Personality Disorders | Symptoms & Treatment Options | Zencare — Zencare

Personality Disorders

Personality is a way of thinking, feeling and behaving that makes us unique and individual. It is generally thought that our unique personality develops through a combination of genetics, our environment and interactions between the two. Our personality usually stays pretty much the same throughout our lives.

Some people find that their personality characteristics create challenges and cause distress. A personality disorder is when personality differs to cultural expectations, causes distress, interferes with participation in normal daily activities like work or relationships, and remains that way over time (1). The problematic patterns of thinking, feeling and behaving that are characteristic of personality disorders usually start by late adolescence or early adulthood.

Without treatment, personality disorders can impact on a person’s life over the long-term. It’s common for people with personality disorders to also experience other challenges like depression, anxiety or substance abuse. However, with the appropriate therapy, many people can change these problematic patterns and engage more fully in life.

Types of personality disorders

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is what mental health professionals use to diagnose personality disorders. The DSM-5 groups personality disorders into several different clusters which share some characteristics. The 10 specific personality disorders are (1):

Cluster A: Odd or eccentric characteristics

  • Paranoid personality disorder: Being suspicious of others, assuming others intend on harming them, and therefore difficulty having close relationships.
  • Schizoid personality disorder: Lack of emotion and disinterest in other people or relationships.
  • Shizotypal personality disorder: Unusual or odd beliefs, thinking or behavior. Being uncomfortable with close relationships.

Cluster B: Dramatic, emotional or erratic characteristics

  • Antisocial personality disorder: Not respecting or violating the rights of others.
  • Borderline personality disorder: Instability in relationships and self-image, intense emotions and impulsivity. You can learn more about Borderline Personality Disorder here.
  • Histrionic personality disorder: Excessive attention seeking and emotions.
  • Narcissistic personality disorder: Lacking empathy for others, a sense of entitlement, self-importance, and a need for admiration.

Cluster C: Anxious or fearful characteristics

  • Avoidant personality disorder: Extreme shyness and sensitivity to criticism.
  • Dependent personality disorder: Needing to be taken care of, and difficulty being independent.
  • Obsessive-Compulsive personality disorder: Excessive need for orderliness, perfection and control.

Many of us will notice some of these characteristics in ourselves. This does not necessarily mean that we have a personality disorder.

How common are personality disorders?

One study found that in the United States around 9% of adults were diagnosed with a personality disorder (2). Of the 9% of adults diagnosed:

  • 5.7% were diagnosed with a personality disorder from cluster A
  • 1.5% with cluster B
  • 6% with cluster C

This data also shows that it’s not uncommon for a person to experience more than one personality disorder.

Symptoms of personality disorders

The symptoms vary depending on the specific disorder. However, there are features common to all personality disorders that distinguishes them from other mental health problems. The patterns of thinking, feeling and behaving in personality disorders are present over the long-term and in more than one context. For example, this might mean that you experience challenges both at work and in your relationships.

Some signs to look out for include having difficulty:

  • Making or keeping close relationships
  • Getting on with people (including family and friends) socially or at work
  • Controlling your emotions
  • Controlling your behavior
  • Listening to other people
  • You might seem to be in trouble or conflict regularly

In addition, you might notice that these things cause you distress and interfere with your ability to participate or engage in work or relationships (3).

Ways to heal from a personality disorder

There are many resources available to help people to recover from a personality disorder. Consider one or more of these options:

  • Therapy. Treatment for personality disorders usually involves therapy, in both individual and group settings. Therapy can help to change your patterns of thinking, feeling and behaving. The type of therapy depends on the specific personality difficulty but is often longer-term. As such, it’s particularly important to find a therapist with whom you feel comfortable and trust. Tips for this are discussed more, below.
  • Medication: Some symptoms of associated mental health problems can be managed with medication. You might wish to seek assessment and discuss this further with a specialist, such as a psychiatrist.
  • Avoid alcohol and drugs: These substances can exacerbate your symptoms and may interact with any medications.
  • Hotlines: If you’re having thoughts of suicide or need immediate support, call the National Suicide Prevention Hotline at 1-800-273-8255. If you have experienced any kind of sexual trauma, the RAINN National Sexual Assault Hotline can provide support and resources at 1-800-656-4673. The Crisis Text Line is available for help without having to speak by texting HOME 741741.
  • Get information: Learn about personality disorders. It can also help to read others’ stories about recovery, such as those available on the Self-Injury Outreach and Support websites.
  • Social supports: It’s important not to isolate yourself. Stay connected to friends and family. If you feel distressed, try phoning a friend or a helpline.
  • Support groups: During the recovery journey, many people find it beneficial to speak with others who are experiencing similar difficulties. Try searching online, including the name of the specific personality difficulty and your location as search terms. One example is TARA: Treatment And Research Advancements for Borderline Personality Disorder.
  • Stay active: Many studies have shown that exercise can improve mood (2).
  • Coping strategies: Try some of the following strategies if you are feeling upset:
  • Talk to someone, or phone a helpline
  • Distract yourself: Listen to music, or watch TV, for example
  • Try a relaxation exercise
  • Go for a walk
  • Write about what is happening in a diary

Personality disorders: Therapy types to consider  

The particular approach taken depends on your individual circumstances and therapist. Some common approaches to treating personality disorders include:

  • Dialectical Behavior Therapy (DBT): Developed for people experiencing Borderline Personality Disorder, DBT helps people learn how to recognize and regulate intense emotions with more adaptive coping strategies and skills. DBT usually involves both group and individual therapy.
  • Cognitive Behavioral Therapy (CBT): This therapy helps people to change unhelpful patterns of thinking, behavior and emotions. It helps people to develop more helpful coping strategies.
  • Family or Couples Therapy: It can be helpful to involve family members or partners in therapy. Here, they can learn about personality disorders and how to best support recovery.
  • Psychodynamic Therapy: This therapy can help to reduce feelings of anxiety or depression. It also explores how the past may influence current patterns of thought, emotion and behavior.
  • Mentalization-Based Therapy: The aim of mentalization-based therapy is to better understand yourself and others through group and individual therapy. It can help to increase awareness of your thoughts and emotions, as well as those experienced by other people.
  • Schema Therapy: In schema therapy, people explore unhelpful beliefs, understand them better and work to change them.

What should I look for in a therapist for personality disorders?

There are several factors to keep in mind when selecting a mental health professional, including:

Education and credentials

Look for a licensed mental health professional who has specialized training in personality disorders and related therapies. For example, if you are looking for help with Borderline Personality Disorder, you might want to look for therapists with certification from the DBT-Linehan Board of Certification. It can be helpful to take a look at therapists’ biographies. This is often where they note their experience and specializations.

Personal fit

It’s important to find a therapist with whom you feel comfortable working with and trust. The trusting working relationship between you and your therapist, known as the “therapeutic alliance” can have a huge impact on the efficacy of therapy. As therapy for personality disorders is often longer-term, it’s particularly important to make sure you find a therapist you can build a strong relationship with.

Talk in advance

The best way to judge how you might feel about your prospective therapist is to ask for a preliminary phone call (you can do this with our vetted Zencare therapists). Most therapists will be happy to oblige. This gives you the opportunity to ask about:

  • Their qualifications
  • Their experience working with people with personality disorders
  • Any ongoing training related to the treatment of personality disorders
  • What type of therapy they suggest, and what that will be like
  • Their participation in insurance plans and cost of therapy

Try to speak to a few different therapists before making your mind up.

New to therapy? Learn about how to find a therapist here.

Sources and references

(1) American Psychiatric Association, “What are personality disorders?

(2) DSM-IV personality disorders in the National Comorbidity Survey Replication

(3) Royal College of Psychiatrists, “Personality disorder"