Guide to Personality Disorders

What Is a Personality Disorder?

These mental health conditions affect your everyday life and relationships. They’re about how you think, feel, and act. You might have a tough time with change, or you may be impulsive or suspicious. You might even do or say things other people find odd or upsetting, making it harder to connect. These long-term patterns can harm your personal and work life as well as your mental health. And you don’t always know if you have one.

Paranoid Personality Disorder

With this condition, you feel that people are always trying to take advantage of you, even when there’s no logical reason for it. You may get angry when someone questions you, or not want to tell people about yourself because you think they’ll somehow use it against you. All this can make it hard to trust others and build healthy relationships.

Schizoid Personality Disorder

This condition can make it hard to express your emotions. You might show little or no reaction if someone yells at you or sings your praises -- this can make you come across as “cold.” You may find it hard to feel pleasure and have little interest in sexual relationships. Others may think you lack goals or ambition.

Schizotypal Disorder

You may have strange beliefs -- that you can read people’s minds, for example -- and your clothes may be odd or messy. You might not react to things that make most people emotional and often doubt or suspect others’ intentions. People may not know how to respond to your rambling and unclear conversation. You might be really anxious around people outside your immediate family and prefer to be alone.

Antisocial Personality Disorder

You may try to make others angry, trick them, or treat them badly to get what you want. You may not care what’s right or wrong. You may lie and do things that are reckless, violent, and even illegal. You usually don’t feel bad when you hurt others, and drug and alcohol abuse may be problems, too. People with this condition often have a hard time keeping a job or taking care of their families.

Borderline Personality Disorder

You may have strong feelings of anger, sadness, or anxiety that suddenly change. You may frantically try to connect with someone if you think they want to separate from you. You swing between extremes: A friend may be “perfect” one day and awful the next. This makes for intense, rocky relationships. You can act impulsively -- drug abuse, reckless driving, or risky sex, for example -- if you don’t have a strong sense of who you are.

Histrionic Personality Disorder

Your desire to be noticed is stronger than every other feeling. You probably have good social skills, but you use them to make yourself the center of attention. You don’t seem interested in other people. You may be too concerned about how you look, and dress sexy to attract people even when it’s not appropriate. You may act like you’re on stage, with over-the-top emotions and speech that changes very quickly.   

Narcissistic Personality Disorder

You want to make yourself look good, even if you must hurt or ignore others to do it. You may brag a lot or pretend to be someone you’re not, or stop people who want to have their say, especially if you think you’re more important. You may get angry when you don’t get treated the way you want. Inside, you’re insecure, oversensitive, and may lash out if criticized. You get moody and depressed if someone makes you feel less than perfect.  

Avoidant Personality Disorder

No one wants to look foolish, but with this condition, you’d rather be alone than take even the smallest risk that someone will reject you or make you look bad in front of others. You may make problems bigger than they need to be, find it hard to try new things, and see yourself as unattractive. This can make you afraid to connect with others and very uncomfortable in large groups.

Obsessive-Compulsive Personality Disorder

A desire to control people, tasks, or situations is at the core of this disorder. Your attention to rules, details, and order can be extreme. You may find it hard to relax or like you have to do everything yourself. You may judge other people harshly.

This isn’t the same as obsessive-compulsive disorder, where a pattern of unreasonable thoughts can lead you to do something over and over, like wash your hands too much to avoid germs.

Dependent Personality Disorder

You may be too clingy because you hate to be apart from those you're closest to. The thought they could leave forever causes serious fear. You don't have a lot of confidence and aren't eager to try new things. Even everyday decisions can be hard as you feel you need approval from others first. When a romantic relationship ends, you often start a new one right away. And you may put up with abuse from someone just to keep them around.

Do I Have One?

You probably won’t know it on your own. People with personality disorders often don’t believe it. You may find out only after you get help for something else, like anxiety or depression, or if someone suggests you start therapy and you go. Because people with these conditions often manage well enough to get by -- though they may have a hard time with relationships -- many never get the help they need.

Diagnosis

Doctors ask questions to learn if parts of your personality are so strict that they harm your relationships at home and at work. They also check how well you control your impulses and see if your view of yourself matches reality. You might have some symptoms without having one of these conditions. Only a professional can tell if you have a personality disorder.

Treatment

These conditions can be intense, constant, affect lots of parts of your life, and be hard to manage. But you can get help. The most common method is talk therapy. You talk with a mental health professional who helps you see -- and change -- patterns of thinking and behavior that cause you problems. Over time, this can help you deal with stress and with other people in a healthier way.

What About Medications?

None are specifically approved to treat personality disorders. But some drugs may help with serious symptoms. In that case, your doctor might prescribe one of these in addition to therapy:

-- Antidepressants

-- Mood stabilizers

-- Antipsychotic medicines 

-- Anti-anxiety meds, except for people with certain personality disorders