I want

What is a Personality Disorder

15 June 2025

We all have emotional, cognitive, and behavioral patterns that characterize our personality. Sometimes these patterns can be rigid and make daily life difficult, for example, in social connections, at work, or impacting our overall well-being. When these rigid patterns cause persistent and significant challenges, they may indicate a personality disorder.

Personality disorders are not uncommon, affecting 10% to 15% of the population. These disorders usually develop during adolescence or during early adulthood and manifest as difficulties in various areas, including interpersonal relationships, emotional regulation, or perception of reality.

It is important to note that, unlike common myths, personality disorders are not a person’s fault or a result of weakness of character. These disorders are due to a combination of biological, psychological, and environmental factors. With the appropriate therapy, the disorder’s symptoms can lessen and become more flexible, and it is possible to achieve a significant improvement in quality of life.

If you or someone close to you experiences similar challenges, remember that you are not alone.

Seeking professional help is a crucial step towards better coping with the disorder and improving daily functioning.

Everyone has emotional, cognitive, and behavioral patterns that characterize our personality. All of these patterns create our personality, forming from early childhood and taking shape during adolescence or early adulthood. Although core personality traits generally remain stable over time, they can also become more flexible and change throughout life.

When an individual’s personality patterns (cognitive, perceptual, emotional, and interpersonal) are rigid, challenging their adaptation to the environment, they significantly hinder their personal, social, or professional functioning and cause significant distress. These persistent and significant challenges may indicate a personality disorder.

Characteristics of a personality disorder

According to the American Diagnostic and Statistical Manual of Mental Disorders (DSM), personality disorders have several key features:

This refers to a persistent pattern of behavior and a different internal experience that deviates markedly from the norms of the individual’s culture and environment. This pattern must be manifested in at least two of the following areas:

  • Cognition: Such as the way individuals understand and make sense of themselves, their relationships with others, and the way they define various events.
  • Emotions: The range, intensity, lability, and appropriateness of emotional reactions to situations.
  • Interpersonal functioning.
  • Impulse control.

Manifests as a pervasive pattern across a wide range of personal and social situations.

This causes significant distress in a variety of areas, including occupational, social relationships, or other important life areas.

Long-standing behavioral patterns that start during adolescence or early adulthood.

The diagnosis of a personality disorder necessitates excluding other explanations for the behavior, such as:

  • Another mental disorder.
  • The physiological effects of substances, such as drugs or medications.
  • Another medical condition, such as head trauma.

Prevalence

The prevalence of personality disorders in the general population is between 10% and 15%. However, there are gender differences in the prevalence of different types of personality disorders, such as antisocial personality disorder, which is more prevalent among men, while borderline and dependent personality disorders are more often diagnosed in women. Additionally, there are differences in the prevalence of disorder rates across different countries, as well as other factors that affect their prevalence, including age, race, family status, social status, culture, and the research methodologies used for assessment.

In general, over 30% of the patients treated in the mental health clinics experience personality disorders. The data is higher when it comes to the hospitalized population in the psychiatric system.

Types of disorders

According to DSM-5, there are ten types of personality disorders classified according to their key identifying characteristics:

This group includes three types of personality disorders:

  • Paranoid Personality Disorder: This disorder is characterized by extreme suspicion towards others and a tendency to interpret their intentions as hostile or harmful. Individuals with this disorder often make accusations and are prone to sensitivity, resentment, and irritability. Additionally, they may isolate themselves due to their distrust. These traits, particularly suspicion, a lack of awareness of their issues, and their habit blaming others, often lead many individuals to avoid seeking treatment.

  • Schizoid Personality Disorder: This disorder is characterized by a significant lack of interest in close social relationships, detachment, and emotional blunting. In most cases, it manifests as a preference for being alone and a disinclination towards social interaction.

  • Schizotypal Personality Disorder: This disorder is characterized by odd behavior and unusual or mystical beliefs, perceived by the society as abnormal. The disorder’s features may include odd or eccentric behavior or appearance, significant difficulties in interpersonal relationships, suspicion, abstract, and occasionally unintelligible speech.

Other key characteristics of this group include difficulties in regulating emotional intensity, impulsivity, and difficulties in impulse control.

This group includes four types of personality disorders:

  • Antisocial Personality Disorder (ASPD): This disorder is characterized by an inability to empathize, impulsiveness, a tendency to seek immediate gratification, and, in cases of provocation or frustration, aggressive behavior may emerge. This pattern of behavior involves violating or consistently disregarding moral and social norms and the rights and emotions of others, often without any regrets or remorse. This disorder often manifests in interpersonal relationships accompanied by exploitation or abuse of others and a lack of accountability. It is important to note that while not all individuals with this disorder engage in criminal behavior, many may have criminal records according to the law.
  • Borderline Personality Disorder: This disorder is characterized by significant fluctuations in self-image, perception of others, mood, behavior, and relationships, which are often stormy and unstable. Additionally, situations perceived as threats of abandonment, rejection, loss, criticism, or failure can trigger extreme reactions in a person. Individuals with this disorder frequently experience feelings of loneliness, emptiness, and self-blame. There is also a high prevalence of substance abuse, risky behaviors in general, self-harm, and suicidal thoughts in particular.
  • Histrionic Personality Disorder: This disorder manifests in an extreme need for attention, a tendency for dramatic and extroverted behavior, and exaggerated expressions of emotions that do not fit the circumstances. The behavior can sometimes involve being sexually seductive, often simply to get attention or be admired. On the surface, this behavior may seem charming, appealing, and very socially open. However, it is often perceived as dishonest and superficial. Relationships are often very demanding and lack consideration for others due to the individual’s need to be the center of attention.
  • Narcissistic Personality Disorder: This disorder is characterized by difficulties in regulating self-esteem. Individuals with this disorder are often preoccupied with fantasies of success, power, beauty, and perfection. They see themselves as unique and entitled ("I deserve it"). They swing between an exaggerated sense of their own importance and a craving for admiration, making them incredibly sensitive to any criticism. In relationships, they tend to exploit others for their own needs, driven by their self-obsession and constant need for praise and admiration.

Key characteristics of this group also include a need for control and for support.

This group includes three types of personality disorders:

  • Avoidant Personality Disorder: This disorder is characterized by an intense fear of rejection and criticism, leading to avoidance of social contact. Individuals with this disorder need and desire social connections, but due to low self-esteem, a feeling of inferiority, and a fear of being hurt, they avoid social interaction and challenging situations.
  • Dependent Personality Disorder: This disorder manifests in an increased need for emotional support, difficulty with daily decision-making, a tendency to give up personal desires to avoid conflicts with others, and a tendency to transfer responsibility for most of the major areas of life to others. They also experience an intense fear of abandonment, difficulty tolerating loneliness, and feelings of helplessness due to excessive fears of being unable to care for themselves.
  • Obsessive-compulsive Personality Disorder: This disorder manifests in an excessive aspiration for perfection that hinders functionality and causes procrastination, adherence to unflexible discipline rules and difficulty performing joint activities with others due to the rigid need for control and order. This disorder also includes a difficulty in expressing emotions and coping with flexibility or unexpected changes. Additionally, there is a tendency to frugality that is not related to scarcity and difficulty parting with old or worthless objects.

The diagnostic process

The diagnosis of a personality disorder is conducted by professionals from the fields of mental health, such as psychiatry, clinical psychology, and clinical social work. Because personality disorders cannot be diagnosed through laboratory tests, the process relies on gathering information from the patient and often through those close to them.

The diagnostic process includes an initial interview with a mental health professional during which extensive information is gathered about the developmental, family, social, and occupational history of the patient. The objective is to establish a comprehensive understanding of the patient’s behavioral patterns, thoughts, and emotions, in accordance with the criteria of the American Psychiatric Association (DSM-5) or the World Health Organization (ICD-11), and to understand their interactions and relationships with others.

Another objective is to determine whether these patterns are limited to a specific event or are persistent, inflexible, and cause long-lasting functional or emotional distress. Therefore, the diagnostic process may require more than one session. 

The clinicians monitor the patient over a certain period to assess whether these are permanent patterns characteristic of a personality disorder or a temporary condition.

An accurate diagnosis is particularly vital because it is essential for developing an appropriate treatment plan, whether psychological, medicinal, a combination of both, or another form of treatment.

Implications and challenges

The very definition of personality disorders includes reference to the individual's difficulties adapting to their environment, a significant impairment to their personal, social, or occupational functioning, and, as a result, a substantial distress. Individuals with personality disorders face their implications for many years, as these disorders develop during adolescence and often persist throughout adulthood.

Individuals with personality disorders often experience difficulties in forming close relationships, building trust, regulating their emotions, and communicating effectively with people around them. They may also encounter difficulties in maintaining occupational stability, succeeding in teamwork, and handling workplace stress. Compared to the general population, individuals with personality disorders are at a greater risk of developing other mental disorders, including depression, anxiety, eating disorders, substance abuse and addiction, and suicidal thoughts. Moreover, their emotional dysregulation and inability to manage frustrations may exacerbate stress conditions, leading to a worsening of the disorder’s symptoms.

These implications highlight the importance of early diagnosis and appropriate treatment. Such interventions can significantly improve quality of life and reduce daily life functional impairment for patients with personality disorders.

Myths which are important to debunk

As with every other topic, lack of information and prejudice are often at the root of myth and stigma creation. Regarding personality disorders, there are several common myths that can lead to judgmental attitudes and aversion. Such attitudes harm those dealing with the disorder and also make it difficult for them to reach a diagnosis and appropriate treatment.

Here are some examples of such myths:

Usually, individuals with personality disorders are not dangerous. There are, actually, at a higher risk of hurting themselves than of harming others. Often, they experience feelings of helplessness, shame, frustration, and guilt about how they act.

Individuals with personality disorders endure significant, long-term suffering, which is neither their fault nor their choice. The disorder stems from a combination of biological, psychological, and social factors. If we make an effort to encourage these individuals with a personality disorder to cope with their difficulties, take responsibility, and seek help instead of facing judgment and avoidance, we can help them significantly.

In many cases, these are persistent difficulties; however, as with many other health issues, much can be done even if a “full” cure is not always possible. Currently, there are numerous methods in psychological therapy, including Dialectic-Behavioral Therapy (DBT), and Cognitive-Behavioral-Therapy (CBT), sometimes with the help of a combination of medications, which have proven effective in achieving an improvement in quality of life, regulating emotions, and enhancing the ability to face crises. Appropriate therapy can help alleviate the disorder’s symptoms and promote greater flexibility. Long-term studies have shown that many individuals experience significant functional improvement.

A personality disorder is not a behavioral problem in the simplest sense of the word. It is a mental disorder in all respects that, as with every other health issue, has various levels of severity (mild, moderate, severe). Individuals with personality disorder are at a higher risk experiencing crises over the years. Therefore, they require significant assistance from their environment and from professional therapists. Regarding the prevalence of personal disorders, they are not rare whatsoever.

Studies have shown that over 20% of the general population experience some kind of personality disorder. It can be asserted that the exact prevalence is significantly higher.

However, due to myths and stigmas, many people carry distress with them but do not reach a diagnosis and do not receive appropriate treatment.

Although in recent years there has been an increase in the public’s awareness of mental disorders, there is still a need for a more open discussion to disprove old stigmas that are not based on facts and add significant additional suffering to the patients and their families.

Behind every diagnosis, there is a whole person with strengths, talents, hopes, and dreams. Although coping with a personality disorder is a significant challenge, it does not define who you are. If you or any of your loved ones experience the difficulties described in this article, remember that you are not alone. There is now much more knowledge, understanding, and a wide range of therapeutic tools. Numerous recovery stories testify to the fact that significant improvement in the quality of life is achievable. The first and most important step is to seek professional help. Do not hesitate to do so, share it with trusted people around you, and remember that everyone deserves a chance to live a fuller and more satisfying life.

 

Further information that might be interesting