Personality disorders: types, symptoms, treatment and recovery

The NHS describes a personality disorder as a condition in which a person thinks, feels, behaves or relates to others very differently from the average person. It is not a judgement of character. It is a recognised mental health condition for which help is available.

NHS inform adds that personality disorders are a common mental health problem and that they usually emerge in adolescence and continue into adulthood. Symptoms may range from mild to severe.

NHS inform lists the following types. Each has a different pattern of symptoms, and the NHS says someone with a personality disorder may also have other mental health problems, such as depression or drug and alcohol misuse.

Symptoms vary depending on the type. NHS inform lists several that can occur across types, and says these may include:

• disordered thinking and problems controlling emotions

• impulsive behaviour

• concerns that other people will abandon you

• intense but unstable relationships, or difficulty keeping stable and close relationships

• avoiding other people

• being overwhelmed with feelings such as anxiety or distress

• feeling empty and emotionally distressed

• periods of losing contact with reality

NHS inform says diagnoses of personality disorders are made by specialist mental health services, which would require a referral from a GP. For borderline personality disorder, the NHS says your GP will ask about your symptoms and how they affect your quality of life, will want to rule out other more common conditions such as depression, and will check there is no immediate risk to your health.

If your GP suspects it, you will probably be referred to a community mental health team for a more in-depth assessment. The NHS says the assessment will probably be carried out by a specialist in personality disorders, usually a psychologist or psychiatrist, and involves questions about your thoughts and feelings, your strengths and difficulties, and how you are managing day to day.

The NHS also notes that the way personality disorders are diagnosed is changing. Instead of a diagnosis of a particular type, you may be diagnosed with mild, moderate or severe personality disorder, with particular personality traits.

The NHS says treatment usually involves a talking therapy and can also include other types of therapy and medicine. Talking therapy helps a person understand their own thoughts, feelings and behaviours better. It can last several months or years, depending on how severe the condition is and what other problems the person has.

For borderline personality disorder the NHS describes several specific therapies, delivered by trained professionals, usually a psychiatrist, psychologist or other trained mental health professional. The type you have may depend on personal preference and what is available locally.

The NHS says no medicine is currently licensed to treat borderline personality disorder, and that medicine is not recommended by NICE guidelines for it. It notes that experts are divided over whether medicine helps, though there is evidence it may help certain problems in some people.

Medicines are often used when someone has another condition, such as depression, anxiety disorder or bipolar disorder. The NHS gives the example of an SSRI antidepressant for moderate to severe symptoms of depression.

The NHS says many people with a personality disorder recover over time. Psychological or medical treatment is often helpful, but support is sometimes all that is needed. There is no single approach that suits everyone, and treatment should be tailored to the individual.

For borderline personality disorder, the NHS says that over time many people overcome their symptoms and recover, and that additional treatment is recommended for people whose symptoms return. Effective treatment may last more than a year.

The NHS says it is not clear exactly what causes personality disorders. They are thought to result from a combination of the genes a person inherits and early environmental influences, for example a distressing childhood experience such as abuse or neglect. NHS inform adds that severe distress or fear during childhood can contribute.

The NHS says to get help from NHS 111 online, or call 111 and select the mental health option, or ask for an urgent GP appointment, if you need urgent help for your mental health. You can also call Samaritans on 116 123 for free, confidential support.

Call 999 or go to A&E now if someone's life is at risk, for example if they have seriously injured themselves or taken an overdose, or if you do not feel you can keep yourself or someone else safe. The NHS says a mental health emergency should be taken as seriously as a physical one.

Many people with borderline personality disorder self-harm and attempt suicide, according to the NHS, so having a crisis plan agreed with your care team is important. The NHS says you will probably be given several telephone numbers to use if you think you are experiencing a crisis.

If you have a personality disorder, the NHS says you may need extra support during pregnancy and after your child is born, and you can speak to a GP, midwife or health visitor about this.

Having a personality disorder can have a big effect on the person's life, and on their family and friends, but support is available. Ask a GP about support groups for personality disorders near you. NHS inform points to the charity Mind for guidance for friends and family.

On the NHS the route normally starts with a GP, who can refer you to a community mental health team or specialist personality disorder service. Services and waiting times vary by area, and some areas have complex needs services in place of community mental health teams.

Some people also see a private psychiatrist or psychologist. If you do, it is reasonable to ask about their experience of personality disorders, as the NHS advises for psychotherapy.