Personality disorders

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What types of personality disorder are there?

Currently psychiatrists tend to use a system of diagnosis which identifies ten types of personality disorder. These are grouped into three categories.

Suspicious:

• Paranoid personality disorder
• Schizoid personality disorder
• Schizotypal personality disorder

Emotional and impulsive:

• Antisocial personality disorder (ASPD)
• Borderline personality disorder (BPD)
• Histrionic personality disorder
• Narcissistic personality disorder

Anxious:

• Avoidant personality disorder
• Dependent personality disorder
• Obsessive-compulsive personality disorder (OCPD)

Each personality disorder has its own set of diagnostic criteria. To get a specific diagnosis you must meet some of these criteria. The minimum amount you need to meet is different for different types, but it should always be more than one or two. If you meet criteria for more than one type this may be called mixed personality disorder. 

It is also possible to get a diagnosis without meeting the full criteria for a specific type. This is known as personality disorder not otherwise specified (PD-NOS) or personality disorder trait specified.

A wide range of people may get the same diagnosis, despite having very different personalities and different individual experiences. Your experience of living with a personality disorder will be unique to you.

Paranoid personality disorder

The thoughts, feelings and experiences associated with paranoia may cause you to:

• find it hard to confide in people, even your friends and family
• find it very difficult to trust other people, believing they will use you or take advantage of you
• have difficulty relaxing
• read threats and danger (which others don't see) into everyday situations, innocent remarks or casual looks from others.

This might become such a big problem in your life that you are given a diagnosis of paranoid personality disorder. See our page on paranoia for more information.

I suffer from extreme paranoia and most people find this extremely irritating and become angry with me when I'm paranoid.

Schizoid personality disorder

Many people with schizoid personality disorder are able to function fairly well. Unlike in schizophrenia or schizoaffective disorder, you would not usually have psychotic symptoms. However, as a result of the thoughts and feelings associated with this diagnosis you may:

• find difficulty forming close relationships with other people
• choose to live your life without interference from others
• prefer to be alone with your own thoughts
• not experience pleasure from many activities
• have little interest in sex or intimacy
• have difficulty relating to or are emotionally cold towards others.

Schizotypal personality disorder

Everyone has their own eccentricities or awkward behaviours. But if your patterns of thinking and behaving make relating to others very difficult, you may receive a diagnosis of schizotypal personality disorder.

Unlike in schizophrenia, you usually would not experience psychosis. However, you may:

• experience distorted thoughts or perceptions 
• find making close relationships extremely difficult
• think and express yourself in ways that others find 'odd', using unusual words or phrases, making relating to others difficult
• believe that you can read minds or that you have special powers such as a 'sixth sense'
• feel anxious and tense with others who do not share these beliefs
• feel very anxious and paranoid in social situations, finding it hard to relate to others.

See our pages on schizophrenia or schizoaffective disorder for more information on the feelings and symptoms associated with schizoid and schizotypal personality disorders.

I always feel rather 'thrown' when someone doesn't do what I expect them to do. Knowing there are lots of ways in which the problem could be approached would have made me feel a lot more prepared for what came next.

Antisocial personality disorder

It is natural to sometimes put our own needs, pleasure or personal gain before those of others around us. However, if these actions occur very frequently and you struggle to keep stability in your life, or you regularly act impulsively out of anger or lack of consideration for others, this could lead to a diagnosis of antisocial personality disorder.

You may:

• put yourself in dangerous or risky situations, often without thinking about the consequences for yourself or other people
• behave dangerously and sometimes illegally (you may have a criminal record)
• behave in ways that are unpleasant for others
• feel very easily bored and act on impulse – for example, you may find it difficult to hold down a job for long
• behave aggressively and get into fights easily
• do things even though they may hurt people – to get what you want, putting your needs and desires above other people's
• have problems with empathy – for example, you may not feel or show any sense of guilt if you have mistreated others
• have had a diagnosis of conduct disorder before the age of 15.

This diagnosis includes 'psychopathy' and 'sociopathy'. These terms are no longer used in the Mental Health Act but a 'psychopathy checklist' questionnaire may be used in your assessment.

Borderline personality disorder (BPD)

Borderline personality disorder (BPD) is also known as emotionally unstable personality disorder (EUPD).

We can all experience difficulties with our relationships, self-image and emotions. But you might get a diagnosis of BPD/EUPD if these feel consistently unstable or intense and cause you significant problems in daily life.

You may:

• feel very worried about people abandoning you, and either do anything to stop that happening or push them away
• have very intense emotions that can change quickly (for example, from feeling very happy and confident in the morning to feeling low and sad in the afternoon)
• not have a strong sense of who you are or what you want from life, with your ideas about this changing significantly depending on who you're with
• find it very hard to make and keep stable relationships or friendships
• act impulsively and do things that could harm you (such as binge eating, using drugs or driving dangerously)
• have suicidal thoughts
• self-harm
• feel empty and lonely a lot of the time
• get very angry, and struggle to control your anger
• struggle to trust other people
• experience other mental health problems alongside BPD, including anxiety, depression, eating problems and post-traumatic stress disorder.

When very stressed, sometimes you might:

• feel paranoid
• have psychotic experiences, such as seeing or hearing things that other people don't
• feel numb or 'checked out' and not remember things very well after they've happened (known as dissociation).

BPD is currently the most commonly diagnosed personality disorder. You can read more about it on our pages on borderline personality disorder (BPD).

BPD is like having no emotional buffer. I can go from nothing to suddenly extremely overwhelming emotions and I struggle with expressing them healthily.

Histrionic personality disorder

Most people enjoy being given compliments or positive feedback about their actions. But if you depend very heavily on being noticed, or are seeking approval so much that this affects your day-to-day living, you might get a diagnosis of histrionic personality disorder.

You may:

• feel very uncomfortable if you are not the centre of attention
• feel that you have to entertain people
• constantly seek, or feel dependent on, the approval of others
• make rash decisions
• flirt or behave/dress provocatively to ensure that you remain the centre of attention
• get a reputation for being dramatic and overemotional
• be easily influenced by others.

After being told my diagnosis I was then able to understand how and why I behaved the way I did: my life made a little bit more sense.

Narcissistic personality disorder

It is human nature to be aware of our own needs, to express them, and to want others to be aware of our abilities and achievements. These are not bad traits. However, if these thoughts, feelings and behaviours are very extreme and cause problems in relating to others, you may get a diagnosis of narcissistic personality disorder.

You may:

• believe that there are special reasons that make you different, better or more deserving than others
• have fragile self-esteem, so that you rely on others to recognise your worth and your needs
• feel upset if others ignore you and don't give you what you feel you deserve
• resent other people's successes
• put your own needs above other people's, and demand they do too
• be seen as selfish and dismissive or unaware of other people's needs.

Avoidant personality disorder

We all have things, places or people we don't like, or which make us anxious. But if these things cause so much anxiety that you struggle to maintain relationships in your life, you may get a diagnosis of avoidant personality disorder (sometimes also called anxious personality disorder).

You may:

• avoid work or social activities that mean you must be with others
• expect disapproval and criticism and be very sensitive to it
• worry constantly about being 'found out' and rejected
• worry about being ridiculed or shamed by others
• avoid relationships, friendships and intimacy because you fear rejection
• feel lonely and isolated, and inferior to others
• be reluctant to try new activities in case you embarrass yourself.

See our pages on anxiety and panic attacks for more information on how to cope with anxiety.

Dependent personality disorder

It is natural to need other people to care for us or give us reassurance sometimes. A healthy balance involves being able to both depend on others as well as being independent from others sometimes. However, if feelings and thoughts about needing others become so overwhelming that they impact your daily life and relationships, you may get a diagnosis of dependent personality disorder.

You may:

• feel needy, 'weak' and unable to make decisions or function day-to-day without help or support from others
• allow or require others to assume responsibility for many areas of your life
• agree to things you feel are wrong or you dislike to avoid being alone or losing someone's support
• be very afraid of being left to fend for yourself
• have low self-confidence
• see other people as being much more capable than you are.

Obsessive-compulsive personality disorder (OCPD)

Obsessive-compulsive personality disorder (OCPD) is separate from obsessive-compulsive disorder (OCD), which describes a form of behaviour rather than a type of personality.

However, similarly to OCD, OCPD involves problems with perfectionism, the need for control, and significant difficulty being flexible in how you think about things.

You may:

• need to keep everything in order and under control
• set unrealistically high standards for yourself and others
• think yours is the best way of doing things
• worry about you or others making mistakes
• feel very anxious if things aren't 'perfect'.

See our page on self-care for obsessive-compulsive disorder (OCD) for information about managing the symptoms of OCD. You can also find more information about OCPD on the OCD UK website.

This information was published in January 2020. We will revise it in 2023.

References and bibliography available on request.

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