Personality disorders are classified by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) as mental illnesses and clearly defines them. Difficulty coping with normal stress and trouble forming relationships with family, friends, and coworkers may be indications of a personality disorder. Those who struggle with a personality disorder often don’t enjoy social activities and may not see themselves as contributing to their problems. While each has its own distinctive features, the personality disorders also share some common characteristics.

“All personality disorders involve a pattern of behavior that deviates from the expectations of one’s culture,” says Scott Krakower, DO, assistant unit chief of psychiatry at Zucker Hillside Hospital in Glen Oaks, New York. “There may be a distortion in a person’s cognition, changes in his affect, or difficulties interacting with others and possibly problems with   impulse control.”

According to Mental Health America, personality disorders fall into three different categories:

  • Cluster A: Odd or eccentric behavior
  • Cluster B: Dramatic, emotional or erratic behavior
  • Cluster C: Anxious fearful behavior

While personality disorders may be responsive to treatment, the challenge is getting the individual with a personality disorder to admit that he has a problem and then agree to treatment. “Many individuals with personality disorders could benefit from individual therapy,” Dr. Krakower says. “But they may choose not to go for treatment or they may go only after a substantial worsening of symptoms in a crisis situation.”

Individuals with personality disorders are prone to comorbid diagnoses like substance abuse disorder, anxiety, and depression, explains Shawna Newman, MD, an adult, child, and adolescent psychiatrist at Lenox Hill Hospital in New York City. “People are genuinely suffering when they have a personality disorder,” she says.  “And while their situation can be managed or controlled with treatment, eliminating a personality disorder can be, at best, very difficult and may not be possible.”  Psychosocial interventions are typically recommended for those with a personality disorder, but there are no FDA-approved medications to treat these disorders, Newman explains.

While you have a moderate level of risk that you will develop a personality disorder if others in your family have one, it’s not a given. “Conditions can run in families just as the risk does for diabetes or heart disease,” says John M. Oldham, MD, interim chief of staff at the Menninger Clinic and Distinguished Emeritus Professor at the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine in Texas. “But even if you have risk factors, you may develop a personality disorder only if you didn’t have stability during your early years if there was a disconnection or derailment in the attachment process during your development.”

Those with personality disorders don’t have it easy when they are around other people, Dr. Oldham says. “There is a lot of stigma, which also is true for almost any mental disorder,” he says.  “However, we are getting a little better about recognizing that these are all illnesses.”

Here, an overview of some of the 10 personality disorders listed in the latest Diagnostic and Statistical Manual of Mental Disorders.

1. Borderline personality disorder is defined by “a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity,” says the DSM. Not only do these individuals lack a solid sense of identity, they have difficulty forming and keeping relationships, Dr. Krakower says. However, they may benefit from certain types of therapy such as dialectical behavior therapy (DBT.) DBT is a cognitive behavioral treatment that combines individual psychotherapy with group skills training classes to help individuals learn new skills and strategies for managing their emotions and reducing conflict in their lives.

Medication can calm down the individual, but it’s not as effective as psychotherapy, says Dr  Oldham. “If people with personality disorders find the right therapist, and they stick with it, there is a good chance they will get better,” he says.

Those with borderline personality disorder are highly worried that people don’t like them, Dr. Oldham says. “They may imagine this so vividly that they may start arguing with a person when the person wasn’t even thinking of them,” he says. “The person’s relationships get rocky because they’re so insecure.” Individuals with borderline personality disorder tend to be antagonistic and antisocial,  and may injure themselves by cutting or burning themselves.

2. Paranoid personality disorder: The individual with this disorder exhibits distrust toward others that typically begins by early adulthood, Dr. Krakower says. “In addition to recurrent suspicions of others, the person reads hidden meanings into benign remarks,” he explains. “The person may suspect that others are deceiving them.”  The DSM defines the disorder as “a pattern of distrust and suspiciousness such that other’s motives are interpreted as malevolent.”

The individual suffering from paranoid personality disorder experiences “suspicion without an objective or sufficient basis,” says Dr. Newman. “The individual can read negative meaning into very innocent remarks. They perceive a lot of unintentional insults and may be very unforgiving.”

3. Schizoid personality disorder: This disorder is “a pattern of detachment from social relationships and a restricted range of emotional expression,” says the DSM. “The person may be more of a loner and choose solitary activities,” Dr. Krakower says. While a person with schizoid personality disorder can benefit from social skills groups, unfortunately, these individuals may choose not to seek out treatment.

4. Schizotypal personality disorder is marked by a pattern of difficulty with relationships that is accompanied by cognitive and perceptual distortions and eccentric behaviors, says Dr. Krakower. “The individual may be superstitious and have magical beliefs or strange and unusual ideas,” he explains. In this disorder, too, while the person could benefit from social skills groups, they often choose not to seek out treatment. Individuals with this disorder are so highly superstitious they are basically dysfunctional, Dr. Newman says. “They may have odd beliefs that influence their behavior, such as ideas about clairvoyance or telepathy, and those with this personality disorder often have very bizarre thoughts,” she says. Individuals tend to have excessive social anxiety with everyone except first-degree relatives, she says.

5. Antisocial personality disorder: This disorder entails a pattern of behavior that is marked by disregard for and violation of the rights of others.   These individuals often fail to conform to social norms, which may result in repetitive arrests and criminal behavior, Dr. Krakower says.  “These individuals may wind up in jail,” he adds. Males with antisocial behavior tend to break the law, disregard rules of conduct, and be manipulative and reckless,” says Dr. Oldham.  “They show no remorse for the things they do, and they don’t conform to social norms,” he says. “There is not a good treatment for antisocial personality disorder and you should start early in life to try to prevent it because once it’s there, it’s hard to fix.”

6. With a histrionic personality disorder, the person exhibits a pattern of attention-seeking behaviors, which may entail a heightened sense of dramatization and inappropriate sexual or provocative behaviors, Dr. Krakower says. Sometimes, this individual has borderline personality disorder as well. She could benefit from a form of therapy known as DBT.

7. Narcissistic personality disorder involves a pattern of grandiose behaviors with an exaggerated sense of self, Dr. Krakower says.  “These individuals are preoccupied with unrealistic images of power and success and may often find others inferior to them,” he says.

The person tends to believe he or she is special and unique and requires excessive admiration from others, Dr. Oldham says. “These individuals are not very good at having empathy,” he says. “Nor are they interested in trying to understand how other people feel.”   A person with a narcissistic personality disorder may concurrently have borderline personality disorder and could benefit from individual therapy, he says, but unfortunately, it’s common for the person to refuse treatment.

8. An avoidant personality disorder involves a pattern of behavior with heightened social inhibition, which is often accompanied by a fear of rejection of others, Dr. Krakower says. The person may have feelings of inadequacy and be hypersensitive to negative evaluation, according to the DSM. “With this disorder, in general people may not even realize that the individual has a personality disorder,” says Dr. Oldham. “People with whom they live and are close to will be aware of it.” Psychotherapy is the primary treatment, he says.

9. A person with a dependent personality disorder exhibits a pattern of behavior marked by excessive neediness or clinginess, accompanied by fears of separation, Dr. Krakower says.

10. A person with anankastic (obsessive-compulsive) personality disorder displays a pattern of behavior of excessive orderliness and perfection, Dr. Krakower explains, and he is frequently inflexible and rigid.  The individual who has this disorder finds it difficult to discard objects, even if they have little emotional value, he says.

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Last Updated: Jul 13, 2021