Personality Disorders

What are Personality Disorders?

Those who struggle with a personality disorder often experience great difficulty relating to and interacting with others. They may appear inflexible, rigid, and unable to adapt to the changing demands of life.

Although their behavior patterns may feel “normal” or “right” to them, these patterns are often narrow, limiting, and disruptive. As a result, individuals with personality disorders may find it challenging to participate fully in social, professional, or community activities.

Recognizing a Personality Disorder

A personality disorder is defined by deeply ingrained and inflexible patterns of perceiving, relating, and thinkingthat are significant enough to cause distress or impairment in functioning.

These patterns typically become noticeable in adolescence or early adulthood, persist throughout much of a person’s life, and may gradually lessen in middle age. Unlike short-term challenges or situational stress, personality disorders are enduring and pervasive, affecting many areas of life.

What Causes a Personality Disorder?

The exact causes of personality disorders remain complex and multifaceted. Some experts suggest that early childhood experiences—such as trauma or inconsistent caregiving—exert a powerful influence on later behavior. Others point to genetic predispositions that make certain individuals more vulnerable.

In many cases, a combination of genetic, biological, and environmental factors contributes to the development of a personality disorder. Environmental stressors may activate underlying vulnerabilities, leading to lasting patterns of thought, emotion, and behavior.

Types of Personality Disorders

There are many formally recognized personality disorders, each with distinct features and challenges. These are often grouped into three categories, or clusters:

Cluster A

  • Schizoid Personality

    Schizoid personalities are introverted, withdrawn, solitary, emotionally cold, and distant. They are often absorbed with their own thoughts and feelings and are fearful of closeness and intimacy with others. For example, a person suffering from schizoid personality is more of a daydreamer than a practical action taker.

  • Paranoid Personality

    The essential feature for this type of personality disorder is interpreting the actions of others as deliberately threatening or demeaning. People with paranoid personality disorder are untrusting, unforgiving, and prone to angry or aggressive outbursts without justification because they perceive others as unfaithful, disloyal, condescending or deceitful. This type of person may also be jealous, guarded, secretive, and scheming, and may appear to be emotionally “cold” or excessively serious.

  • Schizotypal Personality

    A pattern of peculiarities best describes those with schizotypal personality disorder. People may have odd or eccentric manners of speaking or dressing. Strange, outlandish or paranoid beliefs and thoughts are common. People with schizotypal personality disorder have difficulties forming relationships and experience extreme anxiety in social situations. They may react inappropriately or not react at all during a conversation or they may talk to themselves. They also display signs of “magical thinking” by saying they can see into the future or read other people’s minds.

Cluster B

  • Antisocial Personality

    People with antisocial personality disorder characteristically act out their conflicts and ignore normal rules of social behavior. These individuals are impulsive, irresponsible, and callous. Typically, the antisocial personality has a history of legal difficulties, belligerent and irresponsible behavior, aggressive and even violent relationships. They show no respect for other people and feel no remorse about the effects of their behavior on others. These people ware at high risk for substance abuse, especially alcoholism, since it helps them to relieve tension, irritability and boredom.

  • Borderline Personality

    People with borderline personality disorder are unstable in several areas, including interpersonal relationships, behavior, mood, and self-image. Abrupt and extreme mood changes, stormy interpersonal relationships, an unstable and fluctuating self-image, unpredictable and self-destructive actions characterize the person with borderline personality disorder. These individuals generally have great difficulty with their own sense of identity. They often experience the world in extremes, viewing others as either “all good” or “all bad.” A person with borderline personality may form an intense personal attachment with someone only to quickly dissolve it over a perceived slight. Fears of abandonment may lead to an excessive dependency on others. Self-mutilation or recurrent suicidal gestures may be used to get attention or manipulate others. Impulsive actions, chronic feelings of boredom or emptiness, and bouts of intense inappropriate anger are other traits of this disorder, which is more common among females.

  • Narcissistic Personality

    People with narcissistic personality have an exaggerated sense of self-importance, are absorbed by fantasies of unlimited success, and seek constant attention. The narcissistic personality is oversensitive to failure and often complains of multiple somatic symptoms. Prone to extreme mood swings between self-admiration and insecurity, these people tend to exploit interpersonal relationships.

Cluster C

  • Avoidant Personality Disorder

    Avoidant personalities are often hypersensitive to rejection and are unwilling to become involved with others unless they are sure of being liked. Excessive social discomfort, timidity, fear of criticism, avoidance of social or work activities that involve interpersonal contact are characteristic of the avoidant personality. They are fearful of saying something considered foolish by others; worry they will blush or cry in front of others; and are very hurt by any disapproval by others. People with avoidant personality disorder may have no close relationships outside of their family circle, although they would like to, and are upset at their inability to relate well to others.

  • Dependent Personality Disorder

    People with dependent personality disorder may exhibit a pattern of dependent and submissive behavior, relying on others to make decisions for them. They require excessive reassurance and advice, and are easily hurt by criticism or disapproval. They feel uncomfortable and helpless if they are alone, and can be devastated when a close relationship ends. They have a strong fear of rejection. Typically lacking in self-confidence, the dependent personality rarely initiates projects or does things independently. This disorder usually begins by early adulthood and is diagnosed more frequently in females than males.

  • Obsessive-Compulsive Personality Disorder

    Compulsive personalities are conscientious and have high levels of aspiration, but they also strive for perfection. Never satisfied with their achievements, people with compulsive personality disorder take on more and more responsibilities. They are reliable, dependable, orderly, and methodical, but their inflexibility often makes them incapable of adapting to changed circumstances. People with compulsive personality are highly cautious, weigh all aspects of a problem, and pay attention to every detail, making it difficult for them to make decisions and complete tasks. When their feelings are not under strict control, events are unpredictable, or they must rely on others, compulsive personalities often feel a sense of isolation and helplessness.

Treatment of the Personality Disorder

Although personality disorders can be challenging, effective treatment is available. Therapy provides patients with tools to increase self-awareness, improve relationships, and manage distressing emotions and behaviors.

Evidence-based approaches such as Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), and Schema Therapy can help patients build healthier coping skills, regulate emotions, and change unhelpful patterns of thinking.

In some cases, medication may be recommended to address co-occurring symptoms such as depression or anxiety. With consistent treatment and support, many patients are able to achieve meaningful improvements in their daily livesand relationships.