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Your personality is the unique pattern of ways that you think, feel, relate to others, and act. Everyone's personality traits include patterns that come up often and can be noticeable to others. For example, some people are very outgoing and generally think that new social interactions will be positive—or at least not negative. Other people are more reserved and may feel a bit nervous or self-conscious when they meet new people.
What is a personality disorder?
A personality style is how someone usually thinks, feels, relates, and acts—and is not a problem. Styles become problems when they’re inflexible and can’t adjust to different situations. A personality disorder is what happens when someone's personality style causes problems and doesn’t adjust to different situations.
While everyone's personality style can lead to conflict with others from time to time, a personality disorder is a persistent pattern of being inflexible that lasts for a long time.
Personality disorders include:
Paranoid personality disorder
Patterns of suspicions. People with paranoid personality disorder don’t trust others and are suspicious of others' actions or intentions. They may assume that people are lying and may spend a lot of time looking for clues to justify their beliefs. They may have a hard time sharing their thoughts and feelings because they think others will use that information against them. People with paranoid personality disorder tend to manage their anger poorly, so they may react very strongly over minor disagreements or misunderstandings.
Schizoid personality disorder
Patterns of detachment. People with schizoid personality disorder usually have few relationships, even with close family members, in part because they easily feel engulfed or intruded upon by others. At times people with schizoid personality disorder may struggle to navigate social cues or interactions, but they are often highly aware of their own emotions and the emotions of others. When this illness is more severe, symptoms include difficulty making sense of others’ behaviour, flattened emotions, and unusual or absent thought processes. Many people with schizoid personality disorder say that they feel hurt or upset when they can’t build relationships.
Schizotypal personality disorder
Patterns of poor social relationships. People with schizotypal personality disorder have a hard time understanding social cues and making social relationships. They may appear eccentric to others with unusual beliefs, ideas, mannerisms, or patterns of speech. People with schizotypal personality disorder experience a lot of social anxiety, even with people they know, and may be very suspicious of others.
Antisocial personality disorder
Patterns of disregarding the rights and property of others. People with antisocial personality disorder tend to view others as a means to an end—for example, by manipulating or lying for their own personal gain. People with antisocial personality disorder may be aggressive or impulsive and may disregard their own safety or the safety of others. They often don't feel remorse or regret for their actions and may try to rationalize actions that harm others or else blame the victim. People with antisocial personality disorder may break laws often.
Borderline personality disorder
Patterns of instability. People with borderline personality disorder have unstable rapidly changing emotions. Their emotional responses are fast and intense, and they can quickly move between emotions. For example, someone might feel extremely happy and then extremely sad in a short period of time. They tend to have intense relationships and may easily feel abandoned or rejected. They may see others in very different lights at different times, such as rapidly switching between positive and negative feelings towards another person. Behaviour can include risk-taking, deliberate self-harm and suicidal behaviour. The way they see themselves may vary based on their current mood, as people with borderline personality disorder tend to have a vague sense of self and often feel empty. This inner emptiness can make it hard to tolerate being alone, and can, at times, lead to loss of touch with reality.
Histrionic personality disorder
Patterns of seeking attention, usually in a sexual way. People with histrionic personality disorder feel like they must be the centre of attention. To get attention, they may do things that are dramatic, excessive, inappropriate or exaggerated. People with histrionic personality disorder are very sensitive to criticism and may constantly seek approval from others. They are easily influenced by other people, so they may seem gullible or blindly trust others.
Narcissistic personality disorder
Patterns of self-importance. People with narcissistic personality disorder believe they are superior and can only be understood by other superior people. They expect others to recognize their superiority and respond accordingly. They want to be the centre of attention and may manipulate others or act out if they don’t get the attention they think they deserve. While people with other personality disorders want attention, people with narcissistic personality disorder want admiration or recognition.
Avoidant personality disorder
Patterns around fears of rejection or inadequacy. People with avoidant personality disorder avoid social interactions in order to avoid criticism. They tend to want to know they’ll be liked before they will get to know others. They may spend a lot of time worrying about disapproval and may react very strongly to even minor criticism. People with avoidant personality disorder usually want social relationships, but they feel inadequate and find it difficult to open up over fears of embarrassment.
Dependent personality disorder
Patterns of relying on others a lot. People with dependent personality disorder tend to feel helpless or incapable of taking care of themselves. They depend on others for help, sometimes with even basic everyday tasks, or need a lot of support and reassurance to make decisions. People with dependent personality disorder may have a hard time disagreeing or sharing their true thoughts and opinions over fears that they will lose approval. They may fear losing support or separation and may worry a lot about being left alone. People who rely on others this much are vulnerable to be exploited or harmed in relationships.
Obsessive-compulsive personality disorder
Patterns of rigidity, perfectionism and order. People with obsessive-compulsive personality disorder need neatness, order, and control. They focus on lists, rules, or details to the point that the purpose is lost and they struggle to complete the original task. They tend to be perfectionists and may not be able to complete a project unless it meets what are sometimes-unrealistic expectations of perfection. They may have a hard time leaving work behind, sticking to a to-do list at the expense of time off, relaxation and social relationships. People with obsessive-compulsive disorder are usually very inflexible in their expectations of themselves and others, their morals and values and their understanding of rules.
Everyone has experiences like difficult relationships, strong emotions, or fears of rejection at times. When someone has a personality disorder, these experiences don't match a particular situation. It's common to mistrust someone that has lied or hurt you in the past. However, someone with paranoid personality disorder may distrust most people and feel very guarded in most interactions. It's also common to put a lot of time and attention into a task when you want to complete it well. But for someone with obsessive-compulsive personality disorder, they may demand perfectionism in all tasks to the point that they can't relax or enjoy time off and may struggle to understand why others don’t hold the same standards.
Who do they affect?
The number of people thought to experience a personality disorder varies a lot by diagnosis and study. In a meta-analysis of studies in Western countries, obsessive-compulsive personality disorder (about 4% of people) was the most common and dependent personality disorder (about 0.7% of people) was the least common.
Personality disorders are usually noticeable by the time someone is a young adult and symptoms are generally consistent over time. The severity of symptoms may worsen later in life after a stressful event like losing a job or losing a loved one.
What can I do about it?
If you think you or a loved one may have a personality disorder, it's best to talk to a doctor or mental health professional. It can be tempting to look at a list of symptoms and decide that someone must have a personality disorder, especially when you don't understand their behaviours, but that can make it harder to understand what's really going on and delay help. Personality disorders are complicated, and diagnosis can be tricky even for professionals. Different mental illnesses, substance use, and even some physical health problems can overlap with some symptoms. Traumatic events earlier in life by someone in a position of love, trust or need are sometimes part of the picture as well. Doctors need to look at all possible causes before they come to a diagnosis.
If you are diagnosed with a personality disorder, your treatment will depend on the exact diagnosis. Many personality disorders are treated with psychotherapy. A psychotherapy called dialectical behaviour therapy (DBT) was developed specifically to treat borderline personality disorder, and DBT is now used to treat other mental illnesses. DBT is the most widely available psychotherapy for a personality disorder in BC. Other psychotherapies that help people manage a personality disorder are mentalization-based therapy, transference-focused therapy, and schema therapy.
There are no medications specifically for personality disorders, but your doctor may suggest an antidepressant, antipsychotic, or anti-anxiety medication for specific symptoms you experience.
Where do I go from here?
In addition to talking with your doctor, nurse practitioner, or mental health provider, check out the resources below for more information about personality disorders.
Borderline Personality Disorder Society of BC
Visit www.bpdbc.ca to learn more about BPD and accessing help in BC, find support groups, and access a resource library.
BC Partners for Mental Health and Substance Use Information
Visit www.heretohelp.bc.ca for the Managing Mental Illnesses series, more info sheets and personal stories about personality disorders. You'll find information, tips and self-tests to help you understand mental health. You'll also find the Borderline Personality Disorder issue of Visions Journal.
Canadian Mental Health Association, BC Division
Visit www.cmha.bc.ca or call 1-800-555-8222 (toll-free in BC) or 604-688-3234 (in Greater Vancouver) for information and community resources.
1-800-SUICIDE
If you are in distress or are worried about someone in distress who may hurt themselves, call 1-800-SUICIDE 24 hours a day to connect to a BC crisis line, without a wait or busy signal. That's 1-800-784-2433. (If you prefer to text, for similar help, you can text 988 any time of day or night to reach the national Suicide Crisis Helpline.)
Alcohol & Drug Information and Referral Service
If you're concerned about your alcohol or drug use or concerned about some else’s use, call the Alcohol and Drug Information and Referral Service at 1-800-663-1441 (toll-free in BC) or 604-660-9382 (in Greater Vancouver). This service is available seven days a week, 24 hours a day.
HealthLink BC
Call 811 or visit www.healthlinkbc.ca to access free, non-emergency health information for anyone in your family, including mental health information. Through 811, you can also speak to a registered nurse about symptoms you're worried about, or talk with a pharmacist about medication questions.
BC Mental Health Support Line
Crisis lines aren't only for people in crisis. You can call for information on local services or if you just need someone to talk to. If you are in distress, call 310-6789 (no area code) 24 hours a day to connect to a BC crisis line, without a wait or busy signal.
About the author
The Canadian Mental Health Association promotes the mental health of all and supports the resilience and recovery of people experiencing a mental illness through public education, community-based research, advocacy, and direct services. Visit www.cmha.bc.ca.
