Personality disorders are a group of mental health conditions characterized by pervasive, highly-disruptive patterns of thinking, mood, and behavior related to others. These patterns can lead to significant personal and social challenges. Although some conditions are more common than others, recent studies suggest up to 20% of teens have a personality disorder. 

What are Personality Disorders?

Personality disorders are a group of  10 mental health conditions characterized by inflexible and unhealthy thinking, feeling, and behavioral patterns. A teen living with a personality disorder will often struggle to forge and maintain healthy relationships with others. They may also experience difficulties managing everyday problems and challenges in ways that are considered acceptable or “normal” for others. 

Someone living with a personality disorder will generally believe that their way of behaving or thinking (although typically the opposite of what is socially acceptable) is normal or the appropriate way to “do things.” The feelings and actions of 18 when they have personality disorder will typically cause them to place blame for their daily struggles on those around them, including friends, parents, or coworkers. This behavior generally leads to significant problems in personal, employment, academic, and social settings.

What Causes Personality Disorders?

Research into personality disorders and their causes suggests that these conditions are among the least understood and least recognized mental health diagnoses. Like many mental health conditions, there is no single or precise cause for personality disorders. However, researchers suggest several factors all contribute to developing new or worsening personality disorder symptoms.

Brain changes

Some studies have identified specific changes in the brains of people with certain personality disorders. For example, studies on schizotypal personality disorders showed alterations to the size of the frontal lobe in the brain. Also, studies on paranoid personality disorder showed alterations in the function of the amygdala. Although research remains to be done, the results of these studies suggest that brain examining these brain differences may allow for early detection of some types of personality disorders.

Genetics

Research has uncovered a specific malfunctioning gene that may be a factor in increasing the risk of obsessive-compulsive personality disorder. Scientists are also exploring genetic links two several traits that are common among many personality disorders, such as aggression, fear, and anxiety.

Abuse

Some studies suggest that verbal abuse experienced during childhood increases one’s risk of developing a personality disorder later in life. One study indicated those who experienced verbal abuse as a youth were up to three times as likely to develop a narcissistic personality disorder, borderline personality disorder, obsessive-compulsive disorder, or paranoid personality disorder as adults. 

Cultural factors

Cultural factors and expectations may also play a critical role in developing personality disorders. The exact relationship between cultural factors and the prevalence of personality disorders needs to be better understood. However, it may relate to social and cultural expectation differences between cultures. 

Trauma

Studies show a link between childhood trauma and personality disorder development. For example, adults with borderline and antisocial personality disorders who experience challenges with intimacy and trust may have experienced childhood abuse and trauma. 

How are Personality Disorders Diagnosed? 

Diagnosing personality disorders can be challenging since most teens and adults with a personality disorder do not believe their thoughts or behaviors are problematic. For this reason, people with a personality disorder will usually avoid or forego treatment for their condition. Often, they seek help when a loved one refers them to a mental health professional because their behavior is harmful or toxic to others. 

When they do seek help (voluntarily), it is because another mental health condition such as depression, anxiety, a substance use disorder, or problems created by their personality disorder has caused problems such as divorce or unemployment. They are unlikely to seek help for the condition itself, just the problems it creates that affect certain aspects of their lives. 

Because teens with a personality disorder may not realize their behaviors are harmful to others, mental health professionals like our providers at Beachside often work with family members to collect additional information about your teen’s medical and mental health history. Many personality disorders go undiagnosed because providers may focus on specific symptoms such as depression or anxiety. These symptoms may overshadow signs that point to a particular personality disorder diagnosis. 

A Brief Review of Personality Disorder Types

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists 10 unique personality disorders categorized into three groups or clusters. 

Cluster A disorders

Cluster A disorders are characterized by odd, eccentric, or bizarre behaviors. Personality disorders that are classified as cluster A disorders include paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder. Conditions that fall into this category share several similar symptoms and similar risk factors. Disorders from cluster A are believed to affect approximately 5.7% of the population. 

Cluster B disorders 

Cluster C personality disorders involve challenges with impulse control and regulating emotions. Others might describe someone with a cluster B disorder as emotional, dramatic, or erratic. Cluster C disorders are the least common of all three clusters affecting between 1% and 6% of the population. Cluster C disorders include borderline personality disorder, narcissistic personality disorder, antisocial personality disorder, and histrionic personality disorder. 

Cluster C disorders

People with cluster C disorders experience overwhelming fear and anxiety. Often, these symptoms affect one’s ability to function and carry out everyday tasks and obligations. Personality disorders in this cluster are the most common of all three clusters affecting approximately 6% of people. Diagnoses that are part of cluster C include avoidant personality disorder, obsessive-compulsive disorder, and dependent personality disorder. 

Three common symptoms of personality disorders

Each of the 10 personality disorder diagnoses is characterized by symptoms unique to that condition. Although many of the symptoms may seem similar and, in some cases, overlap, each condition is uniquely distinguished from the other by its symptoms in some way. However, teens and adults who live with personality and disorder symptoms generally experience problems in three basic categories.

Difficulties relating to others

People with personality disorders often struggle to forge and maintain close or stable relationships with others. This can occur due to problematic beliefs and behaviors arising from their specific personality disorder diagnosis. It can also happen because the root causes of their personality disorder, such as childhood trauma or abuse, make it difficult to develop personal and social relationships. It is not uncommon for someone with a personality disorder to lack respect or empathy for others. They may seem emotionally detached or, the exact opposite, be overly needy of attention and care, so much so that others’ relationship needs go unmet. 

Lack of identity and sense of self

Personality disorders often lead to difficulties in developing a positive self-image. Teens with a personality disorder frequently lack a stable image of themselves. They struggle to see themselves in a positive light and how they see themselves from day to day will change based on the situation or the people they are with at the time. Depending on their diagnosis, their self-esteem may be unrealistically high or dangerously low. In some instances, support and guidance from peers and loved ones are insufficient to improve self-image or self-esteem. Also, for some teens, clear evidence of positive achievements cannot offer a positive sense of self.

Lack of self-awareness

Those with a personality disorder often lack the ability to reflect on themselves and how their behaviors impact others. They are frequently incapable of seeing a need to change their behaviors. They may also lack the ability to change their behaviors. Many people with a personality disorder engage in high-conflict behaviors. They often hold others responsible for all their problems, meaning their children, spouses, coworkers, and friends become the targets of hostility and blame. By placing blame on others and lacking the ability to look inward, they can continue their behavior without needing or wanting to change.   

Treatment for Personality Disorders at Beachside

Personality disorders are among the most challenging mental health conditions to treat. This is primarily because those with a personality disorder diagnosis do not see their behaviors and actions as problematic and rarely seek treatment. Also, because people with personality disorders so infrequently seek help, there are very few widely researched treatment options, including no mental health medications approved for personality disorder treatment. However, several medications have proven effective for common personality disorder symptoms such as anxiety and depression. 

Psychotherapy is another effective element of personality disorder treatment. Psychotherapy or talk therapy aims to help your teen identify and change negative and harmful behaviors, emotions and thoughts. A mental health professional at Beachside can help your teen explore their symptoms and develop healthier ways to manage their emotions. 

Psychotherapy for personality disorders helps reduce stressors, decrease unhealthy social behaviors, modify problematic personality traits, and better understand that many emotional challenges are internal, not caused by others. There are several different psychotherapy models, and each unique personality diagnosis requires a different type. 

Unfortunately, there is no known way to prevent personality disorder development. However, many problems related to these conditions, such as relationship problems, issues with employment or academics, and social challenges, can be minimized by seeking treatment as soon as possible. Encouraging your teen to seek treatment as soon as symptoms present can decrease the severity of the disruption to one’s life caused by personality disorders. 

It is essential to remember that personality disorders are mental health conditions. Like other mental health diagnoses,  the symptoms that occur with each condition may look different from person to person. Because mental health conditions affect everyone in unique ways, it is essential to choose a treatment program that develops care plans based on the needs of the individual, not the diagnosis. A Beachside, we will work with your teen and family to develop a plan of care designed to help your teen heal physically, emotionally, and spiritually. Let us help your teen as they begin their recovery. To learn more about our programs, contact a member of our admissions team today.  

https://www.apa.org/topics/personality-disorders/causes

https://www.mayoclinic.org/diseases-conditions/personality-disorders/symptoms-causes/syc-20354463

https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596