Personality disorders are complex mental health conditions that effect multiple areas of a person’s life, including behaviour, thoughts, and feelings, on a daily basis. They can also affect how you understand and relate to other people, as well as your general health and wellbeing. There are many types of personality disorders and they can range from being mild and relatively manageable, to having a severe and enduring impact on an individual’s ability to function. There are 10 recognised types of personality disorder. It’s likely that the symptoms you experience will vary depending on the specific type of personality disorder you are struggling with. Symptoms will also vary from person to person. The 10 types are: Different types of personality disorders have different symptoms. For example, it is very unlikely that someone with borderline personality disorder would experience the same symptoms as someone with paranoid personality disorder. To help us understand some of the symptoms and characteristics a little better, personality disorders can be categorised into three different clusters. Cluster A – includes personality disorders that are characterised by unconventional behaviour. This group includes paranoid personality disorder, schiziod personality disorder, and schizotypal personality disorder. Cluster B - groups together disorders with dramatic and unpredictable symptoms. This group includes antisocial personality disorder, histrionic personality disorder and narcissistic personality disorder. Borderline personality disorder, also known as emotionally unstable personality disorder, and empulsive personality disorder also fit into cluster B. Cluster C – a grouping that includes disorders where people typically experience fearful and anxious symptoms. This group includes avoidant personality disorder, obsessive-compulsive personality disorder, and dependent personality disorder. When you visit your GP or specialist for a personality disorder assessment, they will be able to explain each cluster in more detail to you and where you may fit in. Identifying Personality DisordersParanoid personality disorderCharacterised by a difficulty in trusting others and believing they will take advantage of you in some way. If you have paranoid personality disorder, you may interpret danger in everyday situations which other people don’t observe, and you will always be watching other people closely in case they become hostile. Schizoid personality disorderYou may feel that relationships get in the way of your day-to-day life, and that other people will only cause you problems. This means you tend to have an ongoing disinterest in forming relationships, even with other family members. It can be difficult to experience pleasure from everyday life, with little interest in emotional connection or intimacy. Schizotypal personality disorderOften compounded by eccentric behaviour, finding and making close relationships is often incredibly difficult. You may use words and phrases which other people find unusual, while delusional thoughts and beliefs, such as believing you have special powers, can lead you to feeling anxious or tense when others don’t share these ideas. Antisocial personality disorder (ASPD)People with antisocial personality disorder (ASPD) may behave dangerously and sometimes illegally, and generally act in ways that are unpleasant to others. You may already have a criminal record and feel little or no sense of guilt when mistreating or upsetting other people. Borderline personality disorder (BPD)Also known as emotionally unstable personality disorder, EUPD, you will often experience intense emotions which can last anywhere from a few hours to several days. Fluctuations will vary between the extremes of happiness and self-belief to feeling low later, often in the same day. You may find it hard to maintain stable relationships, while suicidal thoughts and self-harming behaviour can also be experienced. Impulsive personality disorderIs a subtype of BPD, and is very different from other types of the disorder in that you will appear charismatic to others. Enjoying being at the centre of attention, you may be adventurous to the point of engaging in dangerous activity, although meaningful connections with others can be difficult to come by. Histrionic personality disorderSimilar to impulsive personality disorder, with histrionic personality disorder you might feel uncomfortable not being centre of attention at social events or in the workplace. You may have an overwhelming urge to entertain people regularly, and can be easily emotionally influenced by other people and their opinions towards you. Narcissistic personality disorderIf you struggle with narcissistic personality disorder, you may appear selfish and regularly put your needs above others. You believe that there are unique reasons that make you different or better than other people, although you have a delicate self-esteem which is built upon others’ recognition of your value and attributes. Obsessive compulsive personality disorder (OCPD)You feel the need to keep everything in order and be in control of your surroundings, which can make you have high expectations of yourself and other people in work and other ability focused settings. You will think that awful things are about to happen if something doesn’t go your way, while you will dwell on the mistakes of yourself and others. Avoidant personality disorderAlso known as anxious personality disorder, with avoidant personality disorder you will tend to avoid situations where you have to spend a significant amount of time with others, such as at work or social gatherings. You will feel overly sensitive to disapproval and will constantly worry about being rejected in social settings. You may feel inferior to others, and avoid developing relationships for fear that you may be ridiculed or rejected. Dependent personality disorderYou are dependent on others to make decisions in your daily life, and will often let others take responsibility for you in many areas. You may have low self-confidence and appear submissive or passive to others. In work meetings for example, you will agree to things even if you dislike a thought or opinion so that you don’t lose the support of others. What to do if you suspect you have a Personality Disorder?If you suspect you have a personality disorder, you need to visit your GP or another type of medical professional. They will be able to talk you through any symptoms you may be experiencing and provide a general observation from your initial meeting. Once you have had your first meeting, you will be able to get clear answers as to whether you do have a personality disorder as well as what kind of disorder you may have. It’s important to understand that having a personality disorder does not make a person untreatable and that different treatments are available depending on the type of personality disorder. Treatment for personality disorders at Priory aims to reduce the impact of the condition on your life, and there are several psychotherapies can help to achieve this. Medication can also be helpful in dealing with distressing symptoms. Depending on the severity of a personality disorder and how far along the treatment process you are, our expert teams are able to offer residential, day care, inpatient and outpatient based treatment for personality disorder. Medically reviewed by Yalda Safai, MD, MPH — Written by Kristeen Cherney — Updated on July 13, 2022 Borderline personality disorder (BPD) is a mental health condition that causes intense emotions and impulsive behavior. When these symptoms are directed inwards, not outwards, some people call this “quiet BPD.” Borderline personality disorder (BPD) is a mental health condition that’s known for fluctuations in mood and behaviors. People with BPD may also struggle with relationships as well as their own self-image. It’s been suggested that there are “subtypes” of BPD, but this theory is unproven. One such subtype is known as “quiet” BPD, which means that you direct your struggles more inward so others don’t notice. However, quiet BPD is not a recognized diagnosis. A person can only be diagnosed with BPD, not quiet BPD. BPD can be difficult to diagnose and treat, but the earlier you seek help, the better the outcome. Here’s what you need to know. Experts don’t agree on what quiet BPD is or whether it is different from BPD in general. You can’t be diagnosed with “quiet BPD” specifically. You can only be diagnosed with BPD. To be diagnosed with BPD, a person must have:
Clinicians also look at more specific symptoms and behavior patterns before making a diagnosis. You must have multiple signs and symptoms of BPD in order to be diagnosed with the condition. In general, the experience of living with BPD can be different from person to person. This means that people diagnosed with BPD may not have many symptoms in common with each other. So what do people mean when they refer to quiet BPD? The term can be traced back to psychologist Theodore Millon, who proposed four subtypes of BPD:
In the past, some clinicians used the term “quiet” to describe people with BPD who direct many of their mood swings and behaviors inward, rather than directing them toward others. In other words, quiet BPD was thought to be about “acting in,” rather than “acting out.” This label has also been used to describe people with BPD who avoid communicating their emotions and getting close to other people. People with BPD tend to experience intense emotions. In theory, “quiet BPD” describes when these significant feelings are directed toward yourself without letting others see them. Some of the emotions associated with BPD include:
Quiet BPD has sometimes been called “high-functioning” BPD. This reflects the idea that some people with BPD may not “show” their symptoms and are still able to cope in everyday situations, such as work and school. However, these are only theories. Because there’s no real way to diagnose BPD subtypes, there is limited research on quiet BPD. A better understanding of BPD subtypes could eventually lead to improved treatments, according to studies from 2017 and 2018. But overall, there’s not enough evidence to say whether subtypes like quiet BPD really exist. Different symptoms don’t actually represent specific types of BPD. But, historically, the theory of “quiet BPD” referred to symptoms such as:
Even though people have used the term “quiet BPD” for these symptoms, it is not a separate diagnosis from BPD in general. BPD can look quite different from person to person. BPD symptoms can include:
The causes of what’s called “quiet BPD” are the same as the causes of BPD in general. Like certain other mental health conditions, an increased risk of BPD is thought to be passed down in families (inherited). Studies have found that BPD may have genetic links, but more evidence is needed to understand the connection. Genetics probably aren’t the only cause of BPD. Several studies have found that emotional and physical abuse, as well as childhood neglect can increase an individual’s risk. Exposure to — or a personal history of — unstable relationships may also contribute. Physical changes to the brain and alterations in the neurotransmitter serotonin may be associated with BPD. However, it’s not clear whether brain changes lead to BPD or if they occur after the fact. There are no specific side effects or complications associated with BPD types. The possible side effects are linked to the actual BPD diagnosis, not a subtype theory. It can sometimes be difficult to start the process of seeking a diagnosis and treatment for mental health symptoms. Without help, though, the symptoms may worsen over time. Increased risk of other mental health conditionsSome other mental health conditions may be more likely to occur alongside BPD. These include: Hard to establish and sustain relationshipsIt can be difficult to establish and sustain relationships when you have BPD, and some of the related symptoms can cause even more difficulties in this area. You might find it hard to connect emotionally with others because of the constant push and pull where you’re afraid of getting hurt but are also afraid of being alone. Difficult to maintain work or school scheduleYou might also find it increasingly challenging to maintain your role at work or in school. Untreated BPD may increase your risk for acting out impulsively, and engaging in uncontrolled spending, gambling, drinking, and other dangerous behaviors. Self-harm and suicidal thoughts may occurThoughts of suicide and self-harm are possible with BPD. Always take any talk or feelings of suicide seriously. Due to misconceptions and the inward nature of this condition, it’s possible for quiet BPD to be misdiagnosed as another condition, such as depression or social anxiety disorder. While such conditions may occur together, BPD is a separate diagnosis that only a mental health professional can make. Licensed mental health professionals, such as psychiatrists and psychologists, can diagnose BPD based on an interview with you. They may also have you fill out surveys based on your symptoms to gain some insight. There’s no medical test for BPD per se, but undergoing a medical exam may help rule out other conditions that may be contributing to your symptoms. It’s also important to let your clinician know if you have any personal or family history of BPD or other common co-occurring conditions such as anxiety, depression, or eating disorders. An at-home BPD online survey may also help guide your way to obtaining a diagnosis. Keep in mind that such online screenings are not official tests, and they are not the same thing as speaking with a licensed mental health professional. Self-diagnosing a mental health condition can be problematic. There are no specific risk factors for quiet BPD, because it is not an accepted diagnosis. The risk factors apply to BPD in general. Certain risk factors have been shown to influence the development of BPD. These may include:
BPD sometimes happens alongside other mental health conditions such as:
However, having another mental health condition does not necessarily lead to BPD. Because you can’t be diagnosed with quiet BPD, the treatment options are the same as for BPD in general. Working with a psychologist, psychiatrist, or licensed therapist can help people with BPD manage their symptoms. Therapy provides a “safe space” to unlearn old habits, and develop healthy strategies. It can be tough to acknowledge when it’s time to talk to someone about your struggles, but you’ll likely find a sense of freedom and validation once you do so. Schema therapySchema therapy has been shown to be effective for treating BPD. Typically, this type of therapy:
Mentalization based therapy (MBT)MBT is another treatment option that’s shown promising results in research. During MBT, your therapist guides you to think through your emotions and reactions. This therapy focuses on improving your ability to:
Dialectical behavior therapy (DBT)DBT is another type of therapy to consider for BPD. DBT may be helpful because it teaches:
With practice, this can help reduce self-destructive thoughts and actions. MedicationsIf a psychiatrist recommends it, certain mental health medications may help ease some of your symptoms. However, you shouldn’t rely on medications alone, as they don’t necessarily address the underlying causes of your BPD. Such medications often work best in conjunction with psychotherapy. Living with BPDKeeping up with your treatment plan is your best route to living well with BPD. Mental health treatment isn’t always easy. You might feel like you aren’t ready to get started with therapy. Or, you might find it hard to stick with therapy over time. But remember that you deserve to feel better. Getting help can lead you toward healthier habits, and stronger relationships with yourself and others. You may be wondering how to help a loved one cope with BPD. Here are some tips for supporting someone during a mental health struggle:
Your loved one may experience anger or thoughts of self-harmBPD has the potential to cause episodes of anger or suicidal ideation. It’s important to talk with your loved one about how to handle these episodes, before they happen. Find out what kinds of emergency mental health resources are available in your area, such as a local crisis team or inpatient program. Talk with your loved one about options for crisis intervention and emergency treatment. Learn what their preferences are, so that you can advocate for them if an emergency happens. All in all, it’s not always easy to support a loved one through a health struggle. It’s completely normal to feel lots of different emotions along the way. Remember to prioritize caring for yourself, so that you can continue to be there for your loved one. Not everyone with BPD has exactly the same set of symptoms. Some people’s symptoms may be more outwardly noticeable, and others’ less so. Even so, “quiet BPD” is only a theory, not an actual diagnosis. BPD can take time to identify, but the sooner you understand your symptoms, the sooner you can take action. It’s important to recognize that your feelings do matter, and that it’s perfectly acceptable to share them with others. While you might quietly struggle with persistent guilt and poor self-worth, the truth is you deserve a happy and fulfilling life. See a licensed mental health professional to get started. Last medically reviewed on July 13, 2022 |