Personality Disorder (PD)

Personality disorders (PD) are categorized into three clusters (A, B, C), each showing consistently dysfunctional patterns of thinking and behaving. Individuals with PDs have difficulty understanding emotions, tolerating distress, controlling impulsivity, and relating to others. Each PD has at its core a vicious circle: the more a person does something unhelpful or undesirable, the more they experience a negative impact; the more they experience a negative impact, the more they do of the undesirable something. For example, the more a narcissist feels ridiculed and hurt, the more they fly into narcissistic rage and seek revenge; the more they experience anger and a need for revenge, the more they feel put down and ashamed. PDs are frequently comorbid, with shared symptoms (often due to the blurry lines between them). Causes of PDs are believed to be a combination of genetic predisposition (family history of personality disorders, anxiety, or depression) and environmental factors (childhood experiences, like abuse, trauma, neglect, or learning behaviors from parents). PDs are lifelong and recovery is difficult but possible with customized intervention, requiring longer-term treatment compared to serious mental illnesses (SMIs). The three clusters are:

• Cluster A: Odd, bizarre, eccentric behaviors, reflecting suspicion, no interest in others. Includes paranoid PD, schizoid PD, and schizotypal PD
• Cluster B: Dramatic, erratic/unpredictable, overly emotional thinking/behavior. Includes borderline PD (BPD), narcissistic PD (NPD), antisocial PD
• Cluster C: Anxious, fearful thinking/behavior, social inhibition and avoidance. Includes dependent PD (DPD), avoidant (AVPD), obsessive-compulsive PD (OCPD)