Everyone has a unique personality consisting of traits that affect how we relate to the world, understand life events and view ourselves. Ideally, these personality traits are stable and allow us to adapt to situations, cultivate healthy relationships and cope with whatever emotions come our way.

Sometimes, though, your personality might include disruptive patterns of thinking or behavior that prevent you from relating to others or cause you significant distress. When this happens, you might have a personality disorder.

At The Ohio State University Wexner Medical Center in Columbus, Ohio, our mental and behavioral health experts specialize in treating all types of personality disorders and offer evidence-based care to help you and your family manage your condition.

What is a personality disorder?

Personality disorders are characterized by inflexible and unhealthy thought patterns and behaviors that deviate markedly from the expectations of someone’s culture. There are 10 recognized types of personality disorders that have a range of symptoms, including distorted perceptions of reality, eccentric behavior and paranoia.

People with a personality disorder may not seek treatment because they may not recognize their troubling behavior and the negative effects it has. When the personality disorder results in problems relating to others and performing daily life tasks, people may blame others for their challenges.

Personality disorders are diagnosed by mental health professionals and require treatment for someone to get better, so it’s important to talk to your doctor and complete a psychiatric evaluation if you’re struggling.

Roughly 9% of American adults have a personality disorder. Those under 18 are rarely diagnosed with one, because their personalities are still developing.

What causes personality disorders?

Research has shown that for some personality disorders biology and an individual’s environment are the main contributors. Early childhood experiences, especially trauma and verbal abuse, and cultural factors can also play a role.

Types of personality disorders

There are 10 types of personality disorders. While some symptoms may be similar, each type has different symptoms. Generally, personality disorders are organized into cluster A, cluster B and cluster C based on the symptoms.

Cluster A personality disorders

Cluster A personality disorders focus on odd or unusual thinking and behaviors. These conditions include:

• Paranoid personality disorder – The main symptom of this condition is paranoia, which is a debilitating mistrust of other people for no apparent reason. People with this personality disorder often think people are being mean or spiteful, and struggle to build relationships.
• Schizoid personality disorder – When someone is detached from or doesn’t seek social relationships, they might have this personality disorder. Showing little emotion is also common.
• Schizotypal personality disorder – In this condition, someone is very uncomfortable with close relationships, might have odd beliefs or distorted thinking and may have social anxiety.

Cluster B personality disorders

Cluster B personality disorders are characterized by dramatic or intense behaviors, including impulsivity, unstable emotions or erratic thoughts. These conditions include:

• Antisocial personality disorder – This condition involves troubling symptoms of disrespecting people, not conforming to social norms or impulsivity. People with this disorder might break the law or harm people, physically or emotionally, without taking responsibility for their actions.
• Borderline personality disorder – People with this disorder have difficulty regulating their emotions, which can lead to mood swings, low self-esteem, trouble with relationships, impulsive behaviors, self-harm or suicide attempts.
• Histrionic personality disorder – Attention seeking and need for approval from others are hallmarks of this disorder. This usually stems from a distorted self-image and leads to excessive emotion or dramatic, often inappropriate, behavior to get that attention.
• Narcissistic personality disorder – Low self-confidence can lead to a pattern of need for admiration and a lack empathy for others. Someone with narcissistic personality disorder might act like they’re better than others and with a sense of entitlement.

Cluster C personality disorders

Cluster C personality disorders revolve around fear and severe anxiety. These conditions include:

• Avoidant personality disorder – People with this condition often feel inadequate and have a fear of being criticized or judged by others. Because of this, they tend not to get involved with others and see themselves as socially inept.
• Dependent personality disorder – This condition is marked by clingy or submissive behavior, which leads to needing to be taken care of by someone or constantly seeking reassurance from others.
• Obsessive-compulsive personality disorder – Symptoms of this condition include perfectionism and extreme need for orderliness that interferes with relationships or completing tasks. It’s different from obsessive-compulsive disorder (OCD), which is an anxiety disorder, because people with OCD are aware of their behaviors and feel they are negative whereas people with this personality disorder are often not aware of the behaviors and feel they are correct.

Treatment for personality disorders at Ohio State

Personality disorders can often be difficult to treat, because their symptoms can mimic those of other mental health conditions. These complicated conditions can also occur alongside other mental health disorders, and it takes specialized training to be able to effectively treat these conditions.

The main way personality disorders are treated is psychotherapy (talk therapy). We have several different types of psychotherapy from which you might benefit. Sometimes medications can help with symptoms of depression or anxiety, which are common in people with a personality disorder.

Psychotherapies for personality disorders

Psychotherapy for personality disorders can help you learn coping skills for stress, recognize negative behaviors and modify personality traits causing difficulty. Types of psychotherapy that might be used include:

• Dialectical behavior therapy (DBT)
• Cognitive behavioral therapy (CBT)
• Group therapy
• Psychoeducation for the individual and family

Medications for personality disorders

Currently, there are no medications approved by the U.S. Food and Drug Administration for personality disorders, but several psychiatric medicines might help your symptoms. They include:

• Antidepressants
• Mood stabilizers
• Anti-anxiety medications
• Antipsychotic medications

Inpatient treatment for personality disorders

Sometimes symptoms of a personality disorder can be so severe or even dangerous that you might require hospitalization to stabilize your condition. Ohio State Harding Hospital has a state-of-the-art inpatient program where we can keep you safe while we create a treatment plan that gets you back to independent living and enjoying life.

What happens when a personality disorder is left untreated?

If a personality disorder is left untreated, it can cause a variety of physical and emotional consequences. Those include:

• Loss of job
• Lack of meaningful relationships and support system
• Poor quality of life
• Development of a substance use disorder
• Development of co-occurring mental health condition, such as a mood disorder or anxiety
• An increased risk of harming yourself or someone else
• Suicide