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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.

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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.

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

Avoidant personality disorder

Borderline personality disorder

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Dependent personality disorder

Histronic personality disorder

Narcissistic personality disorder

Obsessive-compulsive personality disorder

Paranoid personality disorder

Schizoid personality disorder

schizotypal personality disorder

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

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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.

Commonly used types of psychotherapy include:

• Psychoanalytic/psychodynamic/transference-focused therapy
• Dialectical behavior therapy
• Cognitive behavioral therapy
• Group therapy
• 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

References

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