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Personality is the way of thinking, feeling and behaving that makes a person different from other people. Some people are easy-going whereas others are controlling and demanding. Some people are good at telling jokes, others do not like to be the center of attention but enjoy laughing at others telling jokes. Some people are carefree and fun-loving but may not be very responsible when it comes to being on time for an appointment. Others may be less emotional but can be counted on when they say they will do something. Having a bad temper. Being stuck up. Having a good sense of humor. Generous. Cheap. Perfectionistic. Careless. Reserved. Fun-loving. These are all descriptions of personality traits. When personality traits become extreme, when they are rigid and inflexible and make it difficult to deal with people and handle life’s problems, then the person may have a personality disorder./p
An individual’s personality is influenced by experiences, environment (surroundings, life situations) and inherited characteristics. A person’s personality typically stays the same over time.
Personality refers to an individual’s pattern of behavior and traits that are long-standing and present since adolescence or early adulthood. Aspects of personality include the way people tend to think about themselves (e.g. self-confident or lacking confidence), how they relate to people (e.g. shy vs. friendly), how they interpret and deal with events in the environment (e.g. paranoid people believe that others are out to get them and may try to attack first before being attacked), and how they react emotionally to all of this.
It is not easy to define a “healthy personality,” but in general it allows one to cope with the normal stress of life and develop and maintain satisfying friendships and intimate relationships. Of course, everyone has a bad day and behaves in an uncharacteristic way at times. However, when long-standing patterns of thinking, behaving, and emotional response are rigid, inflexible, and cause significant distress or impairment in functioning then a personality disorder is diagnosed. To be classified as a personality disorder, one's way of thinking, feeling and behaving deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time.1 The pattern of experience and behavior usually begins by late adolescence or early adulthood and causes distress or problems in functioning. Without treatment, personality disorders can be long-lasting.
Types of Personality Disorders
There are 10 specific types of personality disorders in the DSM-5-TR. Personality disorders are long-term patterns of behavior and inner experiences that differ significantly from what is expected. They affect at least two of these areas:
Way of thinking about oneself and others
Way of responding emotionally
Way of relating to other people
Way of controlling one’s behavior
Antisocial personality disorder is characterized by selfish, irresponsible, unlawful, and impulsive behavior that shows a lack of regard for the rights of others. Individuals with antisocial personality disorder find it easy to lie if it serves their purpose. Physical aggression is common. Trouble at work can result from not arriving on time, missing too many days, not doing their work, or not following the rules. There is a general failure to conform to society’s rules either by engaging in illegal activities or not honoring obligations. Examples of antisocial behavior include quitting a job without other work in sight, spending money on things that one could do without thus being unable to pay for household necessities such as food, rent, or the utility bill. Reckless driving, speeding tickets, driving under the influence of drugs or alcohol, and ignoring recommended safety precautions are examples of a lack of regard for the safety of oneself or others. Individuals with antisocial personality disorder usually do not feel remorseful at having hurt others but instead justify or rationalize their behavior. • a pattern of disregarding or violating the rights of others. A person with antisocial personality disorder may not conform to social norms, may repeatedly lie or deceive others, or may act impulsively. More on antisocial personality disorder in the APA blog.
Avoidant personality disorder is characterized by extreme shyness related to low self-esteem and sensitivity to rejection and criticism from others. Individuals with avoidant personality disorder have difficulty making friends and feel very uncomfortable in social situations. It is difficult to share personal feelings and thoughts in close relationships because of the fear of being put down. They worry about making a bad impression, and they believe that they are not interesting or fun to be with. Their fears of criticism and rejection can influence the type of career they choose (one that does not involve a lot of contact with people), or career advancement (turning down promotions or job opportunities that would require more contact with people).a pattern of extreme shyness, feelings of inadequacy, and extreme sensitivity to criticism. People with avoidant personality disorder may be unwilling to get involved with people unless they are certain of being liked, be preoccupied with being criticized or rejected, or may view themselves as not being good enough or socially inept.
Borderline personality disorder. A good way of thinking about borderline personality disorder is that it is a disorder of emotional regulation. People with borderline personality disorder have very strong and intense emotions, often in reaction to how they perceive and believe others are treating them, and these emotions are difficult to control. Not surprisingly, individuals who have strong emotional reactions that are difficult to control have problems in interpersonal relationships and self-image. Interpersonal relationships are affected by strong fears of being abandoned, and the individual with borderline personality disorder may go to extremes to keep others from leaving. At an extreme, suicide may be threatened to keep someone from leaving. Relationships tend to be stormy with many ups and downs as the person alternates between having strong positive and negative feelings. The moods of the individual with borderline personality disorder are strong and frequently change. There are problems with controlling anger, and anger outbursts are common. Individuals with borderline personality disorder do not have a stable sense of their identity, and they feel empty inside much of the time. Self-destructive behavior is common. Individuals with borderline personality disorder may make recurrent suicide attempts, suicide threats, or engage in self-harming behavior such as cutting or burning. They may also do impulsive things that can cause problems such as gambling, spending money, sex, drug and alcohol use, stealing, eating binges, or reckless driving.
Dependent personality disorder. Individuals with dependent personality disorder have difficulty making everyday decisions on their own. They seek advice and reassurance for everyday decisions, and let others make decisions about important areas of their life. Individuals with dependent personality disorder bend over backwards to the point of doing unpleasant tasks for others in order to get support and gratitude. It is difficult for the person with dependent personality disorder to start projects on their own because they do not feel confident in their own abilities, and it is hard to disagree with others for fear of losing support or approval from others. Individuals with dependent personality disorder do not like being alone. They believe that they cannot care for themselves, and if a close relationship ends they may be desperate to get into another relationship quickly even if it was not the best person for them.
Histrionic personality disorder. Individuals with histrionic personality disorder are loud, overly emotionally expressive, and attention seeking. They cry at weddings, embrace people upon greeting them, and act as if they are on stage. Individuals with histrionic personality disorder do not feel comfortable unless they are the center of attention. They can be flirtatious, sexually seductive, and use physical appearance to get people’s attention. They may feel a close bond to someone they have just met, and they are quick to share personal details of their life with new acquaintances. They are often described by others as shallow.
Narcissistic personality disorder. Individuals with narcissistic personality disorder have an elevated opinion of themselves. They see themselves as accomplishing great things that establish their superiority over others. They view themselves as special and unique, and believe that only similarly special people could understand them. There is a sense of entitlement, and they feel that they have earned the right to special treatment or consideration because of who they are or what they’ve done. They are often so self-absorbed that they are intolerant of others, and they lack the capacity to understand how others feel. The admiration of others is important, and they dream of attaining status. They will take advantage of others, if necessary, to get what they desire. Individuals with narcissistic personality disorder are envious of others who have more than them, and/or believe that that others are jealous of them.
Obsessive-compulsive personality disorder is characterized by a pattern of perfectionism, stinginess, stubbornness, and inflexibility. Individuals with obsessive-compulsive personality disorder often spend so much time on small details that they lose sight of the main thing they were trying to do. They may be workaholics, who spend so much time working that they have little time for family activities, friendships, or entertainment. Others may complain that they are too strict about moral issues, and that they are cheap. Individuals with obsessive-compulsive personality disorder find it difficult to throw anything away, even when the object is old and worn and has no sentimental value. Words such as inflexible, stubborn and close-minded are used to describe individuals with obsessive-compulsive personality disorder. a pattern of preoccupation with orderliness, perfection and control. A person with obsessive-compulsive personality disorder may be overly focused on details or schedules, may work excessively, not allowing time for leisure or friends, or may be inflexible in their morality and values. (This is NOT the same as obsessive-compulsive disorder.)
Paranoid personality disorder. Individuals with paranoid personality disorder are suspicious and distrustful of others. They think that others do things just to annoy or hurt them, and they read hidden threats or put downs in the comments of others. They worry that friends or coworkers are not really loyal or trustworthy, and they are reluctant to confide in others because they believe that there is a price to pay when something personal is shared. Paranoid people have problems with anger. They are easily slighted and hold grudges. They find that people say things to attack their character or ruin their reputation, even though it does not seem that way to others. Individuals with paranoid personality disorder read too much into things, take offense at things that were not meant to be critical, and often try to get back at the person they believe is attacking them. When involved in a relationship, they often worry that their partner is unfaithful.
Schizoid personality disorder is characterized by lack of emotionality and social relationships. Individuals with schizoid personality disorder are socially isolated, and this does not bother them. They prefer to work and do things alone. They are emotionally cold, and they are neither bothered by criticism from others nor joyful when complimented. Individuals with schizoid personality disorder get pleasure from few activities, and they have little interest in sexual experiences with another person.
Schizotypal personality disorder: Individuals with schizotypal personality disorder are odd and eccentric. They dress, act, or speak in a peculiar manner. They are suspicious and paranoid, and they feel anxious in social situations because of their distrust. Because of these beliefs they have few friends. People with schizotypal personality disorder feel that others are talking about them behind their back, and that strangers are taking special notice of them. When walking into a room they sometimes think that people start talking or acting differently because they are there. Individuals with schizotypal personality disorder misinterpret reality. They may mistake noises for voices, and shadows or objects for people. They may believe in ESP, hexes, telepathy, and superstitions more strongly than most people, and their behavior is influenced by these beliefs.
A diagnosis of a personality disorder requires a mental health professional to evaluate long-term patterns of functioning and symptoms. People under 18 are typically not diagnosed with personality disorders because their personalities are still developing. Some people with personality disorders may not recognize a problem. Also, a person may have more than one personality disorder. An estimated 9% of U.S. adults have at least one personality disorder.2
Treatment
Certain types of psychotherapy have shown to be effective for treating personality disorders. Ideally, during psychotherapy, an individual can gain insight and knowledge about their disorder, what is contributing to symptoms, and get to talk about thoughts, feelings and behaviors. Psychotherapy can help a person understand the effects their behavior may be having 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.
Psychoeducation (teaching the individual and family members about the diagnosis, treatment and ways of coping)
There are no medications specifically used to treat personality disorders. However, in some cases, 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, a social worker and family members.
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 one's family doctor.
Join a support group of others with personality disorders.
Write in a journal to express one's emotions.
Try relaxation and stress management techniques such as yoga and meditation.
Stay connected with family and friends; avoid becoming isolated.
Source: Adapted from Mayo Clinic, Personality Disorders
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.
Physician Review
Mark Zimmerman, M.D.
November 2024
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR). American Psychiatric Association. (2022).
Lenzenweger MF, Lane MC, Loranger AW, Kessler RC. 2007. DSM-IV personality disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 62(6), 553-564.
