October 19, 2021

The 10 Personality Disorders | Signs, Symptoms, & Treatment

 There are 10 personality disorders in the Diagnostic and Statistical Manual of Mental Disorders. Personality disorders are persistent, rigid behavioral patterns that affect daily functioning. While the symptoms can be mild or severe, many people with personality disorders struggle to identify their problems. They typically believe their thoughts and behavior are normal, posing a significant barrier to seeking treatment. 

Cluster A Disorders

Cluster A disorders consist of eccentric, odd behaviors that seem inappropriate or strange to others. Cluster A includes paranoid, schizoid, and schizotypal personality disorders. 

Paranoid Personality Disorder

Paranoid personality disorder entails an ongoing mistrust of others that interferes with relationships and everyday functioning. Someone with this personality disorder presents as overly suspicious and guarded. As a result, they struggle to open up and confide in others. In addition, they often hold deep grudges if they were wronged (or if they perceive they were wronged). Finally, they usually look at the most subtle clues to affirm that something is wrong.

Common symptoms include:

  • Paranoia about people or things in seemingly benign situations.
  • Isolating from others (due to mistrust).
  • Constant fears about something terrible happening.
  • Falling prey to conspiracy beliefs about their safety and welfare.
  • Intense feelings of anger or hostility towards others.
  • Doubting anyone’s loyalty. 
  • Being hypersensitive to criticism. 

Treatment options can be challenging because someone with paranoid personality disorder may have difficulty trusting a mental health professional. However, even if it’s slight, establishing that trust can make a tremendous difference in their prognosis. 

Talk therapy can help people understand their triggers and practice different ways of coping with their paranoia. In some cases, psychiatric medication, such as antidepressants, benzodiazepines, or mood stabilizers may reduce symptom severity. 

Schizoid Personality Disorder 

Schizoid personality disorder consists of persistent patterns of social detachment and a limited range of emotional expression. People with schizoid personality disorder isolate themselves from others, and they gain little to no pleasure from interpersonal relationships(https://medlineplus.gov/ency/article/000920.htm).

Common symptoms include:

  • Presenting as a “loner” in social activities or in the workplace. 
  • Appearing as detached, cold, or guarded against others.
  • Social awkwardness due to seemingly missing social cues.
  • Presenting as having little pleasure in life.

Many people with this condition do not readily seek out treatment. They often don’t believe they have a problem. Talk therapy may be difficult, as these individuals struggle with forming trusting relationships with others. They may benefit from structured treatments that focus on concrete goals like work, self-esteem, or decision-making skills. 

Schizotypal Personality Disorder 

Schizotypal personality disorder consists of ongoing patterns of interpersonal difficulties. These individuals present as uncomfortable in social settings, which impacts their ability to form close relationships. They often appear distant from others or isolated altogether. But unlike those with schizoid personality disorder, these individuals display other eccentric behaviors, such as delusions or strange superstitious beliefs.

Common symptoms include:

  • Having limited contact with others or having no close relationships. 
  • Limited and guarded emotional expression. 
  • Having delusions.
  • Believing they have magical powers or other special skills.
  • Ongoing paranoia or suspicion about others.
  • Dressing in strange ways or avoiding hygiene altogether.
  • Speaking and engaging with others in odd patterns.

People with schizotypal personality disorder may have hallucinations or delusions, but they are not as intense as those in people with schizophrenia. Furthermore, those with schizotypal personality disorder may be more aware of the differences between their fantasies and actual reality. Treatment, therefore, may include a combination of medication, such as mood stabilizers, and talk therapy. 

Cluster B Disorders 

Cluster B disorders consist of overly emotional, unpredictable, and erratic behavior. Cluster B includes antisocial, borderline, histrionic, and narcissistic personality disorders. 

Antisocial Personality Disorder 

Antisocial personality disorder refers to a lack of empathy and regard for the well-being of others. As a result, people with this personality disorder often manipulate, punish, or otherwise mistreat people without remorse. Symptoms emerge in childhood or adolescence, and adults with antisocial personality disorder usually meet the criteria for conduct disorder during their youth. 

Common symptoms include:

  • Lacking moral guidelines for social constructs about right or wrong.
  • Consistently manipulating others to meet individual needs.
  • Ongoing problems with the law due to criminal behavior.
  • Hostility and agitation.
  • Abusing others in relationships.
  • Having no consideration for the adverse consequences of malicious behavior.
  • Aggression towards people or animals.

Like with most personality disorders, people with this condition may not seek help on their own. However, they may be mandated to treatment after legal issues. Beneficial treatment may include structured anger management programs and talk therapy. 

Borderline Personality Disorder 

Borderline personality disorder consists of ongoing intense moods, poor self-image, and impulsive behavior. People with this condition struggle with severe mood swings and persistent identity issues. They often view the world in extremes, meaning people are either “good” or “bad,” and they are either “perfect” or a “failure.”

Common symptoms of BPD include:

  • Making serious efforts to avoid real or perceived abandonment.
  • Persistent feelings of emptiness.
  • Patterns of unstable, intense relationships.
  • Oscillating between idealizing others and devaluing them completely.
  • Reckless behaviors (substance use, compulsive eating, unsafe sex).
  • Suicide and self-harm behaviors.
  • Intense and seemingly uncontrollable behavior.

People with borderline personality disorder may benefit from dialectical behavior therapy (DBT). DBT is an evidence-based treatment model that focuses on themes of mindfulness, emotional regulation, and distress tolerance. This treatment tends to be highly structured and long-term. With that said, an individual’s commitment to treatment can reduce symptom severity.

Histrionic Personality Disorder

Histrionic personality disorder is characterized by an intense need to be noticed and approved by others. To meet this need, individuals with this condition act and carry themselves in dramatic ways that often appear inappropriate.

Common symptoms include:

  • Wanting to be in the center of attention at all times. 
  • Changing emotions rapidly.
  • Dressing overly seductively in various settings.
  • Flirting inappropriately with others.
  • Acting as if life is “on stage” and a big performance.
  • Having intense preoccupations with physical appearance.
  • Asking for continuous approval from others.
  • Reacting negatively to any criticism.
  • Becoming bored quickly and needing to “change things up” often.
  • Presenting as self-centered and arrogant. 

Histrionic personality disorder and borderline personality disorder can look similar. But those with histrionic personality disorder do not necessarily have the same feelings of emptiness. They also do not typically struggle with intense suicidal thoughts or self-harm behaviors. 

Many people with histrionic personality disorder also have co-occurring disorders like depression or anxiety. They may initially enter therapy for support with those issues. Cognitive-behavioral therapy (CBT) can teach individuals more about the relationship between their distorted thoughts. Becoming more aware of these patterns can shift how people behave, therefore reducing unwanted symptoms.

Narcissistic Personality Disorder 

Narcissistic personality disorder is characterized by an inflated self-image, arrogance, and lack of empathy for others. People with this condition typically believe they are entitled to what they want when they want it. Subsequently, they often manipulate, gaslight, or demean others to meet their needs. At the same time, they seek ongoing admiration and will often go to extreme lengths to achieve that goal.

Common symptoms include:

  • Only following certain rules or laws that meet their best interest.
  • Exaggerating talents or accomplishments.
  • Needing to be the main focus of conversation.
  • Excessive jealousy at other people’s successes.
  • A general sense of superiority over most people.
  • Having little regard for how other people feel or think.
  • Coming across as self-centered, boastful, or grandiose.
  • Becoming irrationally angry if things don’t go as planned.
  • Demanding perfectionism from themselves and others at all times.

Narcissistic personality disorder symptoms can overlap with antisocial personality disorder symptoms. However, those with narcissistic personality disorder do not necessarily react with violence or aggression. For these reasons, they are less likely to have legal issues/

Long-term therapy may be beneficial for people with narcissistic personality disorder. However, many people with this condition do not readily enter treatment. That’s because they don’t believe they have a problem. However, working with a trained professional who understands personality disorders can help people learn how to work on their fragile sense of selves while building more empathy for others.

Cluster C Disorders 

Cluster C personality disorders consist of fearful, anxious styles of thinking. Cluster C includes avoidant, dependent, and obsessive-compulsive personality disorders.

Avoidant Personality Disorder 

Avoidant personality disorder consists of pervasive feelings of inferiority and inadequacy. People with this condition are hypersensitive to feedback. They do not want to be negatively perceived by others. Even though they want close relationships, this fear often prevents them from forming them successfully. 

Common symptoms include:

  • Extreme sensitivity to any perceptions of disapproval. 
  • Lack of close relationships due to fear of not being accepted.
  • Severe anxiety in social situations.
  • Gravitating towards solitary jobs or recreational activities. 
  • Presenting as shy or socially awkward to others.
  • Fear of taking risks or making appropriate changes.
  • Persistently low self-esteem.

Avoidant personality disorder and social anxiety disorder share many similarities. However, people with social anxiety disorder can recognize that their fears may be irrational or exaggerated. Those with avoidant personality disorder fundamentally believe they are incompetent or inadequate. As a result, they tend to be avoidant in nearly all situations, whereas someone struggling with social anxiety may only avoid one or a few social settings.

People with avoidant personality disorder may respond well to treatment. Many times, these individuals want help and are willing to integrate professional therapeutic interventions. For example, exposure-based CBT can teach people how to become more comfortable in fearful situations. Over time, this can help people feel less distressed in specific settings. 

Dependent Personality Disorder 

Dependent personality disorder consists of pervasive patterns of helplessness and difficulties taking care of oneself. As a result, these people rely excessively on others, often to the point where they cannot make basic decisions. When they are alone, people with dependent personality disorder often feel afraid and helpless, and they may experience panic attacks. 

Common symptoms include:

  • Presenting as excessively clingy or needy with others. 
  • Indecisiveness about everyday choices. 
  • Inability to take personal responsibility.
  • Fears of being alone or being abandoned.
  • Low self-esteem and lack of belief in oneself.
  • Difficulties with criticism. 
  • Persistent fears of rejection that affect daily life. 

Dependent personality disorder symptoms can overlap with borderline personality disorder symptoms. However, with borderline personality disorder, individuals often react with rage or compulsion when feeling alone. On the other hand, those with dependent personality disorder tend to respond with submissive behaviors or seeking out a new relationship as quickly as possible. They want to avoid being alone at all costs. 

People with dependent personality disorder may benefit from short-term therapy. Long-term therapy may increase the risk of dependence on the therapist. Ideally, treatment should focus on building self-esteem, improving assertiveness, and increasing self-efficacy. 

Obsessive-Compulsive Personality Disorder

Obsessive-compulsive personality disorder refers to a pattern of extreme order, rigidity, and demands for perfection. People with this condition strongly believe things need to be specific, and they experience immense distress when reality does not match their needs.

Common symptoms include:

  • Unwillingness to adapt to other expectations or ways of thinking. 
  • Intense need for order or cleanliness.
  • Excessive adherence to work or certain activities.
  • Perfection that interferes with getting things done on time.
  • Extreme frugality without legitimate financial reasons.
  • Hoarding behaviors.
  • An ongoing obsession with small details, rules, or regulations.

This disorder can look similar to OCD, but people with OCD have insight into their obsessions. They recognize they are irrational, even if they still abide by them. However, people with obsessive-compulsive disorder consistently believe their thoughts are appropriate. They believe their way is the right way and do not readily deviate from that mindset.

Treatment can be challenging, as people with this condition do not think they have a problem. They may, however, enter therapy after a related event, such as losing a job or a meaningful relationship. In this case, treatment should focus on highlighting cognitive distortions and practicing healthier coping skills for managing distress. 

Final Thoughts 

Personality disorders are complex conditions that can be challenging to understand. However, we have come a long way in recognizing symptoms and advocating for better care. Professional treatment can make a meaningful difference and help people live more fulfilling lives.

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Disclaimer: This information is not specific medical advice and does not replace information you receive from your healthcare provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or lifestyle choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care provider’s advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you.

You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care provider’s advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you.

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