People with personality disorders often have a hard time taking responsibility for their feelings and behaviors. They sometimes even blame others for their problems. However, each of them is suffering and is aware that their life is not going well. Approaching a friend about her painful feelings or the frustrations and disappointments in her life, and offering to listen, might be a way to help her consider treatment. If you have had a successful experience in therapy, share that with your friend, even if it wasn’t necessarily for “personality problems” (an off-putting term for many people). Most people with personality disorders enter treatment with another problem, such as depression, anxiety, substance abuse, a job loss, a romantic break-up, etc. The challenge is to get your friend “in the door,” so to speak, not to commit to long-term treatment at the beginning.

People with borderline personality disorder have significant problems in relationships. On the one hand, they can be very needy and clingy in relationships. On the other hand, they push people away because they are insecure themselves and distrust others. They would rather be the one who leaves than the one who is abandoned. To be able to tolerate the borderline person’s anger and aggression, family members must appreciate that the person is reacting out of a sense of weakness and suffering. That is not to say that family members should accept anger and abuse directed at them – limits must be set. Family members must be able to walk away, if necessary, from a situation for their own good, and without guilt. To help a person with borderline personality disorder people need to respect themselves enough to protect themselves. If you let yourself be abused, you will react with anger, push your brother away and confirm his suspicion that you do not love him (enough).

Dialectical behavior therapy (DBT) is one type of psychotherapy that is effective in treating people with borderline personality disorder. Other effective psychotherapies include transference-focused psychotherapy (TFP), mentalization-based therapy (MBT), cognitive-behavioral therapy (CBT) and various forms of supportive psychotherapy. DBT was developed to treat suicide-related behaviors (such as self-cutting and drug overdoses) that are common in people with borderline personality disorder. It seems to be particularly suited for these problems. DBT usually involves a weekly individual psychotherapy session and a weekly group session. These address increasing a person’s awareness of the situations and feelings that lead to self-destructive acts. DBT helps people learn ways to gain control over emotions, feel more competent and able to handle relationships, and understand ways of dealing with painful feelings that are not destructive. Therapy ordinarily lasts a year, at least. Therapists should be well-trained

Some theories of personality disorder view it as developmental delay, which a person may be able to grow out of. Studies show that a fair number of children and early adolescents report signs and symptoms consistent with a personality disorder. For many, these symptoms decrease over time. Children with more symptoms are at greater risk for being diagnosed with a personality disorder in early adulthood. So, on the one hand, it could be argued that time will address many personality problems. On the other hand, if a young person is at risk for a serious mental disorder that may have devastating effects, then early intervention and prevention should be recommended. Currently, this approach appears to be gaining steam. Clinics and therapists are increasingly recognizing and developing treatment interventions for personality disorder symptoms in children and adolescents.

Technically, according to DSM-5*, a person can receive more than one personality disorder diagnosis. People who are diagnosed with a personality disorder most often qualify for more than one diagnosis. A person with a severe personality disorder might meet the criteria for four, five or even more disorders! In practice, clinicians usually recognize that meeting more criteria for personality disorders means more severe disorder.