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 feel numb or 'checked out' and not remember things very well after they've
happened (known as dissociation).

BPD is currently the most commonly diagnosed personality disorder. You can read more
about it on our pages on borderline personality disorder (BPD).

"BPD is like having no emotional buffer. I can go from nothing to suddenly extremely
overwhelming emotions and I struggle with expressing them healthily."

Histrionic personality disorder

Most people enjoy being given compliments or positive feedback about their actions. But if
you depend very heavily on being noticed, or are seeking approval so much that this
affects your day-to-day living, you might get a diagnosis of histrionic personality disorder.

You may:
 feel very uncomfortable if you are not the centre of attention
 feel that you have to entertain people
 constantly seek, or feel dependent on, the approval of others
 make rash decisions
 flirt or behave/dress provocatively to ensure that you remain the centre of
attention
 get a reputation for being dramatic and overemotional
 be easily influenced by others.

"After being told my diagnosis I was then able to understand how and why I behaved the
way I did: my life made a little bit more sense."

Narcissistic personality disorder

It is human nature to be aware of our own needs, to express them, and to want others to
be aware of our abilities and achievements. These are not bad traits. However, if these
thoughts, feelings and behaviours are very extreme and cause problems in relating to
others, you may get a diagnosis of narcissistic personality disorder.

You may:
 believe that there are special reasons that make you different, better or more
deserving than others
 have fragile self-esteem, so that you rely on others to recognise your worth and
your needs
 feel upset if others ignore you and don’t give you what you feel you deserve
 resent other people’s successes
 put your own needs above other people’s, and demand they do too
 be seen as selfish and dismissive or unaware of other people's needs.

Avoidant personality disorder

We all have things, places or people we don't like, or which make us anxious. But if these
things cause so much anxiety that you struggle to maintain relationships in your life, you
may get a diagnosis of avoidant personality disorder (sometimes also called anxious
personality disorder).

You may:
 avoid work or social activities that mean you must be with others
 expect disapproval and criticism and be very sensitive to it

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 worry constantly about being ‘found out’ and rejected

 worry about being ridiculed or shamed by others
 avoid relationships, friendships and intimacy because you fear rejection
 feel lonely and isolated, and inferior to others
 be reluctant to try new activities in case you embarrass yourself.

See our pages on anxiety and panic attacks for more information on how to cope with
anxiety.

Dependent personality disorder

It is natural to need other people to care for us or give us reassurance sometimes. A
healthy balance involves being able to both depend on others as well as being
independent from others sometimes. However, if feelings and thoughts about needing
others become so overwhelming that they impact your daily life and relationships, you
may get a diagnosis of dependent personality disorder.

You may:
 feel needy, 'weak' and unable to make decisions or function day-to-day without
help or support from others
 allow or require others to assume responsibility for many areas of your life
 agree to things you feel are wrong or you dislike to avoid being alone or losing
someone's support
 be very afraid of being left to fend for yourself
 have low self-confidence
 see other people as being much more capable than you are.

Obsessive compulsive personality disorder (OCPD)

Obsessive compulsive personality disorder (OCPD) is separate from obsessive
compulsive disorder (OCD), which describes a form of behaviour rather than a type of
personality.

However, similarly to OCD, OCPD involves problems with perfectionism, the need for
control, and significant difficulty being flexible in how you think about things. You may:
 need to keep everything in order and under control
 set unrealistically high standards for yourself and others
 think yours is the best way of doing things
 worry about you or others making mistakes
 feel very anxious if things aren’t 'perfect'.

See our page on self-care for obsessive compulsive disorder (OCD) for information about
managing the symptoms of OCD. You can also find more information about OCPD on
the OCD UK website.

Personality disorder not otherwise specified (PD-NOS)

Everybody is individual and behaves in unique ways, so it is only natural to not fit
neatly into the categories described above.

If you experience a number of personality disorder traits but not enough to fully meet
the criteria of a specific type, you may receive a diagnosis of personality disorder not
otherwise specified (PD-NOS). This diagnosis may also be known as personality
disorder trait specified.

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What causes personality disorders?

Just as everybody's experience of a personality disorder is unique to them, the causes
will be unique as well.

There's no clear reason why some people develop the feelings and behaviours associated
with personality disorders, and others don't. Most researchers believe that a complex mix
of factors seems to increase the risk of developing or triggering these experiences,
including:
 environment and social circumstances
 early life experiences
 genetic factors.

Environment and social circumstances

The environment and social circumstances we grow up in and the quality of care we
receive can affect the way our personality develops. You may experience difficulties
associated with personality disorders if you've experienced:
 an unstable or chaotic family life, such as living with a parent who is an alcoholic
or who struggles to manage a mental health problem
 little or no support from your caregiver – this may be especially hard if you've
experienced a traumatic event or situation
 a lack of support or bad experiences during your school life, peer group or wider
community, such as bullying or exclusion
 poverty or discrimination
 some form of dislocation, such as migration from abroad.

"I have narcissistic borderline personality disorder. At first it was difficult to accept that
the problem was essentially me, my personality. But then being able to put it into
perspective as a developmental flaw was much easier to accept – that it was simply the
way I'd developed in response to my environment and the situations I'd experienced."

Early life experiences

Our experiences growing up can affect our personality in later life. If you had a difficult
childhood, you might have developed certain beliefs about the way people think or act and
how relationships work. This can lead to developing certain strategies for coping which
may have been necessary when you were a child, but which aren't always helpful in your
adult life.

If you have been given a personality disorder diagnosis you are more likely than most
people to have experienced difficult or traumatic experiences growing up, such as:
 neglect
 losing a parent or experiencing a sudden bereavement
 emotional, physical or sexual abuse
 being involved in major incidents or accidents
 often feeling afraid, upset, unsupported or invalidated.

Not everyone who experiences a traumatic situation will develop these problems
however. Your unique reactions, as well as the consistency and quality of support and
care you received, will make a difference.

Similarly, not everyone who develops a personality disorder will have had a traumatic
experience.

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Genetic factors
Personality is very complex and researchers currently don't know much about what
makes up our personalities and to what extent genes play a part in this.

Some elements of our personality are likely to be genetic. We are born with different
temperaments – for example, babies vary in how active they are, their attention span and
how they adapt to change.

While some experts believe genetic inheritance may play a part in the development of
personality disorder, others point out that it is difficult to know whether similarities in
temperament and behaviour have been handed down the generations genetically or
through the behaviour children were modelled as they grew up. More research needs to
be done in this area.

Why is it controversial?
Our understanding of mental health problems is constantly evolving. So is the language
we use when talking about them. The diagnosis of 'personality disorder' can be
controversial because:

 specialists disagree about how to understand personality disorders

 it doesn't take social context into enough account
 the term itself can be stigmatising.

Some people with this diagnosis hold the view that their feelings and behaviours are a
reasonable, human reaction to going through difficult life experiences. So it's unhelpful
and upsetting to call it an illness or 'disorder' in their personality. They argue that
professionals should consider what in their life may have contributed to their difficulties,
and help with these. Not focus on finding problems in them as an individual.

On the other hand, some people find that getting this diagnosis helps them to name and
understand their experiences, to explain themselves to other people, and sometimes get
treatment and support they otherwise might not.

Mind is committed to ensuring that voices on all sides of this debate are heard. This
includes those who:
 understand their experiences and behaviours as a disorder
 think of them as a natural reaction to adversity
 reject the personality disorder label
 do not fully agree with the label but accept it being as a way to access support.

If you have been diagnosed with a personality disorder but you're concerned that this isn't
right for you, we have information on what you can do if you think your diagnosis is
wrong.

Specialists disagree about how to understand personality disorders

The system of personality disorder diagnosis we list on our page on types of personality
disorder is the one psychiatrists tend to use in the UK. However, some psychiatrists
disagree with its use and find it unhelpful because:

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 Most people who are diagnosed with a personality disorder do not fit any one
category, and may be diagnosed with more than one.
 Some people believe the focus should instead be on what each person needs in
order to deal with their problems and discover new ways of living, not what
category they are in.

It doesn't take social context into enough account

People are complicated. There are many social factors that can affect our capacity to
cope, to relate to others and to respond to stress. For example:

 Experiencing trauma in childhood (such as abuse or neglect), or trauma that lasted

for a long time.
 Issues to do with your situation and environment, such as poverty and social
deprivation, or having to move home to a totally new place or culture.
 Experiencing stigma and discrimination, like racism, sexism, homophobia, biphobia
or transphobia.
 If people have treated you badly in past relationships (including your parents or
carers).

Any of these can lead to you often feeling overwhelmed with unbearable feelings. This
can make it very difficult to deal with the daily challenges of adult life.
For more information on how traumatic experiences may affect your mental health, see
our pages on trauma.

The term itself can be stigmatising

Some people feel that the term 'personality disorder' can sound very judgmental. Being
given a diagnosis or label of personality disorder can feel as if you're being told there's
something wrong with who you are. You may feel upset, insulted and excluded. Language
evolves and it may be that a different term will be used by professionals in future.

"Stigma can sometime come from the professionals themselves, whether intentionally or
not."

It's important to remember that you're not alone – there are other people out there
experiencing what you are. However you choose to make sense of your difficulties, you
deserve to be treated fairly. Here are some options you can consider:

 Show people this information to help them understand more about what your
diagnosis really means.
 Get involved in your treatment – our pages on seeking help for a mental health
problem and advocacy provide guidance on having your say in your treatment,
making your voice heard and steps you can take if you're not happy with your
care.
 Know your rights – our pages on legal rights provide more information.
 Take action with Mind – see our campaigning page for details of the different ways
you can get involved in helping us to challenge stigma.

That said, it takes energy to challenge stigma. When you are particularly unwell you may
not have the capacity to do any of these things. Be kind to yourself and try not to put
yourself under pressure to do anything other than rest and recover when that is what
you need.

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