Personality Disorder: key facts
How does it feel to have this disorder?
- Our 'personality' is the collection of ways
that we think, feel and behave that makes us all individuals.
- Most of the time, our personality allows us to get on
reasonably well with other people, but for some of us, this isn't
- If you have a personality disorder, parts of your personality
make it hard for you to live with yourself and/or other
- You often feel unhappy or distressed and/or find that you upset
or harm other people.
- You may experience severe difficulties over a long period of
time in several of these areas:
- making or keeping relationships and friendships
- getting on with people at work or with friends and family
- keeping out of trouble
- controlling your feelings or behaviour
How common is PD?
Probably about 1 in 10
people has a PD, but many will not be severe.
Personality disorders tend
to fall into three groups according to the aspect of personality
which seems to cause the main problems:
Cluster A: 'Suspicious' - includes
- You are suspicious of other people - you feel that they are
being nasty to you.
- You are sensitive to rejection and tend to hold grudges
- You don't have strong emotions, don't like contact with other
people and prefer your own company.
- You have a rich fantasy world.
- You have odd ideas and difficulties with thinking. Other people
may see you as eccentric.
- You may see or hear strange things.
Cluster B: 'Emotional and Impulsive' -
- You don't care about the feelings of others, get easily
frustrated, fight, commit crimes and find it hard to have close
- You do things on the spur of the moment, don't feel guilty and
don't learn from unpleasant experiences.
Borderline, or Emotionally
- You do things without thinking, find it hard to control your
emotions, and feel empty.
- You feel bad about yourself and often self-harm.
- You make relationships quickly, but easily lose them.
- You often feel paranoid or depressed and, when, stressed, may
hear noises or voices.
- You over-dramatise events and tend to be self-centered.
- Your emotions are strong, but change quickly.
- You worry a lot about your appearance and crave
- You feel very important and dream of success, power and
- You crave attention, tend to exploit others and ask for favours
that you don't return.
Cluster C: 'Anxious' - includes
- You are perfectionist, worry about detail and are perhaps
- You are cautious and find it hard to make decisions.
- You have high moral standards, tend to judge other people and
worry about doing the wrong thing.
- You are sensitive to criticism and may have obsessional
thoughts and behaviours.
Avoidant or Anxious
- You are very anxious and tense, you worry a lot, feel insecure
- You want to be liked and accepted, and are sensitive to
- You rely on others to make decisions for you and do what others
want you to do.
- You find it hard to cope with daily tasks, feel hopeless and
incompetent, and easily feel abandoned by others.
Treatments that can help
Psychologists and psychiatrists can help. You
can learn to control aspects of your emotions and behaviour which
cause these problems.
Our personalities tend to stay constant over a long period of
time, so the treatment will often be long-term.
The main treatments for Personality Disorder are based
on talking therapies, behavioural therapies and regular
contact with support services. For most people treatment is most
effective a community setting. Drug treatments can also help
in a small number of people.
It has been difficult to study the benefits of medications in
Personality Disorder, which means evidence for their effects is
limited. Medication may be used to manage distressing and severe
symptoms in some people, usually in the short-term. They are also
used to treat other mental disorders, such as depression which
people with Personality Disorders may also suffer with at times.
Most drug trials are based on Borderline Personality Disorder.
drugs can help if people feel paranoid, or are hearing
noises and voices.
Antidepressants can help
treat depressive and anxiety disorders in people with Personality
Disorders. There is some evidence to suggest they may also help
with reducing aggressive, impulsive and self-harming
stabilisers such as lithium, carbamazepine and sodium
valproate may also reduce impulsiveness and aggression in some
How effective is treatment?
The evidence is weak because treatments are usually quite
complicated, so it is hard to know what part actually worked. The
studies are also usually small and rather too short, and the ways
of measuring improvement are poor. However, there is growing and
encouraging evidence to show that symptoms of Borderline
Personality Disorder can improve and even resolve over time.
Which approach is best for me?
This depends on what approach and setting you prefer, as well as
the type of problem that you have. However, a lot depends on what
is available in your area. The choice of treatment should be
discussed with your psychiatrist or care co-ordinator.
How to help yourself
There are lots of things you can do to help you manage and
reduce your difficulties. Some of these things may sound obvious,
but they can make a big difference. For example:
- Develop a hobby or interest. This can help you
deal with stress. Any activity or interest can help, from
knitting to reading to watching football, so long it is something
you enjoy doing.
exercise. Although this can be difficult to do in
stressful times, it can be a very good stress-reliever. Any
sort of exercise can help, such as a brisk walk for 30 minutes a
day - whatever you feel most comfortable with.
use. When we’re feeling low or stressed, alcohol can
provide some temporary relief. However, more often it makes us feel
even more stressed and angry. Avoid alcohol in stressful times and
this can greatly reduce the chance of you coming to any harm (from
other people and from yourself).
- Avoid any illicit
drugs. Like with alcohol, drugs can seem like they help
relieve stress, but in reality they make situations much more
difficult to deal with, and make people much more vulnerable to
developing even more negative feelings.
sleep. Irregular or lack of sleep can leave us
feeling tired which makes most people vulnerable to becoming
more irritable and stressed. Regular sleep can make us better
prepared to face challenges which life can throw at us.
- Engage with your
mental health team. Sticking with your treatment plan can,
over time, provide a helpful routine and allow you develop
better ways of coping. Seeking help from your team at times of
crisis can also help you avoid coming to harm in difficult
How other people can help?
Some people think it can be helpful to let
those around you know about you mental health problems, whether
they are family, friends or colleagues at work. This may help
people know what things can help you, especially during times of
It is not easy to be open with people about
these issues. It may help to discuss this with your doctors or
mental health team to decide if this is the right approach for
Helping someone else
It can be difficult to understand why someone
might be behaving in a certain way. Their behaviour may be
difficult and even dangerous. It is important to try to understand
things from their perspective, however difficult that may be at
times. If you are concerned about someone with a Personality
Disorder, it may be useful to encourage them to adopt some of
the simple, ‘healthy-living’ measures outlined above. You may also
find it helpful to get advice from your local doctor.
For more in-depth information see our main leaflet: Personality Disorders
This leaflet reflects the most up-to-date evidence at the time
Produced by the RCPsych Public Education Editorial Board.
Series Editor: Dr Philip Timms
Reviewed by Dr Michael Yousif
© January 2016. Due for
review: January 2018. Royal College of
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