What to Know About Personality Disorders

Personality disorders are a type of mental disorder where someone has a rigid, unchanging pattern of thinking that is considered unhealthy.

00:06 04 May 2022

When you bring someone new into your life, whether it’s a friend, romantic partner, or even an employee, you might do your best to find out as much as you can about them. From asking questions to doing online searches to learn more about their background, you want to keep yourself and everyone around you safe. 

 

At the same time, there are things that you can’t find out from background checks, online searches, or sometimes even from talking to a person. 

 

Whether they have serious mental health conditions is one of those things. Personality disorders can be especially tricky to notice at first. For example, someone who has a narcissistic personality disorder will begin a relationship being very charming and loving. Then, over time that changes, and they can become resentful, angry, and aggressive. 

 

Personality disorders are difficult to diagnose and treat—even more so than many other mental health disorders. 

 

The following is a general guide and overview of what to know about these disorders and what they can look like. 

 

What is a Personality Disorder?

Personality disorders are a type of mental disorder where someone has a rigid, unchanging pattern of thinking, behaving, and functioning that’s considered unhealthy. Someone with a personality disorder has a difficult time perceiving situations and relating to people. Personality disorders cause problems at work, school, and within relationships. 

 

Someone with one of these disorders very often doesn’t recognize they have one because it all seems natural to them. With this disorder, it’s common to blame others for the challenges they experience. 

 

These disorders usually start in the teen years or early adulthood. 

 

Our personalities are the combination of our thoughts, emotions, and behaviors. The way you view the world, how you understand it and relate to it, as well as how you view yourself are all part of your personality. 

 

Your personality forms during your childhood and is a combination of your genetics and your environment. 

 

Disorders related to the personality are thought to be a combination of genetics and environmental factors. For example, genes can make you more vulnerable to developing a personality disorder, while a situation in your life or environment could trigger the actual development. 

 

Risk factors for personality disorders include a family history of such disorder or other types of mental illness, an abusive or chaotic family life, or having a childhood conduct disorder. Variations in the chemical makeup and structure of the brain can also play a role. 

 

These disorders are characterized by long-term patterns. 

 

Below, we talk more about some of the common types of disorders. 

 

Borderline Personality Disorder

Borderline personality disorder involves problems managing emotions and behavior, patterns of instability in relationships, and problems with self-image. Someone with this disorder has a strong fear of instability or abandonment and can’t tolerate being alone. 

 

Despite a fear of being alone, the personality disorder can also cause impulsive, angry behavior and mood swings which ultimately push other people away. 

 

Signs of borderline personality disorder can include:

 

• A strong fear of abandonment
• Going to extremes to avoid rejection
• Unstable relationship patterns where someone is idealized at first and then ends up being demonized
• Changes in self-image and self-identity
• Periods of paranoia, especially related to stress
• Impulsive or risky behavior
• Feelings of emptiness
• Intense anger in inappropriate situations

 

Narcissistic Personality Disorder

With narcissistic personality disorder, people suffering from the condition have an over-inflated sense of their self-importance. This personality disorder causes someone to need excessive amounts of attention and admiration from others. Problems in relationships and a lack of empathy also characterize narcissistic personality disorder. 

 

Even though someone with this disorder will come off as highly confident, they actually have a very fragile sense of self and low self-esteem, and they’re highly vulnerable to what they perceive as even the slightest criticism. 

 

Signs and symptoms include:

 

• An exaggerated sense of self-importance
• Sense of entitlement
• Needing to be recognized as superior, even without achievements
• An exaggerated sense of talents and achievements
• Preoccupation with fantasies about being powerful, brilliant, beautiful, or perfect
• Feel like they can only associate with equally unique and special people
• Monopolizes conversations
• Taking advantage of other people to get what they want
• Expects special treatment
• Unable to recognize other people’s needs or feelings
• Can become angry when not feeling like they’re receiving special treatment
• Depression or moodiness
• Secret feelings of shame or humiliation
• Issues regulating behavior and emotions

 

Obsessive-Compulsive Personality Disorder

Obsessive-compulsive personality disorder or OCPD is characterized by the need for order, perfection, and neatness. Someone with this disorder needs to put their own standards on the environment around them. 

 

Sometimes OCPD is confused with obsessive-compulsive disorder. There are similarities but also major differences. 

 

OCD is defined by intrusive thoughts, which are obsessions. These obsessions cause anxiety, and they lead someone to do compulsions as a way to try and get relief from the obsession. OCPD is more about perfectionism and an intense focus on details. 

 

People with OCPD are not self-aware that they have an issue, whereas someone with OCD usually is. 

 

Symptoms of OCPD include:

 

• Perfectionism to the point that it impacts the ability to complete tasks
• Formal or rigid mannerisms
• Extreme financial frugality
• The overwhelming need for punctuality
• Extreme focus on detail
• Devotion to work that affects relationships
• Hoarding items with no use
• Not being able to delegate work
• Preoccupation with lists
• Rigid following of rules and regulations

 

Paranoid Personality Disorder

Paranoid personality disorder or PPD is grouped into a set of condition called eccentric personality disorders. 

 

These are also called Cluster A disorders, and people with these types of disorders appear odd to others around them. 

 

Someone with PPD has constant mistrust, suspicion, and paranoia of others without a valid reason to feel that way. 

 

Symptoms of PPD include:

 

• Always being on guard
• Feeling others are constantly trying to harm or threaten them
• Doubting the trustworthiness of others
• Belief other people are deceiving or exploiting them
• Inability to confide in other people because they fear what they say will be used against them
• Holding grudges and being unforgiving
• Hypersensitive
• Reading meaning into remarks or casual looks from other people 
• Cold and distant in relationships
• Quick to retaliate against perceived attacks
• Has problems relaxing
• Are hostile and argumentative
• Develop negative stereotypes of other people

 

Avoidant Personality Disorder

When someone has an avoidant personality disorder, they’ll experience a sense of inadequacy, and they’ll be very sensitive to what they see as a negative judgment from other people. Someone with an avoidant personality disorder has the desire to interact with other people and form relationships, but they don’t because of extreme fear of rejection. 

 

Symptoms of avoidant personality disorder include:

 

• Overly sensitive to perceived criticism or disapproval
• Fear of rejection or humiliation
• Few if any close friends
• Reluctant to get involved with other people
• Extreme fear or anxiety in social situations
• Self-conscious, awkward or shy in social situations
• Exaggeration of problems
• Unwilling to try new things
• Poor self-image

 

How Are Personality Disorders Diagnosed?

The above are only some of the personality disorders. Each one has its own set of diagnostic criteria. The diagnostic criteria are included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. 

 

The diagnosis of a personality disorder, regardless of the specific one, includes long-term deviation from expectations in culture related to at least two of four areas. 

 

The first area is how you perceive and interpret yourself, others, and events. The second is how appropriate your emotional responses are. The third is how you function in relationships and when dealing with other people, and the fourth is whether you can control impulses. 

 

Once someone is diagnosed with a personality disorder, their treatment depends on a lot of individual factors. 

 

Someone with mild symptoms that are generally well-controlled might just need to work with a counselor or therapist. 

 

Psychotherapy, also called talk therapy is the primary form of treatment for personality disorders. 

 

When someone participates in talk therapy, they learn more about their condition and share their thoughts, feelings, and behaviors. The goal of psychotherapy is to help someone learn how to deal with stress and manage the symptoms of their mental health disorder. 

 

Psychotherapy can take place in different settings, including in group settings or sessions with family members. 

 

Some people with personality disorders benefit from social skills training. 

 

There aren’t medications specifically for the treatment of personality disorders, but there are several types that can still be used for the management of symptoms.

 

For example, antidepressants can help if someone has a personality disorder and also has a depressed mood or periods of hopelessness, anger, impulsivity, or irritability. 

 

Mood stabilizers are helpful for symptoms of impulsivity, aggression, and irritability. Antipsychotics can help if someone’s symptoms include losing touch with reality, known as psychosis. 

 

Anti-anxiety medicines can also help some people with personality disorders.

 

Again, because personality is such an ingrained part of who we are, it can be difficult to diagnose and treat these disorders, but not impossible. If you love someone with a personality disorder, the best thing you can do is encourage them to speak to a professional mental health provider.