Patterns that feel like "just who I am" can change with the right care.
A personality disorder is a long-standing pattern of thinking, feeling, and relating to others that causes real distress or gets in the way of work, relationships, and daily life. These patterns usually take shape in the teens or early twenties, and people often spend years believing nothing can be done about them. That isn't true.
What it can look like
- Borderline personality disorder: intense and fast-changing emotions, fear of abandonment, unstable relationships, impulsive behavior, and sometimes self-harm.
- Avoidant and dependent patterns: deep sensitivity to rejection, difficulty being alone or making decisions without reassurance.
- Obsessive-compulsive personality: rigid perfectionism and control that strains relationships and work.
- Narcissistic, paranoid, and other patterns: persistent difficulty with trust, empathy, or self-image that repeats across situations.
Personality disorders very often travel with depression, anxiety, ADHD, trauma, or substance use, and it takes a careful evaluation to tell what is what.
How we treat it
Psychotherapy is the foundation, and approaches like dialectical behavior therapy (DBT) and other skills-based therapies have strong evidence, especially for borderline personality disorder. We help you find the right therapist if you don't already have one. Medication doesn't treat the personality disorder itself, but it can make a real difference for the mood swings, anxiety, impulsivity, or sleep problems that come with it. Dr. Shaikh's years leading the Professionals in Crisis and young adult programs at The Menninger Clinic mean this is familiar ground.
Common questions
Is a personality disorder diagnosis permanent?
No. Personality disorders were once thought to be unchangeable, and that turned out to be wrong. Borderline personality disorder in particular responds well to skills-based therapy, and many people no longer meet criteria after sustained treatment. The patterns took years to form, so change takes time, but it happens.
What's the difference between borderline personality disorder and bipolar disorder?
Both involve mood swings, but in bipolar disorder the shifts last days to weeks and come with changes in sleep and energy. In borderline personality disorder, emotions change within hours, often in response to relationships, along with fear of abandonment and an unstable sense of self. They can occur together, which is why a careful evaluation matters.
Does medication help with a personality disorder?
Medication doesn't treat the personality disorder itself, and no medication is approved for that purpose. It can make a real difference for depression, anxiety, impulsivity, or sleep problems that come with it, and it can make therapy easier to engage in. We keep medication simple and review it regularly.
What kind of therapy works best?
Dialectical behavior therapy (DBT) has the strongest evidence for borderline personality disorder, and other structured, skills-based approaches help with avoidant, dependent, and obsessive-compulsive patterns. We help you find a therapist with the right training and coordinate medication alongside their work.
Can teenagers be diagnosed with a personality disorder?
Patterns usually take shape in the teens or early twenties, and while clinicians are cautious about labeling adolescents, early treatment for emotional instability and self-harm clearly helps. Dr. Shaikh led the adolescent and young adult programs at The Menninger Clinic and sees teens with their parents or guardians.