Personality disorder is a psychological condition that affects an individual’s behaviors and interactions with others, as it is characterized by permanent changes in the pattern of thinking, feeling, and behavior that affect the way a person deals with himself and others, so it is one of the most prominent psychological challenges that affect the individual in various aspects of his life. This article discusses the different types of personality disorders, their causes, symptoms, diagnosis, and treatment methods, as well as how to support people with these disorders and how to improve their social and emotional lives.
What are personality disorders?
Personality is vital to a person’s identity; it is the way of thinking, feeling, and behaving that distinguishes one person from another. Personality involves a unique combination of traits (including attitudes, thoughts, and behaviors), as well as how a person expresses these traits in their interactions with others and the world around them.
Personality disorder is a mental health condition that involves long-term, pervasive, and disruptive patterns of thinking, behavior, moo,d and communication with others. The person with personality disorder shows a persistent pattern of seeing themselves and reacting to others in ways that cause them distress. People with personality disorders also often find it difficult to understand emotions and tolerate distress, making it difficult for them to communicate with others and affecting their family and social life, their performance at work and school, as well as their overall quality of life.
Types of personality disorders: Different groups
There are ten specific types of personality disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) (the standard reference for recognized mental illnesses), each with important differences, as these disorders affect at least two of these aspects:
- Thinking about oneself and others
- How to interact with others
- Emotional Response Method
- Behavior Management Method
According to their common features and symptoms, these disorders are categorized into three main groups:
Group A personality disorders
Cluster A personality disorders are characterized by a persistently dysfunctional pattern of thinking and behavior that reflects suspicion or lack of concern for others:
Paranoid personality disorder
The main characteristic of paranoid personality disorder is that the person feels distrustful and suspicious of others for no good reason. People with paranoid personality disorder often feel that others are trying to belittle, hurt, or threaten them.
Schizoid Personality Disorder
This disorder is characterized by a consistent pattern of detachment from and lack of interest in interpersonal relationships, and sufferers have a limited range of emotions while interacting with others (emotional detachment, lack of interest in relationships, and narrow feelings).
Schizotypal Personality Disorder
People with this condition show a consistent pattern of extreme discomfort and limited need for close relationships, and their distorted view of reality, superstitions, and unfamiliar behaviors cause interpersonal and relationship difficulties (social discomfort, strange thoughts, superstitions, unfamiliar behavior, and relationship difficulties).
Group B personality disorders
Type B personality disorders involve dramatic and erratic behaviors, with people with these types exhibiting intense, unstable emotions and impulsive behaviors. Type B personality disorders include:
Borderline personality disorder (BPD): Emotional fluctuations and troubled relationships
In this disorder, the person has difficulty regulating emotions resulting in low self-esteem, and is characterized by mood and emotional fluctuations and impulsive behaviors leading to subsequent difficulties in relationships with others.
Antisocial personality disorder (ASPD): Unethical behaviors and lack of discipline
People with this disorder show a lack of respect for others and do not follow socially accepted norms and rules, they may break the law or inflict physical or emotional harm on others around them, and usually do not feel remorse for hurting others but justify their actions and are characterized by selfish and irresponsible behavior.
Narcissistic personality disorder: Need for admiration and lack of empathy
This condition involves a consistent pattern of feeling superior, grandiose, and imposing on others, as well as an excessive need for praise and admiration, and a lack of empathy for others. These thoughts and behaviors are often caused by low self-esteem and lack of confidence.
Hysterical personality disorder
This disorder is characterized by intense and unstable emotions and a distorted self-image, and one of the most prominent features of the hysterical personality is that sufferers’ self-esteem depends on the approval of others and does not stem from a true sense of self-worth, and they feel an overwhelming desire to attract the attention of others and may display dramatic or inappropriate behaviors in order to do so.
Group C personality disorders
Types of this group include extreme anxiety and fear and include:
Avoidant personality disorder
People with this condition suffer from chronic feelings of inadequacy and are very sensitive to negative judgments from others. Although they want to interact with others, they tend to avoid social interaction due to their extreme fear of rejection.
Dependent personality disorder
The condition is characterized by a constant and excessive need to care for another person and includes submissiveness, a need for constant reassurance, and an inability to make decisions. People with this disorder often become very close to another person and go to great lengths to try to please them, exhibit a sense of clinginess, and have a great fear of separation.
Obsessive-Compulsive Personality Disorder (OCPD)
The condition is characterized by a constant and intense need for order, perfection, and control with no room for flexibility, which ultimately slows down or interferes with task accomplishment and can also interfere with relationships. This condition differs from obsessive-compulsive disorder (OCD), which is classified as an anxiety disorder. While people with OCD usually recognize that OCD is the cause of their behavior and accept their need for change, people with OCPD usually have little or no self-awareness of their behaviors.
How common are personality disorders?
About 6% of the world’s population suffers from a personality disorder and about 9% of adults in the United States have some type of personality disorder. Borderline personality disorder (BPD) and antisocial personality disorder are the most common personality disorders.
Symptoms of personality disorders: How do you recognize the early signs?
Symptoms of personality disorders can be varied and reflect consistent patterns of thinking and behavior that significantly affect a person’s life. Recognizing the early signs helps with early intervention and appropriate support. Each of the 10 types of personality disorders listed above has its own signs and symptoms, but personality disorders generally involve issues with:
- Identity and sense of self: People with a personality disorder generally lack a clear or stable image of themselves, and their view of themselves often changes depending on the situation or the people they are dealing with. Their self-esteem may be unrealistically high or low.
- Relationships: People with personality disorders find it difficult to form close and stable relationships with others due to their problematic beliefs and behaviors. They may lack empathy or respect for others, be emotionally detached, or have an excessive need for attention and care.
Another hallmark of personality disorders is that most sufferers often have little or no understanding of how their problematic thoughts and behaviors affect their lives. In some cases, the sufferer may not even know they have a personality disorder because their thinking and behavior seem normal to them, and they may also believe that others are responsible for their challenges.
Causes of personality disorders: Psychological, environmental, and genetic factors
Personality disorders are thought to be caused by a combination of genetic and environmental factors that affect an individual’s life. Genetics and certain life situations may also increase the likelihood of developing a personality disorder. Although the exact causes of personality disorders are not fully known, certain factors seem to increase the risk of developing them, including factors that lead to personality disorders:
- Psychological factors and early life experiences: This includes an unstable or unsupportive home environment, a history of trauma such as neglect, physical abuse, emotional abuse, or sexual abuse, and a relationship between childhood trauma and the development of disorders, especially in those with borderline and antisocial personalities.
- Environmental factors: Childhood trauma, verbal abuse, and social pressures play an important role in the development of personality disorders, as people who were verbally abused in childhood are more likely to develop disorders such as borderline and narcissistic personality.
- Brain changes: Studies point to differences in the brain, such as changes in the amygdala in people with paranoid personality disorder and reduced frontal lobe volume in people with schizotypal personality disorder.
- Genetic factors: Certain genes may be responsible for personality disorders such as obsessive-compulsive personality disorder, with possible links between genes and aggression and anxiety.
- Cultural factors: They play a role as there are marked disparities in rates of personality disorders between different countries.
However, personality disorders are among the least understood mental health conditions and scientists are still trying to figure out exactly what causes them.
How are personality disorders diagnosed?
\Diagnosing personality disorders is challenging because people with them often don’t realize they have a problem with their behavior or way of thinking. As a result, most people with personality disorders don’t seek help themselves. Instead, others, such as family or social workers, may refer them to mental health professionals because of the impact their behavior has on others. When people do seek help, it’s often for conditions such as anxiety, depression, or substance abuse, or for problems stemming from the personality disorder, such as divorce or unemployment, rather than the disorder itself. Diagnosing personality disorders depends on three main factors:
- Initial consultation: The basic step to begin a diagnosis, usually when a person or their loved ones seek help for issues or complications caused by a personality disorder. The diagnosis of a personality disorder is based on the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association.
- Non-aggressive questions: The doctor uses general and broad questions that do not provoke a defensive or threatening reaction, but rather focus on:
- Personal history: including childhood and upbringing
- Social relationships: with family and friends
- Professional history: such as work and previous jobs
- Reality testing: the ability to distinguish between reality and illusions
- Emotion management: the ability to control anger or stress
- The role of family and friends: Because a person may lack full awareness of their behaviors, more information is often gathered by talking to family members or friends about the person’s behaviors and history.
However, personality disorders can sometimes be inaccurately diagnosed because doctors initially focus on symptoms of anxiety or depression, which are more commonly seen in the general population than personality disorders, so a correct diagnosis of personality disorders requires a thorough assessment that includes personal history, relationships, and behaviors, and may require gathering information from multiple sources such as family and friends.
Treatments for personality disorders: From psychotherapy to medication
How are personality disorders treated?
Personality disorders are some of the most difficult disorders to treat in psychiatry, mainly because sufferers do not believe that their behavior is an issue and therefore do not seek treatment very often. The most appropriate treatment depends on the type of personality disorder a person has, the severity of the disorder, as well as their living situation, so treatment often requires a group approach to meet their psychological, medical, and social needs, as treatment relies mainly on psychotherapy (talk therapy), which is useful in managing the symptoms and complications of the disorder, and pharmacotherapy may also be useful in some cases, and personality disorder treatment may take months or years to recover.
Psychotherapy: Cognitive behavioral therapy and psychological support
Psychotherapy is a term that refers to a variety of treatment techniques aimed at helping a person identify and change troubling feelings, thoughts, and behaviors. Working with a psychotherapist can provide support, education, and guidance to help with treatment. The main goals of psychotherapy for personality disorders include
- Helping the person understand that their issues are internal and not caused by other people or situations.
- Reduce unhealthy and socially undesirable behaviors.
- Minimize immediate distress such as anxiety and depression.
- Modify the personality traits that cause difficulties.
There are different types of psychotherapy, and each personality disorder requires different types. Cognitive behavioral therapy (a form of psychotherapy also known as talk therapy) is the main method of treating personality disorders. It focuses on treating risky behaviors, including behaviors that may lead to suicide, as well as behaviors that may interfere with treatment or affect quality of life.
Cognitive behavioral therapy consists of weekly individual sessions with a psychotherapist and can last for about a year. Professionals who treat patients using cognitive behavioral therapy also regularly attend consultation groups where they talk about issues related to treatment and the most effective methods of treatment. Another advantage of this treatment is that it is available by phone or other means to provide the necessary guidance, which ensures that the treatment discussed during the sessions is properly applied in real life. This treatment also includes psychological sessions that focus on:
- Effective communication with others
- Emotional control
- Dealing with distress
- Practicing mindfulness
The role of medications in treating personality disorders
Although psychotherapy, especially cognitive behavioral therapy (CBT), is the cornerstone of treatment for personality disorders, pharmacotherapy plays a supporting role as well. To date, the US Food and Drug Administration (FDA) has not approved any medications to specifically treat personality disorders, but several types of psychiatric medications may help alleviate the symptoms of personality disorders, including:
- Anxiety medications: These medications may help if you feel anxious, irritable, or unable to sleep, but in some cases, they can make you more impulsive, so they are not used with some types of personality disorders.
- Antidepressants: Antidepressants may help if you feel depressed, angry, impulsive, irritable, or hopeless, as these symptoms may be related to personality disorders.
- Antipsychotic medications: Also called antipsychotics, they help with psychosis (loss of contact with reality) and may also help with some anxiety or anger issues.
- Mood stabilizers: These medications can alleviate mood swings or reduce irritability and impulsivity as well as aggression.
Hospitalization for personality disorder
In some cases, the personality disorder may be severe enough to require hospitalization for psychiatric and sometimes pharmacological care. This is usually only recommended when the person cannot properly care for themselves or when they pose an immediate risk of harming themselves or someone else. Once the person is stable in the hospital, a mental health professional may recommend a hospital day program, residential program, or outpatient treatment to ensure a full recovery.
How to support people with personality disorders: Tips for parents and friends
Supporting people with personality disorders requires great understanding and patience, but a supportive and stable environment plays a big role in helping people improve their quality of life, and some of the most important tips to help support someone with a personality disorder include the following:
- Believe their feelings: Understand that their reactions may seem irrational, but validating their feelings promotes emotional support. It may be difficult or impossible to understand why they feel or react the way they do, but recognizing and validating their feelings can mean a lot to them. For example, saying: “Things are hard for you right now” without having to agree with their every action.
- Remain calm during bouts of difficult emotions stay with them without having to talk, and use a common word or signal to alert them when they feel they are losing control.
- Education about the personality disorder: Learn about the nature of the disorder to better challenge social stigma and support, and participate in support programs if available.
- Help them seek treatment: Helping them make or attend appointments can be helpful, but it’s best to encourage them to make decisions on their own to avoid over-dependence.
- Plan ahead to deal with crises: Discuss with them how to help them when they have negative or suicidal thoughts, and what the care plan is, if any.
- Remind them of the positives: Remind them of their good qualities that are not altered by the disorder, such as intelligence or kindness, to boost their self-esteem.
- Set clear boundaries: Agree on relationship boundaries and expectations to avoid misunderstandings, especially in difficult situations.
- Patience and understanding of mood swings and challenging behaviors.
- Don’t neglect the importance of mental health while supporting them, and ask for support when feeling overwhelmed.
By following the above tips, family and friends can play a big role in supporting the affected person and convincing them to start treatment and stick to it, then they can be a major reason for their recovery from this mental disorder.
In conclusion, personality disorders are a medical and psychological challenge that requires an accurate and comprehensive understanding of the symptoms and influencing factors. Early diagnosis and appropriate therapeutic intervention, whether through psychotherapy or social support, play a pivotal role in improving patients’ quality of life. Early diagnosis and appropriate therapeutic intervention, whether through psychotherapy or social support, play a pivotal role in improving the quality of life of patients.
Sources:
- National Institute of Mental Health. (n.d.). Personality disorders statistics. Retrieved May 23, 2025, from
- Mayo Clinic (n.d.). Personality disorders: Symptoms and causes. Retrieved May 23, 2025, from
