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Personality Disorders

Your personality is what makes you you — a unique blend of your experiences, environment, thoughts, and emotions. It shapes how you understand yourself, how you connect with others, and how you respond to the world around you.  

But sometimes, certain patterns in how you think, feel, and behave can lead to ongoing distress and difficulty managing daily life. When these patterns are persistent, deeply rooted, and interfere with your sense of self, relationships, or ability to function, they may be signs of a personality disorder. 

What is a personality disorder?  

A personality disorder is a mental health condition that involves long-term patterns of thinking, feeling, and behaving that are significantly different from what is typically expected in a person’s culture. These patterns are often rigid and unchanging, and they can create serious challenges in how someone sees themselves, relates to others, and manages everyday life. 

Everyone has moments of emotional difficulty, strained relationships, or stress-related reactions — that’s part of being human. But with a personality disorder, these patterns are more persistent and deeply rooted. They often begin in adolescence or early adulthood and can impact a person’s ability to function at work, maintain relationships, or respond to life’s challenges in healthy ways. 

Personality disorders are not a sign of weakness or something someone chooses to have. They are complex conditions shaped by a mix of biological, psychological, and environmental factors — and with the right support, people living with personality disorders can find ways to cope, heal, and thrive. 

Types of Personality Disorders 

The 10 personality disorders are classified into three clusters based on the most representative emotional responses and behaviors: 

Cluster A personality disorders 

Those with Cluster A personality disorders have difficulty relating to other people and often behave in a way that others might consider odd or eccentric. 

Paranoid personality disorder: People with this personality disorder tend to perceive others around them as being deceitful, patronizing, or mean toward them. This might make them feel untrusting and angry all the time, leading them to have destructive outbursts and avoid developing close relationships. 

Schizotypal personality disorder: Those diagnosed with this disorder may feel very anxious in social situations and uncomfortable and awkward in close relationships. People with this personality disorder may also have paranoid ideas, odd beliefs or distorted perceptions.  For example, they may feel they can read other people’s minds, see into the future, or have close relationships with beings from another planet. 

Schizoid personality disorder: Those diagnosed with schizoid personality disorder may usually appear shy, withdrawn, distant, not socially responsive or disinterested in others. They may find themselves absorbed in daydreaming and fantasizing a lot.  

Cluster B personality disorders 

Cluster B personality disorders often have difficulty controlling their emotions and a tendency to act unpredictably. 

Narcissistic personality disorder (NPD): Those with NPD may feel superior to everyone else and often fantasize about unlimited beauty, power, money, and success. To earn these, they may feel it’s necessary to get other people out of the way by any means, without acknowledging their needs or feelings. They might also be extremely sensitive to criticism and failure and experience intense variations in your mood. 

Antisocial personality disorder: Mental health professionals diagnose antisocial personality disorder when there’s a persistent display of impulsive, reckless, and aggressive behaviors and no remorse about them. They may have a history of abusive relationships, violent exchanges, legal challenges, or substance use disorder.  

Borderline personality disorder: People living with borderline personality disorder (BPD) often experience intense and rapidly shifting emotions, which can deeply affect their self-image and relationships. They may view others in extremes — idealizing someone one moment and rejecting them the next — leading to instability in personal connections. This pattern of thinking can contribute to chronic feelings of emptiness, disappointment, or despair. 

Fear of abandonment is common in BPD and may lead individuals to engage in behaviors aimed at preventing perceived rejection. These behaviors can include emotional withdrawal, self-harm, or threats of suicide. These coping strategies, while often misunderstood, reflect the deep emotional pain and fear of isolation that many people with BPD face. 

Language matters 

The term “borderline” is considered controversial because it has been misused to judge or discriminate against groups of people. We refer to this term here as a clinical diagnosis established by the DSM-5 and not as a judgment. 

Histrionic personality disorder:  Someone with histrionic personality disorder (HPD) feels they need to be the center of attention in all situations. This may lead to overdramatic behaviors that others might perceive as odd and inappropriate. If you live with HPD, you may feel anxious and frustrated if others ignore you or give more attention to someone else over you. You may also place a lot of importance on your physical appearance and modify it in a way that you feel will call more attention to you. 

Cluster C personality disorders 

People with Cluster C personality disorders usually live with strong feelings of anxiety, doubt, and fear. 

Obsessive-compulsive personality disorder: Obsessive-compulsive personality disorder is not the same as obsessive-compulsive disorder (OCD). Someone with a personality disorder is likely not aware of their behavior, while someone with OCD realizes their obsessions and compulsions aren’t rational.  

Dependent personality disorder: Someone with a dependent personality disorder may tend to act submissive, letting other people assume control over their lives and decisions. They might also feel a strong need for others to take care of them. They may be perceived as a “people pleaser” and feel very anxious when they’re alone.  

Avoidant personality disorder: A diagnosis of avoidant personality disorder may mean someone is extremely fearful of rejection and abandonment. This could lead them to avoid almost all social activities and events, even when internally they wish to go. With this personality disorder, they may also feel insecure around other people, worrying that they may say something silly or inappropriate. Sometimes, if they have to interact with others, they may end up blushing, crying, and trembling. People with this personality disorder feel the need to connect to others and establish close relationships, but they don’t because of their insecurities. This, in turn, makes them very upset. 

Who do they affect? 

Approximately 6% to 15% of Canadians are estimated to live with a personality disorder. Personality disorders can affect anyone — across all ages, backgrounds, and communities — but some people may be more vulnerable due to personal history, life circumstances, or access to care. 

Some groups may be more likely to experience personality disorders or face additional barriers to diagnosis and care: 

Gender and Diagnosis 

These patterns may reflect differences in how symptoms present — or in how they are interpreted by healthcare providers. 

Signs and Symptoms 

Personality disorders can be difficult to recognize — both for the person experiencing them and for those around them. The signs often appear as deeply rooted patterns of thinking, feeling, and behaving that persist over time and significantly impact how a person relates to others, views themselves, and handles everyday challenges.  

While each personality disorder has its own specific traits, many shares common features.  

These may include;  

People who live with personality disorders might struggle to set or respect boundaries, blame others for personal struggles, have difficulty regulating emotions like anger or sadness, and may fear rejection or abandonment. They might avoid social situations due to feelings of inadequacy or act impulsively in ways that can be risky or harmful. In some cases, they may even feel disconnected from reality or experience paranoid thoughts. These patterns often cause ongoing distress and deserve compassionate, professional attention. 

It is normal for everyone to show some traits associated with personality disorders at times. But a true personality disorder involves long-standing patterns of thoughts, feelings, and behaviors that are extreme, rigid, and deeply affect daily life and relationships.  

These symptoms often begin in childhood or adolescence and may change in intensity over time, depending on the type of disorder and life circumstances. For example, borderline personality disorder may become less intense in mid-adulthood, while narcissistic traits might not appear until later in life. Personality disorders do not just affect the individual — they also deeply impact loved ones.  

A person’s fixed patterns can make it hard to adapt to changing situations, often placing strain on relationships as others feel pressure to adjust around them. When that does not happen, emotional distress can grow, creating a cycle of tension and misunderstanding for everyone involved.  

Compassion, awareness, and proper support are essential to break that cycle. 

Causes 

Personality disorders are complex mental health conditions that develop through a combination of genetic, biological, psychological, and environmental influences. While there is no single cause, certain risk factors are commonly linked to their development — especially when the factors listed below interact over time. 

Personality disorders are the result of many factors that have influenced your life, including: 

Biological and Genetic Factors 

Some people may be more biologically predisposed to developing a personality disorder. This vulnerability can stem from inherited traits or differences in brain chemistry and how the nervous system responds to stress. While these biological factors do not determine outcomes on their own, they can increase the likelihood of developing a personality disorder — particularly when paired with challenging life circumstances. 

Early Life Experiences and Trauma 

Early relationships and experiences play a significant role in shaping personality. Many individuals diagnosed with a personality disorder have experienced significant stress or trauma during childhood — such as abuse, neglect, loss, or growing up in an emotionally unstable environment. These experiences can have a lasting impact on self-esteem, emotional regulation, and how a person relates to others. For example, chronic invalidation or inconsistent caregiving may contribute to patterns seen in disorders like borderline or narcissistic personality disorder. 

Social and Environmental Stressors 

Ongoing stress in adulthood, such as poverty, housing instability, or lack of access to supportive services, can increase emotional strain and make it harder to cope with daily challenges. These stressors may not only contribute to the development or worsening of personality disorders but can also delay diagnosis and access to care — especially for people in underserved or marginalized communities. 

Treatment 

Although personality disorders are difficult to treat, there is evidence that many treatments help reduce distress and symptoms and improve quality of life. Most personality disorders are ego-syntonic, meaning they are compatible with a person’s self-concept, so there may initially be little or no motivation to change.

Mental health professionals have developed and applied different therapeutic techniques to help those with these conditions learn more adaptive ways of thinking and behaving, and research suggests that positive change is possible for many.

These are some of the common types of psychotherapy for personality disorders: 

Treatment for personality disorders is typically long term. It requires a strong commitment and persistence. But the individual may experience relief and learn how to manage some emotions if they continue treatment. 

Resources

Sources: CMHA BC, Statistics Canada, CAMH, American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Simcoe Addiction and Mental Health, Youth Mental Health Canada 
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