Learn / Beyond the Stigma: Recovery From Personality Disorders

Beyond the Stigma: Recovery From Personality Disorders

By 
Hannah Friedman
|
 December 11th, 2022|   Clinically Reviewed by 
Rajnandini Rathod

Yes, you can find treatment for a personality disorder. These are serious conditions, but they’re not monsters under the bed. Your personality is not broken.

Data shows that there are many effective ways to treat these mental health issues. In a rehab program for personality disorders, you’ll have access to a variety of therapies. Prepare for recovery by learning about your options.

Overcoming the Stigma Around Personality Disorders

As a group, personality disorders are generally misunderstood.1 And unfortunately, it’s not just the public who carry ignorant views of these diagnoses. Some healthcare providers also have harmful ideas about personality disorders. As a result, stigma is often a barrier to treatment.2

For Amanda Wang, living with borderline personality disorder (BPD) was overwhelming:3

“I felt like something was wrong with me. It would start out with something small and it would escalate to thinking that I was probably the worst person in the world and that I wasn’t good enough.”

And without unbiased professional advice, it can be hard to plan your recovery.

So it’s understandable if you’re hesitant to seek help. But facing your condition head-on can empower you to heal. In fact, long-term studies show that remission is common for people with personality disorders,4 even in the most severe cases. Specialized therapies reduce your symptoms, improve your quality of life, and make it easier to navigate the world.

Not all therapists are qualified to support your healing journey. And it might take a while to find the right provider. Set yourself up for success by researching ahead of time, so you know what to look for in a therapist.

Effective Treatments for Personality Disorders

People with personality disorders rarely start treatment5 because of those issues alone. More often, patients first enter recovery for addiction or another mental health issue. In that case, you might get diagnosed with a personality disorder once you’re already in rehab.

Once you begin healing, consistency is the key to treatment.4 With talk therapy and medication, many people make slow, steady progress. Then, for some people, personality disorder symptoms simply vanish in middle age.6

To find the right type of therapy, you first need a formal evaluation from a therapist. They’ll assess the intensity of your emotions and your relationships, and ask about other symptoms. Then, with a diagnosis in hand, you and your care team can consider a range of treatment options.

Transference-Focused Psychotherapy Helps You Build Relationships

Transference-focused psychotherapy (TFP) helps you improve your relationships.7 Patients do this by practicing interpersonal skills with a therapist. In that dynamic, you can learn to relate to others’ emotions more easily. This empowers you to build stronger, more sustainable relationships. TFP can treat BPD8 and narcissistic personality disorder, among other conditions.

Most people attend about 2-3 sessions per week for 1-3 years, and get additional support outside of therapy. Your relationship with your therapist is central to this process. By observing the way you act toward them, they’ll learn how you approach other dynamics. Then, they can help you develop healthier behavioral patterns.

Schema-Focused Therapy Soothes Your Inner Child

In schema-focused therapy (ST), you learn how to comfort yourself.9 It’s based on the idea that personality disorders result from childhood trauma. Patients recover by soothing their inner child. ST is especially effective for people with BPD10 and anxious personality disorders, like avoidant personality disorder.

For example, many people with personality disorders were abandoned as children.11 That trauma can cause an intense fear of abandonment in adulthood. ST teaches these patients how to manage that fear. You and your therapist might roleplay a conversation with a parent who abandoned you in the past. You’ll use specific coping skills to regulate your feelings, and still express yourself in a healthy way. This empowers patients to meet their own needs.

Dialectical Behavior Therapy Teaches Emotion Regulation

Dialectical behavior therapy (DBT) teaches you how to process intense emotions healthily. Research shows that DBT reduces symptoms of several personality disorders.12 Specifically, it helps patients improve impulse control, mindfulness, and emotion regulation.

This is a very practical approach to personality disorder treatment. Treatment includes both individual and group sessions. You’ll go through assignments from a textbook, complete homework, and share what you learn. In some ways, DBT is more like a class than it is like group therapy.

DBT teaches you to accept yourself,13 intense emotions and all. You can’t hate yourself into recovery. Instead, patients cultivate the desire to heal because they deserve to be well.

Mentalization-Based Therapy Lets You Understand Others’ Feelings

Mentalization is related to empathy.14 According to the American Psychological Association, mentalizing15 is “the ability to understand one’s own and others’ mental states.” This lets you understand why people do what they do, and what effect those actions will have.

Mentalization based therapy (MBT)16 teaches people how to mentalize in a balanced way. Studies prove MBT can reduce the symptoms of BPD17 and other mental health conditions. Empathy is especially hard for people with narcissistic personality disorders,18 so mentalization is an important skill to learn in treatment.

In MBT, patients practice mentalization during both group and 1:1 sessions. You might use specific events from your real life as examples. You’ll describe a situation—say, a recent argument with a friend. And your therapist will help you imagine how your friend might have felt. They’ll also help you identify and regulate your own feelings. These skills can improve your relationships with other people, and with yourself.

Medication Can Manage Symptoms

Currently, there are no medications specifically designed to treat personality disorders.19 Despite this, your doctor might recommend a prescription to control your symptoms. Antidepressants and mood stabilizers are common treatments. But it’s important to note that personality disorders aren’t purely neurochemical.20 On the contrary, experts think some of them may have environmental causes. As a result, it’s unlikely that medication alone will “fix” your personality disorder. You might also need to make some major behavioral changes. These complex conditions can impact every aspect of your life.

What Is a Personality Disorder?

Personality disorders affect more than your thoughts and feelings21—they also impact relationships. Even though they’re highly stigmatized, almost 10% of adults in the U.S. have a personality disorder.22

People with personality disorders have intense emotions,23 which can lead to unhealthy behaviors. Your mental health may interfere with your relationships, schoolwork, career, and more. And because people with personality disorders are so sensitive to stress24 that adversity can make your symptoms worse.

There’s some debate about when these conditions develop. Some experts say that personality disorders appear in adolescence.25 Others describe symptoms during childhood. And some caution against diagnosis before patients reach adulthood. At any age, these are serious conditions.

Scientists categorize personality disorders into 3 different clusters:

Cluster A Personality Disorders

People with cluster A personality disorders26 share a few traits. Most people with these conditions are socially withdrawn. You might actively mistrust the people around you, or you might just prefer solitude. You may also have a hard time expressing how you feel. Cluster A includes 3 diagnoses:

  • Schizoid personality disorder (ScPD): People with ScPD have a hard time showing emotion, and prefer to be alone most of the time. They rarely have relationships outside of family.
  • Paranoid personality disorder (PPD): The main characteristic of PPD is a distrust of others. This condition makes it hard to build or maintain relationships.
  • Schizotypal personality disorder (STPD): People with STPD may have strong superstitions, or think they have supernatural abilities. This often undermines relationships.

Cluster B Personality Disorders

People with cluster B personality disorders have intense emotions and low impulse control. This can make it hard for anyone—including them—to predict their behavior. As a result, they often have a pattern of unstable relationships. There are a few different Cluster B personality disorders:

  • Antisocial personality disorder (ASPD) describes people who don’t conform to social norms. In particular, they may disregard other people’s safety. People with ASPD often engage in risky activities, like high-risk sexual behavior or drug abuse. They generally lack remorse for this behavior.
  • Borderline personality disorder (BPD) involves a pattern of instability in relationships, self-image, and identity. People with BPD are highly emotionally sensitive.
  • Narcissistic personality disorder (NPD)27 occurs in 2 types. Grandiose NPD includes an inflated sense of self, boldness, and sometimes aggression. Vulnerable NPD appears as hypersensitivity and defensiveness.
  • Histrionic personality disorder (HPD) includes attention-seeking behavior and emotional sensitivity. People with HPD place a lot of value on their reputation and physical appearance.

Much of the stigma around personality disorders comes from a misunderstanding of cluster B diagnoses. As a result, finding treatment for cluster B disorders might be the most difficult.26 But at the same time, a great deal of research on personality disorders focuses on cluster B types.27 That research proves recovery is common, even in the most severe cases.

Cluster C Personality Disorders

On the other hand, cluster C personality disorders have the most treatment options.26 For these patients, the healing process resembles recovery from anxiety or depression. That’s because cluster C usually includes anxious thought patterns. There are 3 cluster C personality disorders:

  • Avoidant personality disorder (AvPD) features strong feelings of inadequacy. People with AvPD are sensitive to criticism. They usually fear intimacy and connection with other people.
  • Dependent personality disorder (DPD) involves being highly submissive in relationships. DPD undermines confidence, making it hard to make decisions for yourself.
  • Obsessive-compulsive personality disorder (OCPD), centers on perfectionism and the need for control. People with OCPD are hyperaware of rules and social norms, but reluctant to ask for help. This condition is notably different from obsessive-compulsive disorder (OCD).

Experts continue to research new treatments for all 3 clusters of personality disorders. Despite that growing body of work, the cause of these conditions is largely unknown.

What Causes Personality Disorders?

Scientists have several theories about what causes personality disorders.23 But they still need more data. Some experts theorize that biology might play a role in these conditions.26 For instance, ScPD has a similar biological cause as schizophrenia, which hints at a genetic link.

Meanwhile, other studies show that ASPD and BPD have a similar impact on brain chemistry. That could explain why both conditions interfere with impulse control.

Other experts believe that childhood trauma can cause personality disorders. For example, people with BPD are more than 3 times more likely to report childhood adversity.28 And it’s not just BPD. Other personality disorders are linked to childhood traumas,29 like physical and emotional abuse.

Not all the data supports this theory. According to some, childhood trauma “does not appear to be a key factor” in the development of personality disorders.30 But they’re certainly linked to other diagnoses. For example, many people with personality disorders also experience addiction.22

The Link Between Personality Disorders and Addiction

Researchers have identified a link between personality disorders and substance abuse.26 Specifically, addiction is more common in people with ASPD, BPD, and STPD than others.

Studies show that over 50% of people with BPD have a history of addiction.31 And people with schizotypal personality disorder often have addictions32 to cannabis and alcohol.

There’s also a complex relationship between antisocial personality disorder and addiction.33 Some experts believe one condition can cause the other. Others think that both ASPD and addiction develop in response to underlying issues, like unresolved trauma. From that viewpoint, both conditions are ineffective coping strategies for untreated symptoms. And working through those symptoms might help you recover.

High-risk behavior, including self-harm, is associated with several personality disorders.26 In other words, addiction can be a symptom. But that’s not always the case. Some people use drugs to cope with other symptoms of their personality disorders. For instance, many people with AvPD have intense social anxiety.26 And, whether or not you have AvPD, there’s a clear link between social anxiety and alcohol abuse.

If you or a loved one is at risk of self-harm, you can get help right away. Call The National Alliance on Mental Illness HelpLine at 1-800-950-6264 or text “HelpLine” to 62640.

If you have these co-occurring disorders, it’s important to treat both at the same time. Your personality disorder might make recovery more complex. But with the right treatment, you can learn to manage your symptoms with healthier coping skills.

Recovery and Remission From Personality Disorders

Untreated personality disorders can impact every area of your life. Serious symptoms can interfere with your mental health, work, relationships, and dreams for the future. But it’s important to note that many of these symptoms are behavioral. And by learning better behaviors, you can heal both your symptoms and their underlying causes. With the right types of ongoing care, it’s even possible to go into complete remission.

To start recovery, browse our rehabs that treat personality disorders and learn more about their pricing, locations, and different types of therapy.

Reviewed by Rajnandini Rathod

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