What are personality disorders?
As individuals, we all have our own patterns of thoughts, feelings and behaviours which make us unique. These patterns, or personality traits, develop in childhood and tend to continue through adulthood. Our personality traits form our identity and make us who we are. Parts of our personality can sometimes cause issues with friendships, relationships, work and learning.
When areas of a person’s life are seriously affected by their personality, they may have an underlying personality disorder. Personality disorders involve patterns of negative thoughts and behaviours across every aspect of a person’s life, including work, home, study, and leisure. Personal relationships with others are very important for our overall wellbeing and people who experience personality disorders may have difficulty forming and keeping friendships and relationships.
Although someone may have an existing personality disorder, their own thoughts and behaviours may not feel distressing to them. However, when that person is able to see the effects of their behaviour on others, they may feel impacted or distressed by it.
Types of personality disorders
Paranoid personality disorder causes people to become distrustful and often suspicious of others and they may believe others' motivations are threatening or hostile.
Schizoid personality disorder causes people to become detached from social relationships and may restrict their ability to express emotions around others.
Forming close relationships becomes very difficult for someone with schizotypal personality disorder, as it causes them to become very uncomfortable around others. It may also cause jumbled thoughts and unusual behaviours.
Antisocial personality disorder may cause people to ignore or violate the rights of others, with a lack of remorse for the way their behaviour might impact on somebody else.
Histrionic personality disorder can cause people to become overly emotional. It can also result in a person constantly seeking the attention of others.
Narcissistic personality disorder can cause a person to have strong beliefs in their own greatness, which shows in the way that they behave. They may also seek admiration from others and have trouble understanding or processing how other people think and feel.
A person with avoidant personality disorder tries to avoid having to interact with others because they are afraid of criticism, disapproval or rejection.
Dependent personality disorder causes people to become overly needy or dependent on others to do things for them. This may lead to a person giving in very easily, being clingy or afraid of separation.
Obsessive-compulsive personality disorder results in extremely controlled, ordered and perfectionist behaviour. It may make people become obsessed with details, rules or procedures which can interfere with their ability to function in some situations.
Borderline personality disorder causes people to be extremely emotionally sensitive to the events in their lives. This results in extreme and unpredictable mood swings, anger, panic, despair and ongoing emptiness. It can also mean people have unstable or intense relationships which include fear of abandonment, impulsive or reckless behaviour (including suicide attempts or self harm). Borderline personality disorder may also be associated with brief episodes of paranoia and a loss of touch with reality.
How common are personality disorders?
Around 1 in 10 people have some form of personality disorder. Personality disorders are even more common among people who have alcohol, tobacco and/or other drug issues, where the number is approximately 1 in 2.
The most common personality disorders among people who have issues with alcohol, tobacco and/or other drugs are antisocial and borderline personality disorders.
Personality disorders and co-occurring substance abuse
Sometimes people can rely on using substances (i.e., alcohol and/or other drugs) to help them overcome negative emotions. This is called 'self-medication'. Other aspects of a person’s personality disorder may also impact on their substance use.
For example, if a person is avoidant, drugs and alcohol may help to deal with social anxiety. If someone has an antisocial personality disorder, they may use drugs or alcohol because it is a ‘deviant’ behaviour which means they know it is considered unacceptable.
Although there are many reasons that a person may use alcohol and/or other drugs if they have a personality disorder, some people feel like they develop problems because they feel like they need to drink or take more to feel the way they would like to. This can sometimes cause personality disorders to become worse which makes maintaining relationships even more difficult and complicated.
When should you seek help?
If you answer 'yes' to any of the following questions, you should consider seeking professional support:
- Do you have pervasive personality traits that cause distress to yourself or others?
- Do your personality traits or substance use interfere with your home, work, study, relationships or social life?
- Do you use alcohol, tobacco and/or other drugs to cope?
- Have you ever thought about harming yourself or others?
How are personality disorders treated?
Personality disorders are usually treated through either psychological therapies, medication or a combination of both. Often when a person learns how to better manage and respond to personality traits, their substance use becomes easier to manage as well.
Psychological treatments usually involve therapy that is focussed on coping with negative emotions, learning how to interact with people in different situations, understanding and changing underlying beliefs that may contribute to some maladaptive personality traits, and managing self-harm and suicidal behaviour.
Some of the most common psychological treatments for personality disorders are Cognitive Behavioural Therapy (CBT) and Dialectical Behaviour Therapy (DBT).
Medication may also be helpful alongside psychological therapies. The type of medication depends on the personality disorder, but might include antidepressants, mood stabilisers, or anti-psychotic medications.
Medications can be helpful in managing your emotions; however, some people experience unpleasant and distressing side effects. In most instances there is a choice of medication, but it may take time to establish which medication is best suited to your needs. Tell your doctor about any side effects that are distressing you.
Tips for staying well
There are a number of things you can do to look after yourself, including:
- Taking care of yourself.
- Making sure you eat healthily and get regular exercise.
- Ensuring you make time for exercise, as it provides an outlet for the stress that has built up in your body.
- Planning to do something you enjoy each day. This doesn’t have to be something big or expensive as long as it is enjoyable and provides something to look forward to that will take your mind off your worries.
Where can you get help?
In an emergency, call Triple Zero (000).
You can also contact your local GP, or call/click the following services:
Beyond Blue: 1300 22 4636
eCliPSE Service Locator
Kids Helpline: 1800 55 1800
Lifeline: 13 11 14
National Alcohol and Other Drug Hotline: 1800 250 015