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What are Personality Disorders?

two faces depicting personality disorders

The Mayo Clinic describes personality as “the combination of thoughts, emotions, and behaviors that makes you unique. It’s the way you view, understand, and relate to the outside world, as well as how you see yourself.” Although your personality evolves throughout your life, your core personality forms during childhood, influenced by the environment you grew up in and by inherited factors.

If you are experiencing significant impairments in the way you interact with others and have one or more pathological personality traits, you may have a personality disorder, according to the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Pathological personality traits may include behavior that is extreme and unacceptable, an inability to control powerful emotions, disinhibition, emotional detachment, and more.

To meet diagnostic criteria, DSM-5 requires pathological traits to be:

  • Relatively stable across time and consistent across situations
  • Not normative for the individual’s developmental stage or socio-cultural environment
  • Not solely due to the direct effects of a substance or general medical condition

Personality disorders can dramatically affect your life and the lives of those you care about. They can damage personal and professional relationships, lead to social isolation and contribute to substance use disorder or other addictive behavior.

Remember: this isn’t medical advice. If you are concerned that you may be struggling with a personality disorder, please consult with a healthcare professional.

Types of Personality Disorders

The DSM-5 recognizes ten personality disorders that fall into one of three groups (or clusters). Although not always the case, disorders within a certain cluster may overlap with one another.

Cluster A symptoms include behavior that may be considered odd, bizarre, or eccentric by the general society at large. Personality disorders that fall into this group include the following:

  • Paranoid: You distrust others, even family and close friends, believing they are not loyal or faithful and are working to deceive you. You are extremely sensitive to setbacks, prone to feelings of shame and humiliation, and have difficulty building close personal relationships.
  • Schizoid: You are aloof, lack emotional responses, cannot recognize normal social cues, and have no desire for social or sexual relationships. You do not conform to common social expectations and may be more interested in an inner fantasy life. Although you take little pleasure in most things, you function well enough in your daily life that your personality disorder may go undetected.
  • Schizotypal: You may have an odd or unusual way of appearing, behaving, or speaking, your emotions are flat and you may fear social interaction. Other symptoms may be like those of schizophrenia and may include hearing voices, believing you can make something appear or happen because of your thoughts (magical thinking), and obsessive thoughts. If you have a schizotypal personality disorder, you have a higher than average probability of developing schizophrenia.

Cluster B symptoms include behavior that is dramatic or erratic. The following personality disorders fall under this group.

  • Antisocial: You do not respect social rules or obligations, act impulsively, cheat, lie and have trouble sustaining personal relationships. On the surface, you may appear charming but exhibit a lack of empathy or concern for the feelings or safety of others. You may act aggressively and are more likely to commit a crime. These symptoms are more common in men than women.
  • Borderline: You may have an intense fear of abandonment, a tendency to experience intense but unhealthy relationships, impulsive, often risky behavior, mood swings, and outbursts of anger or violence. You may express suicidal ideation or inflict self-harm, which may lead to medical interventions. Some experts believe borderline personality disorder stems from childhood sexual abuse.
  • Histrionic: You have low self-esteem and need the attention and approval of others to feel more worthy. Your emotions are shallow and rapidly changing. Because you crave attention, you may obsess over your appearance and may act dramatically or seductively to draw the desired response. You are impulsive and crave excitement which may lead to risky behaviors. You may misjudge the closeness of your relationships, believing they are more intimate than they really are.
  • Narcissistic: You have an elevated sense of your own importance, power, and attractiveness and feel you deserve the admiration of others. Your lack of empathy enables you to lie and exploit others without remorse in order to get what you want. If someone or something prevents you from your goals, you may fly into a destructive rage, also called “narcissistic rage.”

Cluster C symptoms include behavior that is anxious or fearful. The following personality disorders fall under this group:

  • Avoidant: You are extremely shy and avoid social situations, believing you are inferior, undesirable, and socially incompetent. You avoid new people and activities in fear of criticism, rejection, or humiliation. If forced to interact with another, you constantly evaluate both your own “performance” and how you believe the other person is perceiving you. This disorder often co-occurs with anxiety disorders.
  • Dependent: You see yourself as helpless and inadequate, feel incapable of making your own decisions or caring for yourself and look to others to be your caretaker. You hold your caretaker in unnaturally high regard, allowing them to act and answer for you. Your submissive behavior may make you especially vulnerable to exploitation and abuse.
  • Obsessive-compulsive: You are a perfectionist who focuses excessively on order, details, rules and schedules, and are rigid in your need to control people and situations. If your expectations are not met, you may react with extreme distress. You lack a sense of humor and are stingy with money, tightly controlling your finances. You view morality, ethics, values, and actions as either black or white. Your inflexibility damages relationships with family, friends, and co-workers. Obsessive-compulsive personality disorder is not the same as obsessive-compulsive disorder, a type of anxiety disorder.

Personality disorders are treatable. If you or a loved one is struggling with a personality disorder, talk to your doctor or a mental health professional for guidance.

Personality Disorders and Addiction

Individuals with personality disorders are typically at a higher risk for developing substance use disorders or addictive behaviors. Some individuals may use drugs or alcohol as a coping mechanism for intrusive or disruptive thoughts or symptoms, while others may find that their substance use worsens their pre-existing mental health diagnosis.

If you or a loved one have been diagnosed with a personality disorder and are also struggling with addiction, it’s important you seek out a reputable dual diagnosis treatment program. These programs are specially designed to help treat addiction and mental health challenges simultaneously, as recommended by the National Institute on Drug Abuse.

Turning Point of Tampa has been offering Licensed Residential Treatment for Addiction, Eating Disorders and Dual Diagnosis in Tampa since 1987.

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