Personality disorders

Explains personality disorders, including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and family.

Your stories

Having a BPD diagnosis - my reality

Rebecca's account of being diagnosed with borderline personality disorder.

Rebecca
Posted on 21/11/2014

A disordered personality?

Debbie talks about her experience of borderline personality disorder.

Debbie
Posted on 30/07/2014

"What are you like when you're well?"

Louise talks about how her response when she was asked this question.

Posted on 27/04/2015

What treatment can help?

There are a range of treatments that can help you if you experience a personality disorder:

Can things improve for me?

Sometimes people assume that it's not possible for us to change, especially when it comes to our personality. But research is showing that this isn't the case.

With time, with the right treatment for you and with helpful relationships with others, it is possible for things to change and improve.

All my life I have felt different, alienated and completely alone. It is only since my diagnosis of BDP that I began to understand why and, with help, to realise that I could actually do something to change those feelings and feel that I can achieve a life worth living.

Talking treatments

Research is ongoing into what treatments help people with personality disorder. More research is needed but some talking treatments have been found to help.

Depending on where you live and the problems you want help with, the following talking treatments may be available to you:

  • Arts therapies are a way of using the arts – for example, music, art, dance or drama – in a therapeutic environment with a trained therapist. See our pages on arts therapies for more information.
  • Cognitive behavioural therapy (CBT) looks at how your feelings, thoughts and behaviour influence each other and how you can change these patterns.
  • Cognitive Analytic Therapy (CAT) combines CBT's practical methods with a focus on the relationship between you and your therapist. This can help you reflect on how you relate to people (including yourself) and why these patterns have developed. You can read more about CAT on our pages about talking treatments.
  • Dialectical behaviour therapy (DBT) – a treatment specifically developed for borderline personality disorder (BPD). It uses individual and group therapy to help you learn skills to manage your emotions. See our section on DBT for more information.

Since starting a course of DBT, hard as the course is, I am finally beginning to feel that I am worth something.

  • Mentalisation Based Therapy (MBT) – a long-term talking treatment which aims to improve your ability to recognise and understand your and other people's mental states, and to help you examine your thoughts about yourself and others to see if they're valid.
  • Schema therapy is usually a long-term talking treatment which aims to help you change the ways of thinking (or 'schemas') which cause you difficulty, while strengthening the ways of thinking which are helpful to you.
  • Therapeutic communities (TC) – programmes where you work with a group of other people experiencing mental health problems to support each other to recover. Most therapeutic communities are residential (often in a large house) where you might stay for all or part of the week. Activities can include different types of individual or group therapy, as well as household chores and social activities. The Consortium for Therapeutic Communities provides a directory of therapeutic communities in the UK.

I spent 18 months as part of a Therapeutic Community, and I'm not exaggerating when I say it's changed my life. My mood swings are far less frequent, and it's rare that they reach the extremes that they used to.

How can I access treatment?

You can access treatment in different ways. This may be through the NHS, privately or through a charity or organisation. See our pages How can I access a talking treatment? for more information.

If you are struggling to access the treatment you need, finding an advocate can be helpful.

Avoidant personality disorder... at first it was a relief to know that I wasn't alone in feeling the way I did – but for a couple of months afterwards I did use the label as an excuse to behave in particular ways and blame it on my ‘condition’. Fortunately, with the help of CBT, I realised that I didn't have to live like that.

Medication

There are no drugs specifically licensed for the treatment of personality disorder. Your GP may prescribe medication to help you manage problems such as depression, anxiety or psychosis. These medications could include:

The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best practice in health care – recommends that you are only prescribed medication for a short time, if you're in crisis or to treat another problem.

Before you take any medication

Before deciding to take any medication, make sure you have all the facts you need to feel confident about your decision. For guidance on the basic information you might want, see our pages on:

How can I be involved in my treatment?

A really important factor in your treatment is the relationship you form with the professionals who are helping you – whether they are a social worker, psychiatric nurse, therapist or psychiatrist. Having good treatment also depends on you being actively involved in it and having your say. You should expect to:

  • Have your say in treatment – your GP or psychiatrist should discuss all your treatment options with you, and your views and preferences should always be taken into account when making decisions about your treatment. See seeking help for a mental health problem for more information on having your say.
  • Be involved in your care plan – a care plan is an agreement between you and the professionals you're working with, about what you want to get out of your treatment. It should include the problems you want help with, any treatments you may need and planning for a crisis.

It was only when I met some dedicated professionals willing to go that extra mile that I started to change and believe in myself. I was able to begin therapy and develop a good trusting relationship which has been consistent and secure.

When don't I have a choice in my treatment?

You may not have a choice in your treatment if you:
  • do not have mental capacity – this is where you are considered too unwell to make informed decisions about a specific situation; see our pages on the Mental Capacity Act for more information
  • are being kept in hospital under a section of the Mental Health Act (sometimes called being sectioned)
  • are being treated under a Community Treatment Order (CTO) – this means you are given supervised treatment in the community
  • are being treated under a court order – this may be if you have committed an offence.

See our pages on limits to your choices for more information.


This information was published in August 2016. We will revise it in 2019.


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