A note on language
Diagnosing a personality disorder can be complex. Some people find the term unhelpful or stigmatising. Here, we use terms that are currently recognised in the UK. It is completely your choice which words, if any, feel right for your experience. Everyone deserves understanding and support.
What is a personality disorder?
Our personalities are a collection of thoughts, feelings, attitudes, and behaviours. We all have our own individual personalities, which make us who we are. A personality disorder is a mental health condition where these ways of thinking, feeling, and behaving can become unhelpful fixed patterns. These patterns affect how you think, feel, relate to others, and cope with everyday life. These patterns often last a long time. They may show up in adolescence or early adulthood.
You may find it hard to manage your emotions, maintain relationships, or trust others. You also might not feel secure in your sense of self. This can be distressing, but you are not alone. Around 4.4% of people in the UK meet the criteria for a personality disorder.
What are the signs of a personality disorder?
Personality disorders can affect people in different ways. Common signs can include:
- finding relationships difficult or intense
- struggling with trust, identity, or self-worth
- feeling emotions strongly or finding them hard to manage
- acting impulsively or in ways that feel hard to control
- feeling empty, disconnected, anxious, angry, or overwhelmed
- using coping strategies that may harm you
If these experiences feel familiar and have affected you for some time, it may help to talk to a mental health professional.
How are personality disorders diagnosed?
A mental health professional, such as a psychiatrist or psychologist, diagnoses personality disorders. They look at how you experience yourself, relate to others, manage emotions, and cope in daily life. They consider how long these difficulties have been present. They also look at whether these issues affect different areas of your life. They may also explore whether another condition might explain these difficulties.
Severity: mild, moderate and severe
In the UK, personality disorders are often described as mild, moderate, or severe. This reflects how much your experiences affect your daily life, relationships, and well-being.
For example, your difficulties may be described as mild if they affect some areas of your life or moderate if they have a wider impact. They may be described as severe if they affect most areas of your life or your safety.
These terms are used to help guide support and treatment, not to minimise what you are going through.
How diagnosis has changed in the UK
Before changes in 2022, people with a personality disorder were diagnosed with one of 10 specific “types”. Today, diagnosis in the UK focuses on severity and personality traits. This aims to focus on how you experience yourself and relate to others, instead of trying to fit symptoms into a single, fixed category.
Types of personality disorder
You may still see information about the 10 types of personality disorders. These were previously grouped into three clusters: A, B and C.
This system is no longer the main way personality disorders are diagnosed in the UK. However, these terms are still sometimes used and may appear in older resources or diagnoses. You might still come across some of these terms:
- Cluster A: paranoid personality disorder; schizoid personality disorder; schizotypal personality disorder.
- Cluster B: antisocial personality disorder; borderline personality disorder (BPD) or emotionally unstable personality disorder (EUPD); histrionic personality disorder; narcissistic personality disorder.
- Cluster C: dependent personality disorder; avoidant personality disorder; obsessive-compulsive personality disorder.
Understanding personality disorder traits
Traits are used to describe patterns of thoughts, feelings, and behaviours. They are not diagnoses. They are used to help professionals understand what support may be most helpful. If you are diagnosed with a personality disorder, your experiences or behaviour may also be described using traits. Your diagnosis may include none, one, or more of these traits. These can include:
Experiencing difficult emotions (negative affectivity)
This can include experiencing emotions very intensely, reacting very negatively to criticism, problems, or setbacks, and getting easily frustrated or upset. It can also include low self-esteem or low self-confidence, and difficulty trusting other people.
Feeling detached from others (detachment)
This trait can include avoiding social interactions, friendships, relationships and intimacy, as well as looking for opportunities that involve little or no contact with others, or finding it difficult to talk about or express how you feel. It can also include being unresponsive to things others may find emotional, including struggling to feel pleasure or take interest in things.
Difficulty feeling empathy for others (dissociality)
You might have this trait included in your diagnosis if your doctor believes that you put your needs and desires above other people's, that you feel there are special reasons that make you different, better or more deserving than others, or if you have problems with empathy. Showing signs of manipulative behaviour, or wanting attention and being very upset when you feel like you aren’t being noticed, can also contribute.
Impulsive behaviour (disinhibition)
This trait might be included in your diagnosis if your doctor believes that you make immediate decisions without thinking about the consequences, get easily distracted and find it hard to stay focused and complete tasks, are easily bored or frustrated with routines, or find it difficult to keep deadlines.
Perfectionism (anankastia)
This can include a need to keep everything in order or under control, setting unrealistically high standards (for yourself or others), difficulty with flexible thinking, or a strong belief in ‘right’ or ‘wrong’. It can also include thinking your way is the best way of doing things, continuing to worry about making mistakes, feeling anxious if things aren’t ‘perfect’, difficulty making decisions, or struggling to maintain relationships if others don’t conform to your standards.
Borderline pattern
This trait may be included if you experience intense and rapidly changing emotions, struggle with relationships and self-identity, and often feel empty or fearful of being abandoned. You may also act impulsively, find it hard to trust others, or experience suicidal thoughts or self-harm. During periods of high stress, some people may feel paranoid, disconnected, or have experiences such as seeing or hearing things others don’t.
What if I was diagnosed under the old personality disorder system?
Some people still use personality disorder “types”. This includes professionals and those diagnosed under the previous system. This doesn’t mean your diagnosis is wrong. You can continue to use the language that feels most comfortable for you. A mental health professional can help explain what this means for you.
Borderline personality disorder
Borderline personality disorder is still a widely used diagnosis in the UK. Some people find the term helpful. Others feel it does not fully reflect their experiences or can carry stigma. You can find out more about BPD, including symptoms and accessing support.
What causes a personality disorder?
Experts do not know the exact cause of personality disorders. It is likely to be a mix of factors. These could include genetics, environment, relationships, and life experiences.
Some people experience trauma, neglect, or difficult circumstances growing up. This can affect how they relate to themselves and others. Not everyone who has these experiences will develop a personality disorder.
Finding help and support for personality disorders
Many people with a personality disorder can recover over time with help and support. There is no single approach that best suits everyone. Trying different options to find out what works best for you can be helpful.
Talking therapy is recommended. You might also benefit from or be recommended other types of therapy and medicine.
Your GP can help refer you to local support and specialist services. This includes community mental health teams, community mental health hubs, personality disorder services, and complex emotional needs (CEN) services. In some areas, you can self-refer to local services.
Talk therapy for personality disorders: how counselling can help
Talk therapy can help you better understand your thoughts, feelings and behaviours. Therapy can help you to focus on your beliefs, how to understand, recognise, and control your emotions, as well as how to manage symptoms.
Many people find it helpful to talk about what they are going through. It can be helpful to talk with friends, family, a counsellor or therapist.
A therapist specialising in personality disorders can listen and discuss important issues with you. They can help you identify strategies to resolve problems and challenge unhelpful behaviours that might be affecting you.
How long you will need therapy sessions for can vary. Some people attend therapy for months or years. It will depend on how much support you need and other mental health problems you might experience.
Different types of talk therapy can help with personality disorders. Psychotherapy and CBT are considered to be among the most effective. Group therapy has also been shown to help.
Dialectical behavioural therapy (DBT) can help you learn skills to manage your emotions and behaviour.
Mentalisation-based therapy (MBT) can help you recognise your thoughts and feelings. It can also help you understand how others may think or feel, and how these thoughts and feelings can affect behaviour.
Cognitive analytic therapy (CAT) can help to identify patterns that may be causing problems in your life. CAT can also help you discover where these patterns may have been learned.
Art and creative therapies can offer a supportive way of expressing yourself if you find it hard to put into words how you are feeling. They can also be helpful if you struggle to control your emotions, as they offer a structured way to express yourself.
Therapeutic communities
Therapeutic communities (TCs) are places where someone can stay or visit for intensive group therapy. Usually attended for weeks or months, TCs provide structured group living therapy. They can help people with complex personality disorders. Some are residential. Others offer intensive day programmes. A GP or community mental health team referral is typically needed.
Medicine
There is no medication specifically for personality disorders. You may be prescribed medication to help with other mental health conditions or difficulties. These can include anxiety, depression, or sleep problems.
Will I have to go to hospital?
Most people with a personality disorder are supported through regular appointments, with ongoing care in the community rather than in hospital.
If you’re having a particularly difficult time, a short stay in hospital might sometimes be suggested so you can get extra support. This is usually only considered when other options haven’t been enough, and is typically for a brief period.
Self-care
Self-care can help when you feel overwhelmed, frustrated, angry, or restless. Alongside other support, it can make stress easier to manage. It can also help you protect your energy and improve your mood.
Some people find breathing exercises or mindfulness helpful. These can help you feel more grounded and present. Creative activities like colouring, drawing, writing, or journaling can give you a way to express yourself.
Looking after your body can also help. Try to stay active, get enough sleep, and eat regular, balanced meals. Even small changes can make a difference.
Frequently asked questions about personality disorders
Why are personality disorders controversial?
People have different views about personality disorders. Some find the term helpful. It can give a name to their experiences and help them make sense of how they feel. Others don’t like the term. They may feel it labels their thoughts and behaviour in an unhelpful way. There are also concerns about stigma. Some people have negative or inaccurate ideas about personality disorders. This can lead to misunderstanding or judgement.
Who can diagnose a personality disorder?
Some mental health professionals, including psychiatrists and psychologists, can diagnose personality disorders. Your GP cannot diagnose a personality disorder. You can speak with them about a referral for an assessment.
What if I have been misdiagnosed with a personality disorder?
If your diagnosis doesn’t feel right, you’re not alone. It’s OK to question it. You can talk to a mental health professional about your concerns. They can review your diagnosis with you. You can also ask for a second opinion if you’d like more clarity.
Further help and resources
- Helping someone diagnosed with personality disorder - Mind
- Out of the FOG - a community for people who have a family member or partner with a personality disorder
- Personality disorders - NHS
Finding a therapist or a counsellor
If you’re thinking about counselling, finding the right therapist matters. Take your time to explore your options. It’s important to choose someone you feel comfortable with.
Living with a personality disorder can feel challenging at times. But support is available, and change is possible. With the right help, many people learn to understand themselves better. You can build stronger relationships and feel more in control of your life.
