Though personality disorders may seem to share many characteristics and symptoms, this group of mental health problems has a wide range of effects on the people they impact. From borderline and antisocial personality disorder to schizotypal and obsessive-compulsive personality disorder, personality disorders have more differences than similarities.

However, one common thread between all personality disorders is the long-lasting and pervasive nature of all personality disorders. Personality disorders are notoriously difficult to treat, but with the interventions listed, people with these conditions can take steps toward improving their symptoms.

Medications for Treating Personality Disorders

Currently, there are no medications specifically designed for or used to treat personality disorders directly. Instead, mental health prescribers evaluate each individual and recommend medications based on the symptoms causing distress.

Possible medication options for personality disorders include:

  • Antidepressant medications
  • Antipsychotic medications
  • Anti-anxiety medications
  • Mood stabilizers

Antidepressant Medications

Many people with personality disorders experience low mood, irritability and low energy while feeling less motivation and interest in pleasurable activities. These people could find relief with antidepressant medications.

While there are several different types of antidepressants, selective serotonin reuptake inhibitors (SSRIs) are the most common. These medications increase the amount of serotonin in the brain, reducing depressive symptoms.

Some examples of antidepressant medications are:

  • Prozac
  • Celexa
  • Lexapro
  • Zoloft

Antipsychotic Medications

Psychiatrists prescribe antipsychotic medications in various situations. In some cases, the person will have hallucinations or delusions and struggle to distinguish reality from fantasy. Other times, people with a personality disorder will use antipsychotics to address symptoms of anger or anxiety.

Types of antipsychotics include:

  • Zyprexa
  • Geodon
  • Risperdal

Anti-Anxiety Medications

If high levels of anxiety accompany a person’s personality disorder, anti-anxiety medication could be an excellent way to manage symptoms. Anti-anxiety medications address stress, tension and worry while also lowering agitation and improving sleep problems.

Although they may reduce symptoms, one group of anti-anxiety medications called benzodiazepines should be avoided because their use can result in:

  • Drug abuse and dependency
  • Overdose
  • Inhibition

Examples of benzodiazepines include:

Mood Stabilizers

Mood stabilizers like Lamictal may also be used for personality disorder treatment. This drug class may reduce a variety of symptoms connected to personality disorders, like:

  • Depression
  • Anxiety
  • Mood instability
  • Impulsivity or poor decision-making skills

Be sure to consult with a trained and experienced mental health prescribe before taking any medication for a personality disorder. All medications used for personality disorders should be prescribed by qualified professionals.

Therapy for Treating Personality Disorders

Medications may be beneficial for some, but many people also benefit from therapy for personality disorders. Psychotherapy is a general term used to describe several talk therapy styles and approaches.

Psychotherapy may consist of individual therapy, group therapy or family therapy sessions. Some helpful therapy approaches for personality disorders include dialectical behavior therapy, cognitive behavior therapy, transference-focused psychotherapy, STEPPS and psychoeducation.

Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) was designed especially for chronic suicidality and self-injury linked to borderline personality disorder, but the approach can be applied to other disorders. DBT involves a combination of individual and group sessions focused on:

  • Developing mindfulness and self-awareness
  • Managing intense emotions
  • Tolerating distressing feelings, situations and people
  • Boosting communication skills and relationships

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a popular therapeutic approach used to treat mental health conditions like depression, anxiety, trauma and personality disorders. CBT — sometimes called cognitive therapy or CT — focuses on addressing people’s thoughts and beliefs about themselves and the world.

A therapist using CBT sees personality disorders as issues stemming from unhealthy or inaccurate core beliefs. Many of these core beliefs come from negative childhood experiences. Therapy helps individuals revisit those experiences to acknowledge the roots of their issues.

By identifying and challenging these beliefs, the person can begin to change their worldview. When their worldview changes, the person with a personality disorder may react and behave in dysfunctional ways less often.

Transference-Focused Psychotherapy

Transference-focused psychotherapy (TFP) for personality disorders may also be called psychoanalytic or psychodynamic therapy. Treatment involves the therapist asking questions and looking for intense or reactive responses from the client. From there, the therapist encourages the person to search for understanding and meaning in their reactions so that they can respond more appropriately in the future. TFP for personality disorders also attempts to help clients develop a consistent sense of self and improve relationships by increasing assertive communication styles

STEPPS

System training for emotional predictability and problem solving (STEPPS) incorporates techniques from various treatment styles into 20 group therapy sessions that take place over 20 weeks. In STEPPS treatment for personality disorders, the client will:

  • Learn to manage their emotions
  • Confront negative thinking
  • Improve self-care skills
  • Set healthy goals
  • Eliminate or avoid illegal substances
  • Attend to their physical health by improving diet, physical activity and sleeping habits

STEPPS involves clients and their friends, family, co-workers and other community supports. The therapy uses these people to provide instructions to the client during periods of intense symptoms.

Psychoeducation

People with personality disorders and their family members can benefit from psychoeducation. In psychoeducation, the therapist provides helpful information and statistics about personality disorders to the client and family.

With this information, the person and their family can better understand the disorder, available treatments and coping skills that can improve symptoms. Psychoeducation can help people set realistic expectations and goals for the future.

Personality Disorder Support Groups

While support groups may not be an adequate replacement for professional treatment, they can increase one’s social support system and improve coping skills. Some available support groups for personality disorders include:

Treatment for Personality Disorders and Co-Occurring Conditions

Personality disorders frequently co-occur with other mental health disorders, like depression, anxiety, eating disorders and addiction. For lasting results, a person with comorbid mental health conditions needs to seek comprehensive care that addresses the symptoms of all these disorders.

Without looking at the entire person, treatment may address some symptoms while others increase in intensity. Always start the treatment process with a complete evaluation from a mental health expert to fully understand all conditions affecting the individual.

Personality Disorders and Substance Abuse

Many people with personality disorders also have substance use issues. Often, drug abuse comes from a need for self-medication to manage the intense feelings and distress linked to personality disorders.

If you feel like your personality disorder and substance abuse issues are becoming problematic, it may be time to call The Recovery Village. When you do, you’ll speak to a trained representative who can recommend treatment options for your co-occurring substance use and personality disorders.

    

Dingfelder, S.F. “Treatment for the ‘Untreatable’.” American Psychological Association. March 2004. Accessed April 2, 2019.

Gabbard, G.O. “Psychotherapy of Personality Disorders.” Journal of Personality Disorders. Winter 2000. Accessed April 2, 2019.

Mayo Clinic. “Borderline Personality Disorder: Diagnosis and Treatment.” June 28, 2018. Accessed April 2, 2019.

Mayo Clinic. “Personality Disorders: Diagnosis and Treatment.” September 23, 2016. Accessed April 2, 2019.

Robitz, Rachel. “What are Personality Disorders?” American Psychiatric Association. November 2018. Accessed April 2, 2019.

Skodol, Andrew. “Borderline Personality Disorder (BPD).” Merck Manual. May 2018. Accessed April 2, 2019.

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