Personality disorders in teens develop in childhood and adolescence, and benefit from early detection and treatment. But unlike in adults, it can be more difficult for parents to differentiate telltale signs of a personality disorder from “typical teenage behavior”. We expect adults to be more “in control” of their behavior and accept teens sometimes push the limits of what is accepted or expected to learn more about themselves and the world around them.
But when a teen’s behavior hints at a potential personality disorder, early treatment can be the key to developing the necessary coping mechanisms to help them lead fulfilling and happier lives. Left undiagnosed or misdiagnosed, a personality disorder can turn a person’s life upside down, ruining relationships and career opportunities, and isolating them from those who love and care for them. And the longer such a condition develops – especially in the growing mind of a teenager – the more difficult it can be to treat.
Understanding Personality Disorders in Teens
Personality disorders in teens are a series of conditions characterized by thinking and behavior that deviates quite extremely from the norm, to the point it causes long-term distress over months and years, and affects day-to-day functioning across multiple settings (home, school, work, etc). A personality disorder is more than just a strange character trait or an annoying quirk.
A teen diagnosed with an emerging personality disorder is consistently experiencing thoughts (and thereby engaging in behavior) that are dangerous, unacceptable, and/or unhealthy, and that remain rigid and unchanging even in the face of earnest disapproval and multiple adverse experiences. This isn’t their fault. It is a mental health condition often developing as a result of both internal factors (genetic likelihood) and external factors (life experiences and traumatic situations).
Types of Personality Disorders
Personality disorders in teens do not always fit a textbook definition, but years of accumulated research and learning in the field of psychiatry has helped develop three distinct clusters within which most cases fall. These clusters each have their own set of different diagnoses based on very distinct key behaviors and patterns, but individual cases may come with their own unique elements or quirks.
Ultimately, these definitions can help us understand how and why certain thoughts lead to resulting behaviors, but it’s important to know that any one teen will require a wholly individual profile and treatment process. The three main clusters of personality disorders are:
Cluster A – Odd, Magical or Eccentric
Cluster A personality disorders are characterized by “magical” or odd thinking, and examples of strange or distorted perceptions of reality, paranoia, or erroneously seeing connections or patterns where there are none. The three personality disorders in Cluster A are:
- Paranoid Personality Disorder: Characterized by consistent paranoia and unjustified suspicion, as well as aggressiveness in response to perceived or misinterpreted insults.
- Schizoid Personality Disorder: Characterized by a detached and seemingly emotionless state, lack of interest in other people romantically or sexually, and little to no emotional expression.
- Schizotypal Personality Disorder: Characterized by odd and peculiar thinking, superstition, belief in magical occurrences or concepts, and strange or unnatural experiences (including auditory hallucinations).
Cluster B – Overly Dramatic or Unpredictable
Cluster B personality disorders are characterized by impulsive and/or dramatic behavior, intense interpersonal conflict, or issues with empathy. The four personality disorders in Cluster B are:
- Antisocial Personality Disorder: Characterized by “antisocial behavior”, particularly repeatedly disregarding other people’s feelings and needs, unwarranted aggressiveness, lack of remorse, and impulsiveness.
- Borderline Personality Disorder (BPD): Characterized by pervasive and repeated instability in mood and behavior, borderline personality disorder is named such because its definition evolved over decades, starting out as a condition on the “borderline” between other conditions. Other characteristics include threats of suicide, signs of depression, significant ups and downs, risk-taking behavior, and outbursts.
- Histrionic Personality Disorder: Characterized by attention-seeking behavior, including grand displays of emotion and provocative behavior, such as inappropriate or sexually-suggestive behavior. Other symptoms include repeatedly and consistently making grand statements with little to no substance and being overwhelmingly shallow with one’s thoughts and opinions.
- Narcissistic Personality Disorder: Characterized by an overwhelming sense of self-importance, delusions of grandeur, extreme arrogance, and aggressiveness in response to any perceived threats to one’s superiority. Narcissistic personality disorder is also characterized by extremely manipulative behavior, and a failure to recognize anyone else as special or worth respecting.
Cluster C – Anxious or Fearful
Cluster C personality disorders are characterized by intense anxiety and fearful thinking, avoidance, or excessive dependence. The three personality disorders in Cluster C are:
- Avoidant Personality Disorder: Characterized by a crippling level of fear regarding interpersonal contact and social perception, including fear of disapproval and ridicule in every setting, and constant feelings of inadequacy.
- Dependent Personality Disorder: Characterized by a level of dependence that interferes with normal, everyday function, including being unable to start or continue projects or endeavors alone, lacking any form of self-confidence, and immediately starting new relationships when old ones break down.
- Obsessive-Compulsive Personality Disorder (OCPD): Not to be confused with obsessive-compulsive disorder (OCD), OCPD is a personality disorder characterized by an incredibly rigid ruleset, extreme perfectionism, and desire to be in control always.
Personality Disorder Causes
Personality disorders in teens are understood to be caused by a combination of genetic predisposition and certain external risk factors that may trigger their development. Personality is a complex concept, one which in part is informed by our thoughts and behaviors, how they shape the world around us, and how that world feeds back into our mental framework.
While the genetic component implies that there is a neurological difference between people with and without personality disorders, researchers have not identified all the contributing genes, and how they function or cause personality disorders. Neurotransmitters, such as dopamine and serotonin, may play an important role. Current research on genetic epidemiology simply indicates that all currently recognized personality disorders are at least modestly heritable.
Could My Teen Have a Personality Disorder?
Personality disorders in teens are not easy to identify. Emergent personality disorders may appear as little more than strong personality traits, especially in teenagers, who are still developing in every sense. However, if you have serious concerns regarding your teen’s interpersonal skills, sense of self, and other characteristics mentioned previously, it may be a good idea to talk to a professional and ask your teen about visiting a psychiatrist together. They may be confused about their own thoughts and behaviors and frustrated about how hard it is to fit in with others.
Treatment for a personality disorder is not simple, either. There is no cure, and many of these conditions last for a lifetime. Your teen may struggle more with some symptoms and thoughts than others, and most treatment centers around one-on-one therapy with a professional to address, describe, and cope with these thoughts, and control the resulting behaviors. Some symptoms, such as strong feelings of anxiety or depression, may be alleviated through certain medications.