Our personality is the way we think, feel, and behave. Many people have difficulties with how they think, feel, and behave at times, especially when this differs from what other people expect, and this is part of normal life. However, for some people, these difficulties cause distress and stop them from getting on with their lives. In these cases, a diagnosis of personality disorder may be made.
If you have a personality disorder, you tend to think, feel, and react to things in a different way to most people, and your reaction may become worse when you are stressed out. You might find it hard to change or modify your behaviour to deal with different circumstances or cope with the stresses of everyday life.
The diagnosis of personality disorder is not meant to suggest that someone has a “wrong” type of personality, but it is meant to acknowledge the distress the person experiences. It can also help the person to understand and overcome their difficulties, and allow the person to receive the treatment needed.
Mild personality disorders are fairly common, whilst severe personality disorders are quite rare and affect less than 2% of the population. People with personality disorder usually receive their diagnosis in their late teens or early twenties, but some people are diagnosed later.
There are thought to be several different types of personality disorder. However, there is some disagreement about what the different types are, and some people will have features of more than one type of personality disorder.
Common types of personality disorder include borderline (also known as emotionally unstable), avoidant, obsessive compulsive, and antisocial, but there are several other types.
Symptoms of personality disorder
The symptoms of personality disorder vary with the different types. The symptoms will have been long-standing and significantly affected your life.
Symptoms can include:
- Negative feelings, such as feeling anxious, angry, abandoned, worthless, flawed, empty, distressed, or bad about yourself.
- Having difficulty managing your thoughts and feelings, which may seem intense.
- Using harmful mechanisms to cope with your thoughts and feelings, such as self-harming, abusing alcohol, abusing drugs, not looking after yourself, taking lots of risks, or threatening other people.
- Displaying behaviour or reacting in a way that might be considered unusual, over-the-top, or impulsive.
- Feeling suicidal or feeling like hurting yourself, or actually harming yourself over and over again.
- Having difficulty forming close and lasting relationships, or having relationships that are intense but unstable.
- Feeling unsure of who you are or your purpose in life.
- Finding that your opinions of other people change rapidly.
- Having difficulty trusting other people; feeling suspicious about other people’s motives.
- Being demanding or argumentative towards other people.
- Avoiding people, feeling socially inhibited, or making excessive efforts to avoid feeling abandoned by other people.
- Sometimes losing touch with reality (known as dissociation), hearing voices, or feeling paranoid, especially if under stress.
People with personality disorders can also have other mental health problems, such as depression, at the same time as the personality disorder.
If you would like more information about personality disorders and the way they affect young people, visit the YoungMinds website Personality Disorder pages. You can also find out about how depression affects young people on the YoungMinds website.
Treating personality disorder
If you think you may have a personality disorder try to talk to someone about your concerns, maybe a parent, friend or teacher.
If you prefer you can go straight to your GP – try to explain how you are feeling, give clear examples and make notes before you go about things you want to discuss.
If your doctor thinks you have a personality disorder they may refer you to CAMHS or a specialist to ensure you get the right help.
Psychological therapies (‘talking’ therapies) are thought to be the best way to treat personality disorders. These focus on discussing your thoughts, feelings and emotions to try to improve your ability to regulate them.
The type of psychological therapy used could be psychodynamic psychotherapy (looking at negative childhood experiences that may distort thinking and behaviour), cognitive behavioural therapy (changing how we think about a situation, and therefore how we act), or interpersonal therapy (examining any negative associations with interpersonal relationships).
Medicines are not thought to be very useful for personality disorders, and no medicines are licensed for the treatment of personality disorders. Medicines cannot ‘cure’ personality disorders, whereas psychological therapies can help people with personality disorder to manage and overcome their difficulties.
However, medicines are sometimes used to manage some of the symptoms of a personality disorder in the short-term, especially in a crisis. Also, sometimes medicines will be used to treat a mental health condition that the person has in addition to the personality disorder.
If you are prescribed a medicine, it is important to give it a fair chance to see if it helps before asking to try a different medicine. This means that you may need to take the medicine for several weeks or months. Take the dose the doctor recommended and avoid missing doses. That way, you will get the most out of the medicine.
If the doctor recommends a medicine to you, then the HeadMeds medication search website will provide you with more information about the medication they are recommending, how it works, how you should take it, and how you might feel. It should also be able to answer any questions you might have about going on medication.
You may also be able to access more information about personality disorders and medicines used to treat it on the Choice and Medications website (www.choiceandmedication.org), which is usually free to access via your mental health trust.
- NHS choices. Available online http://www.nhs.uk/pages/home.aspx
- Choice and Medications website (www.choiceandmedication.org – usually free to access via your mental health trust)
- NICE CG77 Antisocial personality disorder: prevention and management. Jan 2009. Available online www.nice.org.uk
- NICE CG78 Borderline personality disorder: recognition and management. Jan 2009. Available online www.nice.org.uk
On a journey out of a very black hole, medication, particularly lithium, has provided some much needed foot holes, it’s just other stuff has, longer term, helped me not to slip back down