Do You or a Loved One Have a Personality Disorder and What Are the Best Treatment Options?

Personality disorders are a group of mental health conditions characterized by persistent patterns of thinking, feeling, and behaving that deviate significantly from cultural expectations, cause distress or impairment, and are stable over time. They typically emerge in adolescence or early adulthood.

The DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision) categorizes personality disorders into three clusters based on descriptive similarities:

 Cluster A: Odd or Eccentric Disorders

These involve social awkwardness and distorted thinking.

1. Paranoid Personality Disorder

   • Distrust and suspicion of others, interpreting motives as malevolent.

   • Often believes others are out to harm or deceive them.

2. Schizoid Personality Disorder

   • Detachment from social relationships.

   • Limited emotional expression and preference for solitary activities.

3. Schizotypal Personality Disorder

   • Acute discomfort in close relationships.

   • Cognitive or perceptual distortions (e.g. magical thinking, paranoia).

   • Eccentric behavior or appearance.

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Cluster B: Dramatic, Emotional, or Erratic Disorders

These involve problems with impulse control and emotional regulation.

4. Antisocial Personality Disorder

   • Disregard for the rights of others, often violating social norms.

   • Deceitfulness, impulsivity, lack of remorse.

   • Often associated with criminal behavior.

5. Borderline Personality Disorder

   • Instability in self-image, emotions, and relationships.

   • Fear of abandonment, impulsivity, and self-harm.

   • Intense emotional swings and chronic feelings of emptiness.

6. Histrionic Personality Disorder

   • Excessive emotionality and attention-seeking.

   • Easily influenced, considers relationships more intimate than they are.

   • Often dramatic, theatrical, or seductive behavior.

7. Narcissistic Personality Disorder

   • Grandiosity, need for admiration, lack of empathy.

   • Often exploits others, has a sense of entitlement.

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Cluster C: Anxious or Fearful Disorders

These are dominated by anxiety and fearfulness.

8. Avoidant Personality Disorder

   • Social inhibition, feelings of inadequacy.

   • Hypersensitivity to negative evaluation.

   • Avoids social interaction despite craving closeness.

9. Dependent Personality Disorder

   • Excessive need to be taken care of.

   • Submissive and clingy behavior; fear of separation.

   • Difficulty making everyday decisions without reassurance.

10. Obsessive-Compulsive Personality Disorder (OCPD)

    Preoccupation with orderliness, perfectionism, and control.

    Rigid and stubborn; often interferes with task completion.

    Different from OCD, which involves unwanted thoughts and rituals.

Important Notes:

• A person can exhibit traits of more than one disorder (called personality disorder traits).

• These disorders cause significant impairment in personal, social, and/or occupational areas.

• Diagnosis is done by trained mental health professionals through comprehensive assessment.

  
  

Common Treatments for Personality Disorders

Personality disorders can be challenging but are treatable with the right approach. Here’s a breakdown of common strategies:

🧠 Psychotherapy (Main Approach)

• Cognitive Behavioral Therapy (CBT): Helps challenge distorted beliefs and develop healthier behaviors.

• Dialectical Behavior Therapy (DBT): Especially effective for Borderline PD; focuses on emotional regulation, mindfulness, and distress tolerance.

• Schema Therapy: Targets deep-seated patterns developed in childhood; great for Cluster B and C disorders.

• Psychodynamic Therapy: Explores unconscious conflicts, early relationships, and emotional development.

  
  

💊 Medication

• No meds specifically treat personality disorders, but symptoms like depression, anxiety, or impulsivity may be managed with:

  • Antidepressants (SSRIs)

  • Mood stabilizers

  • Antipsychotics (especially in BPD or Schizotypal)

    
    

🧍‍♂️ Group Therapy / Social Skills Training

• Can help develop interpersonal skills, empathy, and support systems—especially for Avoidant or Schizoid PD.

  
  

🛡️ Long-Term Commitment

• Treatment is often long-term due to the ingrained nature of personality patterns.

• Strong therapeutic alliance (trust with the therapist) is crucial.

Kathryne Arnold is a Licensed Mental Health Therapist at Wellness Counseling, and is an Integrative Mental Health Provider as well. Kathryne is also a Certified Fellow of Clinical Hypnotherapy. Please reach out to her directly at 727-537-9211 to schedule a free 15-minute consultation to discuss her services and how she can help you start your journey to better mental health.