“People will tell you that you’re broken. Don’t believe them. They were not the person that could help you. They have not walked your path. God has a plan to bring people into your life that have lived through a similar hell. In the end, it isn’t the number of people that are on your side. It is the people that understand what your side is that matters.” — Shannon L. Alder
Personality disorders are a special kind of mental health condition. Until the release of the DSM V in 2013, personality disorders were actually assigned their own special place in the psychiatric literature, Axis II. The 5th Edition of Diagnostic and Statistical Manual of Psychiatry essentially eliminated the multi-axis system. However, it continues to remain popular among many mental health professionals.
In brief, there were five Axes with the most popular being Axis I and Axis II. Axis I conditions are disorders that most people are familiar with. These include things such as anxiety disorders (panic disorder), mood disorders (depression), eating disorders (bulimia and anorexia), schizophrenia, etc. These disorders are acute and generally require immediate attention.
Axis II disorders are personality disorders and also include mental retardation. These disorders tend to be more complicated and in most cases do not require immediate attention. Axis II would include such things as borderline personality disorder, narcissistic personality disorder, and schizoid personality disorder.
“Although 67% of the people meeting the criteria for an Axis II, or personality disorder, also meet the criteria for an Axis I disorder, the reverse is not true. Only 25% of people meeting the criteria for an Axis I disorder also meet the criteria for an Axis II disorder.” — Lenzenweger, 2007
AXIS II disorders or personality disorders are unlike all other psychiatric disorders, in that they are enduring, difficult to treat, ego-syntonic (consistent with oneself), and often go undiagnosed and untreated. The following are the ten currently recognized personality disorders along with the cluster they belong to and the hallmark symptoms of each:
The American Psychiatric Association’s Diagnostic and Statistical Manual of mental disorders (DSM) divides personality disorders into three clusters and ten distinct diagnoses:
Cluster A (The odd or eccentric disorders)
- Paranoid personality disorder: Characterized by irrational suspicions and mistrust of others
- Schizoid personality disorder: Characterized by a lack of interest in others and flat emotions
- Schizotypal personality disorder: Characterized by odd behavior and magical thinking
Cluster B (The dramatic, emotional, or erratic disorders)
- Antisocial personality disorder: Characterized by a blatant disregard for the rights of others and an absence of remorse.
- Histrionic personality disorder: Characterized by attention-seeking behavior and exaggerated emotions.
- Borderline personality disorder: Characterized by fears of abandonment, impulsivity, and reckless behavior.
- Narcissistic personality disorder: Characterized by a need for admiration and a lack of empathy.
Cluster C (anxious or fearful disorders)
- Dependent personality disorder: Characterized by extreme dependence on other people.
- Obsessive-compulsive personality disorder: Characterized by conformity to rules and excessive orderliness.
- Avoidant personality disorder: Characterized by feelings of inadequacy and avoidance of social situations.
For more information on personality disorders including causes, symptoms, treatments, and long term prognosis refer to the book Wounded Personalities written by Gregory Pacana with Foreword by Edward Hicks, M.D.
DSM-IV(1994), DSM-5(2013), American Psychiatric Association, Wounded Personalities, G.Pacana