Personality Disorders in Teens: What You Should Know

Historically, people would not received a diagnosis for personality disorders until they were at least in their 20’s. The nature of the illness indicates a long-term unhealthy pattern of thought and behavior and a person needs to have a history of life challenges that might indicate a personality disorder exists.


However, there is an ongoing debate in the mental health field about whether to diagnose teens with personality disorders, even if they may be exhibiting symptoms. For instance, some experts argue that teens can’t be diagnosed with a personality disorder because their personalities are not yet fixed. They are still developing, including their brains. These experts note that if the brain is still changing, then the characteristics of an individual will also change. Additionally, any psychological illness that a teen may have will also change.


At the same time, more and more mental health clinicians are beginning to see traits of certain personality disorders in teens, which would already point to a diagnosis. For this reason, adolescents can exhibit signs of a personality disorder, of which the various types are described below. And these experts claim that the sooner there is a diagnosis, the sooner there can be intervention and support for an adolescent.


What is a Personality Disorder?


A personality disorder is considered to be a mental illness in which there are long-lasting unhealthy behaviors, thought patterns, and inner experiences, which seem to hold true across many areas of an adolescent’s life and are not usually well accepted in the culture. These patterns tend to develop early and are typically unchanging or inflexible, bringing about significant distress in life.


Furthermore, the pervasiveness of these unhealthy patterns often make it difficult for someone to function in their life. They may cause friction in relationships and difficulty at school or in the workplace. It’s common that those with a personality disorder are not aware that they have a psychological illness, which can get in the way of a teen having insights of their own.


How Many Personality Disorders Are There?


There are a total of 10 personality disorders, which are grouped into three different categories, as described below.


Cluster A – This group includes the personality disorders that have avoidance, rigidity, and an inability to see reality. Cluster A includes:

  • Paranoid Personality Disorder
  • Schizoid Personality Disorder
  • Schizotypal Personality Disorder


Cluster B – This group of personality disorders have impulsivity, antisocial tendencies, and emotional dysregulation in common. These are:


Cluster C – This group of personality disorders include traits of avoidance and anxiety. This group includes:

  • Obsessive-Compulsive Personality Disorder
  • Avoidant Personality Disorder
  • Dependent Personality Disorder


Four of the most common personality disorders among the general public are borderline personality disorder, dependent personality disorder, narcissistic personality disorder, and paranoid personality disorder.


Why Diagnose a Teen with a Personality Disorder?


As mentioned above, there are some valid reasons to diagnose a teen with a personality disorder. At the same time, there are some downsides to doing so as well. Below is a list of pros and cons for diagnosing a teen or young adult while they are still developing:


Pros for Diagnosing a Personality Disorder

  • When a teen is diagnosed early, they and their family can seek support immediately.
  • A diagnosis can also lead to long-term treatment planning and prevention.
  • The diagnosis can be a reflection of where the teen is now developmentally.
  • The diagnosis gives the symptoms and difficulty a teen is having validity so that they and their family can do something about it.
  • There are effective treatments of personality disorders, which can only be accessed with the proper diagnosis.


Cons for Diagnosing a Personality Disorder

  • There is a great tendency for a personality disorder diagnosis to stay with a teen as they progress into adulthood and not be revised if the teen grows out of the diagnosis.
  • This diagnosis carries a great stigma.
  • Many clinics and treatment centers will not treat those with personality disorders because of the assumption that there won’t be any progress or change.
  • The diagnosis of a personality disorder might too general and not include the traumas or family history that a teen or young adult has experienced.


What Types of Treatment Work for Teen Personality Disorders?


Despite the prevailing belief that someone with a personality disorder is unlikely to get better, there are treatment modalities for these disorders. These include:

  • Dialectical Behavioral Therapy (DBT)
  • Systems Training for Emotional Predictability and Problem Solving (STEPPS)
  • Multisystemic Therapy


All of these treatment types have resulted in improvements in a teen’s life. Essentially, treatment are aimed at addressing unhealthy patterns of thought and behavior. A therapist aims to facilitate awareness so that a teen can develop insight and patterns can eventually be changed. It’s common for someone with a personality disorder to participate in long-term psychotherapy, with a clinician who is trained in the specific type of personality disorder being treated. A therapist might also help an individual develop healthy coping tools so that he or she can manage stress and personal conflicts in healthy ways.


Can Teens with Personality Disorders Have Other Disorders Too?


It’s common for personality disorders to exist as co-occurring disorders, along with psychological illnesses. Some disorders that are common to exist alongside a personality disorder include:

  • Major Depressive Disorder
  • Generalized Anxiety Disorder
  • Substance Abuse Disorder
  • Post Traumatic Stress Disorder
  • Eating Disorder (Anorexia Nervosa or Bulimia Nervosa)
  • ADHD
  • Panic Disorder
  • Bipolar Disorder


It’s also important to note that many of those who are diagnosed with a personality disorder commonly are diagnosed with a second personality disorder. For instance, borderline personality disorder often co-occurs with narcissistic personality disorder and schizotypal personality disorder. Those with antisocial personality disorder also frequently have traits that meet the criteria for borderline personality disorder.


In order to properly determine the presence of other co-occurring disorders, treatment often begins with a thorough assessment. This ensures that any co-occurring disorders can be identified and treated as well.


If you are concerned about your teen and possible symptoms of a personality disorder, it’s important that you schedule a psychological assessment. With the right information, a proper diagnosis and treatment planning can follow. Contact a mental health provider today for professional support.