Personality disorders are mental illnesses characterized by inflexible thought and behavior patterns, difficulty adapting to change, and conflict with self and others. These patterns lead to significant distress and impaired functioning at home, work or school, and in relationships.
In general, personality disorder symptoms include frequent mood swings, social isolation, mistrust of others and outbursts of anger. Symptoms typically emerge in adolescence and continue throughout adulthood, although many people with personality disorders only begin to understand their symptoms after consulting with a therapist. Like other mental health disorders, personality disorders are likely caused by a combination of genetics and adverse childhood experiences, notably neglectful and abusive treatment from parents or other caregivers.
Many people with one personality disorder also have symptoms of at least one additional personality disorder. According to the National Institute of Mental Health, 9.1% of adults in the United States fit the criteria for a personality disorder, but only 39% receive treatment. Personality disorders are usually grouped into three categories. Here are the various personality disorder symptoms that go along with each condition:
Cluster A – Odd or eccentric behavior
- Paranoid Personality Disorder: As the name implies, people with paranoid personality disorder are distrustful and suspicious of others. Believing others to be disloyal or unfaithful, they tend to be angry, secretive and/or guarded around them. Other paranoid personality disorder symptoms include having a tendency to hold grudges, perceiving innocent remarks or nonthreatening situations as personal insults and being difficult to get along with due to aggressiveness and hostility. People exhibiting paranoid personality disorder symptoms tend to isolate themselves because of their suspicions. Paranoid personality disorder has a prevalence rate of 2% to 4% in the general population.
- Schizoid Personality Disorder: Distant and withdrawn, people with schizoid personality disorder are consumed by their thoughts and feelings and have difficulty expressing themselves and reading other people’s social cues. They are the classic “loner,” the type that doesn’t answer the door or lives alone in a cabin in the woods. Other symptoms include appearing humorless, feeling little desire for sexual relationships and having few if any close friends. Schizoid personality disorder occurs in less than 1% of the general population.
- Schizotypal Personality Disorder: Individuals with schizotypal personality disorder have odd ways of thinking. They may act or dress unusually and struggle with paranoia or beliefs that they can read minds or see into the future. They are not loners, but tend to respond indifferently or inappropriately when interacting with others. For example, they are the individuals you might run into who are warning everyone around them that aliens are coming. Schizotypal personality disorder affects about 4% of the general population.
Cluster B — Dramatic, erratic or emotional behavior
- Borderline Personality Disorder: Instability in mood, relationships, self-image and other areas is characteristic of people with borderline personality disorder. More often diagnosed in women than men, the disorder is also marked by impulsivity, attention-seeking, bouts of anger and volatility in relationships. People with BPD experience intense moods that can last for days or for just a few hours. They may also have difficulty feeling empathy for others and take part in such risky behaviors as reckless driving, substance abuse and unsafe sex. Approximately 1.6% of American adults have borderline personality disorder.
- Narcissistic Personality Disorder: Power and success are irresistible to people with narcissistic personality disorder. They exaggerate their abilities and achievements in order to garner praise and attention, often at the cost of other people’s feelings. Narcissists have a sense of entitlement and take advantage of others to get what they want. They put themselves on a pedestal, valuing themselves more than they value others. This disorder is thought to occur in about 6% of the general population.
- Antisocial Personality Disorder: People with antisocial personality disorder don’t live by normal rules of behavior. They tend to be callous and irresponsible and feel little to no remorse for hurting others, which may result in violence and/or legal problems. Approximately 1% of adults have antisocial personality disorder.
- Histrionic Personality Disorder: Individuals diagnosed with histrionic personality disorder have a need to be highly provocative and seductive. They also absolutely must be the center of attention. While this disorder is sometimes confused with narcissism, narcissists don’t always need to be the center of attention (as long as they feel their place as the cream of the crop is secure). Because histrionics suffer from low self-esteem, they seek constant approval from others. Conversely, narcissists staunchly believe they are superior to others. Histrionics are prone to shallow and rapidly shifting emotions, and have an excessive flair for the dramatic, although the underlying reasons for the behavior are vague. It is thought to affect about 2% of the U.S. population.
Cluster C — Anxious, fearful behavior
- Obsessive-Compulsive Personality Disorder: Not to be confused with obsessive-compulsive disorder (OCD), an anxiety disorder, obsessive-compulsive personality disorder (OCPD) is associated with extreme perfectionism and a need to be in control. It is the most common personality disorder. The obsessive personality is rigid and drawn to minute details. Although orderly and reliable, people with an obsessive personality are never satisfied and have difficulty adapting to change. While OCPD has some of the same symptoms as OCD, a distinct difference is that people with OCD have unwanted thoughts that they know are unreasonable, while people with OCPD are comfortable with their thoughts, believing that their way is the right and best way. OCPD occurs in 2% to 8% of the general population.
- Dependent Personality Disorder: People with dependent personality disorder are excessively dependent and submissive, relying heavily on others for reassurance and guidance on making decisions. With a strong fear of being alone or rejected, these individuals have difficulty taking criticism or coping when a relationship ends, and may stay in an unhealthy or abusive relationship. They also will avoid disagreeing with others for fear of rejection. Dependent personality disorder affects about 0.6% of adults, mostly young women in the lowest income bracket.
- Avoidant Personality Disorder: Difficulty relating to others is a key element of avoidant personality disorder, which is about far more than being socially awkward or shy. People with this disorder face such crippling stress in their day-day-day lives that their ability to socialize and maintain relationships is greatly compromised. They feel inferior to others and are so hypersensitive to criticism that they often isolate themselves to avoid it. An estimated 2% of adults have an avoidant personality disorder.
Find the Best Personality Disorder Treatment Center
Whether you are struggling with obsessive-compulsive, borderline, narcissistic or any other personality disorder, a variety of psychotherapies will be woven together to meet your individual needs. These are also effective when people with a personality disorder have a co-occurring drug or alcohol addiction. For example, nearly 80% of adults with BPD also develop a substance use disorder or addiction at some time in their lives. Here are the most common modes of treatment:
- Cognitive behavioral therapy (CBT), which focuses on changing the unhealthy patterns of thinking and behavior that may underlie an individual’s self-destructive behavior. With CBT, negative or false beliefs are tested and restructured.
- Dialectical behavior therapy (DBT), a mindfulness-based form of CBT that teaches individuals skills to handle difficult situations, improve their relationships and better ride out and regulate their feelings. In one-on-one and group training sessions, people learn to focus their attention on the present moment, to observe, non-judgmentally, what is going on internally and externally, and decide what to pay attention to and what to ignore. DBT seeks a balance between accepting behaviors and changing them.
- Schema therapy, which challenges the dysfunctional “schemas” or beliefs and feelings learned in childhood. Schema therapists essentially re-parent the individual to help them change entrenched, self-defeating life patterns, or schemas.
- Medications including mood stabilizers, antidepressants and antipsychotics, which have been shown to help with personality disorder symptoms. However, no medication is currently approved specifically for the treatment of personality disorders.
While personality disorders can vary in their symptoms, one thing they all have in common is that they will generally not relent without professional treatment. If you think you might have a personality disorder with or without an accompanying substance abuse problem, we can help you find a treatment plan that works for you. Your ability to manage the disorder will be much greater with professional help.
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