Personality disorders

What is a personality disorder?

There are many different types of personality disorder. As a general rule, they can affect how you relate to yourself and others.

You may be diagnosed with a personality disorder if all these things apply to you:

• Your thoughts, feelings and behaviour cause serious problems to your day-to-day life, like being unable to trust other people.

• These problems affect different parts of your life, including how you feel emotionally and manage relationships.

• You’ve experienced the problems for a significant amount of time.

• The issues cannot be explained by drugs, medication or a medical condition.

Personality disorder types

There are 10 different types of personality disorder, which are grouped into three clusters.

Cluster A personality disorders

If you have a Cluster A personality disorder, experts may describe your behaviour as a ‘suspicious’ personality type. You can seem strange or eccentric, and you usually find it hard to relate to others. Cluster A disorders include:

• Paranoid personality disorder

• Schizoid personality disorder

• Schizotypal personality disorder

• Antisocial personality disorder (ASPD)

Cluster B personality disorders

The following Cluster B personality disorders fall into the ‘emotional and impulsive’ category. It can mean you act unpredictably, and find it difficult to control your emotions:

• Borderline personality disorder (BPD)

• Histrionic personality disorder

• Narcissistic personality disorder

Cluster C personality disorders

Intense feelings of fear or anxiety characterise these personality disorders. Cluster C personality disorders include:

• Dependent personality disorder

• Avoidant personality disorder

• Obsessive-compulsive personality disorder (OCD)

What causes personality disorders?

The exact cause of personality disorders is unclear, but experts think a combination of where and how we grow up and our early experiences play a big part.

People with personality disorders have often grown up with an unstable family life or chaotic parenting. They may have had negative experiences, like poverty or discrimination or had very little support from those close to them. Traumatic experiences, like abuse, neglect and sudden bereavements, are another big risk factor.

It’s thought that genes could also play a part, although this is an area that still needs more research.

Treatment for personality disorders

Treatment usually involves long-term talking therapy to help you gain better control over your thoughts and feelings. The therapy will depend on what type of personality disorder you have and what works best for you. You may need a combination of treatments or to try different types at different times.

Therapies may include:

• Mentalisation-based therapy (MBT) encourages you to take a step back and examine your thoughts and beliefs before acting.

• Cognitive behavioural therapy (CBT) – helps you understand how your thoughts affect your behaviour and teaches you coping strategies for different situations.

• Dialectical behaviour therapy (DBT) – designed especially for people with BPD, aims to help you accept and validate your emotions and open up to new ideas and opinions.

• Cognitive Analytic Therapy (CAT) – looks at the relationship patterns you struggle with and how you can change them.

• Psychodynamic or psychoanalytic therapy – a long-term treatment that looks into your emotional and relationship problems.

• Therapeutic communities – involves working with other people who have mental health problems to support each other and recover as a group.

Medication

Medication isn’t usually recommended to treat personality disorders. But medicines like antidepressants, mood stabilisers and antipsychotics may be used to treat associated mental health conditions, like depression, anxiety or bipolar disorder.

Learning to manage a personality disorder

The range of thoughts and emotions that come with a personality disorder can be overwhelming and tricky to cope with, so it’s crucial to find ways to look after your wellbeing.

Different things help different people, and you may need to try several tactics until you find something that works for you. Here are a few suggestions:

• Record your moods in a diary – this can be a useful way to help you understand your emotions better and recognise triggers

• Create a self-care box – fill a box with things that help to lift your mood, like some of your favourite photos, special objects, a stress ball or a candle

• Try exercising your mind – mindfulness or meditation can help to focus thoughts and feelings

• Stay active – regular activity helps to boost mental health

• Get outside – fresh air and nature are two things that can have a positive effect on mental wellbeing.