Therapy for Personality Disorders

Personality Disorders (PD) are often misunderstood conditions that are frequently underdiagnosed. Symptoms like depression or anxiety often overlap with these conditions, and specific PD symptoms are overlooked or mistaken for mere personality quirks.

Personality Disorders affect how people think, feel, and relate to others, typically in ways that aren’t deemed the “social-norm”. While everyone experiences life differently, this lack of understanding about PD’s can lead to significant stigma.

With compassionate support and evidence-based therapy, individuals can build healthier coping skills and live more fulfilling lives.

What are Personality Disorders?

A personality disorder is a mental health condition involving persistent patterns of thinking, feeling, and behaving that are inflexible and significantly different from cultural expectations.

These patterns can cause distress, impair daily functioning, and make it hard to form stable, supportive relationships.

People with personality disorders often:

• Struggle to adapt their behaviors to different social situations
• Experience intense or unstable emotions
• Misinterpret others’ intentions or actions
• Face challenges with self-image, empathy, and impulse control

“Someone with a personality disorder may be unable to manage their emotions either by being easily overwhelmed by their emotions or avoiding their emotions. They may have distorted beliefs such as being hurt or rejected by others. As a result, they may struggle to maintain healthy relationships because of their inability to manage their emotions and distorted beliefs.” -Lindsay Thompson, Licensed Mental Health Counselor at Handel Behavioral Health 

Common Signs and Symptoms of Personality Disorders

Symptoms often develop in adolescence and early adulthood and can vary widely depending on the type.

General signs and symptoms of Personality Disorders include:

• Persistent patterns of behavior that cause distress or difficulty in daily life
• Trouble managing emotions, leading to intense reactions or emotional numbness
• Difficulty sustaining healthy relationships
• Seeing the world in very black-and-white terms
• Strong fears of abandonment, rejection, or inadequacy
• Repetitive, impulsive, or self-defeating behaviors

These behaviors and attitudes often result in challenges and limitations in relationships, social settings, work, and school settings. You may find yourself feeling isolated, distressed, anxious, or depressed as a result.

Types of Personality Disorders

Diagnostic systems group personality disorders into three major clusters based on common experiences and symptoms:

Cluster A — Odd or Eccentric Ways of Thinking

• Paranoid personality traits (mistrust, suspicion)
• Schizoid traits (social withdrawal, indifference)
• Schizotypal traits (unusual beliefs or behaviors)

Cluster B — Emotional or Impulsive Behaviors

• Borderline traits (emotional instability, intense relationships)
• Antisocial traits (disregard for others’ rights)
• Histrionic traits (excessive attention-seeking)
• Narcissistic traits (need for admiration, lack of empathy)

Cluster C — Anxious or Fearful Patterns

• Avoidant traits (fear of criticism, social inhibition)
• Dependent traits (excessive need for care)
• Obsessive-compulsive traits (perfectionism, rigidity)

Note that individuals may experience traits of more than one personality disorder.

What Causes Personality Disorders?

There is no single known cause, but research suggests personality disorders emerge from a mix of:

• Genetics: Biological traits passed through family history
• Brain development: Subtle neurological differences may play a role
• Early life experiences: Trauma, emotional neglect, unstable environments
• Coping patterns: Habitual responses to stress or relationships that become entrenched over time

Personality itself develops early in life, so disruptions during formative years can influence long-term patterns, especially related to attachment, safety, and emotional regulation.

How Are Personality Disorders Diagnosed?

Diagnosis involves a comprehensive assessment by a mental health professional. This may include:

• Clinical interviews and questionnaires
• Reviewing personal history and symptom patterns
• Ruling out other medical or mental health conditions
• Comparing experiences with DSM-5 diagnostic criteria

A clear diagnosis helps guide individualized treatment planning and ensures the most effective therapeutic support.

“My goal as a therapist is to help improve my clients’ life satisfaction in all areas of their life, from work to personal relationships. We work together to find healthy coping strategies, reduce their everyday distress, and find balance in life.” – Lindsay Thompson, LMHC at HBH Therapy

Therapy and Treatment for Personality Disorders

Although personality disorders can be complex, meaningful improvement is possible with the right care. Therapy is the core of treatment, but a holistic approach to healing includes a compassionate support system and appropriate medication management.

Talk Therapy

Therapy helps individuals understand their emotional patterns, build coping skills, and relate to others more effectively. Research shows therapy can lead to lasting change over time.

Common evidence-based approaches include:

• Dialectical Behavior Therapy (DBT) – Builds emotional regulation, distress tolerance, and interpersonal effectiveness through mindfulness practices
• Cognitive Behavioral Therapy (CBT) – Identifies harmful thinking patterns, emotions, and behaviors, and teaches healthy coping skills to prevent further negative feelings.
• Mentalization-Based Therapy (MBT) – Deepens understanding of thoughts and emotions within yourself and others

Medication

While there are no medications specifically approved to treat personality disorders, certain medications may help manage the related symptoms, such as mood instability, anxiety, or depression.

Medications that are often used in the treatment of personality disorders include antidepressants, mood stabilizers, and anti-anxiety medications.

Medication management can be guided by one of HBH’s in-house psychiatrists, so there’s no interruption of care or shuffling of doctors and appointments.

Additional Support

Support groups, peer connections, and structured programs can reinforce skills, reduce isolation, and foster emotional growth.

Loved ones can also make efforts to educate themselves on the signs, symptoms, and ways they can support someone with a personality disorder. This can decrease the stigma and judgment they may feel and can lead to more open and honest conversations.

Looking for Therapy for Personality Disorders Near You?

Living with a personality disorder can feel overwhelming  and isolating, especially when symptoms affect relationships, work, or self-esteem.

With the support of HBH’s compassionate therapists trained in treating personality disorders, individuals can make meaningful progress in managing symptoms, build coping skills, and lead happier and healthier lives.

If you’re noticing symptoms in yourself or a loved one, consider reaching out to us by contacting us today at (413) 343-4357 or request an appointment online.

We have licensed mental health counselors ready to work with you in-person from our offices in Amherst, Wilbraham, West Springfield, Franklin, Natick, and online throughout Massachusetts. 

 

Further Reading:

Loving My Brother With Schizophrenia

Your Guide to Schizophrenia

How to Support Someone with Borderline Personality Disorder (BPD)

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