Personality disorders

What are personality disorders?

Personality disorders can be extremely difficult to diagnose as personalities are so unique. There is no uniform pattern to the way that people respond to situations, or think and behave. However, there are some circumstances where behaviour and thoughts are considered to be extreme and inflexible. This can impact on a person's ability to function in daily life if they are unable to respond to and cope with new situations and people surrounding them (such as education and work contexts). In such cases, a person may be considered to have a personality disorder.

There are many different kinds of personality disorders that can affect a person's ability to function normally. Most personality disorders emerge in childhood, the time in which personalities tend to stabilise for most people and persist throughout adulthood. In many situations, people may not be aware that there is any problem, as their behaviours and ways of thinking come naturally to them, which can be exacerbated by the fact that people may blame others (e.g. feeling as though everyone else has a problem, not themselves).

How can I tell if someone has a personality disorder?

It can be difficult to distinguish between a personality disorder and another type of mental health concern. Many of the signs this might be a problem (such as erratic behaviour, mood swings, or problems in relationships) can be caused by a number of factors. It is particularly important that someone is not assumed to have a personality disorder, because there is an assumption with personality disorders that these will be persistent and more difficult to change than other mental health conditions, and people with personality disorders experience a higher level of stigma than people with many other conditions. For this reason, they are best identified by mental health professionals after careful and thorough assessment.

Risk factors

While little is known about what causes personality disorders, there are some factors that increase a person’s chances of developing a personality disorder.

These include:

• a family history of mental illness, especially personality disorders
• unstable or chaotic childhood
• history of childhood abuse or neglect
• trauma experienced during childhood (e.g. loss of a parent or sibling)
• diagnosis of childhood conduct disorder.

Types of personality disorders

Personality disorders tend to be clustered into three groups:

Cluster A: odd or eccentric behaviours

• Paranoid: characterised by extreme distrust and suspicion of others, interpreting other peoples' intentions as malicious.
• Schizoid: characterised by detachment from relationships and limited emotional expression.
• Schizotypal: characterised by having little regard for others and bizarre or eccentric thinking and behaviour.

Cluster B: dramatic, emotional or erratic behaviour

• Antisocial: characterised by little disregard for others, acting aggressively toward others or violating others rights.
• Borderline: characterised by highly impulsive behaviour (excessive risk taking) and unstable moods.
• Histrionic: characterised by ‘over the top’ emotional reactions and attention seeking tendencies.
• Narcissistic: characterised by a constant need for admiration as well as behaviour and speech that often displays a sense of grandiosity.

Cluster C: anxious or fearful behaviours

• Avoidant: characterised by extreme shyness, hypersensitivity to perceived or actual criticism and rejection. General feelings of inadequacy are also usually present.
• Dependent: characterised by a fear of separation, leading to submissive and ‘clingy’ behaviour. A person with a dependent personality type requires constantly being taken care of.
• Obsessive-compulsive: a preoccupation with rules, order and organisation, that comes at the expense of flexibility and being able to complete tasks. They may work excessively and not allow time for leisure or friends.

Many of these characteristics (such as impulsiveness, shyness, a need for admiration) are common in many people. A personality disorder would only be diagnosed when these traits are severe, and impact on the person's ability to function.

What students can do about personality disorders

Given young people may be unaware of having a personality disorder they can be fairly difficult to treat. If worried about having a personality disorder, it is important to discuss issues with a school counsellor, or local GP in order to establish what the best course of management will be. This may include psychological therapy or in some circumstances medication. Routine medical care may be also important, even if the symptoms feel under control.

Other steps young people can take include learning about personality disorders, which can enable individuals to realise how they are being affected by their disorder, and to become attuned to the associated symptoms or warning signs that may trigger symptoms (such as an angry outburst). This may also be a helpful thing for friends and family to ensure they understand the nature of the personality disorder. Improving and developing coping strategies can be useful to minimise anger and frustration.

ReachOut.com resources on personality disorders

• What are personality disorders?
• Borderline personality disorder
• Building coping skills
• Counsellors
• Support services for personality disorders