In a crisis?
For urgent medical attention, for example, if you’re worried about acting on thoughts of suicide, or you’ve seriously harmed yourself, you can call 999 or go straight to A&E.
What are personality disorders?
Our personality is the collection of thoughts, feelings and behaviours that makes each of us the individuals we are.
We don’t always think, feel and behave in exactly the same way – it depends on the situation we are in, the people with us and many other interconnecting factors.
However, if you experience significant difficulties in how you relate to yourself and others and have problems coping day to day, you may receive a diagnosis of personality disorder.
“I just felt like things were happening over and over again and no one would understand I couldn’t stop it. I tried to explain it, and I just feel like no one understands what it is like to be me, to have to live with this all the time.”
You can only be diagnosed with a personality disorder by a mental health professional experienced in diagnosing and treating mental health problems, such as a psychiatrist or psychologist – not by your GP.
Our understanding of what it means to experience a personality disorder is constantly evolving. It is a controversial diagnosis. People have different views about these terms, and not everyone agrees with using them. This can be because specialists disagree on how to understand personality disorders. It doesn’t take social context into account and because term itself can be stigmatising.
The important thing to remember is that the feelings and behaviours associated with personality disorders can be difficult to live with. However, you can understand your diagnosis, and whatever terms you prefer to use – and you deserve understanding and support.
You might be given this diagnosis if all of these apply:
- The way you think, feel and behave causes you significant problems in daily life. For example, you may feel unable to trust others or you may often feel abandoned, causing you or others distress in day-to-day relationships.
- You experience these problems across different aspects of your life. For example, you may struggle to start or keep friendships, to control your feelings and behaviour, or get on with people. There may be an intensity to your emotions that makes them feel frightening and overwhelming sometimes.
- These problems continue for a long time. These difficult patterns may have started when you were a child or teenager and can carry on into your life as an adult.
- These problems arenot solely caused by a substance or a medical condition. For example, using drugs or medication can cause changes in people, as can the physical effects of experiences like head trauma.
“I felt like a diagnosis of a personality disorder would make me defective, or that they were saying I was fundamentally wrong as I was but I’ve always tried to be a good person. That hurt, but in the end it’s just a diagnosis, it’s just about saying this is what’s happening for you and it gives you the steps to make a clearer treatment plan.”
What types of personality disorders are there?
Currently psychiatrists tend to use a system of diagnosis which identifies ten types of personality disorder. These are grouped into three clusters suspicious, emotional and impulsive and anxious.
Cluster A: SUSPICIOUS
Paranoid personality disorder
The thoughts, feelings and experiences associated with paranoia may cause you to:
- find it hard to confide in people, even your friends and family
- find it very difficult to trust other people, believing they will use you or take advantage of you
- have difficulty relaxing
- read threats and danger (which others don’t see) into everyday situations, innocent remarks or casual looks from others.
Schizotypal personality disorder
Everyone has their own eccentricities or awkward behaviours. But if your patterns of thinking and behaving make relating to others very difficult, you may receive a diagnosis of schizotypal personality disorder.
Unlike in schizophrenia, you usually would not experience psychosis. However, you may:
- experience distorted thoughts or perceptions
- find making close relationships extremely difficult
- think and express yourself in ways that others find ‘odd’, using unusual words or phrases, making relating to others difficult
- believe that you can read minds or that you have special powers such as a ‘sixth sense’
- feel anxious and tense with others who do not share these beliefs
- feel very anxious and paranoid in social situations, finding it hard to relate to others.
Antisocial personality disorder
It is natural to sometimes put our own needs, pleasure or personal gain before those of others around us.
However, if these actions occur very frequently and you struggle to keep stability in your life, or you regularly act impulsively out of anger or lack of consideration for others, this could lead to a diagnosis of antisocial personality disorder.
- put yourself in dangerous or risky situations, often without thinking about the consequences for yourself or other people
- behave dangerously and sometimes illegally (you may have a criminal record)
- behave in ways that are unpleasant for others
- feel very easily bored and act on impulse – for example, you may find it difficult to hold down a job for long
- behave aggressively and get into fights easily
- do things even though they may hurt people – to get what you want, putting your needs and desires above other people’s
- have problems with empathy – for example, you may not feel or show any sense of guilt if you have mistreated others
- have had a diagnosis of conduct disorder before the age of 15.
Cluster B: EMOTIONAL AND IMPULSIVE
Borderline personality disorder (BPD)
Borderline personality disorder (BPD) is also known as emotionally unstable personality disorder (EUPD).
We can all experience difficulties with our relationships, self-image and emotions. But you might get a diagnosis of BPD/EUPD if these feel consistently unstable or intense and cause you significant problems in daily life.
- feel very worried about people abandoning you, and either do anything to stop that happening or push them away
- have very intense emotions that can change quickly (for example, from feeling very happy and confident in the morning to feeling low and sad in the afternoon)
- not have a strong sense of who you are or what you want from life, with your ideas about this changing significantly depending on who you’re with
- find it very hard to make and keep stable relationships or friendships
- act impulsively and do things that could harm you (such as binge eating, using drugs or driving dangerously)
- have suicidal thoughts
- feel empty and lonely a lot of the time
- get very angry, and struggle to control your anger
- struggle to trust other people
- experience other mental health problems alongside BPD, including anxiety, depression, eating problems and post-traumatic stress disorder.
When very stressed, sometimes you might:
- feel paranoid
- have psychotic experiences, such as seeing or hearing things that other people don’t
- feel numb or ‘checked out’ and not remember things very well after they’ve happened (known as dissociation).
Histrionic personality disorder
Most people enjoy being given compliments or positive feedback about their actions. But if you depend very heavily on being noticed or seek approval so often that this affects your day-to-day living, you might get a diagnosis of histrionic personality disorder.
- feel very uncomfortable if you are not the centre of attention
- feel that you have to entertain people
- constantly seek, or feel dependent on, the approval of others
- make rash decisions
- flirt or behave/dress provocatively to ensure that you remain the centre of attention
- get a reputation for being dramatic and overemotional
- be easily influenced by others.
Narcissistic personality disorder
It is human nature to be aware of our own needs, to express them, and to want others to be aware of our abilities and achievements. These are not bad traits. However, if these thoughts, feelings and behaviours are very extreme and cause problems in relating to others, you may get a diagnosis of narcissistic personality disorder.
- believe that there are special reasons that make you different, better or more deserving than others
- have fragile self-esteem, so that you rely on others to recognise your worth and your needs
- feel upset if others ignore you and don’t give you what you feel you deserve
- resent other people’s successes
- put your own needs above other people’s, and demand they do too
- be seen as selfish and dismissive or unaware of other people’s needs.
Cluster C: ANXIOUS
Avoidant personality disorder
We all have things, places or people we don’t like, or which make us anxious. But if these things cause so much anxiety that you struggle to maintain relationships in your life, you may get a diagnosis of avoidant personality disorder (sometimes also called anxious personality disorder).
- avoid work or social activities that mean you must be with others
- expect disapproval and criticism and be very sensitive to it
- worry constantly about being ‘found out’ and rejected
- worry about being ridiculed or shamed by others
- avoid relationships, friendships and intimacy because you fear rejection
- feel lonely and isolated, and inferior to others
- be reluctant to try new activities in case you embarrass yourself.
Dependent personality disorder
It is natural to need other people to care for us or give us reassurance sometimes. A healthy balance involves being able to both depend on others as well as being independent from others sometimes. However, if feelings and thoughts about needing others become so overwhelming that they impact your daily life and relationships, you may get a diagnosis of dependent personality disorder.
- feel needy, ‘weak’ and unable to make decisions or function day-to-day without help or support from others
- allow or require others to assume responsibility for many areas of your life
- agree to things you feel are wrong or you dislike to avoid being alone or losing someone’s support
- be very afraid of being left to fend for yourself
- have low self-confidence
- see other people as being much more capable than you are.
Obsessive compulsive personality disorder (OCPD)
Obsessive compulsive personality disorder (OCPD) is separate from obsessive compulsive disorder (OCD), which describes a form of behaviour rather than a type of personality.
However, similarly to OCD, OCPD involves problems with perfectionism, the need for control, and significant difficulty being flexible in how you think about things.
- need to keep everything in order and under control
- set unrealistically high standards for yourself and others
- think yours is the best way of doing things
- worry about you or others making mistakes
- feel very anxious if things aren’t ‘perfect’.
Personality disorder not otherwise specified (PD-NOS)
Everybody is individual and behaves in unique ways, so it is only natural to not fit neatly into the categories described above.
If you experience a number of personality disorder traits but not enough to fully meet the criteria of a specific type, you may receive a diagnosis of personality disorder not otherwise specified (PD-NOS). This diagnosis may also be known as personality disorder trait specified.
How can I help myself?
Self-care and being kind to yourself can help you manage symptoms. This might include:
- Keeping a mood diary
- Create a safety plan (coming soon)
- Make a self-care box full of things you like or enjoy, including pictures/quotes, favourite books etc.
- Grounding exercises such as the ‘5-4-3-2-1 senses technique’ (name 5 things you can see, 4 things you can feel, 3 things you can hear, 2 things you can smell, 1 thing you can taste). Focus on the details of the things and their physical properties.
- Maintaining and building healthy stable support networks
This could be through peer support – accessible through Dorset Mind.
What help is there?
- Talking to your GP can be a good place to start. They can refer you to your CMHT or CAMHS who may give you a personality disorder diagnosis.
- Long term treatments often combine a mix of medication and talking therapies.
- Dorset Mind Your Head doesn’t currently provide immediate support services for young people who are experiencing a severe mental health crisis or psychological distress. Contacting a listening service when in crisis or feeling out of control can give you immediate support
The Samaritans offer emotional support and a listening ear, 24 hours a day, 365 days a year. It’s a FREEPHONE number that can even be called from a mobile with no credit.
– Call them on 116 123 (24hr)
– Or email: firstname.lastname@example.org
A helpline for people of all ages in Dorset who are experiencing mental health issues & need support.
– Call 111 and select ‘mental health’
– Or dial 0300 1235440 to access support.
Papyrus provides confidential support and advice for young people struggling with thoughts of suicide and anyone worried about a young person.
– Call 0800 068 4141 or 07860 039967, 9am to 10pm weekdays, 2pm to 10pm weekends and bank holidays
– Or email: email@example.com
Kooth provides FREE, safe, anonymous support for children and young people. You can live chat or message the team of counsellors, join discussion boards and use a daily journal to track your feelings.
– Visit kooth.com
Shout provides a 24/7 text service, FREE on all major mobile networks, for anyone in crisis. It’s a place to go if you’re struggling to cope and you need immediate help.
– Text SHOUT to 85258.
Provides information and support for under 25s. Get advice about sex, relationships, drugs, mental health, money and jobs. Provides a Crisis Messenger, helpline and 1-2-1 Chat online via themix.org.uk.
– Call 0808 808 4994
– Or text THEMIX to 85258.
Young Minds is a national charity that supports young people with mental ill health and campaigns about the issues. They provide a range of resources plus specialist help for parents whose children have mental health issues.
– Text YM to 85258,
– Or if you are a parent worried about your child, call 0808 802 5544.