Personality disorder The Royal College of Psychiatrists A personality is the collection of ways we think, feel and behave, making each of us an individual and allowing us to interact with other people. But for some of us, this isn't the case.

You may have a personality disorder if:

• Parts of your personality make it hard for you to live with yourself and other people
• Experience doesn’t teach you how to change the unhelpful parts of yourself
• You find it hard to make or keep relationships with friends, family and work colleagues
• You find it hard to control your feelings or behaviour
• You find that you upset or harm other people because you’re distressed

The cause of a personality disorder is not clear, but there is some evidence that, similar to other mental disorders, genes, brain problems and background can play a part. It’s thought one in ten people has some form of personality disorder.

Personality disorders tend to fall into three groups, with their own complex sub-groups:

Suspicious

• Paranoid, where you are suspicious of other people, sensitive to rejection and have a tendency to hold grudges.
• Schizoid, where you are unable to make contact with other people, preferring your own company and developing a rich fantasy world.
• Schizotypal, where you have odd ideas and difficulties with thinking. Other people see you as eccentric and you may see or hear strange things.

Emotional and impulsive:

• Antisocial: where you don't care about other people’s feelings, get easily frustrated and aggressive, and find it difficult to develop close relationships. You do things on the spur of the moment without feeling guilty and are unable to learn from unpleasant experiences.
• Borderline or emotionally unstable: where you do things without thinking and find it hard to control your emotions. You may feel empty inside or so bad about yourself you self-harm. Although you make relationships quickly, you can easily lose them. You can also feel paranoid or depressed and may hear noises or voices.
• Histrionic: where you tend to be self-centered and over-dramatise events. Your emotions are strong, but change quickly. You worry a lot about your appearance and crave excitement.
• Narcissistic: where you crave success, power and status. You seek attention and tend to exploit others for your own gain.

Anxious

• Obsessive-compulsive: where you are perfectionist, worrying about the detail in everything. You are cautious and find it hard to make decisions. You have high moral standards, worrying about doing the wrong thing and judging other people. You are sensitive to criticism and may have obsessional thoughts and behaviours.
• Avoidant: where you are very anxious and tense, worrying about insecurities. You feel inferior to others and want to be accepted. You are sensitive to criticism.
• Dependent: where you rely on others to make decisions for you and do what others want you to do. You find it hard to cope with daily tasks, feeling hopeless and incompetent and easily feel abandoned by others.

Professional help

Various therapies, including psychotherapy and cognitive behavioural therapy are shown to help.

Treatment in a therapeutic community where you can attend (or sometimes stay in) for several weeks or months has also been shown to help. Most of the work is done in groups, where you learn from being with other people in a unit. It differs from 'real life' as any disagreements or upsets happen in a safe place. The staff and other patients help you to get through problems and learn from them.

Antipsychotic drugs can reduce the suspicious group of disorders and can also help with borderline personality disorder if people feel paranoid, or are hearing noises or voices.

Antidepressants can help with the emotional group of disorders. Some selective serotonin reuptake inhibitor (SSRI) antidepressants can also reduce the anxiety personality disorders. Mood stabilisers such as lithium may also reduce impulsiveness and aggression.

This article was first published in May 2009.