Personality Disorders

What is a Personality Disorder?

Personality disorders are defined as long-standing patterns of thinking, behaving, and emotionally reacting that become rigid, inflexible, and disruptive. While everyone has a unique personality, individuals with personality disorders often have traits that are unusually intense, difficult to adjust, or limiting in ways that affect functioning and relationships. Some people may not view their traits as problematic, while others experience significant inner tension and may turn to unhealthy coping strategies – such as self-harm, substance use, disordered eating, or impulsive behaviors – to manage overwhelming emotions or distress.

A personality disorder diagnosis is made by a mental health professional, typically in adulthood, when personality traits become stable. Early intervention for emerging traits can meaningfully improve functioning, relationships, and quality of life.

How Common are Personality Disorders?

Approximately 9 percent of US adults meet criteria for at least one personality disorder.

What causes Personality Disorders?

Personality traits develop through a combination of genetics and environmental influences. Research suggests that personality disorders have a moderate degree of heritability, though the exact percentage varies by specific disorder. Heritability reflects how much genetics contribute overall – it does not mean an individual directly inherits a disorder from a parent. Even among identical twins, if one has a personality disorder, the likelihood of the other having the same condition is only about 50%. Environmental factors such as early relationships, trauma, nourishment, and exposure to stressors or toxins also play a significant role in shaping personality traits and the development of personality disorders.

Different Types of Personality Disorders

There are ten recognized types of personality disorders, which mental health providers in the U.S. organize into three clusters – A, B, and C. Grouping them this way helps clinicians understand shared traits across related disorders and tailor treatment recommendations based on those similarities.

Cluster A Personality Disorders: 

Cluster A Personality Disorders are categorized by a consistently dysfunctional pattern of thinking and behavior. This pattern may reflect suspicion, a lack of interest in, or unusual/ eccentric thoughts about others, or the world in general. They include:

• Paranoid Personality Disorder
• Schizoid Personality Disorder
• Schizotypal Personality Disorder

Cluster B Personality Disorders

Cluster B Personality Disorders are categorized by a consistently dysfunctional pattern of thinking and behavior. This pattern may be driven by intense emotions and emotional reactivity, that may lead an individual to be thought of as dramatic, or may lead to problematic, unpredictable, or dangerous behaviors, to cope with the intense emotions. They include:

• Borderline Personality Disorder
• Histrionic Personality Disorder
• Narcissistic Personality Disorder
• Antisocial Personality Disorder

Cluster C Personality Disorder

Cluster C Personality Disorders are categorized by a dysfunctional pattern of thinking and behaviors. The problematic traits and symptoms can be thought of as being driven by anxious thoughts or insecurities. They include:

• Avoidant Personality Disorder
• Dependent Personality Disorder
• Obsessive Compulsive Personality Disorder

When to Seek an Evaluation for a Personality Disorder

If an individual’s patterns of emotions, feelings or behaviors cause significant distress or interfere with school, work or their relationships, we recommend reaching out for help.

If unhealthy or unsafe coping strategies develop – such as self-harm, substance use, disordered eating, promiscuity, or suicidal thoughts – it may signal that long-standing personality traits have become distressing, problematic and difficult to manage. Seeking a mental health evaluation at that point is important, as early assessment can help clarify whether symptoms are connected to a personality disorder and what support is needed. If someone is in immediate danger or experiencing suicidal thoughts, call 911 or 988 right away.

Personality Disorder Treatment Options

Treatment for Personality Disorders and their symptoms may include:

• Psychotherapy is a core treatment approach for personality disorders and can help individuals understand patterns of thinking, emotional reactions, and behaviors that feel rigid, intense, or difficult to manage. Evidence-based modalities may include DBT (dialectical behavior therapy) for emotion regulation and impulse control, CBT (cognitive behavioral therapy) for reframing unhelpful thought patterns, EMDR for trauma-related symptoms, and mindfulness-based therapies to build awareness and coping skills. These approaches support long-term change by helping individuals develop healthier ways of navigating stress, relationships, and daily challenges.
•  Medication management may be recommended when symptoms related to a personality disorder become difficult to manage on their own. While medication does not treat a personality disorder directly, it can help reduce specific symptoms that interfere with daily functioning or emotional wellbeing. A psychiatric provider works closely with each patient to determine whether medication is appropriate and how it can support broader therapeutic goals. Additionally, many people with personality disorders have other psychiatric conditions (co-occurring conditions), which can also be managed with medication management.
• Group psychotherapy may be recommended to help individuals who share similar emotional patterns, stressors, or coping challenges. For people with personality disorders, group settings can provide a structured space to practice communication skills, build emotional awareness, and learn healthier ways of relating to others.
• Behavioral and lifestyle modifications can play a helpful role in managing symptoms associated with personality disorders. These recommendations support emotional regulation, improve coping capacity, and strengthen overall mental and physical wellbeing when used alongside psychotherapy and, when appropriate, medication management.

Why Choose Rittenhouse Psychiatric Associates for Personality Disorder Care

The providers at Rittenhouse Psychiatric Associates are academically oriented providers, most of whom teach, or have taught, at academic institutions. Our providers are Board Certified Psychiatrists and Psychiatric Nurse Practitioners and we have several licensed and doctoral level therapists and psychologists. We are experienced in working with individuals who struggle with various psychiatric conditions, including various Personality Disorders.

• Board Certified Psychiatrists and Psychiatric Nurse Practitioners
• Licensed Therapists and Doctoral Level Psychologists
• Academically Oriented providers, most of whom teach, or have taught, at local Academic Institutions, such as Johns Hopkins Hospital & The University of Pennsylvania.
• Appointments generally available within 2 weeks.
• In-office and online Virtual Appointments for Personality Disorder Treatment
• Providers experienced in treating co-occurring psychiatric conditions.
• Providers who are welcoming to all individuals.

Of note, we do not offer all forms of treatment for personality disorders. Please call to discuss your specific conditions and needs. It is not uncommon for our psychiatrists or other mental health provider to collaborate (as a team) with providers outside of our practice, when treating personality disorders. For example, an individual who has a psychiatric evaluation with one of our psychiatrists or psychiatric nurse practitioners may continue in medication management within our practice, but may also be referred to a DBT program in the community, for that specific treatment.