Personality Disorders

Personality disorders are characterized by inflexible and unhealthy patterns of thinking, functioning and behaving. A person with a personality disorder has difficulty perceiving and relating to particular situations as well as to people. This causes significant problems that often disrupts personal, professional, work and/or social life. Personality disorders usually begin in the teenage years or early adulthood.
Causes of Personality Disorder
The cause of personality disorders is unknown. However, genes and childhood experiences may play a role.
Symptoms of Personality Disorder
The symptoms of each type of personality disorder are different and can range from mild to severe. People with personality disorders may have trouble realizing that they have a problem.
Diagnosing Personality Disorder
Based on the symptoms typically present, personality disorders are clustered into three groups:
Odd or Eccentric Personality Disorders
  • Paranoid personality disorder is diagnosed in people who are cold, distant and unable to form close interpersonal relationships. Often overly, yet unjustifiably, suspicious of their surroundings, they generally cannot see their role in conflict situations and often project their feelings of paranoia as anger onto others.
  • Schizoid personality disorder is diagnosed in persons who are often cold, distant, introverted and have an intense fear of intimacy and closeness. They are often too absorbed in their own thinking and daydreaming that they exclude themselves from attachment with persons and reality.
  • Schizotypal personality disorder is similar to schizoid personality disorder, but people with schizotypal personality disorder also exhibit disordered thinking and perception and ineffective communication skills. Many symptoms of schizotypal personality disorder resemble schizophrenia, but are less mild and intrusive.

Dramatic or Erratic Personality Disorders
  • Borderline personality disorder is diagnosed when the patient has instability in their perceptions of themselves and difficulty maintaining stable relationships. Moods may also be inconsistent, but reality is always seen in "black and white." People with borderline personality disorder often incessantly seek a higher level of caretaking from others.
  • Antisocial personality disorder is diagnosed when a person characteristically disregards the feelings, property, authority and respect of others for their own personal gain. This may include violent or aggressive acts involving or targeting other individuals, without a sense or remorse or guilt for any of their destructive actions. 
  • Narcissistic personality disorder is characterized by severely overly inflated feelings of self-worth, grandiosity and superiority over others. People with narcissistic personality disorder are often overly sensitive to criticism, judgment and defeat.
  • Histrionic personality disorder is diagnosed in people who are overly conscious of their appearance, are constantly seeking attention and often behave dramatically in situations that do not warrant this type of reaction. The emotional expressions of people with histrionic personality disorder are often judged as superficial and exaggerated.

Anxious or Inhibited Personality Disorders
  • Dependent personality disorder is diagnosed in people who rely heavily on others for validation and fulfillment of basic needs. Often unable to properly care for themselves, people with dependent personality disorder lack self-confidence and often have difficulty making decisions.
  • Avoidant personality disorder occurs in people who are hypersensitive to rejection and, thus, avoid situations with any potential for conflict.
  • Obsessive-compulsive personality disorder is diagnosed in people who are inflexible to change and bothered by a disrupted routine due to their obsession for order. They often become uncomfortable in situations that are beyond their control and have difficulty maintaining positive, healthy interpersonal relationships as a result.

Treating Personality Disorder
Personality disorders are often difficult to treat and may require long-term attention to change the behavior and thought patterns. Treatment usually involves one of more of the following approaches.
  • Psychotherapy (‘talk’ therapy; in individual or groups settings that may include family members) is the primary approach for personality disorders. The goal is to learn healthy ways to manage symptoms and reduce negative behaviors that interfere with functioning and relationships.
  • Medications (antidepressants, antianxiety drugs, mood stabilizers and antipsychotic drugs) can be helpful in controlling symptoms of the various personality disorders.


Our physicians at Houston Methodist specialize in managing personality disorders at the following convenient locations: