Personality Disorder Resources

What Is Personality?

Personality is a particular set of behaviors, traits, emotions, and patterns that make up a person, his character, and their individuality. Personality includes how we see the world, our thoughts, attitudes, and feelings. Personality is strongly influenced by our values, attitudes, perception of ourselves, and predicts our reactions to people, the world, stress, and problems.

While there are many different definitions of personality, most focus on the pattern of behaviors and characteristics that can help predict and explain a person’s behavior.

Explanations for personality can focus on a variety of influences, ranging from genetic explanations for personality traits to the role of the environment and experience in shaping an individual’s personality.

Environmental factors that can play a role in the development and expression of personality include such things as parenting and culture. How children are raised can depend on the individual personalities and parenting styles of caregivers as well as the norms and expectations of different cultures.

So what actually makes up a personality? Traits and patterns of thought and emotions play important roles, and some of the other fundamental characteristics of personality include:

• Consistency: There is generally a recognizable order and regularity to behaviors. Essentially, people act in the same ways or similar ways in a variety of situations.
• Psychological and physiological: Personality is a psychological construct, but research suggests that it is also influenced by biological processes and needs.
• It impacts behaviors and actions: Personality does not just influence how we move and respond in our environment; it also causes us to act in certain ways.
• Multiple expressions: Personality is displayed in more than just behavior. It can also be seen in our thoughts, feelings, close relationships, and other social interactions.

Personality is not just who we are, it is also how we are.

What Is A Personality Disorder?

A person’s personality may be influenced by experiences, environment (surroundings, life situations) and inherited – genetic – characteristics. A person’s personality typically stays the same over time.

While personality disorders differ from mental disorders, like schizophrenia and bipolar disorder, they do, by definition, lead to significant impairment. Personality disorders are estimated to affect about 10 percent of people, although this figure ultimately depends on where clinicians draw the line between a “normal” personality and one that leads to significant impairment.

A personality disorder is a way of thinking, feeling, and behaving that is different from the expectations of the culture, causes distress, problems functioning, and lasts over time. Personality disorders are almost always associated with marked social and personal disruption and are both pervasive and inflexible. While these behaviors can produce poor coping skills, leading to personal issues including anger, anxiety, depression, and distress, they are considered appropriate by the person with the disorder.

Some types of personality disorder were in previous versions of the diagnostic manuals but have been removed. Examples include sadistic personality disorder (pervasive pattern of cruel, demeaning, and aggressive behavior) and self-defeating personality disorder or masochistic personality disorder (characterized by behaviors consequently undermining the person’s pleasure and goals). They were listed in the DSM-III-R appendix as “Proposed diagnostic categories needing further study” without specific criteria. The psychologist Theodore Millon and others consider some relegated diagnoses to be equally valid disorders, and may also propose other personality disorders or subtypes, including mixtures of aspects of different categories of the officially accepted diagnoses.

Now, there are 10 specific types of personality disorders. Personality disorders are long-term patterns of behavior and inner experiences that differs significantly from what is expected. The pattern of experience and behavior begins by late adolescence or early adulthood and causes distress or problems in functioning.

Without treatment, personality disorders can be long-lasting. Personality disorders must affect at least two of the following areas:

• Way of thinking about oneself and others
• Way of responding emotionally
• Way of relating to other people
• Way of controlling one’s behavior

What Causes Personality Disorders?

The development of personality disorders in certain people – and not others from a similar background – remains the subject of much debate among researchers and scientists, however, research suggests that genetics, abuse, and other factors may contribute to the development personality disorders.

In the past, many people believed that people who have personality disorders were lazy, the devil, or evil. Thankfully, new research has begun to explore such potential causes as genetics, parenting, and peer influences in the development of personality disorders:

Genetic Factors: Researchers are beginning to identify some possible genetic factors behind personality disorders. New developments into the role of genetics in mental health and personality disorders occur every single day.

• (for example) One research team has identified a malfunctioning gene that may be a factor in obsessive-compulsive disorder.
• Other researchers are exploring genetic links to aggression, anxiety and fear — traits that may play a role in the lives of those who have personality disorders.

Childhood trauma. Findings from one of the largest studies of personality disorders, offer clues about the role of childhood experiences in the development of personality disorders.

• One study found a link between the number and type of childhood traumas and the development of personality disorders. People with borderline personality disorder, for example, had especially high rates of childhood sexual trauma.

Verbal abuse. Even verbal abuse can have an impact. In a study of 793 mothers and children, researchers asked mothers if they had screamed at their children, told them they didn’t love them or threatened to send them away.

• Children who had experienced such verbal abuse were three times as likely as other children to have borderline, narcissistic, obsessive-compulsive or paranoid personality disorders in adulthood.

High reactivity: Sensitivity to light, noise, texture and other stimuli may also play a role in developing personality disorders

• Overly sensitive children, who have what researchers call “high reactivity,” are more likely to develop shy, timid or anxious personalities.
• However, high reactivity’s role is still far from clear-cut. Twenty percent of infants are highly reactive, but less than 10 percent go on to develop social phobias.

Peers. Certain factors can help prevent children from developing personality disorders.

• Even a single strong relationship with a relative, teacher or friend can offset negative influences from peers, say psychologists.

As researchers continue to make new discoveries about the roles of genetic, environmental factors, and abuse in personality disorders, we will be able to understand, identify, and treat people who have personality disorders more effectively.

What Are TheTypes of Personality Disorders?

Before jumping into characterization of these 10 personality disorders, it should be emphasized that they are more the product of historical observation than of scientific study, so that they are rather vague and imprecise constructs. As a result, these personality disorders rarely present in their classic textbook form, but instead tend to blur into one another. Their division into three clusters in DSM-5 is intended to reflect this tendency – any given personality disorder most likely to blur with other personality disorders within its cluster.

The majority of people with a personality disorder never come into contact with mental health services, and those who do usually do so in the context of another mental disorder, or at a time of crisis; commonly after self-harming or breaking the law. Nevertheless, personality disorders are important to health professionals, because they predispose people to other mental health disorders and affect the presentation and management of existing mental disorders. Personality disorders also result in considerable distress and impairment, and so may need to be treated on their own.

These personality disorders have been divided into three clusters, Cluster A, Cluster B, and Cluster C. Each cluster has personality disorders (not all listed here) that fall within them.

Cluster A: Paranoid, Odd, or Eccentric Behavior

Cluster A is comprised of paranoid, schizoid, and schizotypal personality disorders.

Paranoid Personality Disorder:

Those who suffer with paranoid personality disorder interpret the actions of others as deliberately threatening or demeaning. People who have paranoid personality disorder are often unforgiving, distrusting, and prone to aggressive outbursts (without justification) as they see others as disloyal, condescending, unfaithful, or lying. People with paranoid personality disorder may be jealous, secretive, guarding, and scheming, and may seem emotionally cold or extremely serious.

Paranoid personality disorder is characterized by a pervasive distrust of others, including even friends, family, and partners. As a result, a person with paranoid personality disorder seems guarded, suspicious, and constantly on the lookout for clues or suggestions to validate their fears. They will also has a strong sense of personal rights: they are overly sensitive to setbacks and rebuffs, are easily shamed and humiliated, and persistently bears grudges. Unsurprisingly, they tends to withdraw from others and to struggle with building close relationships.

The principal ego defense in paranoid PD is projection, which involves attributing one’s unacceptable thoughts and feelings to other people. A large, long-term twin study found that paranoid PD is modestly heritable, and that it shares a portion of its genetic and environmental risk factors with schizoid PD and schizotypal PD.

Schizoid Personality Disorder:

People who suffer from Schizoid Personality Disorder are solitary introverts that seem cold, distant, and withdrawn. People who have schizoid personality disorder spend much time lost in their own thoughts and feelings and feel fearful of intimacy with others.

The term “schizoid” means that a person a natural tendency to direct attention toward one’s inner life and away from the external world. A person with schizoid PD acts detached and are aloof and prone to introspection and fantasy. They have no desire for social or sexual relationships, they are indifferent to others and to social norms and conventions, and lacks a visible emotional response.

A competing theory about people who have schizoid PD is that they are actually highly sensitive with a rich inner life: they experience a deep longing for intimacy, but find initiating and maintaining close relationships too difficult or distressing, and so they go back into their inner world. People with schizoid PD rarely present for medical treatment, because despite their reluctance to form close relationships, they are mostly well-functioning and untroubled by their apparent oddness.

Schizotypal Personality Disorder:

Those who suffer Schizotypal Personality Disorder exhibit a pattern of peculiarities, with odd mannerisms while speaking or dressing. Schizotypal PD is characterized by oddities of appearance, behavior, and speech, unusual perceptual experiences, and anomalies of thinking similar to those seen in schizophrenia People who have schizotypal personality disorder often have wildly paranoid beliefs and, as such, have difficulties with relationships and feel marked anxiety while in social situations. They may not react at all (or react inappropriately) during a conversation, or instead, they may talk to themselves. People with schizotypal personality disorder may also believe that they can see the future or read minds, have odd beliefs, magical thinking (for instance, thinking that speaking of the devil can make him appear), suspiciousness, and obsessive ruminations.

People with schizotypal PD often fear social interaction and think of others as harmful. This may lead them to develop so-called ideas of reference — that is, beliefs or intuitions that events and happenings are somehow related to them. So whereas people with schizotypal PD and people with schizoid PD both avoid social interaction, with the former it is because they fear others, whereas with the latter it is because they have no desire to interact with others or find interacting with others too difficult.

People with schizotypal PD have a higher than average probability of developing schizophrenia, and the condition used to be called “latent schizophrenia.”

Cluster B: Dramatic, Erratic, or Emotional Behavior

Borderline Personality Disorder:

In borderline PD (or emotionally unstable PD), the person essentially lacks a sense of self and, as a result, experiences feelings of emptiness and fears of abandonment. There is a pattern of intense but unstable relationships, moods, self-image, interpersonal behaviors,  emotional instability, outbursts of anger and violence (especially in response to criticism), and impulsive behavior. Suicidal threats and acts of self-harm are common, for which reason many people with borderline PD frequently come to medical attention. Borderline PD was named as people who suffered from it were believed to be walking the border between neurotic (anxiety) disorders and psychotic disorders, like schizophrenia and bipolar disorder. I

Research seems to show that people who have borderline personality disorder as a result of childhood sexual abuse, which makes it much more common in women, in part because women are more likely to suffer sexual abuse. However, feminists have argued that borderline PD is more common in women, because women presenting with angry and promiscuous behavior tend to be labeled with it, whereas men presenting with similar behavior tend instead to be labeled with antisocial PD.

Abrupt, extreme mood swings, an unstable, fluctuating self-image, and stormy relationships are common for a person with borderline personality disorder. People with borderline personality disorder often view the world in black and white – all good or all bad. Someone with borderline personality disorder may have an intense relationship, only to have it devolve over a simple perceived slight. Extreme fear of abandonment may lead to extreme dependency upon others and self-injurious behaviors may be used as manipulation or as a means to get attention.

Antisocial Personality Disorder:

Until Kurt Schneider broadened the concept of personality disorders to include those who “suffer from their abnormality,” being diagnosed with a “personality disorder” was more or less synonymous with antisocial personality disorder. Those with Antisocial Personality Disorder ignore social rules of behavior and act out their problems as they desire. People with Antisocial Personality Disorder are callous, irresponsible, and impulsive. Generally speaking, someone with antisocial personality disorder may have a history of legal problems, aggressive or violent relationships, and a belligerent attitude. Those with antisocial personality disorder often have no regard for others, no respect for others, and feel no remorse about their actions.

Antisocial PD is found to occur much more often in men than in women and is characterized by a callous unconcern for the feelings of others. The person disregards social rules and obligations, is irritable and aggressive, acts impulsively, lacks guilt, and fails to learn from experience. In many cases, they have had no difficulty finding relationships – and can even appear superficially charming (as a “charming psychopath”) – but these relationships are usually fiery, turbulent, and short-lived.

As antisocial PD is the mental disorder most closely correlated with crime, they are likely to have a criminal record or have a history of being in and out of prison.

Narcissistic Personality Disorder:

For people who have narcissistic PD, the affected individual has an overblown feeling of self-importance, a tremendous sense of entitlement, absorbed by fantasies of grandeur, and an excessive need to be admired, and seek constant attention. This person is jealous of others and expects them be jealous in return. This person also lacks empathy and readily lies and exploits others to achieve their aims. To others, they may seem self-absorbed, controlling, intolerant, selfish, or insensitive. If this person feels obstructed or ridiculed, they can fly into a fit of destructive anger and revenge. This is called “narcissistic rage” and can have disastrous consequences for all involved.

People with Narcissistic Personality Disorder are overly sensitive to failure and often complain of mild somatic (non-specific, medical-type) symptoms, such as headaches or stomach aches.

Histrionic Personality Disorder:

People with histrionic PD lack a sense of self-worth and depend on attracting the attention and approval of others for their well-being. They often seem to be overly-dramatizing or “playing a part” in a bid to be heard and seen. Indeed, “histrionic” derives from the Latin histrionicus, which means “about to the actor.” People with histrionic PD may take great care of their appearance and behave in a manner that is overly charming or inappropriately seductive. As they crave excitement and act on impulse or suggestion, they can place themselves at risk of accident or exploitation. Their dealings with others often seem insincere or superficial, which in the longer term can adversely impact their social and romantic relationships.

This is especially distressing, as they are sensitive to criticism and rejection and react badly to loss or failure. A vicious circle may take hold in which the more rejected they feel, the more histrionic they become — and the more histrionic they become, the more rejected they feel. These people want to be the center of attention in any group, and become very angry if they are not. People with histrionic PD have shallow relationships and may use their social skills to manipulate others around them.

It can be argued that a vicious circle of some kind is at the heart of every personality disorder and, indeed, every mental disorder.

Cluster C: Anxious or Fearful Disorders

Obsessive-Compulsive (Anankastic) Personality Disorder:

First and foremost, obsessive-compulsive personality disorder is not the same thing as obsessive-compulsive disorder.

Anankastic  PD is characterized by an excessive preoccupation with details, rules, lists, order, organization, or schedules; perfectionism so extreme that it prevents a task from being completed. Their unending and devotion to work and productivity costs many their interpersonal relationships. A person with anankastic PD is typically doubting and cautious, rigid and controlling, humorless, and miserly. Their underlying anxiety arises from a perceived lack of control over a world that they don’t understand, and the more they try to exert control, the more out of control they feels. As a consequence, they have little tolerance for complexity or nuance, and tends to simplify the world by seeing things as either all good or all bad (often referred to as black and white thinking).

Their relationships with colleagues, friends, and family are often strained by the unreasonable and inflexible demands that they makes upon loved ones.

Dependent Personality Disorder:

Dependent PD is characterized by a major lack of self-confidence, often show patterns of dependent and submissive behavior, and have an excessive need to be cared for by another person or persons. People with dependent personality disorder need a lot of help to make everyday decisions and often surrenders important life decisions to others. They greatly fear abandonment and may go through considerable lengths to secure and maintain relationships. A person with dependent PD sees themselves as inadequate and helpless, and gives up any personal responsibility and submits themselves to one or more protective others. They imagine that they are at one with these protective other(s), whom they idealize as competent and powerful, and towards whom they behave in a manner that is ingratiating and self-effacing. Those who have Dependent Personality Disorder will rarely initiate projects or work independently.

People with dependent PD often end up with people with a cluster B personality disorder, who feed on the unconditional high regard in which they are held. Overall, people with dependent PD maintain a naïve and child-like perspective and have limited insight into themselves and others. This entrenches their dependency, leaving them vulnerable to abuse and exploitation. These people require extreme advice and reassurance and are easily hurt by disapproval or criticism. People with Dependent Personality Disorder feel helpless when alone and may be devastated when a relationship ends, due in part to their strong fear of rejection.

Avoidant Personality Disorder:

People with avoidant PD believe that they are socially inept, unappealing, or inferior, and fear being embarrassed, criticized, or rejected. People with Avoidant Personality Disorder often avoid any activities that involve interpersonal contact as they’re afraid of saying something wrong, they worry they’ll cry in front of others, and are very hurt when they are disapproved of by others. These people are sensitive to rejection and avoid meeting others and engaging in activities unless they are certain that they’ll be liked or good enough; they’re restrained even in their intimate relationships. Avoidant PD is strongly associated with anxiety disorders, and may also be associated with actual – or imagined – rejection by parents or peers during their childhood.

Research is showing that people who have avoidant PD excessively monitor internal reactions – of their own and those of others – which prevents them from engaging naturally or fluently in social situations. A vicious circle takes hold in which the more they monitor their internal reactions, the more inept they feel; and the more inept they feel, the more they monitor their internal reactions.

They feel extremely uncomfortable in social situations, are timid, and are afraid of being criticized.

These people may have no close relationships beyond their family (although they’d like to) because they’re too afraid of their inability to relate well to others.

Other Ways Of Classifying Personality Disorders:

In addition to classifying by category and cluster, it is possible to classify personality disorders using additional factors such as attribution, its impact on social functioning, and severity of the disorder.

Impact on Social Functioning: Social function is affected by many other aspects of mental functioning than just that of personality. But, whenever there is persistently impaired social functioning in conditions in which it wouldn’t be expected, evidence suggests that this may be more likely to be created by personality abnormality than by other clinical variables.

Attribution: Many people who have a personality disorder don’t see any abnormality in their functioning and will continue to believe that there is no abnormality with how the person functions. This group of people have been called the “Type R,” or “treatment-resisting personality disorders,” as opposed to the Type S or treatment-seeking ones, who are very interested on altering their personality disorders and often clamor for treatment  The classification of 68 personality disordered patients on the caseload of an assertive community team using a simple scale showed a 3 to 1 ratio between Type R and Type S personality disorders with Cluster C personality disorders being significantly more likely to be Type S, and paranoid and schizoid (Cluster A) personality disorders significantly more likely to be Type R than others.

Severity of the Personality Disorder: The extent to which the dysfunctions in the below areas are associated with distress or impairment in personal, family, social, educational, occupational or other important areas of functioning.

Aspects of personality functioning that contribute to severity determination in Personality Disorder (Adapted from the ICD-11 Clinical Descriptions and Diagnostic Guidelines for Personality Disorder) include the following:

Degree and pervasiveness of disturbances in functioning of aspects of the self:

• Stability and coherence of one’s sense of identity (such as: the extent that the sense of self is always changing and inconsistent or overly rigid and fixed).
• Ability to maintain an overall positive and stable sense of self-worth.
• Accuracy of one’s view of one’s characteristics, strengths, and limitations.
• Capacity for self-direction, ability to plan, choose, and implement appropriate goals.
• Degree and pervasiveness of interpersonal dysfunction across various types of relationships such as, romantic relationships, school/work, parent-child, family, friendships, peer contexts
• Interest in engaging in relationships with others.
• Ability to understand and appreciate others’ perspectives.
• Ability to develop and maintain close and mutually satisfying relationships.
• Ability to manage conflict in relationships.
• Pervasiveness, severity, and chronicity of emotional, cognitive, and behavioral manifestations of the personality dysfunction

Emotional manifestations:

• Range and appropriateness of emotional experience and expression.
• Tendency to be emotionally over- or under-reactive to stimuli
• Ability to recognize and acknowledge unwanted emotions (such as anger, sadness).

Cognitive manifestations

• Accuracy of situational and interpersonal appraisals, especially under stress.
• Ability to make appropriate decisions in situations of uncertainty.
• Appropriate stability and flexibility of belief systems.

Behavioral manifestations

• Flexibility in controlling impulses and modulating behavior based on the situation and consideration of the consequences.
• Appropriateness of behavioral responses to intense emotions and stressful circumstances (such as a propensity to self-harm and/or violence).

Mild Personality Disorder	Moderate Personality Disorder	Severe Personality Disorder
Disturbances affect some areas of personality functioning but not others (such as: problems with self-direction in the absence of problems with stability and coherence of identity or self-worth and may not be apparent in some contexts.	Disturbances affect multiple parts of personality functioning (examples are identity or sense of self, ability to form intimate relationships, ability to control impulses and modulate behavior. However, some areas of personality functioning may be relatively less affected.	There are severe disturbances in functioning of the self (such that their sense of self may be so unstable that people state they do not have a sense of who they are and/or so rigid that they refuse to participate in any but an extremely narrow range of situations. The internal self may be characterized by self-contempt and/or be grandiose or highly eccentric.
There are problems in many interpersonal relationships and/or in performance of expected occupational and social roles, but some relationships are maintained and/or some roles carried out.	There are marked problems in most interpersonal relationships and the performance of most expected social and occupational roles are compromised to some degree. Relationships are likely to be characterized by conflict, avoidance, withdrawal, or extreme dependency (e.g., few friendships maintained, persistent conflict in work relationships and consequent occupational problems, romantic relationships characterized by serious disruption or inappropriate submissiveness).	Problems in interpersonal functioning seriously affect virtually all relationships and the ability and willingness to perform expected social and occupational roles is absent or severely compromised.
Specific manifestations of personality disturbances are generally of mild severity	Specific manifestations of personality disturbance are generally of moderate severity	Specific manifestations of personality disturbance are severe and affects most, if not all, areas of personality functioning.
Is typically not associated with substantial harm to self or others.	Is sometimes associated with harm to self or others.	Is often associated with harm to self or others.
May be associated with substantial distress or with impairment in personal, family, social, educational, occupational or other important areas of functioning that is either limited to circumscribed areas (e.g., romantic relationships; employment) or present in more areas but milder.	Is associated with marked impairment in personal, family, social, educational, occupational or other important areas of functioning, although functioning in circumscribed areas may be maintained.	Is associated with severe impairment in all or nearly all areas of life, including personal, family, social, educational, occupational, and other important areas of functioning.

Mild Personality Disoder	Moderate Personality Disoder	Severe Personality Disorder
The person’s sense of self may be somewhat contradictory and inconsistent with how others see them.	The person's sense of self may become incoherent in times of crisis.	The person's self-view is very unrealistic and typically is highly unstable or internally contradictory.
The person has difficulty recovering from injuries to self-esteem.	The person has considerable difficulty maintaining positive self-esteem or, alternatively, has an unrealistically positive self-view that is not modified by evidence to the contrary.	The person has serious difficulty with regulation of self-esteem, emotional experience and expression, and impulses, as well as other aspects of behavior (such as perseveration, indecision).
The person’s ability to set appropriate goals and to work towards them is compromised; the individual has difficulty handling even minor setbacks.	The person has poor emotion regulation in the face of setbacks, often becoming highly upset and giving up easily. Alternatively, the individual may persist unreasonably in pursuit of goals that have no chance of success.	The person is largely unable to set and pursue realistic goals.
The person may have conflicts with supervisors and co-workers, but is generally able to sustain employment.	The person may exhibit little genuine interest in or efforts toward sustained employment.	The person is unwilling or unable to sustain regular work due to lack of interest or effort, poor performance (e.g., failure to complete assignments or perform expected roles, unreliability), interpersonal difficulties, or inappropriate behavior (e.g., anger management issues, temper, insubordination).
The person's limitations in the ability to understand and appreciate others’ perspectives create difficulties in developing close and mutually satisfying relationships.	Major limitations in the ability to understand and appreciate others’ perspectives hinder developing close and mutually satisfying relationships.	The person's interpersonal relationships, if they have any, lack mutuality; are shallow, extremely one-sided, unstable, and/or highly conflictual, often to the point of violence.
There may be estrangement in some relationships, but relationships are more commonly characterized by intermittent or frequent, minor conflicts that are not so severe that they cause serious and long-standing disruption. Alternatively, relationships may be characterized by dependence and avoidance of conflict by giving in to others, even at some cost to themselves.	Problems in those relationships that do exist are common and persistent; may involve frequent, serious, and volatile conflict; and typically are quite one-sided (e.g., very strongly dominant or highly submissive).	Family relationships are absent (despite having living relatives) or marred by significant conflict. The person has extreme difficulty acknowledging unwanted emotions (such as an inability or refusal to recognize or acknowledge experiencing anger, sadness, or other emotions
Under stress, there may be some distortions in the person's situational and interpersonal appraisals but reality testing remains intact.	Under stress, there are marked distortions in the person's situational and interpersonal appraisals. There may be mild dissociative states or psychotic-like beliefs or perceptions (such as paranoid ideas).	Under stress, there are extreme distortions in the person's situational and interpersonal appraisals. There are often dissociative states or psychotic-like beliefs or perceptions (such as extreme paranoia).

Common Traits of A Person Who Has A Personality Disorder (per Out Of The Fog):

The list below contains descriptions of some of the more common traits of people who suffer from personality disorders, as observed by family members and partners. Examples are given of each trait, with descriptions of what it feels like to be caught in the crossfire.

Of note: these descriptions are not intended for diagnosis. Refer to the DSM-V or ICD-11 Criteria for Personality Disorders for clinical diagnostic criteria. No one person exhibits all of the traits and the presence of one or more of these traits is not evidence of a personality disorder.

One common criticism is that this list of traits seems so “normal” – more like traits of an unpleasant person than traits of a mentally ill person. This is no accident. Personality disordered people are normal people. Approximately 1 in 11 people meet the diagnostic criteria for having a personality disorder. Personality-disordered people don’t fit the stereotypical models for people with mental illnesses but their behaviors can be just as destructive. These descriptions are offered in the hope that non-personality-disordered family members, caregivers and loved-ones might recognize some similarities to their own situation and discover that they are not alone. Many thanks to Out of the Fog for their amazing list of personality traits. These traits may include:

Abusive Cycle: the name for the ongoing rotation between destructive and constructive behavior which is typical of many dysfunctional relationships and families.	Mirroring: Imitating or copying another person's characteristics, behaviors or traits.
The Abuser Profile: description of what a typical abuser "looks like"	Moments of Clarity: Spontaneous periods when a person with a Personality Disorder becomes more objective and tries to make amends.
Alienation: cutting off or interfering with an individual's relationships with others.	Mood Swings: Unpredictable, rapid, dramatic emotional cycles which cannot be readily explained by changes in external circumstances.
"Always" and "Never" StatementsD"Always" and "Never" Statements are declarations containing the words "always" or "never". They are commonly used but rarely true.	Munchausen's and Munchausen by Proxy Syndrome: A disorder in which an person repeatedly fakes or exaggerates medical symptoms in order to manipulate the attentions of medical professionals or caregivers.
Anger: People who suffer from PDs often feel a sense of unresolved anger and a heightened or exaggerated perception that they have been wronged, invalidated, neglected or abused.	Name-Calling: Use of profane, derogatory or dehumanizing words to describe another person or group of people.
Avoidance: The practice of withdrawing from relationships with other people as a defensive measure to reduce the risk of rejection, accountability, criticism, or exposure.	Narcissism: is a set of behaviors characterized by a pattern of grandiosity, self-centered focus, need for admiration, self-serving attitude and a lack of empathy or consideration for others.
Baiting: A deliberately provocative act used to solicit an angry, aggressive, or emotional response from another person.	Neglect: A passive form of abuse in which the physical or emotional needs of a dependent are disregarded or ignored by the person responsible for them.
Belittling, Condescending and Patronizing: this is a type of speech that's actually a passive-aggressive approach to giving someone a verbal put-down while maintaining a facade of reasonableness or friendliness.	Normalizing: Normalizing is a tactic used to desensitize another person to abusive, coercive or inappropriate behaviors. In essence, normalizing is the manipulation of another human being to get them to agree to, or accept something that is in conflict with the law, social norms or their own basic code of behavior.
Blaming: The practice of identifying a person or people responsible for creating a problem, rather than identifying ways of dealing with the problem.	"Not My Fault" Syndrome: The practice of avoiding personal responsibility for one's own words and actions.
Bullying : Any systematic action of hurting a person from a position of relative physical, social, economic, or emotional strength.	No-Win Scenarios: When you are manipulated into choosing between two bad options
Catastrophizing: The habit of automatically assuming a worst case scenario and inappropriately characterizing minor or moderate problems or issues as catastrophic events.	Objectification: The practice of treating a person or a group of people like an object(s).
Chaos Manufacture: Unnecessarily creating or maintaining an environment of risk, destruction, confusion or mess.	Obsessive-Compulsive Behavior: An inflexible adherence to arbitrary rules and systems, or an illogical adherence to cleanliness and orderly structure.
Cheating: Sharing a romantic or intimate relationship with somebody when you are already committed to a monogamous relationship with someone else.	Panic Attacks: Short intense episodes of fear or anxiety, often accompanied by physical symptoms, such as hyperventilating, shaking, sweating and chills.
Chronic Broken Promises: Repeatedly making and then breaking commitments and promises is a common trait among people who suffer from personality disorders.	Parental Alienation Syndrome: When a separated parent convinces their child that the other parent is bad, evil or worthless.
Circular Conversations: Arguments which go on almost endlessly, repeating the same patterns with no resolution.	Parentification: A form of role reversal, in which a child is inappropriately given the role of meeting the emotional or physical needs of the parent or of the family’s other children.
Confirmation Bias: The tendency to pay more attention to things which reinforce your beliefs than to things which contradict them.	Passive-Aggressive Behavior: Expressing negative feelings in an unassertive, passive way.
"Control-Me" Syndrome: This describes a tendency which some people have to foster relationships with people who have a controlling narcissistic, antisocial or "acting-out" nature.	Pathological Lying: Persistent deception by an individual to serve their own interests and needs with little or no regard to the needs and concerns of others. A pathological liar is a person who habitually lies to serve their own needs.
Cruelty to Animals: Acts of Cruelty to Animals have been statistically discovered to occur more often in people who suffer from personality disorders than in the general population.	Perfectionism: The maladaptive practice of holding oneself or others to an unrealistic, unattainable or unsustainable standard of organization, order, or accomplishment in one particular area of living, while sometimes neglecting common standards of organization, order or accomplishment in other areas of living.
Denial: Believing or imagining that some painful or traumatic circumstance, event or memory does not exist or did not happen.	Physical Abuse: Any form of voluntary behavior by one individual which inflicts pain, disease or discomfort on another, or deprives them of necessary health, nutrition and comfort.
Dependency: An inappropriate and chronic reliance by an adult individual on another individual for their health, subsistence, decision making or personal and emotional well-being.	Projection: The act of attributing one's own feelings or traits to another person and imagining or believing that the other person has those same feelings or traits.
Depression: People who suffer from personality disorders are often also diagnosed with symptoms of depression.	Proxy Recruitment: A way of controlling or abusing another person by manipulating other people into unwittingly backing “doing the dirty work”
Dissociation: A psychological term used to describe a mental departure from reality.	Push-Pull: A chronic pattern of sabotaging and re-establishing closeness in a relationship without appropriate cause or reason.
Domestic Theft: Consuming or taking control of a resource or asset belonging to (or shared with) a family member, partner or spouse without first obtaining their approval.	Ranking and Comparing: Drawing unnecessary and inappropriate comparisons between people or groups of people.
Emotional Abuse: Any pattern of behavior directed at one person by another which promotes in them a destructive sense of Fear, Obligation or Guilt (FOG).	Raging, Violence and Impulsive Aggression: Explosive verbal, physical or emotional elevations of a dispute. Rages threaten the security or safety of another individual and violate their personal boundaries.
Engulfment: An unhealthy and overwhelming level of attention and dependency on another person, which comes from imagining or believing one exists only within the context of that relationship.	Relationship Hyper Vigilance: Maintaining an unhealthy level of interest in the behaviors, comments, thoughts and interests of others.
Escape To Fantasy: Taking an imaginary excursion to a happier, more hopeful place.	Riding the Emotional Elevator: Taking a fast track to different levels of emotional maturity.
Favoritism and Scapegoating: Systematically giving a dysfunctional amount of preferential positive or negative treatment to one individual among a family group of peers.	Sabotage: The spontaneous disruption of calm or status quo in order to serve a personal interest, provoke a conflict or draw attention.
Fear of Abandonment: An irrational belief that one is imminent danger of being personally rejected, discarded or replaced.	Scapegoating: Singling out one child, employee or member of a group of peers for unmerited negative treatment or blame.
Feelings of Emptiness: An acute, chronic sense that daily life has little worth or significance, leading to an impulsive appetite for strong physical sensations and dramatic relationship experiences.	Selective Memory and Selective Amnesia: The use of memory, or a lack of memory, which is selective to the point of reinforcing a bias, belief or desired outcome.
Frivolous Litigation: The use of unmerited legal proceedings to hurt, harass or gain an economic advantage over an individual or organization.	Selective Competence: Demonstrating different levels of intelligence, memory, resourcefulness, strength or competence depending on the situation or environment.
Gaslighting: The practice of brainwashing or convincing a mentally healthy individual that they are going insane or that their understanding of reality is mistaken or false. The term “Gaslighting” is based on the 1944 MGM movie “Gaslight”.	Self-Aggrandizement: A pattern of pompous behavior, boasting, narcissism or competitiveness designed to create an appearance of superiority.
Grooming: is the predatory act of maneuvering another individual into a position that makes them more isolated, dependent, likely to trust, and more vulnerable to abusive behavior.	Self-Harm: Any form of deliberate, premeditated injury, such as cutting, poisoning or overdosing, inflicted on oneself.
Harassment: Any sustained or chronic pattern of unwelcome behavior by one individual towards another.	Self-Loathing: An extreme hatred of one's own self, actions or one's ethnic or demographic background.
High and Low-Functioning: A High-Functioning Personality-Disordered Individual is one who is able to conceal their dysfunctional behavior in certain public settings and maintain a positive public or professional profile while exposing their negative traits to family members behind closed doors. A Low-Functioning Personality-Disordered Individual is one who is unable to conceal their dysfunctional behavior from public view or maintain a positive public or professional profile.	Self-Victimization: Casting oneself in the role of a victim.
Hoarding: Accumulating items to an extent that it becomes detrimental to quality of lifestyle, comfort, security or hygiene.	Sense of Entitlement: An unrealistic, unmerited or inappropriate expectation of favorable living conditions and favorable treatment at the hands of others.
Holiday Triggers: Mood Swings in Personality-Disordered individuals are often triggered or amplified by emotional events such as family holidays, significant anniversaries and events which trigger emotional memories.	Sexual Coercion: Sexual Coercion is the act of using subtle pressure, trickery, emotional force, drugs or alcohol to force sexual contact with someone against their will and includes persistent attempts to have sexual contact with someone who has already refused. At it’s core, Sexual Coercion/Abuse is about an imbalance in power and control.
Hoovers & Hoovering: A Hoover is a metaphor taken from the popular brand of vacuum cleaners, to describe how an abuse victim trying to assert their own rights by leaving or limiting contact in a dysfunctional relationship, gets “sucked back in” when the perpetrator temporarily exhibits improved or desirable behavior.	Sexual Objectification: Seeing another person in terms of their sexual usefulness or attractiveness rather than pursuing or engaging in a quality interpersonal relationship with them.
Hysteria: An inappropriate over-reaction to bad news or disappointments, which diverts attention away from the real problem and towards the person who is having the reaction.	Shaming: The difference between blaming and shaming is that in blaming someone tells you that you did something bad, in shaming someone tells you that you are something bad.
Identity Disturbance: A psychological term used to describe a distorted or inconsistent self-view	Silent Treatment: A passive-aggressive form of emotional abuse in which displeasure, disapproval and contempt is exhibited through nonverbal gestures while maintaining verbal silence.
Imposed Isolation: When abuse results in a person becoming isolated from their support network, including friends and family.	Situational Ethics: A philosophy which promotes the idea that, when dealing with a crisis, the end justifies the means and that a rigid interpretation of rules and laws can be set aside if a greater good or lesser evil is served by doing so.
Impulsiveness: The tendency to act or speak based on current feelings rather than logical reasoning.	Sleep Deprivation: The practice of routinely interrupting, impeding or restricting another person's sleep cycle.
Infantilization: Treating a child as if they are much younger than their actual age.	Splitting: The practice of regarding people and situations as either completely "good" or completely "bad".
Intimidation: Any form of veiled, hidden, indirect or non-verbal threat.	Stalking: Any pervasive and unwelcome pattern of pursuing contact with another individual.
Invalidation: The creation or promotion of an environment which encourages an individual to believe that their thoughts, beliefs, values or physical presence are inferior, flawed, problematic or worthless.	Stunted Emotional Growth: A difficulty, reluctance or inability to learn from mistakes, work on self-improvement or develop more effective coping strategies.
Lack of Conscience: people who suffer from Personality Disorders are often preoccupied with their own agendas, sometimes to the exclusion of the needs and concerns of others. This is sometimes interpreted by others as a lack of moral conscience.	Targeted Humor, Mocking and Sarcasm: Any sustained pattern of joking, sarcasm or mockery which is designed to reduce another individual’s reputation in their own eyes or in the eyes of others.
Lack of Object Constancy: An inability to remember that people or objects are consistent, trustworthy and reliable, especially when they are out of your immediate field of vision.	Terminal Uniqueness: Is the false belief that the situation a person is facing is unlike anything anyone has ever faced before. Is so unique that therapy and treatment or recovery programs that work for others will not work for them because they are a special case.
Low Self-Esteem: A common name for a negatively-distorted self-view which is inconsistent with reality.	Testing: Repeatedly forcing another person to demonstrate or prove their love or commitment to a relationship.
Magical Thinking: Looking for supernatural connections between external events and one’s own thoughts, words and actions.	Thought Policing: Any process of trying to question, control, or unduly influence another person's thoughts or feelings.
Manipulation: The practice of steering an individual into a desired behavior for the purpose of achieving a hidden personal goal.	Threats: Inappropriate, intentional warnings of destructive actions or consequences.
Masking : Covering up one's own natural outward appearance, mannerisms and speech in dramatic and inconsistent ways depending on the situation.	Triangulation: Gaining an advantage over perceived rivals by manipulating them into conflicts with each other.
Tunnel Vision - The habit or tendency to only see or focus on a single priority while neglecting or ignoring other important priorities.	Triggering: Small, insignificant or minor actions, statements or events that produce a dramatic or inappropriate response.
Verbal Abuse - Any kind of repeated pattern of inappropriate, derogatory or threatening speech directed at one person by another.

How Are Personality Disorders Diagnosed?

Every person has a characteristic manner of thinking, feeling, and way relating to others. Some of these personality traits can be so dysfunctional as to warrant a diagnosis of personality disorder. The World Health Organization’s International Classification of Diseases (ICD- 10) includes ten personality disorder diagnoses. Three issues of particular importance for the diagnosis of personality disorders are their differentiation from other mental disorders, from general personality functioning, and from each other. Each of these issues is discussed in turn, and it is suggested that personality disorders are more accurately and effectively diagnosed as maladaptive variants of common personality traits.

Researchers have been unable to identify a qualitative distinction between normal personality functioning and personality disorder. DSM-IV and ICD-10 provide specific and explicit rules for distinguishing the presence versus absence of each of the personality disorders, but the basis for these thresholds are largely unexplained and are weakly justified. The DSM-III schizotypal and borderline personality disorders are the only two for which a published rationale has ever been provided.

Characterizing the 10 personality disorders is difficult, but diagnosing them reliably is even more so. For example, how far from the norm must personality traits deviate before they can be counted as disordered? How significant is “significant impairment”? And how is “impairment” to be defined?

Whatever the answers to these questions, they are bound to include a large part of subjectivity. Personal dislike, prejudice, or a clash of values can all play a part in arriving at a diagnosis of personality disorder, and it has been argued that the diagnosis amounts to little more than a convenient label for undesirables and social deviants.

It is important to understand the difference between personality styles and personality disorders. A person who is shy or likes to spend time alone does not necessarily have an avoidant or schizoid personality disorder. The difference between personality style and a personality disorder often can be determined by assessing the person’s personality function in certain areas, including

• Work
• Relationships
• Feelings/emotions
• Self-identity
• Awareness of reality
• Behavior and impulse control

If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical examination. Although there are no laboratory tests to specifically diagnose personality disorders, the doctor might use various diagnostic tests- such as X-rays and blood tests- to rule out physical illness as the cause of the symptoms.

If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a personality disorder. The doctor or therapist bases his or her diagnosis on the person’s description of the symptoms and on his or her observation of the person’s attitude and behavior. The therapist then determines if the person’s symptoms point to a personality disorder as outlined in the DSM-5.

According to DSM-5, a personality disorder can be diagnosed if there are significant impairments in self and interpersonal functioning together with one or more pathological personality traits. In addition, these features must be (1) relatively stable across time and consistent across situations, (2) not better understood as normative for the individual’s developmental stage or socio-cultural environment, and (3) not solely due to the direct effects of a substance or general medical condition.

Treatment of Personality Disorders:

People with personality disorders might not seek treatment on their own; and as a result, many go untreated. One reason for the failure to seek treatment might be that many people with personality disorders can function normally in society, outside of the limitations of their disorder.

Most personality disorders are constant, unrelenting, and very hard to cure. However, treatment can help relieve some of the more disturbing symptoms of many types of personality disorders.

Treatment varies depending on the type of disorder, but psychotherapy (a type of counseling) is the main form of treatment. In some cases, medication might be used to treat extreme or disabling symptoms that might occur. Medications that might be used include antidepressants, anti-psychotics, anti-anxiety drugs, and impulse-stabilizing medications.

Psychotherapy focuses on evaluating faulty thinking patterns, and teaching new thinking and behavior patterns. Therapy also aims to improve coping and interpersonal skills.

There are many options for treatment for those who have a personality disorder. These treatments may include therapies (individual, group, or family), which focus upon helping to see how their thought processes may lead to or cause their symptoms. Therapies may also help people with personality disorders learn to become more flexible in their thoughts and behaviors.

Certain types of psychotherapy are effective for treating personality disorders. During psychotherapy, an individual can gain insight and knowledge about the disorder and what is contributing to symptoms, and can talk about thoughts, feelings and behaviors. Psychotherapy can help a person understand the effects of their behavior on others and learn to manage or cope with symptoms and to reduce behaviors causing problems with functioning and relationships. The type of treatment will depend on the specific personality disorder, how severe it is, and the individual’s circumstances.

Commonly used types of psychotherapy include:

• Psychoanalytic/psychodynamic therapy
• Dialectical behavior therapy
• Cognitive behavioral therapy
• Group therapy
• Psychoeducation (teaching the individual and family members about the illness, treatment and ways of coping)

There are no medications specifically to treat personality disorders. However, medication, such as antidepressants, anti-anxiety medication or mood stabilizing medication, may be helpful in treating some symptoms. More severe or long lasting symptoms may require a team approach involving a primary care doctor, a psychiatrist, a psychologist, social worker and family members.

Outlook for Those With Personality Disorders: 

It is generally assumed that all personality disorders are linked to impaired functioning and a reduced quality of life (QoL) because that is a basic diagnostic requirement. But research shows that this may be true only for some types of personality disorder.

In several studies, higher disability and lower QoL were predicted by avoidant, dependent, schizoid, paranoid, schizotypal and antisocial personality disorder. This link is particularly strong for avoidant, schizotypal and borderline PD. However, obsessive-compulsive PD was not related to a compromised QoL or dysfunction. A prospective study reported that all PD were associated with significant impairment 15 years later, except for obsessive compulsive and narcissistic personality disorder.

One study investigated some aspects of “life success” (status, wealth and successful intimate relationships) and showed somewhat poor functioning for schizotypal, antisocial, borderline and dependent PD, schizoid PD had the lowest scores regarding these variables. Paranoid, histrionic and avoidant PD were average. Narcissistic and obsessive-compulsive PD, however, had high functioning and appeared to contribute rather positively to these aspects of life success.

There is also a direct relationship between the number of diagnostic criteria and quality of life. For each additional personality disorder criterion that a person meets there is an even reduction in quality of life.

Issues For People Who Have Personality Disorders:

In Children:

Early stages and preliminary forms of personality disorders also require a multi-dimensional and early treatment approach if this disorder is to be successfully managed. Personality development disorder is considered to be a childhood risk factor or early stage of a later personality disorder in adulthood.

Research indicates that some children and adolescents do suffer from clinically significant syndromes that resemble adult personality disorders, and that these syndromes have meaningful correlates and are consequential. Much of this research has been framed by the adult personality disorder constructs from Axis II of the Diagnostic and Statistical Manual. Children today are less likely to encounter clinicians and researchers who are simply avoiding use of the PD construct in youth. However, these children and families may encounter under-appreciation of the developmental context in which these syndromes occur.

That is, although PD constructs show continuity over time, they are probabilistic predictors; not all youths who exhibit PD symptomatology become adult PD cases.

At Work:

Depending on the diagnosis, severity and individual, and the job itself, personality disorders can be associated with difficulty coping with work or the workplace—potentially leading to problems with others by interfering with interpersonal relationships. Indirect effects also play a role; for example, impaired educational progress or complications outside of work, such as substance abuse and co-morbid mental disorders, can plague sufferers.

However, personality disorders can also bring about above-average work abilities by increasing competitive drive or causing the sufferer to exploit his or her co-workers.

In 2005 and again in 2009, psychologists Belinda Board and Katarina Fritzon at the University of Surrey, UK, interviewed and gave personality tests to high-level British executives and compared their profiles with those of criminal psychiatric patients at Broadmoor Hospital in the UK. They found that three out of eleven personality disorders were actually more common in executives than in the disturbed criminals:

• Histrionic personality disorder: including superficial charm, insincerity, egocentricity and manipulation
• Narcissistic personality disorder: including grandiosity, self-focused lack of empathy for others, exploitativeness and independence.
• Obsessive-compulsive personality disorder: including perfectionism, excessive devotion to work, rigidity, stubbornness and dictatorial tendencies.

According to leadership academic Manfred F.R. Kets de Vries, it seems almost inevitable that some personality disorders will be present in a senior management team.

Versus Mental Disorders:

The disorders in each of the three clusters may share with each other underlying common vulnerability factors involving cognition, affect and impulse control, and behavioral maintenance or inhibition, respectively. But they may also occur on a spectrum of other mental illnesses.

• Paranoid, schizoid or schizotypal personality disorders have be observed to be premorbid antecedents of delusional disorders or schizophrenia.
• Borderline personality disorder is seen in association with mood and anxiety disorders, with impulse control disorders, eating disorders, ADHD, or a substance use disorder.
• Avoidant personality disorder is seen with social anxiety disorder.

Coping With Personality Disorders:

In addition to actively participating in a treatment plan, some self-care and coping strategies can be helpful for people with personality disorders.

• Learn about the condition. Knowledge and understanding can help empower and motivate.
• Get active. Physical activity and exercise can help manage many symptoms, such as depression, stress and anxiety.
• Avoid drugs and alcohol. Alcohol and illegal drugs can worsen symptoms or interact with medications.
• Get routine medical care. Don’t neglect checkups or regular care from your family doctor.
• Join a support group of others with personality disorders.
• Write in a journal to express your emotions.
• Try relaxation and stress management techniques such as yoga and meditation.
• Stay connected with family and friends; avoid becoming isolated.

Challenges For People Who Have Personality Disorders (Including Loved Ones And Therapists):

The management and treatment of personality disorders can be a challenging and controversial area, as the difficulties are enduring and affect multiple areas of functioning. Challenges often involve interpersonal issues, and there can be difficulties looking for and finding help from area organizations, especially when trying to engage in a therapeutic relationships with a treatment team. Alternately, a person may not consider that they have a mental health problem. On the other hand, community mental health services may view people who have personality disorders as too complex or difficult, and may directly or indirectly exclude people with such diagnoses or associated behaviors.

The disruptiveness that people with personality disorders can create in an organization makes these, arguably, the most challenging conditions to manage.

Many people who have personality disorders don’t believe that they have them. This perspective can be caused by the person’s ability to see him or herself clearly, and unfortunately, there is major social stigma and discrimination related to the diagnosis of a personality disorder.

The term “personality disorder” involves a wide range of issues, each with a different level of severity or disability; thus, personality disorders require fundamentally different approaches and understandings.

Consider that while some disorders or people are characterized by continual social withdrawal and the shunning of relationships, others may cause fluctuations in forwardness. The extremes are worse still: at one extreme lies self-harm and self-neglect, while at the other people with PDs may commit violence and crime. There can be other factors such as problematic substance use, dependency, or behavioral addictions. A person may meet the criteria for multiple personality disorder diagnoses and/or other mental disorders, either at certain times or continually, making coordinated input from multiple services a requirement.

Therapists in this area can become disheartened by lack of initial progress, or by apparent progress that then leads to setbacks. People may be perceived as negative, rejecting, demanding, aggressive or manipulative.

Social skills, coping efforts, defense mechanisms, or deliberate strategies; of moral judgments, or the consideration for motivations for specific behaviors or conflicts can be incredibly challenging in people who have personality disorders and those who treat them. The vulnerabilities of a client (and therapist) may get lost in actual or apparent strength and resilience.

There is always a need to maintain appropriate professional personal boundaries, while allowing for emotional expression, and therapeutic relationships. However, there may be difficulty acknowledging the different worlds and views that both the client and therapist may believe in. A therapist may assume that the kinds of relationships and ways of interacting that make them feel safe and comfortable have the same effect on clients. An example of one extreme is this: people who may have been exposed to hostility, deceptiveness, rejection, aggression, or abuse in their lives, may be made confused, intimidated, or suspicious by presentations of warmth, intimacy, or positivity. On the other hand, reassurance, openness, and clear communication are usually helpful and needed.

It can take several months of sessions, and perhaps several stops and starts, to begin to develop a trusting relationship that can meaningfully address a client’s issues.

Coping With A Loved Ones Personality Disorder:

Family members can be important in an individual’s recovery and can work with the individual’s health care provider on the most effective ways to help and support. But having a family member with a personality disorder can also be distressing and stressful. Family members may benefit from talking with a mental health provider who can provide help coping with difficulties.

It may help to tailor how you approach someone based on the stage of acceptance they appear to be in.

Unawareness: Most people living with a personality disorder don’t realize they have one, even if they realize they aren’t easy to live with. It’s best to share your concern by giving someone specific examples of problem behaviors and follow up by offering the resources needed to find a doctor, or make or attend an appointment.

Denial. Most people who are told they have a personality disorder don’t believe it. It isn’t uncommon for them to get angry or defensive. Keep trying to share your concerns if someone is refusing help.

Resistance. When people first begin to accept there’s a problem, they fight the belief that it’s a serious problem. People with personality disorders often resist getting medical treatment as they believe they can change their behaviors on their own. At this stage, encourage a family member or friend to make medical help a part of their personal treatment plan.

Flakiness. Once they start therapy or medication, people with personality disorders often skip or stop treatment without warning. Be there to remind them that no one is perfect, no one is always at the top of their game, and that tomorrow offers new chances to make healthier choices.

Acceptance. After receiving the support needed to overcome denial, resistance and struggles with staying in treatment, patients with these disorders may come to a place of acceptance. In these situations, treatments are seen as a top priority and appreciated as tools for healthy living.

Coping With A Teen Who Has A Personality Disorder:

It’s sometimes difficult to tell the difference between childhood behaviors, teen angst and true personality disorders. When in doubt, it’s best to get a professional opinion. Talking to a child or teen before or after that stage can be daunting. It’s recommended that loved ones are:

• Be mindful of labels. No one wants to be defined by an illness.
• Learn as much as you can so you can pass on information instead of assumptions.
• Focus on feelings and behaviors.
• Emphasize they have a treatable medical condition.
• Stay positive by choosing words like “challenges” instead of “problems.
• If your child is on medication, talk with them about side effects they might be having.
• Invite your child to talk to you whenever questions arise. The worst-case scenario is having to say, “I’m not sure, but we can find out the answer.