Personality Disorders

What are Personality Disorders?

Personality Disorders are defined as pervasive patterns of thinking, behaving and emotionally reacting that are rigid, inflexible, and can cause the individual significant distress and/or impair function. Everyone has a unique personality, and while there’s no one “healthy” way to feel, react or behave, individuals with personality disorders tend to be outliers regarding their personality traits, their intensity, their rigidity, or in the ways in which traits limit function, or affect relationships. While some individuals with personality disorders do not have any concern about their traits, others may feel such a degree of inner tension from their emotions, thoughts and feelings that they resort to unhealthy coping strategies (such as self-harm, disordered eating, substance use, promiscuity, or even suicidal thoughts or actions) in an attempt to cope.

Personality disorders can be diagnosed by a mental health professional, on or after the age of 18. With that said, personality traits tend to continue to evolve until an individual is approximately 25, and early intervention and treatment for problematic traits can have a significant impact on an individual’s life – including their work, school, overall mental wellbeing and relationships.

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 are influenced by both genetics and one’s environment. While further research is needed, studies suggest that the heritability of personality disorders is approximately 35-60%, with specific rates of heritability differing among specific disorders. Heritability is a statistic explaining the proportion of cases that can be explained by genetics (it does not mean that if a parent has a personality disorder, their child has a 35-60% chance of having that same disorder). Even in identical twins, when one individual has a personality disorder, there is still only about a 50% chance (varies based on specific disorder), that the other will struggle with the same condition. Environment, trauma, nourishment and exposure to toxins, early relationships, and other factors also play a significant role in the development of personality disorders and the evolution of one’s personality traits.

What are Personality Disorder “Clusters?”

Mental health providers in the US, categorize the 10 personality disorders into three different “Clusters:” Clusters A, B and C. By grouping personality disorders in this way, mental health providers (and researchers) are able to study similar personality disorders, and make recommendations for the treatment of disorders that share 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 Should I see a Mental Health Provider, Psychologist or Psychiatrist 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 an individual turns to coping mechanisms that are unhealthy and/or dangerous (such as self-harm, substance use, gambling, promiscuity, suicidal thinking or acts, then an evaluation by a mental health professional, and discussion of treatment options is necessary). *If an individual has suicidal thoughts, we urge them to call 911 or 988, and not to wait for a psychiatric appointment if they are in danger.

What Treatments are Available for Personality Disorders?

Treatment for Personality Disorders and their symptoms may include:

• Psychotherapy including DBT (or dialectical behavioral therapy), mindfulness and mindful meditation, EMDR (or Eye Movement Desensitization and Reprocessing) for specific trauma’s making it difficult to cope with one’s emotions, CBT or Cognitive Behavioral Therapy (to help reframe the way that individuals view the world or react to triggers) and others.
• Medication management may be utilized if an individual has severe symptoms, specific symptoms caused by their personality disorder that can be treated pharmacologically, or when they struggle with co-occurring mental illness, such as an anxiety disorder, PTD, OCD or others.
• Group Psychotherapy may be utilized or recommended, to help patients with similar emotional difficulties or problematic coping mechanisms, to heal and learn new ways to manage.
• Behavioral Modification may be utilized (such as recommendations and plans for diet, exercise, meditation, and others).

Why Choose Rittenhouse Psychiatric Associates for Personality Disorder Treatment?

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.