Personality disorder

Who can diagnose personality disorder?

Some mental health professionals can diagnose personality disorder. They must have experience of diagnosing and treating mental health problems. For example, this could be a psychiatrist or psychologist.

They’ll ask you about your feelings and experiences. And about how this affects you. This is to make sure they can get you the right support.

Your GP cannot diagnose personality disorder. But you can speak to them about your mental health.

They can refer you for an assessment for personality disorder. This might be through your local community mental health team (CMHT) or another specialist team. This introduction to mental health problems has more information about support services, including CMHTs.

Most NHS trusts will only diagnose you with personality disorder if you’re aged over 18.

In rare cases, they might diagnose someone under 18. This is more likely if your experiences have lasted for over one year.

If you’re under 18, YoungMinds has information about personality disorder that might help.

Misdiagnosing personality disorder

You might be diagnosed with personality disorder but feel it doesn’t fit your experiences. You might think a different diagnosis suits you better.

This is more common between certain diagnoses. For example, the categories and traits of personality disorder can overlap with mental health problems like complex PTSD. They can also overlap with conditions like autism and ADHD.

If you’ve been misdiagnosed, it may take time to get the right treatment. This can be frustrating. You may feel like you’re not being listened to.

If your diagnosis doesn’t fit your experiences, you can discuss it with a mental health professional. You can also ask for a second opinion. Where possible, they should allow this.

Mind has more information about how to be more actively involved in your care and how to make yourself heard.

Why is personality disorder controversial?

Lots of people have different views on personality disorder. You might find it a useful way understand your experiences. Or you might find it unhelpful to view your feelings and behaviour as a ‘disorder’.

Some healthcare professionals also disagree with the term. And with when and how it’s diagnosed.

This page covers:

• Problems with diagnosing personality disorder
• Stigma and personality disorder

Problems with diagnosing personality disorder

Lots of people disagree about when and how to diagnose personality disorder. Or whether it should be diagnosed at all.

Confusing and inconsistent diagnosis

Some people find personality disorder confusing. And think that it’s diagnosed in an inconsistent way. For example, some doctors may only diagnose it in severe cases. Others may not use the term at all. Instead, they might use terms like personality difficulties or emotional difficulties.

Or they might give another diagnosis instead of personality disorder. This is because the traits of personality disorder are broad. They can be similar to symptoms of other diagnoses. For example, complex PTSD and ADHD.

The confusion and inconsistency may mean you get the wrong diagnosis for you. This can make it hard to get the support you need.

The criteria for diagnosing personality disorder are changing in the UK. But some people also disagree with the new criteria. Our page on diagnosing personality disorder explains more about these changes.

Not enough focus on social factors

Some people think diagnosis should focus more on social factors. And how these factors might affect how you feel and behave today. They think the criteria for personality disorder don’t cover these factors.

These factors might include:

• Experiencing trauma in childhood, such as abuse or neglect
• Struggling with money, for example if you live on a low income or have lots of debt
• Big changes in your life, like moving to a new country or culture
• Stigma and discrimination, maybe relating to your race, gender, sexual orientation, or disability
• People treating you badly in past relationships

These experiences are likely to affect how we feel or behave. So some people believe that doctors shouldn’t describe our feelings and behaviour as ‘disorder’ at all.

What if I disagree with my diagnosis?

You can speak to a mental health professional if you disagree with your diagnosis. They can help you make sure you’re getting the right support.

See these pages on seeking help for a mental health problem to find tips for making sure your voice is heard.

There’s also information about what you can do if you’re not happy with your doctor.

Stigma and personality disorder

The term ‘personality disorder’ can come with a lot of stigma.

For example:

• Negative views of what personality disorder means, including misconceptions
• Misleading stories in the media about personality disorder, such as in the news or on TV shows
• Health professionals misunderstanding the diagnosis, not taking it seriously, or treating you differently

If you’re diagnosed with personality disorder, this stigma may be difficult to deal with. You might feel upset, insulted or excluded. It could also make it harder to access the care that you need.

If you experience stigma, remember that you aren’t alone. And you shouldn’t have to put up with these views.

If you want to fight stigma, you could:

• Show people this information. This could help them better understand this diagnosis and how it might affect you
• Get more involved in your treatment. See these pages on seeking help for a mental health problem to learn more. This includes guidance on making your voice heard, and overcoming barriers to getting support
• Get to know your rights. Mind’s pages on legal rights have more information, including how you can complain about your care
• Take action with Mind. See Mind’s campaigning pages to help challenge stigma

Treatment for personality disorder

If you’re diagnosed with personality disorder, there are treatments that can help with how you feel.

You might have to try a few things to work out what helps you most. And you might find that different things work better at different times.

This page covers:

• Talking therapies
• Medication
• Art therapy
• How do I get treatment?
• Will I have to go to hospital?
• How can I have a say in my treatment?

Talking therapies

Current evidence shows that talking therapies are the most helpful treatment for those of us with a diagnosis of personality disorder. These types of talking therapies may help. But we need more research to know which is the most effective. 

Dialectical behavioural therapy (DBT)

DBT helps you learn skills to manage your emotions and behaviour. You might be on your own with a therapist, or part of a group. See these pages on DBT for more information.

Mentalisation-based therapy (MBT)

MBT can help you recognise what you think and feel. And understand how other people may think or feel. It also helps to understand how these thoughts and feelings can affect how someone behaves.

It’s a long-term therapy. And it can take place on your own with a therapist, or as a group.

Structured clinical management (SCM)

SCM can help you address things you find difficult. And to develop and meet goals. You might focus on areas such as problem solving and managing your emotions and behaviour. It involves individual and group therapies.

Cognitive analytic therapy (CAT)

CAT is similar to cognitive behavioural therapy (CBT). It can help you identify patterns that are causing problems in your life. And look at where you may have learnt these from your early life experiences.

You then look at which patterns are helpful or unhelpful. And find different ways to prevent negative feelings or experiences.

Talking about borderline personality disorder (BPD)

Watch Lechelle and Debbie talk about having borderline personality disorder. They discuss how a combination of medication and dialectical behaviour therapy (DBT) helps them manage it. Our thanks to Mind for allowing us to share this video.

Medication

Some doctors may prescribe medication for people diagnosed with personality disorder. This might include antidepressants, antipsychotics or mood stabilisers.

These medications aren’t licensed to treat personality disorder specifically. But you may be prescribed them to manage certain feelings or behaviour. You may also be prescribed them for other mental health problems. For example, depression or anxiety.

Your doctor should give you information about any medications you take. This information should be in a format that you can access and understand.

They should also give you regular check-ups to review your medication. So, if this isn’t happening and you’d like to talk about your medication, make an appointment to discuss it with your doctor.

Medication really helps some of us but isn’t right for others. Before deciding to take any drug, it’s important to make sure you have all the facts you need to make an informed choice.

See Mind’s pages on things to consider before taking medication and your right to refuse medication for more information. These pages on coming off medication give guidance on how to come off medication safely.

Art therapy

If you’re diagnosed with personality disorder, art therapy could help. This includes if you find it hard to express how you’re feeling.

It can also help if you struggle to control your emotions. This is because it offers a structured way to express yourself.

See Mind’s page about arts and creative therapies for more information.

How do I get treatment?

Whether a specific treatment is available in your area will depend on where you live. To get treatment through the NHS, you should contact your GP.

They can refer you to your local community mental health team (CMHT) for an assessment.

Or they might refer you to another specialist service. The names for these services may differ depending on where you live. For example, you might also hear them called:

• Complex emotional needs (CEN) services
• Community mental health hubs
• Personality disorder services

In some areas, you may be able to contact your local service yourself. This is called self-referral. You can talk to your GP for advice on self-referral.

Some NHS trusts also run programmes where you can learn about personality disorder. And the different therapies that might help. They can support you if you’re not sure what treatment might help.

Will I have to go to hospital?

Many people diagnosed with personality disorder are treated outside hospital. In rare cases, your doctors may suggest treatment in hospital. This is more likely if you’re in crisis and may risk harming yourself or others. But this should only be a last resort.

Mind has more information about getting hospital treatment for your mental health.

How can I have a say in my treatment?

An important factor in your treatment is the relationship you have with the professionals who are helping you.

You should be able to discuss your treatment with your GP or psychiatrist. Your views and preferences should always be considered when making decisions about your treatment.

You’re also likely to get a care plan if you’re under the care of a CMHT or other specialist team. A care plan is an agreement between you and the professionals you’re working with.

Your care plan should include the problems you want help with, any treatments you may need and what you want to get out of your treatment. It should also cover planning for a crisis.

These pages on seeking help for a mental health problem have more information on having your say. And what you can do if you’re unhappy with your treatment.

Self-care for personality disorder

If you’ve been diagnosed with personality disorder, it might sometimes feel like a struggle. But there are things you can do yourself that may help. Not everything will work for you, and different things might work at different times.

This page covers:

• Coping with feeling overwhelmed right now
• Helping yourself long-term

Coping with feeling overwhelmed right now

If you’re experiencing lots of difficult feelings, it can feel overwhelming. Try to focus on one thing at a time. These tips may help.

If you feel angry, frustrated or restless

You could:

• Try a breathing exercise
• Turn up your favourite music, and dance or sing
• Do something with your hands, like making or fixing something
• Do something creative like colouring, drawing, creative writing or making music
• Write in a journal
• Take a shower – some people find taking a cold shower in particular can help

See our page on how to manage anger for more tips. 

If you feel depressed, sad or lonely

You could:

• Get comfy and watch your favourite TV show
• Read a favourite book
• Write all your negative feelings on a piece of paper and scrunch or tear it up
• Listen to a song or watch a video you find uplifting
• Write a comforting letter to the part of yourself that is feeling sad or alone
• Call or text a friend you’ve not spoken to in a while
• Cuddle a pet or a soft toy

See our page on self-care for depression for more tips.

If you feel anxious, panicky or tense

You could:

• Make yourself a hot drink and drink it slowly, noticing the taste and smell, the shape of the mug and its weight in your hand
• Take ten deep breaths, counting each one out loud
• Write down everything you can think of about where you are right now, such as the time, date, colour of the walls and the furniture in the room
• Take a warm bath or shower – this can help change your mood by creating a soothing atmosphere and a distracting physical sensation

See our page on self-care for anxiety and panic attacks for more tips.

If you feel dissociative or spaced out

You could:

• Breathe slowly
• Listen to sounds around you
• Walk barefoot
• Wrap yourself in a blanket and feel it around you
• Eat or sniff something with a strong taste or smell

See this page on helping yourself with dissociation for more tips.

If you want to self-harm

You could:

• Draw or put a plaster on the area of your body where you want to harm yourself
• Massage the area where you want to harm yourself
• Find creative ways to express these feelings, through writing songs or poetry, drawing, movement or singing
• Have a very cold shower

See our page on helping yourself if you self-harm for more tips.

Helping yourself long-term

There are tips you can try to help how you feel in the longer-term.

Talk to someone 

Talking to someone could help with any difficult feelings. This includes if you feel isolated by your diagnosis and experiences.

It can be hard to talk when you’re not feeling well. You may feel like no one understands what you’re going through. Sharing our information could help if you find it difficult to explain what you’re experiencing.

If you don’t feel you can talk to the people around you, you could contact a helpline. For example, you can talk to Samaritans for free on 116 123 about anything that’s upsetting you. See this page on mental health helplines to find more options.

Try peer support 

Peer support brings together people who’ve had similar experiences. If you’ve been diagnosed with personality disorder, this may help. Especially if it feels hard for others to understand what you’re going through.

There are lots of ways to find peer support. You could:

• Ask your local Mind about peer support
• Ask your NHS trust about Service User Networks in your area – these are peer-led groups for people diagnosed with personality disorder
• Try an online peer support community, like Mind’s Side by Side

Visit these pages on peer support groups to learn more.

Try DBT self-help techniques

Dialectical behavioural therapy (DBT) helps you learn skills to manage your emotions and behaviour.

There are ways to try some DBT skills yourself. For example, using self-help materials on the DBT Self Help website. These include diary cards, exercises and behavioural analysis sheets.

There are also workbooks you can buy to help learn DBT skills at home. And DBT apps you can download. See this page on finding reliable information online for tips on finding apps that are safe and reliable.

But it can be difficult to learn DBT techniques by yourself. Doing DBT by yourself may not work as well as working with a trained therapist. Self-help techniques might help if you’re on a waiting list for treatment.

Keep a mood diary

Recording your moods could help you spot patterns, such as anything that triggers difficult experiences. Or notice early signs when they’re beginning to happen.

Try noting down difficult thoughts or feelings. You could do this in a diary or mood tracking app.

Noting things down can help get them out of your head. This could make them feel less overwhelming. You can then reflect on them when you feel calmer. Or talk about them with someone you trust.

Be kind to yourself and make a note of what’s going well too. Recognise steps you’ve taken or new things you tried. They don’t need to be big things. It could be taking a shower, going for a walk or texting a friend.

Plan for difficult times

You might not always feel able to tell people how you’re feeling or what help you need. It might help to create a crisis plan. This plan can explain what would keep you safe if you’re struggling. And what you’d like to happen in an emergency.

Your plan could include:

• The names and contact details of people you trust. These are people you can ask for help if you’re feeling distressed
• Details of a safe place you can go for support. This could be the home of a friend, family member, or someone else you trust
• What you can do to make your environment safe. For example, removing things you could use to harm yourself
• How to recognise warning signs that you might have a crisis. This could be any changes in your feelings or behaviour that might show you’re having a hard time
• The names and contact details of professionals who can support you. For example, your local crisis team
• Details of helplines and listening services. These have trained professionals who can listen to how you feel and keep you company. This could help if you’re feeling distressed
• Any practical needs. For example, if you have children or pets, make a note of who can look after them when you’re unwell
• What treatments you would like to have or avoid when you’re in crisis
• When you’d like people to consider hospital treatment for you.

If you can, try to make the plan when you’re feeling a bit better. It helps if you can think clearly about what you might need when you’re struggling.

You could also make the plan with someone you trust, such as a friend or therapist.

Developing a crisis plan can take some time. It’s ok if you feel overwhelmed by it or don’t know what to write. It might help to complete it in a few stages.

There are many different types of crisis plan. See this information on planning for a crisis and making a support plan for more information.

Look after your physical health

Looking after your physical health can make a difference to how you feel. This can be hard if you struggle with negative thoughts about yourself. But taking small steps can make things feel less overwhelming.

Here’s some ideas:

• Try to improve your sleep. Sleep can help give you the energy to cope with difficult feelings and experiences. See our tips to improve your sleep for more information
• Think about what you eat. Eating regularly and keeping your blood sugar stable can make a difference to your mood and energy levels. See these pages on food and mental health and eating problems for more information
• Try to do some physical activity. Finding activity that works for you could really help your mental wellbeing. See these pages on physical activity, exercise and mental health for more information
• Spend time outside. Spending time in green space can boost your wellbeing. See these pages on nature and mental health for more information
• Take care with alcohol or drug use. You might use drugs or alcohol to cope with difficult feelings. But they can make you feel a lot worse. And they may stop you from getting the support you need for your mental health. See our pages on recreational drugs, alcohol and addiction for more information

Helping someone diagnosed with personality disorder

It can be tough when someone you know is diagnosed with personality disorder. You might not understand how they feel or behave. And you may not know how to help. But there are lots of things you can do to support them.

This page covers:

• Validate their feelings
• Try to stay calm
• Learn more about personality disorder
• Help them seek treatment and support
• Remind them of what you like about them
• Try to set clear boundaries and expectations
• Plan ahead
• Take care of yourself

Validate their feelings

It can be difficult if you don’t understand why someone is feeling or behaving in a certain way. Especially if their reactions seem upsetting or unreasonable. You may feel like all you want to do is fix things for them.

You might be angry or frustrated. Or want to distance yourself from them.

But try to remember that they may be experiencing things that you don’t understand. And that many people diagnosed with personality disorder struggle to regulate their emotions.

You may not understand why they feel or react like this. But it can mean a lot to acknowledge and validate how they’re feeling.

For example, you could say something like: ‘Things sound really difficult for you at the moment’. You can validate their experiences without agreeing with what they say or do.

Try to stay calm

Try to stay calm when they’re experiencing difficult emotions. This can help them feel more secure and supported.

It might be enough to just sit with them while their emotions feel overwhelming. You don’t have to say anything specific to help.

When they’re feeling well, you could make a plan together about what they’d like you to do when they’re struggling.

You might find it helpful to have a shared word or phrase. You can agree to say this if it feels like their emotions are getting out of control. It could be something like ‘Take a step back’ or ‘Try to pause’. This can remind them to pause and stay calm.

Learn more about personality disorder

Personality disorder can be a complicated diagnosis. They may have to deal with other people’s misconceptions, as well as their own mental health.

Educating yourself can help you to challenge stigma. Our information about personality disorder may help.

Some NHS trusts have programmes called Family Connections. These are courses that can teach coping skills to family members and close friends.

Help them seek treatment and support

You could offer to help them to make appointments, or to prepare for them. For example, making a note of questions they’d like to ask health professionals. Or you could ask if they’d like you to go to appointments with them. Or be involved in any decisions about treatment.

Feeling involved in their treatment can help improve your wellbeing too. But try not to take over. It’s important to encourage and support them to make their own choices. And avoid them depending on you too much.

Remind them of what you like about them

A diagnosis of personality disorder doesn’t change everything about who they are. They may still be likeable, intelligent, funny, kind, highly motivated or creative.

But they might not recognise this themselves. They may struggle with their identity and how they see themselves. It can be reassuring to remind them of the good things you see in them. 

Try to set clear boundaries and expectations

Some people with a diagnosis of personality disorder can find it difficult to set and maintain boundaries. It may help to both know where the boundaries of your relationship are. And what you expect from each other.

You could agree how you expect to speak to each other. And what you’re able to help them with. Agreeing this could help you both deal with difficult feelings and situations. For example, any fears of rejection or abandonment.

Plan ahead

It can be scary if you’re worried someone you care about is hurting themselves. Or that they’re struggling with suicidal thoughts.

Ask them how you could help when things are difficult. Try to find out what can cause them negative thoughts and emotions. You could also get to know their care plan, if they have one.

See our pages on supporting someone who self-harms and supporting someone who feels suicidal for more information.

Take care of yourself

It can be hard to support someone who’s struggling. Try to remember that your own mental health is important as well.

See these pages on coping when supporting someone else and maintaining your wellbeing for more tips to look after yourself.