Personality disorders are a group of mental illnesses. They involve long-term patterns of thoughts and behaviors that are unhealthy and inflexible. The behaviors cause serious problems with relationships and work. People with personality disorders have trouble dealing with everyday stresses and problems. They often have stormy relationships with other people.

The cause of personality disorders is unknown. However, genes and childhood experiences may play a role.

The symptoms of each personality disorder are different. They can mild or severe. People with personality disorders may have trouble realizing that they have a problem. To them, their thoughts are normal, and they often blame others for their problems. They may try to get help because of their problems with relationships and work. Treatment usually includes talk therapy and sometimes medicine.

Personality disorders are relatively stable patterns of thinking, perceiving, reacting, and relating that differ from expected norms and that begin early in life. These patterns cause the person significant distress and/or impair the person’s ability to function socially.

  • There are several types of personality disorders, and each has characteristic problems with self-image and patterns of response to others and to stressful events.
  • Symptoms are different depending on the type of personality disorder, but in general, people have difficulty relating to others and handling stress and/or have a self-image that differs from how others perceive them.
  • Doctors consider diagnosing a personality disorder when people persistently view themselves or others in ways that have no little or no basis in fact or when they continue to act in ways that routinely have negative consequences.
  • Drugs usually do not change personality disorders but may help lessen distressing symptoms.
  • Psychosocial therapies, including certain types of psychotherapy, may help people become aware of their role in creating their problems and help them change their socially undesirable behavior.

Everyone has characteristic patterns of perceiving and relating to other people and stressful events. For example, some people respond to a troubling situation by seeking someone else’s help. Others prefer to deal with problems on their own. Some people minimize problems. Others exaggerate them. However, if their characteristic patterns of behavior are ineffective or have negative consequences, mentally healthy people are likely to try alternative approaches. In contrast, people with a personality disorder do not change their response patterns even when these patterns are repeatedly ineffective and the consequences are negative. Such patterns are called maladaptive because people do not adjust (adapt) as circumstances require. Maladaptive patterns vary in how severe they are and how long they persist. For most people with a personality disorder, the disorder causes moderate problems. However, some people have severe social and psychologic problems that last a lifetime.

About 13% of people have a personality disorder. These disorders usually affect men and women equally, although some types of the disorder affect one sex more than the other. Personality disorders result from the interaction of genes and environment. That is, some people are born with a genetic tendency to have a personality disorder, and this tendency is then suppressed or enhanced by environmental factors. Generally, genes and environment contribute about equally to the development of personality disorders.

Most people with a personality disorder are distressed about their life and have problems with relationships at work or in social situations. Many people also have a mood, anxiety, somatization, substance abuse, or eating disorder. Having a personality disorder and one of these other disorders makes people less likely to respond to treatment for the other disorder and thus worsens their prognosis.

Personality disorders involve mainly problems with

  • Identity and a sense of self: People with a personality disorder lack a clear or stable image of themselves. That is, how they view themselves changes depending on the situation and the people they are with. For example, they may alternate between thinking of themselves as cruel or kind. Or they may be inconsistent in their values and goals. For example, they may be deeply religious while in church but irreverent and disrespectful elsewhere. Self-esteem may be unrealistically high or low.
  • Relationships: People with a personality disorder are usually unable to form close, stable relationships with others. They may be insensitive to others or emotionally detached, or they may lack empathy. Family members and others often find them confusing and/or frustrating.

People with a personality disorder are usually unaware of their role in creating their problems. Thus, they tend not to seek help on their own. Instead, they may be referred by their friends, family members, or a social agency because their behavior is causing difficulty for others. When they do seek help on their own, it is usually because of the problems created by their personality disorder (such as divorce, unemployment, or loneliness) or because of troubling symptoms (such as anxiety, depression, or substance abuse). They tend to believe these problems and symptoms are caused by other people or by circumstances beyond their control.

The more you learn about personality disorders the more you will understand that they are illnesses, with causes and treatments. People can improve with proper care. By seeking out information you can recognize the signs and symptoms of a personality disorder and help yourself or someone you know live a healthier more fulfilling life.

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