The treatment that’s best for you depends on your particular personality disorder, its severity and your life situation. Often, a team approach is appropriate to make sure all of your psychiatric, medical and social needs are met. Because personality disorders tend to be chronic and can sometimes last much of your adult life, you may need long-term treatment.
The team involved in treatment may include your:
• Family doctor or primary care provider
• Family members
• Social workers
If you have mild symptoms that are well controlled, you may need treatment from only your family doctor, a psychiatrist or a therapist. If possible, find medical and mental health providers with experience in treating personality disorders.
Several treatments are available for personality disorders. They include:
Successful treatment depends on your active participation in your care.
Psychotherapy is the main way to treat personality disorders. Psychotherapy is a general term for the process of treating personality disorders by talking about your condition and related issues with a mental health provider. During psychotherapy, you learn about your condition and your mood, feelings, thoughts and behavior. Using the insight and knowledge you gain in psychotherapy, you can learn healthy ways to manage your symptoms.
Types of psychotherapy used to treat personality disorders may include:
• Cognitive behavioral therapy. This combines features of both cognitive and behavior therapies to help you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones.
• Dialectical behavior therapy. This is a type of cognitive behavioral therapy that teaches behavioral skills to help you tolerate stress, regulate your emotions and improve your relationships with others.
• Psychodynamic psychotherapy. This therapy focuses on increasing your awareness of unconscious thoughts and behaviors, developing new insights into your motivations, and resolving conflicts to live a happier life.
• Psychoeducation. This therapy teaches you — and sometimes family and friends — about your illness, including treatments, coping strategies and problem-solving skills.
Psychotherapy may be provided in individual sessions, in group therapy or in sessions that include family or even friends. The type of psychotherapy that’s right for you depends on your individual situation.
There are no medications specifically approved to treat personality disorders. However, several types of psychiatric medications may help with various personality disorder symptoms.
• Antidepressant medications. Antidepressants may be useful if you have a depressed mood, anger, impulsivity, irritability or hopelessness, which may be associated with personality disorders.
• Mood-stabilizing medications. As their name suggests, mood stabilizers can help even out mood swings or reduce irritability, impulsivity and aggression.
• Anti-anxiety medications. These may help if you have anxiety, agitation or insomnia. But in some cases, they can increase impulsive behavior.
• Antipsychotic medications. Also called neuroleptics, these may be helpful if your symptoms include losing touch with reality (psychosis) or in some cases if you have anxiety or anger problems.
Hospitalization and residential treatment programs
In some cases, a personality disorder may be so severe that you require psychiatric hospitalization. Psychiatric hospitalization is generally recommended only when you aren’t able to care for yourself properly or when you’re in immediate danger of harming yourself or someone else. Psychiatric hospitalization options include 24-hour inpatient care, partial or day hospitalization, or residential treatment, which offers a supportive place to live.
Participating in your own care
Try to be an active participant in your treatment. Working together, you and your doctor or therapist can decide which treatment options may be best for your situation, depending on your type of personality disorder, your symptoms and their severity, your personal preferences, insurance coverage, affordability, treatment side effects, and other factors.
In some cases, a personality disorder may be so severe that a doctor, loved one or guardian may need to guide your care until you’re well enough to participate in decision making.