How to Cope With a Personality Disorder

Strategies for Feeling Your Best

Understanding your personality disorder is key.

 

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Approximately 9 percent of the general population has a personality disorder. Despite the high prevalence, many individuals with personality disorders don’t know they have one, let alone understand how to cope with one.

By definition, a personality disorder involves one or more pathological personality traits that create significant impairment in an individual’s life. The features must be stable across time and consistent across situations.

Learning how to cope with a personality disorder is key to functioning at your best. With professional support, you can learn how to manage all aspects of your life.

Types of Personality Disorders

The DSM-5 recognizes 10 different personality disorders. And while each personality disorder involves different symptoms and treatments, there are some strategies that can help anyone living with a personality disorder cope better.

Personality disorders are separated into three different Clusters or groups:

  • Cluster A – Includes odd, bizarre, and eccentric behavior. Paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder are Cluster A disorders.
  • Cluster B – Refers to dramatic and erratic personality disorders. Antisocial personality disorder, borderline personality disorder, histrionic personality disorder, and narcissistic personality disorder are Cluster B disorders.
  • Cluster C – Involves anxious and fearful personality disorders. Avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder are Cluster C disorders.

Work

Solutions to maintaining a job—and working in an environment you enjoy—depend on the type of personality disorder you have.

For example, someone with narcissistic personality disorder may do well in a leadership position (at least in the short-term). Narcissistic personality disorder involves a grandiose view of oneself—something that may lend itself to being in charge.

Individuals with narcissistic personality disorder may be viewed as tyrants by their colleagues which can cause long-term problems. By nature, they tend to lack empathy and may have little compassion for other employees.

Someone with obsessive-compulsive personality disorder may struggle to be productive. Their perfectionism makes it difficult (if not impossible) to complete tasks. Some people with obsessive-compulsive personality disorder may immerse themselves in work at the expense of friends and family.

Know Yourself

No matter which type of personality disorder you have, one of the keys to succeeding at work is to recognize your patterns. Do you have a history of losing your temper in the office? Do you struggle with productivity? Do you get fired after a couple of months or do you tend to quit jobs after only a few weeks?

While recognizing workplace patterns won’t solve the problem, self-awareness can help you identify changes you want to make. In conjunction with a therapist, you may be able to identify strategies that prevent you from repeating the cycle.

Another key to living your best life when you have a personality disorder is finding the right job. Someone with avoidant personality disorder, for example, is likely to feel overwhelmed as a sales professional in a crowded office. But, that same individual may do well to work in a smaller environment with a few trusted colleagues.

It’s also important to consider whether you should reveal your personality disorder to anyone in the workplace. There’s certainly a stigma attached to mental illness. But, notifying a hiring manager when you apply for a job could ensure that your employer will make reasonable accommodations for you.

Self-Care

The emotional pain associated with a personality disorder may cause you to turn to unhealthy coping skills for instant relief. Abusing drugs or alcohol, smoking, overeating, or self-harm are just a few of the strategies you might be tempted to turn to when you’re having a hard time.

Individuals with Cluster B personality disorders are at a greater risk for suicide attempts. Feeling abandoned, being rejected, or experiencing a career-related crisis are some of the factors that may increase an individual’s suicide risk. A healthy self-care plan may reduce that risk.

Some people with personality disorders struggle with basic self-care. They struggle to maintain their household and their health. They may require assistance to stay organized, manage their finances, and attend appointments.

Some individuals with personality disorders do well for a time but then become dysregulated. Then, their symptoms and behaviors become increasingly disruptive. A healthy self-care plan can reduce some of the ups and downs.

Relationships

One of the hallmarks of a personality disorder is interpersonal problems. Each personality disorder presents a slightly different challenge when it comes to relationships.

People with paranoid personality disorder have a pervasive distrust of others, including friends, family members, and partners. They’re constantly looking for clues that validate their fears that other people are out to get them. Consequently, people with paranoid personality disorder struggle to form and maintain relationships.

People with histrionic personality disorder strive to be the center of attention. They depend on approval for others to feel OK. They take great care in their appearance and may seem insincere, superficial, overly charming, or inappropriately seductive. Their behavior can repel people—which is very distressing to them. And the more rejected they feel, the more histrionic they may become.

People with dependent personality disorder have an excessive need for help making everyday decisions. They often defer important life decisions to other people. They see themselves as helpless and have a major fear of loss of support or approval. They view other people as protective and more competent than they are. They can be easily victimized by people who take advantage of their neediness.

Some people with personality disorders manage casual relationships quite well. But, close relationships can be quite difficult for them.

Others, though, actually do best when they’re involved in close relationships. Being in a stable partnership, for example, may reduce symptoms.

Establishing healthy relationships is often a goal of treatment for personality disorders. In order to reach those goals, people with personality disorders may need to learn new social skills, learn healthy ways to regulate their emotions, or improve their self-worth.

It’s important for partners, parents, or adult children to be educated about an individual’s personality disorder. They may be invited to attend family therapy or may be encouraged to attend a support group.

Health

People with personality disorders are at a greater risk for health issues. They also have a reduced life expectancy.

One study found that women with Cluster B disorders are more likely to experience syncope, seizures, and arthritis, Cluster A personality disorders are more likely to experience gastroesophageal reflux disease, and Cluster C are more likely to experience higher rates of recurrent headaches.

Sleep

Personality disorders have also been linked to sleep disturbance. Many individuals with personality disorders, especially borderline personality disorder, report worse sleep quality than other people. Some studies have found, however, that sleep disturbances in individuals with personality disorders are on par with other mental illnesses, such as anxiety and depression.

Pain

Individuals with chronic pain are more likely to screen positive for antisocial or borderline personality traits. Individuals with borderline personality disorder report more chronic back/neck problems, headaches, fibromyalgia, visceral pain, and higher pain severity.

Obesity

Personality disorders have also been linked to obesity. Although people with any psychiatric disorder have greater odds of being overweight, individuals with personality disorders were more likely to be obese.

Higher rates of personality disorders are seen among obese patients referred for bariatric surgery. In one study, adolescents diagnosed with any personality disorder were 1.84 times more likely to be obese 17 years later, even after adjusting for demographic characteristics.

It’s important to take care of your physical health to live your best life. Attend appointments with your physician and follow medical advice. Having a supportive friend, family member, or case manager who can help you navigate the healthcare system can be helpful if you struggle to follow medical advice.

Parenting

A parent with a personality disorder can be very loving, warm, and nurturing. But, that same parent may face some special child-rearing challenges.

A 2015 study that examined mothers with borderline personality disorder and their children found that the mothers with infants had less sensitivity toward their children and more difficulty identifying their child’s emotional state. They tended to be overprotective of older children. The children of mothers with borderline personality disorder had poorer mental health compared to other children.

A 2017 study found that individuals scoring high in narcissism were likely to express little empathy toward their children. Additionally, they were unresponsive to their children’s needs and likely to be overly authoritarian or permissive with their children.

If you have a personality disorder, you might benefit from therapy that targets your specific parenting needs. For example, a parent with narcissistic personality disorder may need to learn how to empathize with their children. Or, a parent with borderline personality disorder may benefit from learning how to improve their own emotion regulation skills.

A parenting group, in-home parenting coach, or family therapy may also be options to help you become the best parent you can.

Work With a Treatment Team

There’s a common misconception that people with personality disorders don’t get better. But, treatment for many personality disorders can be quite effective—although it’s often intensive.

Many people with personality disorders also have other mental health conditions, like depression, anxiety, and eating disorders. Studies show 42 percent of people with Cluster A personality disorders, 83 percent of people with Cluster B personality disorders, and 50 percent of people with Cluster C personality disorders have comorbid conditions.

Studies also estimate 50 percent of individuals with personality disorders have substance use disorders, meaning they may abuse alcohol or be dependent on drugs.

Treatment may involve simultaneously treating the substance use as well as the personality disorder. Or, an individual may need treatment for anxiety for while also undergoing treatment for the personality disorder.

Therapy

Treatment needs depend on the type of personality disorder a person has. But, cognitive behavioral therapy (CBT) is a common treatment strategy.

Dialectical behavior therapy (DBT) is a derivative of CBT and it’s been found to be very effective in treating borderline personality disorder. It focuses on teaching individual’s specific mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills.

Traditional DBT treatment goes beyond one hour per week of therapy. It usually includes:

  1. Weekly individual therapy sessions to focus on managing crises and addressing how to create a life worth living.
  2. A two hour weekly skills training group. Members learn and practice specific skills each week and often, they’re assigned homework to help them begin implementing the skills in their everyday lives.
  3. Access to a phone number where a therapist can be reached 24 hours a day to help manage any crises.

A therapist who is following the traditional DBT model is likely to have weekly access to a consultant to address any problems, questions, or motivational issues that are arising in treatment.

DBT may be used as part of treatment for other personality disorders as well. But it’s important to follow the advice of your treatment providers.

You may be referred for psychological testing if a provider wants more information about your diagnosis, strengths, or weaknesses. Or, you may be referred to a psychiatrist if medication might be helpful.

Some people with personality disorders benefit from case management. A case manager may offer services like arranging for transportation, making referrals to community resources, or organizing your calendar.

Depending on your treatment needs, family members may be invited to be part of your treatment. It may be important for them to learn more about your personality disorder and how it affects you.

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