Personality Disorders
Personality disorders - in Brief
Personality disorders are enduring patterns of inner experience and behaviour that markedly deviate from cultural expectations, that are pervasive and inflexible, and lead to significant distress or impairment in personal, social, and occupational functioning. Unlike episodic psychiatric conditions, personality disorders affect the very structure of personality, impacting identity, emotional regulation, interpersonal relationships, and behavioural control.
Estimates suggest that approximately 10% to 12% of the general population meet criteria for a personality disorder, though many remain undiagnosed due to the subtlety or normalization of maladaptive traits. These disorders often co-occur with mood disorders, anxiety, substance use disorders, and trauma-related conditions, complicating the clinical picture.
Read more: Personality disorders
At JB Private Mental Health and within our partner network, we view personality pathology not through a lens of stigma or fixed traits, but as an opportunity for deep, transformative therapeutic work – guided by advanced assessment tools, discretion, and long-term, relational care. Therapeutic options include psychotherapy such as Dialectical Behaviour Therapy (DBT), Cognitive Behavioural Therapy (CBT), Schema Therapy, Mentalization-Based Therapy (MBT), Transference-Focused Psychotherapy (TFP), and Psychodynamic Therapy. While no medications are approved specifically for personality disorders, targeted pharmacotherapy may address comorbid symptoms such as mood instability, anxiety, sleeping problems, or impulsivity. Medications are most effective when used as an adjunct to psychotherapy.
If you or someone close to you is navigating persistent challenges in identity, emotional regulation, or interpersonal functioning, our network offers private, compassionate, and clinically sophisticated care tailored to your individual story. JB Private Mental Health is dedicated to helping you uncover the insight, balance, and resilience needed to live a life aligned with your highest potential.
JB Private Mental Health stands for absolute privacy and discretion, following a holistic state-of-the-art approach to mental and physical health considering psychological, physical, social, and cultural dimensions to ensure a personalized and optimized service.
Book your first screening today and begin your private journey towards excellence in mental and physical health.
Types of Personality Disorders
Personality disorders are grouped into three clusters based on common characteristics. Each type presents unique challenges and patterns:
Cluster A – Odd or Eccentric Disorders
- Paranoid Personality Disorder: Pervasive distrust and suspicion of others’ motives.
- Schizoid Personality Disorder: Detachment from social relationships and limited emotional expression.
- Schizotypal Personality Disorder: Acute discomfort in close relationships, cognitive distortions, and eccentric behaviour.
Cluster B – Dramatic, Emotional, or Erratic Disorders
- Antisocial Personality Disorder: Disregard for the rights of others, impulsivity, and lack of remorse.
- Borderline Personality Disorder (BPD): Instability in relationships, identity, and emotions; frequent self-harm or fear of abandonment.
- Histrionic Personality Disorder: Excessive emotionality and attention-seeking behaviour.
- Narcissistic Personality Disorder: Grandiosity, need for admiration, and impaired empathy.
Cluster C – Anxious or Fearful Disorders
- Avoidant Personality Disorder: Social inhibition, feelings of inadequacy, and hypersensitivity to criticism.
- Dependent Personality Disorder: Excessive need to be taken care of, leading to submissive and clingy behaviour.
- Obsessive-Compulsive Personality Disorder (OCPD): Preoccupation with orderliness, perfectionism, and control – distinct from Obsessive-Compulsive-Disorder (OCD).
It is important to note that each diagnosis requires comprehensive assessment to distinguish enduring personality traits from context-specific behaviours or other psychiatric conditions.
Key Messages
- Personality disorders are treatable conditions – not fixed or permanent identities.
- Change is possible through sustained, expert-guided work that addresses the roots of relational, emotional, and behavioural difficulties.
- Early diagnosis and intervention can reduce long-term impairment and enhance overall quality of life.
- High-functioning individuals with subtle personality pathology symptoms often benefit most from nuanced, private care available through our comprehensive diagnostic and treatment programs.
- Healing involves not just symptom relief, but the cultivation of self-awareness, emotional stability, and more fulfilling relationships.
Typical symptoms of Personality Disorders
Though presentations vary, hallmark symptoms across personality disorders include:
- Rigid and maladaptive patterns of behaviour that persist across time and situations.
- Distorted self-image or unstable identity.
- Impaired interpersonal functioning, often characterized by conflict, detachment, or over-dependence.
- Emotional dysregulation, such as mood swings, chronic anger, or suppressed affect.
- Difficulties with boundaries, either excessively rigid or overly diffuse.
- Resistance to feedback or insight, particularly under stress.
- Psychological strain related to the consequences of the personality disorder symptomatology.
Many individuals affected by a personality disorder are high-functioning, and their dysfunctional traits may manifest only subtly, often surfacing through recurring patterns in relationships, work, or emotional well-being that are difficult to understand without expert evaluation.
Causes & Risk Factors:
- Genetic predisposition (including family history of anxiety)
- Brain chemistry (imbalances in neurotransmitters like serotonin and dopamine)
- Environmental factors (stress, trauma, severe medical conditions, adverse life experiences)
- Personality traits (high neuroticism, introversion, conscientiousness)
Occasional fears and worries are a normal part of life and reflect an important capacity for human beings. Why these natural mechanisms manifest themselves as pathological, exaggerated anxiety in some individuals has not yet been fully clarified. However, multifactorial triggers and risk factors are being widely discussed. A genetic predisposition may increase susceptibility, while negative learning experiences can heighten fears. Stressful or traumatic life events, interpersonal conflicts, severe medical conditions or impending losses can increase and shape symptoms.
In some cases, specific triggers like crowds or social situations can be clearly identified. On others, anxiety can occur without any clear cause. Unhelpful coping strategies, such as avoidance behaviours or substance use, often reinforce and sustain excessive anxiety. Women suffer twice as often as men from anxiety disorders, and socioeconomic factors such as low income, low level of education, unemployment as well as repetitive aversive interpersonal experiences, are associated with increased risk and symptom severity.
Although comprehensive neurobiological studies have yet to identify reliable biomarkers for the detection of anxiety disorders, the proven effectiveness of medications that influence serotonin transmission in the brain suggests that this system plays a key role in the development of anxiety disorders.
Treatment Options
While personality disorders have historically been viewed as challenging to treat, modern, evidence-based interventions offer real and lasting change – especially when delivered through sustained, relationship-based, and carefully personalized care.
Psychotherapeutic Modalities:
- Dialectical Behaviour Therapy (DBT): Highly effective for Borderline Personality Disorder, DBT emphasizes emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness.
- Cognitive Behavioural Therapy (CBT): Focuses on identifying and restructuring unhelpful ways of thinking and behaving.
- Schema Therapy: Integrates cognitive, behavioural, and psychodynamic elements to reframe deeply ingrained belief systems.
- Mentalization-Based Therapy (MBT) and Transference-Focused Psychotherapy (TFP): Both aim to improve self-awareness, emotional insight, and relationship dynamics.
- Psychodynamic Therapy: Offers long-term exploration of unconscious patterns and relational themes, particularly suited for high-functioning patients seeking depth-oriented change.
Pharmacological Support
While no medications are approved specifically for personality disorders, targeted pharmacotherapy may address comorbid symptoms such as mood instability, anxiety, sleeping problems, or impulsivity. Medications are most effective when used in conjunction with psychotherapy.