Understanding Personality Disorders: Types, Causes, & Treatment Options


Personality disorders refer to a cluster of ten different mental health conditions. Personality disorders are chronic and pervasive- they drastically affect how someone thinks and behaves in the world. Such patterns cause significant distress to individuals and their loved ones.


Research shows that about 9% of the population has some personality disorder. Sometimes personality disorder symptoms are obvious. Other times, the symptoms are confusing or even chaotic. They may mimic other mental health conditions.


People may not understand why their loved one acts the way they do. To complicate matters, someone with a personality disorder does not usually recognize their patterns as problematic. Here's what you need to know.


Types of Personality Disorders

The DSM categorizes personality disorders into three categories. It's common for people to have mixed personality disorders or symptoms of several conditions simultaneously.


Cluster A Personality Disorders

Cluster A is defined by unusual, delusional, or eccentric patterns. These personality disorders still remain largely misunderstood. People with these conditions are the least likely to seek any form of treatment, often because they have some mistrust or worry about healthcare systems.


Paranoid personality disorder: People with paranoid personality disorder experience high levels of mistrust of the world. They present as guarded and suspicious and assume others are conspiring to hurt them.


Schizoid personality disorder: People with schizoid personality disorder present as detached and uninterested in relationships. There is a general sense of apathy for human connection, and they are not bothered by this apathy. As a result, they tend to spend most of their time alone.


Schizotypal personality disorder: People with schizotypal personality disorder experience a combination of warped views of reality, unusual behaviors, and superstitions. They often present with magical thinking, and they may assume certain events have a hidden or special meaning for them.


Cluster B Personality Disorders

Cluster B is defined by intense, erratic, and socially inappropriate behaviors. People with Cluster B personality disorders tend to have extreme emotions and experience tumultuous relationships with others. These personality disorders often coincide with substance use, eating disorders, poor impulse control, and depression.


Antisocial personality disorder (ASPD): People with ASPD generally lack remorse or empathy towards others. As a result, they don't adhere to basic social etiquette, and they may get in trouble for harming others or breaking the law.


Borderline personality disorder (BPD): People with BPD experience immense difficulty with self-esteem and emotional regulation. They have intense mood swings and often oscillate quickly between loving or hating certain people. Many people with BPD struggle with self-injurious behaviors and suicidal ideation.


Histrionic personality disorder (HPD): People with HPD tend to base their worth on validation and approval from others. They have an extreme need to be recognized, and they often dress and act seductively to gain attention. Many times, they present as dramatic and showy.


Narcissistic personality disorder (NPD): People with NPD have high levels of entitlement and superiority. They view themselves as better than most people, causing them to often "use" others for their own gain. As a result, they love being at the center of attention and feel threatened by any perceived competition.


Cluster C Personality Disorders

Cluster C is defined by anxiety, discomfort, and themes of control. People with Cluster C conditions also tend to meet the criteria for anxiety disorders. Their symptoms can be all-consuming and often cause significant frustration to loved ones.


Avoidant personality disorder: People with avoidant personality disorder value social connections, but they are so worried about being negatively judged that they tend to avoid others. Unlike social anxiety, it isn't just about feeling afraid. People with this condition have a core belief that they are inferior and that others also see them in that way.


Dependent personality disorder: People with dependent personality disorder have an intense need for attachment. They care immensely about relationships, and they often present as overly clingy or even obsessive. Separation or even brief periods spent apart trigger immense anxiety.


Obsessive-compulsive personality disorder (OCPD): People with OCPD have an intense need for orderliness and perfection. They present as highly rigid with completing tasks and become distressed when things deviate from their plans. Unlike OCD, people with this condition do not have insight into their anxiety and usually do not wish to change their behavior.


What Causes Personality Disorders?

Like all mental health conditions, researchers aren't exactly sure of the root cause of personality disorders. Instead, it appears that specific risk factors may increase the likelihood of someone developing these conditions, including:


Genetics: Personality disorder traits may run in families. Likewise, researchers are continuing to explore the links between anxiety, aggression, and paranoia, all of which can play a role in certain personality disorders.


Childhood trauma: There is a strong correlation between personality disorders and childhood trauma. In some cases of examining BPD and NPD, for example, upwards of 80-90% of research participants indicated having experienced trauma in the past.


Structural brain changes: It's unclear if mental illness causes brain changes or if brain changes cause mental illness (or if there's just an existing relationship). But brain scans show that people with personality disorders appear to have dysregulated amygdala and frontal lobe functioning.


How Are Personality Disorders Treated?

Personality disorders can be challenging to treat. Many people with these conditions don't readily seek support. If they do reach out for help, it's often for other issues, such as substance use, relationship problems, or difficulties at work.


That said, research shows that therapy can be highly effective for people with personality disorders. There are many evidence-based treatments, such as dialectical behavior therapy (DBT), specifically designed to treat these conditions.


Therapy tends to be long-term, and it's normal for clients to ebb and flow with their progress. The primary goals of treatment typically entail:

  • managing immediate crisis symptoms and ensuring the safety of self of others

  • increasing personal accountability over thoughts and actions

  • increasing prosocial behavior

  • decreasing and reframing personality traits causing problems

  • improving self-esteem and quality of relationships

How We Help

At Mental Health Transitions, we are experienced and competent in understanding personality disorders. We recognize that effective treatment tends to be multifaceted, and we also believe involving the family helps make a comprehensive care plan.


If you are struggling, we are here to help. Contact us today to learn more!

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