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1. What is a personality disorder?
2. What are the causes of a personality disorder?
3. What treatment and support is available for a personality disorder?
4. Self-help tips for personality disorders

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A personality disorder is a mental health condition that affects how a person thinks, feels and behaves. Personality disorders can cause significant difficulties in performing day to day activities and can make relationships with others challenging.

Individuals with a personality disorder tend to experience stigma and are sometimes subject to stereotypes such as being “manipulative” or “attention-seeking”.

Labels such as these are unhelpful and don’t explain that for someone with a personality disorder they may not have the language or confidence to express how they feel and so might behave in a way that seems unusual or, in some cases, is harmful.

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Types of Personality Disorder

There are currently 10 recognised personality disorders and these are usually grouped into 3 categories or “clusters”.

Cluster A: ‘Odd or Eccentric’

1. Paranoid

• Suspicious of others and their motives
• Believe others are trying to harm them
• Tend to hold grudges

2. Schizoid

• Prefer to be alone than with others
• Little interest in forming close relationships with others
• Get little-to-no pleasure from activities

3. Schizotypal

• Behave in an eccentric way
• Believe they have special powers or that there is a hidden meaning where there is none
• Feel uncomfortable in social situations

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Cluster B: ‘Dramatic, Emotional, or Erratic’

4. Antisocial or Dissocial

• Impulsive, reckless behaviour
• Lack of care for others and their feelings
• Become easily frustrated
• No empathy

5. Borderline or Emotionally Unstable

• Experience emotions on a very intense level
• Feel ‘empty’ inside
• Behave impulsively including behaviours that are harmful such as self-harm and/or suicide

6. Histrionic

• Seek out approval and compliments from others regularly
• Speak and/or behave in a dramatic way
• Easily influenced by others

7. Narcissistic

• Believe they are ‘special’ or more important than others
• Behave in a selfish way
• Have low self-esteem and so seek reassurance from others

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Cluster C: ‘Anxious and Fearful’

8. Obsessive/Compulsive

• Stick to set patterns and routines
• Over-cautious due to fear of making a mistake
• Perfectionists

9. Avoidant

• Feel insecure
• Fear being judged or criticised
• Avoid activities that require social contact

10. Dependent

• Rely on others to make decisions
• Extreme fear of rejection or abandonment
• View others as more capable or ‘stronger’

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Causes of personality disorder

Like all mental health conditions, there is no single cause of the condition. There are two key areas that are believed to influence whether or not someone will develop a personality disorder including:

Genetics

Some personality traits are passed down through families in our DNA in the same way as the colour of our hair or eyes. In the same context as hair or eye colour, just because a parent has a personality disorder does not necessarily mean this will automatically be passed on to the child.

Childhood & Early Upbringing

Childhood is the foundation of who we become as adults and so our early experiences and upbringing is vital in moulding our personality. In cases where there is abuse, trauma, neglect, bereavement or lack of support for the child growing up, this can cause a disordered building of the child’s personality and affects how they think, feel and act.

As a result, in adulthood we tend to repeat the same disordered patterns that we have learned as a child and so this can lead to the development of a personality disorder. These often traumatic and disturbing experiences in early life are now referred to as “Adverse Childhood Experiences”.

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Treatment and support for personality disorders

Treatment is dependent on how you are at the time of seeking help. A plan will be made by discussing this with a GP or psychiatrist.

Treatments may include:

• Talking therapy such as Dialectal Behavioural Therapy (DBT), Cognitive Behavioural Therapy (CBT), Cognitive Analytical Therapy (CAT)
• Referral to a community mental health team
• Referral to Community & Voluntary services or support groups

There are no medications currently available that are recommended specifically to treat personality disorders; however, sometimes medication is prescribed for other reasons – an individual with a personality disorder may also have depression or severe anxiety for which an antidepressant or other types of medication might be recommended.

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Self-Help Tips

As well as the supports and treatments mentioned previously, there are things you can do to take care of yourself and improve your wellbeing.

These include:

• Keeping a journal
• Developing a self-care box
• Attending local support groups
• Making time for yourself
• Taking up a hobby
• Developing a routine
• Reducing drug and alcohol use
• Trying mindfulness, relaxation or yoga
• Eating a balanced diet
• Exercising regularly

Finding a service for you

You can locate details of the Extern's mental health services which may be near you here.