A personality disorder is a mental health condition that cause long-term patterns of behavior and thoughts that differ from societal expectations. These patterns can be problematic and disruptive to an individual’s life, leading to difficulties in personal relationships, work, and overall functioning.
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), there are ten distinct personality disorder diagnoses, each with their own specific criteria for diagnosis. These disorders are organized into three clusters based on the similarity of their symptoms and patterns of behavior.
Cluster A: Odd, Eccentric Behavior
The three personality disorders in Cluster A are characterized by odd, eccentric behavior, and unusual beliefs. They include:
Paranoid Personality Disorder
Individuals with paranoid personality disorder tend to have a pervasive distrust and suspicion of others, even when there is no basis for their beliefs. They often suspect that others are trying to harm, deceive, or exploit them in some way, and may avoid relationships or activities that may trigger their paranoia.
People with this condition often hold grudges and are excessively sensitive to criticism, which can impact their interpersonal relationships and overall quality of life.
Having paranoid thoughts or beliefs alone does not necessarily indicate paranoid personality disorder. A diagnosis is typically made when these beliefs and behaviors are persistent, cause significant distress or impairment, and cannot be explained by other mental health conditions or substance abuse.
Schizoid Personality Disorder
A person who has schizoid personality disorder tends to have difficulty showing emotions, expressing themselves or bonding with others, and may prefer to spend time alone with their thoughts and interests rather than socializing.
They may also seem detached or indifferent to social cues, such as facial expressions or tone of voice, which can make it challenging for them to form interpersonal relationships. They may appear aloof or emotionally cold to others and may find it difficult to express emotions, such as joy or enthusiasm, in a typical way.
Individuals with Schizoid Personality Disorder may have difficulty functioning in social roles, such as at work or school, and may struggle to maintain friendships or romantic relationships. They may seem indifferent to praise or criticism and may have difficulty understanding the emotions or needs of others.
Schizotypal Personality Disorder
People with schizotypal personality disorder tend to have odd behaviors or beliefs, including magical thinking or beliefs in paranormal phenomena. They may also experience brief episodes of psychotic symptoms, such as hearing voices or seeing things that are not there, and often struggle with abstract thinking.
In addition, they usually struggle to form and maintain interpersonal relationships, as they may seem socially awkward, emotionally detached or indifferent to others, and may appear to have flattened emotions or difficulty with verbal communication. They may also be suspicious of others thinking that they may be trying influence or control their thoughts.
Cluster B: Dramatic, Erratic Behavior
The four personality disorders in Cluster B are characterized by dramatic, erratic behavior and extreme emotions. They include:
Antisocial Personality Disorder
Individuals with antisocial personality disorder tend to disregard the rights of others and may engage in actions that are illegal or violate societal norms. They may also display characteristics such as a recurrent and consistent pattern of deceitfulness, impulsivity, irritability, and aggressiveness.
They usually also lack empathy or remorse for their actions, based on an inability to understand or acknowledge the harm they have caused others. In fact they blame others or rationalize their behavior, shifting responsibility onto others rather than taking responsibility for their actions.
Borderline Personality Disorder
Borderline Personality Disorder (BPD) manifests as a pattern of instability in interpersonal relationships, self-image, and mood, which can lead to impulsive behavior and intense emotions.
Individuals with BPD may struggle with intense fear of rejection or abandonment, which can lead to behaviors such as frantically trying to avoid such rejection, and extreme mood swings that can result in impulsive or reckless behavior, including self-harm. They may also struggle with a sense of identity and direction in life, which can lead to a feeling of emptiness.
People with BPD tend to experience intense relationships that may quickly become idealized or devalued, causing difficulty maintaining healthy relationships. They may also struggle with chronic feelings of loneliness, mistrust, and difficulty determining the motives of others.
While the experience of BPD can vary widely between individuals, the following symptoms are frequently observed:
- Fear of abandonment
- Impulsive or self-destructive behavior
- Unstable and intense relationships
- Unstable sense of self
- Emotional instability
- A tendency to see things in extremes
Histrionic Personality Disorder
Histrionic personality disorder is characterized by excessive attention-seeking behaviors and a need for approval from others. Individuals with this disorder may engage in dramatic or exaggerated expressions of emotion.
People with HPD may seem overly emotional or expressive and may seek out situations where they can be the center of attention. They may also display flirtatious or seductive behavior, have a tendency to be overly influenced by others, and may turn everyday events into situations in which they are the star.
Individuals with HPD also struggle with maintaining interpersonal relationships, as their behavior can be intense, erratic and can alienate other people. They may have difficulty with self-esteem and may rely on the approval and admiration of others to feel good about themselves.
Narcissistic Personality Disorder
People with narcissistic personality disorder tend to have an inflated sense of self-importance, a need for admiration, and a lack of empathy for others, which can lead to difficulties in personal and professional relationships.
People with NPD may display grandiose or entitled behavior, and may be preoccupied with fantasies of unlimited success or power. They may also have a sense of entitlement, expect to be recognized as superior without appropriate accomplishments, lack empathy, and be intolerant of criticism or perceived slights. They may tend to want to dominate conversations and be dismissive of others’ opinions or feelings.
Individuals with NPD usually struggle with interpersonal relationships and may have difficulty maintaining long-term relationships or friendships. Social relationships may be one-sided, centered around the individual’s needs, and may be used by the narcissist to obtain desired outcomes, as opposed to being a genuine friendship.
Cluster C: Anxious, Fearful Behavior
The three personality disorders in Cluster C are characterized by anxious, fearful behavior and a need for security. They include:
Avoidant Personality Disorder
People with avoidant personality disorder are usually very anxious in social situations, avoid social activities, and struggle to make and maintain relationships. They may also have difficulty expressing themselves assertively, handling criticism, and standing up for themselves. Fear of embarrassment or ridicule can lead them to self-isolate or express negative views about themselves.
These individuals often become over-dependent on family members or close friends, as they may find it difficult to connect with new people and may lack the self-confidence needed to try new things. They are often lonely, and may be overwhelmed by the pressure they put on themselves to perform tasks perfectly.
Dependent Personality Disorder
Individuals with dependent personality disorder tend to be passive, submissive, and overly reliant on others for direction and reassurance. They often struggle to make decisions or express their own opinions, as they may feel uncertain about their judgment.
In addition, they may be excessively concerned with pleasing others and would rather agree than take a risk of contradicting someone else. They may also struggle to say “no” to requests for help and display an excessive need for reassurance from others.
Individuals with DPD may form relationships quickly if they perceive them as beneficial, as they can often rely on the other person to make decisions for them or provide guidance. However, this dependency can make them vulnerable to manipulation or abuse by partners.
Obsessive-Compulsive Personality Disorder
Individuals with obsessive-compulsive personality disorder struggle with rigid thinking patterns and an excessive need for control. They may also have difficulty with flexibility and may become excessively focused on details. They tend to be perfectionists who are overly preoccupied with order, organization and control in their environment.
Individuals with OCPD may also find it difficult to delegate tasks or accept help from others, as they view those tasks as having to be done “just right”. This can lead them to become isolated due to the excessive demands they have on themselves and those around them.
Causes and Treatment
The causes of personality disorders are not fully understood, but genetic and environmental factors are believed to play a role. Early childhood experiences, such as abuse or neglect, may also contribute to personality disorder development.
Treatment for personality disorders often involves psychotherapy, including dialectical behavior therapy, cognitive-behavioral therapy, and psychoanalytic therapy. Medications may also be used to manage symptoms, such as mood stabilizers or antipsychotics.
Personality disorders can be challenging to diagnose and treat, but understanding the ten distinct diagnoses and their respective characteristics can aid in identifying behaviors that may indicate a particular disorder. Early intervention and treatment can be beneficial in managing the symptoms of personality disorders and improving overall quality of life for those affected.