• A personality disorder can affect how you cope with life, manage relationships, how you behave, and how you feel.
• There are different types of personality disorders.
• There is no single cause of personality disorders. It can be a combination of reasons, including genetic and environmental causes.
• Talking therapies are recommended as treatment for personality disorders.
• You can have a personality disorder alongside other mental health problems, such as anxiety and depression.
• There is carer support available for people who support someone with a personality disorder. 

Everyone has different ways of thinking, feeling, and behaving. It is these thoughts, feelings, and behaviours that make up our personality. These are often called our traits. They shape the way we view the world, the way we relate to others and how we behave. By the time we are adults they will make us part of who we are.

You can think of your traits as sitting along a scale. For example, everyone may feel emotional, get jealous, or want to be liked at times. But if these traits cause significant problems for you and others, you may be diagnosed as having a personality disorder.

A personality disorder can affect your emotions, how you cope with life, and how you manage relationships. You may find that your beliefs and ways of dealing with day-to-day life are different from others. You might find it difficult to change them.

You may find your emotions confusing, tiring, and hard to control. This can be distressing for you and others. Because it is distressing, you may find that you develop other mental health problems like depression or anxiety.

You may also do other things like use alcohol or drugs, or self-harm, to cope with distressing emotions. Research has suggested that around 1 in 20 people live with a personality disorder.  

You can find more information on our webpages about:

• Anxiety disorders
• Depression
• Drugs, alcohol, and mental health

Only a psychiatrist can diagnose you with a personality disorder. A psychiatrist is a medical doctor who specialises in mental health.

You can see your GP to begin with. They might refer you to an NHS personality disorder team or to the NHS community mental health team. Psychiatrists work for these teams.

You can find more information about GPs and your mental health on our webpage.  

During the assessment your psychiatrist will talk to you about your mental health. They will ask you questions. The conversation might cover: 

• your symptoms and experiences,
• your feelings, thoughts, and actions,
• your physical health and wellbeing,
• social and family relationships,
• use of drugs or alcohol, and
• past experiences, including similar problems.

The assessment is not a test or an exam. It is about finding the right diagnosis and help for you. 

The more open and honest you are the easier it will be for the psychiatrist. It will help them to reach the right diagnosis and offer you the right treatment and support. 

Once your psychiatrist has assessed you, they might think you have a personality disorder. If they do, they will use a manual to help diagnose you. 

The 2 manuals usually used by medical professionals in England are the: 

• International Classification of Diseases (ICD-11), which is produced by the World Health Organisation (WHO), and  
• Diagnostic and Statistical Manual (DSM-5), which is produced by the American Psychiatric Association (APA).  

When making a diagnosis your psychiatrist will: 

• think about your symptoms and behaviours,
• look at whether there could be any physical
• health concerns causing the symptoms, and
• compare them to the guidelines 

Your psychiatrist may refer you for additional testing if they feel it is needed.

Problems with diagnosis are explored in more detail in the ‘What problems can be linked to personality disorders?’ section below.

How does the ICD-11 diagnose personality disorders? 

The ICD-11 no longer diagnoses personality disorders into different types or groups. Instead, they now diagnose on severity. That is, mild, moderate or severe personality disorder.

‘Trait domain specifiers’ are patterns of personality. There are 6 ‘trait domain specifiers’ in the ICD-11 that are used when diagnosing personality disorders. You may find that one or more of these patterns play a big part in someone’s personality. 

An example of one of these specifiers is ‘borderline pattern’. More information on borderline traits can be found in the ‘What are the different types of personality disorders?’ section below.

How does the DSM-5 diagnose personality disorders? 

The DSM-5 continues to identify 10 different personality disorder types. They are categorised into 3 different groups. They are explained in the 'What are the different types of personality disorders?' section below.

The Diagnostic and Statistical Manual (DSM-5) classifies personality disorder diagnoses into groups. They are grouped into 3 groups: A, B, and C. 

What are the group A personality disorders?

People who live with group A personality disorders can find it hard to relate to other people. Their behaviour might seem unusual or eccentric. 

What is paranoid personality disorder? 

If you have been diagnosed with paranoid personality disorder, you may be suspicious of other people. Sometimes this can make it feel like others are being unfriendly, even when they do not mean to be. You might also be very aware of feeling left out or remember past hurts for a long time.

What is schizoid personality disorder? 

If you live with schizoid personality disorder, you may have few social relationships and might prefer to be alone. You may not enjoy or want to be part of a close relationship. This might include being part of a family. You might seem quiet, private, or emotionally distant in social situations.

What is schizotypal personality disorder?

If you live with schizotypal personality disorder, starting and maintaining relationships with others may feel difficult. You might have unusual thoughts or beliefs, feel cautious around people, or act differently from what others expect. You may also express your feelings in ways that surprise others or are sometimes hard for them to understand.

What are the group B personality disorders?

People with group B personality disorders can find it hard to control their emotions. 

What is borderline personality disorder (BPD)? 

You may have strong emotions, mood swings, and feelings you cannot cope with if you live with BPD. You may feel anxious and distressed a lot of the time. 

You might have problems with how you see yourself and your identity. You may self-harm or use drugs and alcohol to cope with these feelings. This can affect the relationships you have with other people. 

BPD is also known as emotionally unstable personality disorder (EUPD) and emotional intensity disorder (EID).

You can find more information about Borderline personality disorder on our webpage.

What is antisocial personality disorder (ASPD)? 

Being diagnosed with antisocial personality disorder may mean that you sometimes act quickly or take risks. It might also mean that you do not always notice how your actions affect other people at the time.

You may become frustrated easily and react strongly when you feel stressed or challenged. At times, you might say or do things to meet your needs, which others may see as uncaring or selfish. You may also find yourself placing responsibility for problems on other people.

What is histrionic personality disorder? 

If you live with histrionic personality disorder, you may like being the centre of attention. You may feel anxious about being ignored. This can cause you to be lively and over-dramatic. 

You may become bored with normal routines easily. You may care a great deal about your appearance, and want reassurance that you are seen and appreciated. You might also be open to other people’s opinions and easily influenced by those around you. This can sometimes lead to experiencing depression. 

What is narcissistic personality disorder? 

Living with narcissistic personality disorder may mean you feel very important and special compared to other people. You may believe you are better than others and want a lot of attention or praise.

At times, you may feel you deserve more rewards or special treatment than other people. Focusing on your own needs can make it harder to notice how other people feel. You may also feel upset easily by criticism, especially when it affects how you see yourself. 

What are the Group C personality disorders?

People with group C personality disorders have strong feelings of fear or anxiety. 

What is dependent personality disorder? 

If you live with dependent personality disorder, you may allow other people to take responsibility for parts of your life. You might not have much self-confidence or be able to do things alone. You may put other people’s needs first, feel hopeless at times, or be afraid of being alone. You might also feel abandoned by others or let them make decisions for you.

What is avoidant personality disorder? 

If you live with avoidant personality disorder, you may feel anxious, tense, insecure and inferior. This can cause you to feel uncomfortable in social situations. You might not like criticism or you may worry a lot. You might have low self-esteem. You may want affection but worry that you will be rejected.

What is obsessive-compulsive personality disorder? 

If you live with this condition, you may feel anxious about things that seem unorganised or ‘messy’. Everything you do must be just right, and nothing can be left to chance. 

You may be very cautious about things and think a lot about small details. You might have problems completing tasks due to your own high standards. Others may see you as being controlling.   

Obsessive-compulsive personality disorder is different to obsessive compulsive disorder (OCD). If you have obsessive-compulsive personality disorder, you may believe your actions are justified. People with OCD tend to realise that their behaviour is not rational.

You can find more information about Obsessive compulsive disorder (OCD) on our webpage. 

It is not clear what causes personality disorders to develop. It is thought to be a mix of factors.

These can include: 

• biological factors, such as traits passed through your genes and,  
• the environment around you when you were growing up.

Many people diagnosed with personality disorders have experience of trauma. This might include difficulties growing up, including:

• childhood neglect
• physical abuse
• emotional abuse, or
• sexual abuse. 

When you are growing up, you learn to cope with emotional changes and how to make relationships with other people. If you are abused or neglected whilst growing up, often do not learn these things. So, you may find it more difficult to manage how they feel when they are adults. You might develop ways of coping that might lead to further difficulties. 

This does not mean that all people who experience trauma will develop personality disorders. But they are more likely to.  

Personality disorders are usually treated with psychological treatments or talking therapies. See ‘Can therapy help with personality disorders?’ below for more information. 

Treatment can help you to have a more meaningful life or cope better with your condition. 

You and your doctor or healthcare team should agree on a treatment plan that works best for you. 

If your GP feels you are living with a personality disorder they may refer you to:

• an NHS community mental health team, or
• a specialist NHS personality disorder service, if there is one locally. 

You can search on the internet to see if there is a specialist NHS personality disorder service locally. Use a search term like ‘NHS personality disorder service [area where you live].’

These services are made up of professionals such as psychologists, psychiatrists, and therapists. They will have experience in helping people with personality disorders. Sometimes you can contact these services yourself to get help. 

It is always worth asking why a certain treatment is being offered. And if there are other things that could help you get better.

You can find more information about 'NHS mental health teams - Community, crisis, and early intervention' on our webpage. 

How do professionals choose what treatment is best for me?

When choosing your treatment, professionals should follow guidance like the NICE guidelines. NICE stands for 'The National Institute for Health and Care Excellence'. The NICE guidelines recommend treatment for conditions.

For personality disorders NICE only have guidelines for borderline personality disorder (BPD), and antisocial personality disorder, 

You can access the guidelines here: 

• NICE Guidelines on borderline personality disorders
• NICE Guidelines on antisocial personality disorders

Can medication be used to treat personality disorders?

There is no recommended medication for the treatment of personality disorders. 

But your doctor may offer you medication to help with symptoms of anxiety, low mood, or psychosis. These might include antidepressants or antipsychotics.  

If you are offered any medication, your doctor should tell you:

• how it should help, and
• about any side effects that you might experience.

You can find more information on our webpages about:

• Antidepressants
• Antipsychotics
• Psychosis

Talking therapies are used to treat personality disorders. Below are the different types of talking therapy that you may be offered.  

Therapy for personality disorders is usually long term and often involves some group therapy. You might have to complete the full course of therapy to get the most out of it. If you are having issues with your therapy for any reason, you can tell your therapist.   

What is dialectical behaviour therapy (DBT)? 

DBT can help you learn to spot and control your emotions and behaviour.

It helps you to recognise and then change unhelpful behaviours by learning new skills. Unhelpful behaviours might include:

• thinking about suicide,
• self-harming, or
• drinking alcohol or using drugs to cope with your emotions. 

DBT usually involves weekly individual and group sessions. You should be given an out-of-hours contact number to call if your symptoms get worse.

DBT is based on teamwork. You will be expected to work with your therapist and the other people in your group sessions. 

The National Institute for Health and Care Excellence (NICE) says DBT can be helpful if you have borderline personality disorder.  

A course of DBT usually takes place over 18 months. 

You can read more about how DBT is used as a treatment on the NHS website.

What is cognitive analytical therapy (CAT)?  

CAT helps you to look at patterns in how you think, especially around relationships. These patterns may cause you problems and you may find it difficult to change them. You may have learnt these patterns while growing up to cope with difficult emotions. 

You and your therapist will work together to recognise these patterns and then try to change them. It looks at your current situation and the problems you are having. 

This type of therapy can usually last between 4 – 24 weeks. But on average lasts 16 weeks.  

You and your therapist will agree on the end goal at the start of the therapy.

What is mentalisation based therapy (MBT)?

Mentalising is about making sense of what you and other people think, need, or want. It is about being aware of what is going on in your own mind and in the minds of others. Sometimes when you feel distressed, it can be harder to mentalise.

You would attend group and one-to-one therapy. This may help you better understand yourself and others and learn how to mentalise. Treatment programmes can last for 12 to 18 months.  

What is psychodynamic or psychoanalytic therapy?  

This type of long-term therapy helps patients understand and resolve their problems. It helps you notice your thoughts and feelings more clearly. It also shows how they affect your relationships now and in the past.

It helps people to understand and change complex, deep-seated emotional and relationship problems. Deep-seated emotions are strong feelings that have been inside you for a long time, sometimes without you even noticing them.

What are therapeutic communities? 

A therapeutic community is a place where you would get long-term group therapy. 

You would visit, or sometimes stay, for weeks or months. Sometimes you may visit for just a few days a week. 

You learn from spending time with other people in the treatment group. It offers a safe place if there are any disagreements or upsets. People in a therapeutic community often have a lot of say over how the community is run. 

There are only a few therapeutic communities in the UK. You can check with your local Patient Advice Liaison Service (PALS) to see if your NHS trust has one.

You can search for your local PALS office here.

If you are not happy with your care or treatment you can: 

• talk to your doctor about your care and treatment,
• ask for a second opinion,
• get an advocate to help you speak to your doctor,
• make a complaint or,  
• contact Patient Advice and Liaison Service (PALS) 

You can find your local PALS here 

You can find more information on our webpages about: 

• Second opinions – About your mental health diagnosis or treatment
• Advocacy for mental health – Making your voice heard
• How do I complain about the NHS or social services?

Diagnosis

Doctors sometimes find it difficult to diagnose personality disorders. This can be because of the following:

• An overlap with other mental health problems can make it difficult to pinpoint or ‘narrow down’ symptoms. For example, some symptoms of a personality disorder can be similar to complex post-traumatic stress disorder (CPTSD) or bipolar disorder.
• Personality disorders are complex. The symptoms may not easily fit into any one of the groups.
• If you use drugs or drink alcohol a lot, it can make it more difficult for health professionals to reach a correct diagnosis.
• Some doctors are reluctant to give this diagnosis. They might feel that it may be ‘problematic’ or make it harder for you to get help. 

You may feel you have been given a diagnosis of personality disorder because a professional is unsure of your diagnosis. 

You may find it an unhelpful label or that it is stigmatising however, some people find it helpful. It can help them understand certain things they do. It can also help with finding the right treatment and support. 

Jenny’s story

I did not understand why I had been given the diagnosis of personality disorder. At first, it was insulting. It felt like I was being told my personality was wrong or that I was somehow ‘flawed’. Everyone has faults and traits and everyone does things wrong. However, after some encouragement from my partner, I started the therapy that was offered. Over time, I began to learn techniques and methods that slowly helped with how I was feeling.

What can I do if I disagree with my diagnosis?

If you disagree with your diagnosis you can speak to your psychiatrist. You can explain why you do not agree, giving specific reasons. 

If you are still not happy after you have spoken to your psychiatrist, you can ask for a second opinion. 

You do not have a legal right to a second opinion. But your psychiatrist should listen to your reasons for wanting a second opinion. If you are denied a second opinion and you are unhappy about that, you can complain.

You can find more information on our webpages about:

• Second opinions - About your mental health diagnosis or treatment, 
• Complaining about the NHS and social services

Services and recovery

The Department of Health says that people with personality disorders should be able to get the right care and services.

Some people are not always able to get the right treatment. This is because specialist NHS personality disorder services are not in every area.

If this is the case:

• you should still be offered treatment for your personality disorder by NHS mental health services,
• you can speak to your GP to apply to get treated by a personality disorder service in another area, and
• you can complain.

You can find more information on our webpages about:

• NHS treatment – Your rights,
• Complaining about the NHS and social services

Self-harm

Self-harm is harming yourself on purpose. This could include:

• scratching,
• cutting,
• overdosing on medication,
• biting, or
• burning.

Self-harm is common if you live with borderline personality disorder (BPD). 

You may self-harm because you find it difficult to cope with your moods or how you feel. Everyone has their own reasons for self-harming. 

You can find more information about 'self-harm' on our webpage.

Use of alcohol and drugs

People with personality disorders sometimes use drugs or drink alcohol to cope with difficult emotions and feelings.

Drinking alcohol or using drugs can lead to:

• doing things that you might not do normally,
• behaving impulsively which means acting on the spur of the moment, and
• poor physical health.

Antisocial personality disorder and borderline personality disorder have the strongest links with alcohol and drugs.  

Some specialist personality disorder services may have some conditions if you use drugs or drink alcohol. They may say you need to cut down or stop before you can use the service.

You can find more information about 'drugs, alcohol and mental health' on our webpage.

As a loved one of someone living with a personality disorder, you might find that you also need support. Caring for someone with a personality disorder can be challenging.

You might find the following organisations useful:

Carers UK 
Carers UK run an advice line, online support and carers groups throughout the UK.

Phone: 0808 808 7777
Address: 20 Great Dover Street, London SE1 4LX
Email: advice@carersuk.org  
Website: www.carersuk.org 

Carers Trust
Their website gives practical advice about caring for someone. You can also search for support in your area. 

Phone: 0300 772 9600
Address: Carers Trust, 2-6 Boundary Row, London SE1 8HP
Email: info@carers.org
Website: www.carers.org 

GOV.UK - Carers
This is a website where you can find government services and information. They have information on many issues related to caring for someone, including financial affairs and carers’ rights.

Website: www.gov.uk/browse/disabilities/carers   

Your local council might be able to give you information on local carers groups and services in your area.

You can ask your local authority for a carer’s assessment if you feel you need more support to care for your loved one.

There are rules regarding confidentiality and carers. Unless the person you care for agrees, confidential information about them cannot be passed on to you. Professionals should ask their permission and ask what they are happy for others to know. This would also include any care plans they have. 

You can find more information on our webpages about: 

• Supporting someone with a mental illness
• Carers’ assessments – Under the Care Act 2014
• Confidentiality – For carers, friends and relatives

BPD World 

An organisation committed to raising awareness and reducing the stigma of mental health with a focus on borderline personality disorder (BPD). It provides online information, advice and support and has an online forum.

Website: www.bpdworld.org

Tara (Treatment and Research Advancements) for BPD 

An American education-based and support community for carers and families of people living with BPD.

Website: www.tara4bpd.org

Out of the Fog 

They offer information on personality disorders and an online support forum.

Website: https://outofthefog.website/

Borderline Arts

Borderline Arts is a charity that uses the arts to raise awareness of borderline personality disorder. Through increasing understanding of the condition, they not only educate people, but also break down the stigma surrounding it. 

Address: 119 Osmaston Road Derby DE1 2GD
Website: www.borderlinearts.org