest in forming personal relationships or partaking in social interactions. They usually don’t pick up on normal social cues, so they can seem emotionally cold.
- Schizotypal personality disorder: In schizotypal personality disorder, people believe they can influence other people or events with their thoughts. They often misinterpret behaviors. This causes them to have inappropriate emotional responses. They may consistently avoid having intimate relationships.
Cluster B: Emotional and Impulsive
- Antisocial personality disorder: People with antisocial personality disorder tend to manipulate or treat others harshly without expressing remorse for their actions. They may lie, steal, or abuse alcohol or drugs.
- Borderline personality disorder: People with this type of disorder often feel empty and abandoned, regardless of family or community support. They may have difficulty dealing with stressful events. They may have episodes of paranoia. They also tend to engage in risky and impulsive behavior, such as unsafe sex, binge drinking, and gambling.
- Histrionic personality disorder: In histrionic personality disorder, people frequently try to gain more attention by being overly dramatic or sexually provocative. They are easily influenced by other people and are extremely sensitive to criticism or disapproval.
- Narcissistic personality disorder: People with narcissistic personality disorder believe that they are more important than others. They tend to exaggerate their achievements and may brag about their attractiveness or success. They have a deep need for admiration, but lack empathy for other people.
Cluster C: Anxious
- Avoidant personality disorder: People with this type of disorder often experience feelings of inadequacy, inferiority or unattractiveness. They usually dwell on criticism from others and avoid participating in new activities or making new friends.
- Dependent personality disorder: In dependent personality disorder, people heavily depend on other people to meet their emotional and physical needs. They usually avoid being alone. They regularly need reassurance when making decisions. They may also be likely to tolerate physical and verbal abuse.
- Obsessive-compulsive personality disorder: People with obsessive-compulsive personality disorder have an overwhelming need for order. They strongly adhere to rules and regulations. They feel extremely uncomfortable when perfection isn’t achieved. They may even neglect personal relationships to focus on making a project perfect.
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Causes
Personality is the combination of thoughts, emotions and behaviors that makes you unique. It’s the way you view, understand and relate to the outside world, as well as how you see yourself. Personality forms during childhood, shaped through an interaction of:
- Your genes. Certain personality traits may be passed on to you by your parents through inherited genes. These traits are sometimes called your temperament.
- Your environment. This involves the surroundings you grew up in, events that occurred, and relationships with family members and others.
Personality disorders are thought to be caused by a combination of these genetic and environmental influences. Your genes may make you vulnerable to developing a personality disorder, and a life situation may trigger the actual development.
Symptoms
Types of personality disorders are grouped into three clusters, based on similar characteristics and symptoms. Many people with one personality disorder also have signs and symptoms of at least one additional personality disorder. It’s not necessary to exhibit all the signs and symptoms listed for a disorder to be diagnosed.
Cluster A personality disorders
Cluster A personality disorders are characterized by odd, eccentric thinking or behavior. They include paranoid personality disorder, schizoid personality disorder and schizotypal personality disorder.
Paranoid personality disorder
- Pervasive distrust and suspicion of others and their motives
- Unjustified belief that others are trying to harm or deceive you
- Unjustified suspicion of the loyalty or trustworthiness of others
- Hesitancy to confide in others due to unreasonable fear that others will use the information against you
- Perception of innocent remarks or nonthreatening situations as personal insults or attacks
- Angry or hostile reaction to perceived slights or insults
- Tendency to hold grudges
- Unjustified, recurrent suspicion that spouse or sexual partner is unfaithful
Schizoid personality disorder
- Lack of interest in social or personal relationships, preferring to be alone
- Limited range of emotional expression
- Inability to take pleasure in most activities
- Inability to pick up normal social cues
- Appearance of being cold or indifferent to others
- Little or no interest in having sex with another person
Schizotypal personality disorder
- Peculiar dress, thinking, beliefs, speech or behavior
- Odd perceptual experiences, such as hearing a voice whisper your name
- Flat emotions or inappropriate emotional responses
- Social anxiety and a lack of or discomfort with close relationships
- Indifferent, inappropriate or suspicious response to others
- “Magical thinking” — believing you can influence people and events with your thoughts
- Belief that certain casual incidents or events have hidden messages meant only for you
Cluster B personality disorders
Cluster B personality disorders are characterized by dramatic, overly emotional or unpredictable thinking or behavior. They include antisocial personality disorder, borderline personality disorder, histrionic personality disorder and narcissistic personality disorder.
Antisocial personality disorder
- Disregard for others’ needs or feelings
- Persistent lying, stealing, using aliases, conning others
- Recurring problems with the law
- Repeated violation of the rights of others
- Aggressive, often violent behavior
- Disregard for the safety of self or others
- Impulsive behavior
- Consistently irresponsible
- Lack of remorse for behavior
Borderline personality disorder
- Impulsive and risky behavior, such as having unsafe sex, gambling or binge eating
- Unstable or fragile self-image
- Unstable and intense relationships
- Up and down moods, often as a reaction to interpersonal stress
- Suicidal behavior or threats of self-injury
- Intense fear of being alone or abandoned
- Ongoing feelings of emptiness
- Frequent, intense displays of anger
- Stress-related paranoia that comes and goes
Histrionic personality disorder
- Constantly seeking attention
- Excessively emotional, dramatic or sexually provocative to gain attention
- Speaks dramatically with strong opinions, but few facts or details to back them up
- Easily influenced by others
- Shallow, rapidly changing emotions
- Excessive concern with physical appearance
- Thinks relationships with others are closer than they really are
Narcissistic personality disorder
- Belief that you’re special and more important than others
- Fantasies about power, success and attractiveness
- Failure to recognize others’ needs and feelings
- Exaggeration of achievements or talents
- Expectation of constant praise and admiration
- Arrogance
- Unreasonable expectations of favors and advantages, often taking advantage of others
- Envy of others or belief that others envy you
Cluster C personality disorders
Cluster C personality disorders are characterized by anxious, fearful thinking or behavior. They include avoidant personality disorder, dependent personality disorder and obsessive-compulsive personality disorder.
Avoidant personality disorder
- Too sensitive to criticism or rejection
- Feeling inadequate, inferior or unattractive
- Avoidance of work activities that require interpersonal contact
- Socially inhibited, timid and isolated, avoiding new activities or meeting strangers
- Extreme shyness in social situations and personal relationships
- Fear of disapproval, embarrassment or ridicule
Dependent personality disorder
- Excessive dependence on others and feeling the need to be taken care of
- Submissive or clingy behavior toward others
- Fear of having to provide self-care or fend for yourself if left alone
- Lack of self-confidence, requiring excessive advice and reassurance from others to make even small decisions
- Difficulty starting or doing projects on your own due to lack of self-confidence
- Difficulty disagreeing with others, fearing disapproval
- Tolerance of poor or abusive treatment, even when other options are available
- Urgent need to start a new relationship when a close one has ended
Obsessive-compulsive personality disorder
- Preoccupation with details, orderliness and rules
- Extreme perfectionism, resulting in dysfunction and distress when perfection is not achieved, such as feeling unable to finish a project because you don’t meet your own strict standards
- Desire to be in control of people, tasks and situations, and inability to delegate tasks
- Neglect of friends and enjoyable activities because of excessive commitment to work or a project
- Inability to discard broken or worthless objects
- Rigid and stubborn
- Inflexible about morality, ethics or values
- Tight, miserly control over budgeting and spending money
Obsessive-compulsive personality disorder is not the same as obsessive-compulsive disorder, a type of anxiety disorder.
When to see a doctor
If you have any signs or symptoms of a personality disorder, see your doctor or other primary care professional or a mental health professional. Untreated, personality disorders can cause significant problems in your life that may get worse without treatment.
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How Is a Personality Disorder Diagnosed?
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is a reference doctors and mental health professionals use to help diagnose mental health conditions. Each personality disorder has criteria that must be met for a diagnosis. A primary care or mental health provider will ask you questions based on these criteria to determine the type of personality disorder. In order for a diagnosis to be made, the behaviors and feelings must be consistent across many life circumstances. They should also cause significant distress and impairment in at least two of the following areas:
- the way you perceive or interpret yourself and other people
- the way you act when dealing with other people
- the appropriateness of your emotional responses
- how well you can control your impulses
In some cases, your primary care or mental health provider may perform blood tests to determine whether a medical problem is causing your symptoms. They may also order a screening test for alcohol and drugs.
Risk factors
Although the precise cause of personality disorders is not known, certain factors seem to increase the risk of developing or triggering personality disorders, including:
- Family history of personality disorders or other mental illness
- Abusive, unstable or chaotic family life during childhood
- Being diagnosed with childhood conduct disorder
- Variations in brain chemistry and structure
Complications
Personality disorders can significantly disrupt the lives of both the affected person and those who care about that person. Personality disorders may cause problems with relationships, work or school, and can lead to social isolation or alcohol or drug abuse.
How Is a Personality Disorder Treated?
Treatment can vary depending on the type and severity of your personality disorder. It may include psychotherapy and medications.
Psychotherapy
Psychotherapy, or talk therapy, may help in managing personality disorders. During psychotherapy, you and a therapist can discuss your condition, as well as your feelings and thoughts. This can provide you with insight on how to manage your symptoms and behaviors that interfere with your daily life.
There are many different types of psychotherapy. Dialectical behavior therapy can include group and individual sessions where people learn how to tolerate stress and improve relationships. Cognitive behavioral therapy aims to teach people how to change negative thinking patterns so they can better cope with everyday challenges.
Online therapy options
Read our review of the best online therapy options to find the right fit for you.
Medication
There aren’t any drugs approved for the treatment of personality disorders. However, certain types of prescription medications might be helpful in reducing various personality disorder symptoms:
- antidepressants, which can help improve a depressed mood, anger, or impulsivity
- mood stabilizers, which prevent mood swings and reduce irritability and aggression
- antipsychotic medications, also known as neuroleptics, which may be beneficial for people who often lose touch with reality
- anti-anxiety medications, which help relieve anxiety, agitation, and insomnia
What Is the Outlook for Someone with a Personality Disorder?
The most important aspect of treating a personality disorder is the recognition that the problem exists in the first place. People with these types of disorders believe that their personality traits are normal, so they can become quite upset when someone suggests that they may have a personality disorder.
If someone recognizes that they have a personality disorder and engages in treatment, they should see an improvement in their symptoms. It’s beneficial for friends or family members to be involved in their therapy sessions as well. It’s also important for someone with a personality disorder to avoid drinking alcohol and using illicit drugs. These substances can have a negative impact on emotions and interfere with treatment.
How to Help Someone with a Personality Disorder
If you are close to someone you suspect might have a personality disorder, you should encourage them to seek help. They may get angry or defensive, but it’s important to avoid arguing with them. Instead, focus on expressing your feelings and voicing your concerns about their behaviors.
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