A personality disorder is a long-term pathological condition that accompanies a person throughout their life. Personality disorders are enduring patterns of inner experience and behavior that significantly deviate from cultural norms and expectations, affect all areas of a person’s life, and are inflexible. Personality disorders typically begin in adolescence or early adulthood, remain stable over time, and lead to distress or impairment in functioning. These disorders can significantly affect quality of life and an individual’s ability to function across various life domains.

The etiology of personality disorders is complex and multifaceted. It includes genetic factors that may predispose a person to develop certain traits, as well as environmental influences such as upbringing, trauma, and social or cultural factors. Psychological theories emphasize the importance of early childhood experiences and parent–child relationships, which may contribute to the development of certain behavioral and perceptual patterns.

For a long time, there was limited data on the prevalence of personality disorders. Large-scale studies began in the 1990s, and now it is considered that they are relatively common, with estimates ranging between 10% and 15%. Schizotypal, antisocial, and histrionic personality disorders are found in about 2–3% of cases. Narcissistic and avoidant personality disorders are thought to be less common (0.5-1%), while the most prevalent are borderline and obsessive-compulsive personality disorders.

 

Cluster A – Odd or Eccentric Disorders

Paranoid Personality Disorder
Characterized by persistent suspiciousness and distrust of others. People with this disorder tend to interpret others’ intentions as hostile or malicious. They are often convinced that others are trying to harm, deceive, or exploit them. These individuals may be overly sensitive to criticism and see hidden motives in neutral actions, which creates difficulties in interpersonal relationships and may lead to frequent conflicts and isolation.

Schizoid Personality Disorder
Characterized by detachment from social relationships and limited emotional expression. People with this disorder prefer to be alone, avoid close connections (including family), and tend to work in solitary environments. They may appear cold or indifferent to praise or criticism and rarely express strong emotions. Their limited social skills and preference for isolation can make participation in social and professional life difficult.

Schizotypal Personality Disorder
People with this disorder may experience significant discomfort in close relationships, exhibit odd behavior, and have cognitive or perceptual distortions. Their thoughts and views of the world may seem unusual, leading to feelings of alienation and isolation. They may also have peculiar sensory experiences, including illusions or strange bodily sensations. Due to their eccentric behavior and thoughts, they often feel uncomfortable in social situations and tend to avoid them, resulting in social withdrawal.

 

Cluster B – Dramatic, Emotional, or Erratic Disorders

Antisocial Personality Disorder
Characterized by a limited capacity for empathy and disregard for the rights of others. Other symptoms include impulsivity, reckless behavior (including substance abuse), lack of remorse after harming others, deceitfulness, irresponsibility, and aggressive behavior. People with this disorder struggle to control their actions and may repeatedly engage in illegal activities, leading to problems with the law. Although antisocial individuals tend toward rule-breaking, not all engage in criminal acts. Some seek leadership or attention and avoid illegal activity while manipulating others, provoking conflict, and challenging authority.

Borderline Personality Disorder
Marked by instability in interpersonal relationships, self-image, emotions, and strong impulsivity. Individuals often experience intense and shifting emotions, leading to turbulent and conflict-prone relationships. They may display impulsive and risky behavior (e.g., unplanned spending, promiscuity, suicide attempts). These traits make it difficult to maintain stable relationships or achieve professional success.

Histrionic Personality Disorder
Manifests as exaggerated emotionality and a strong need for attention. Individuals with this disorder often feel ignored unless they are at the center of attention. They crave being noticed and validated, which can lead to dramatic or theatrical behavior. Their emotional expressions are typically intense but shallow. When they don’t receive the attention or admiration they seek, they may experience feelings of emptiness and anxiety. In relationships, they often feel neglected and unappreciated, which can result in superficial connections and difficulty forming deep, meaningful bonds.

Narcissistic Personality Disorder
Characterized by a grandiose sense of self-importance, a need for admiration, and a lack of empathy. People with narcissistic traits often experience envy—feeling that others have what they deserve—while also believing others envy them. Despite outward confidence, they are very sensitive to criticism and perceive it as a personal insult, leading to anger or humiliation. They feel entitled to special treatment and privileges and may feel empty or insignificant when they don’t receive them. These feelings often result in strained and conflict-ridden interpersonal relationships.

 

Cluster C – Anxious and Fearful Disorders

Avoidant Personality Disorder
Characterized by social anxiety, feelings of inadequacy, and hypersensitivity to negative evaluation. People with this disorder avoid social interactions and situations where they might be criticized or rejected. They often fear humiliation or ridicule and prefer isolation, which can lead to difficulties in both personal and professional life.

Dependent Personality Disorder
Associated with an excessive need for care and support from others. These individuals often feel helpless and struggle to make decisions without guidance. They may be overly submissive and try to please others to avoid conflict or rejection. Their dependency makes it hard for them to live independently and leaves them vulnerable to exploitation.

Obsessive-Compulsive Personality Disorder
Characterized by an excessive preoccupation with order, perfectionism, and control. People with this disorder may be highly demanding of themselves and others, striving for perfection in tasks. They may have difficulty completing tasks due to their meticulousness and insistence on standards. Their psychological rigidity can create problems in personal and professional relationships.

 

Treatment

When discussing treatment for personality disorders, professionals refer to symptom reduction and improved functioning. Any personality disorder can exist in two main states: adapted and maladapted. The adapted state allows the person to achieve some degree of stability in society and in managing their own life. In the maladapted state, the intensification of personality traits prevents this functionality.

However, research shows that therapy can be helpful for various types of personality disorders.

The primary method of treatment is psychotherapy. The most effective forms of therapy for personality disorders include Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT). Medication may be used to treat comorbid conditions, but it is not considered the first-line treatment for personality disorders.

With consistent therapeutic work, regular follow-up with psychiatrists and medical doctors, and support from family, many people can significantly improve their condition and quality of life.