Personality disorders are deep-seated patterns of maladaptive behavior that typically begin in adolescence and continue into adulthood, causing emotional distress and interpersonal difficulties. Personality disorders are believed to be caused by genetic factors and childhood experiences, especially parental abuse and neglect. Because personality disorders are deeply rooted in heredity and childhood, public health and mental health professionals have long considered them difficult to treat. Some are generally considered more treatable than others. Also, different types of treatment work best for different conditions.

Of the ten personality disorders described in the DSM-5, the four in group B: antisocial, borderline, narcissistic, and histrionic were considered the most difficult to treat. Important research has emerged in recent years, particularly to help us understand boundaries and narcissism. They responded much better to treatment than previously thought.

What are the different types of therapies used?

Dialectic treatment (DBT): DBB is a cognitive behavior that aims to increase the average level of the patient between the patient's difficult feelings and actions. In general, it is performed in individual sessions or as a group session. The focus is on a combination of mindfulness, interpersonal skills, stress tolerance, and emotion regulation. DBT is the most scientifically based treatment for people with borderline PD. It is one of the most cost-effective treatments because symptoms can be directly targeted and grouped. It can also be shorter than many other types of treatment.

Affect-Based Therapy: This is a type of psychodynamic therapy that focuses on teaching the patient to 'mentalize,' or imagine the emotions that others will feel in response to their actions. It is less directive than DBT and relies heavily on the therapist-patient relationship. Because they are relationship-based and personal, they can be somewhat longer and therefore more expensive than DBTs.

Schematic therapy: Schematic therapy involves a technical combination of four different proven treatments. The goal of treatment is for the patient to challenge false 'schemas' or beliefs/feelings learned in childhood. Some of these involve re-education of the patient by the therapist. Schema therapy may take longer, but it takes place on a deeper level for the patient. Research shows that it can be cost-effective as it is more expensive but very effective.

Psychodynamic therapy: This proven treatment is usually done individually. The focus is on helping the patient identify how his childhood influences his current life. Communication with the therapist is used by patients to understand how their feelings, emotions, and behaviors affect others. Psychodynamic therapy usually takes longer and is therefore usually more expensive.

Behavior therapy: This is a very targeted therapy. It usually applies to a single symptom that is the main focus of treatment. It is most effective when applied to the specific behavior the patient is trying to stop, especially when the behavior is the result of fear. Therefore, it can be very helpful for anxiety-based personality disorder. Because it is targeted and specific, it is one of the shortest and most cost-effective treatments. However, it treats the symptoms and does not necessarily affect the underlying structure of the personality.

Social skills training: Some personality disorders, especially those related to psychosis, interfere with the patient's ability to understand, read, and respond appropriately to the behavior and feelings of others. Schizotypal, schizotypal, and paranoid PDs often benefit from direct training in this area. Teaching social skills is often done in groups. Because it is intensive and educational group therapy, it can be very effective and sometimes very short.

Medication: Medication is somewhat controversial in the treatment of personality disorders. After all, this condition does not heal itself. However, reducing symptoms such as anxiety, depression or psychosis may be important for more effective treatment. When done correctly, medication can be a useful tool in the treatment of all forms of PD.