Mixed Personality Disorder: Symptoms, Causes, and Treatment (2022)

Mixed personality disorder refers to a type of personality disorder that does not fall into the 10 recognized personality disorders.It is possible for people to have traits or symptoms of more than one personality disorder at the same time, while not meeting the criteria for any single one of them.

In DSM-IV, this was referred to as "Personality Disorder Not Otherwise Specified (NOS)." This terminology has been replaced in theDSM-5 by "Other Specified Personality Disorder."

This is not a surprising category as there is a significant overlap between the symptoms of several of the personality disorders. Since this is in a way a "catch-all" category for people with some symptoms of many different personality disorders, there is a wide range of symptoms among people who receive this diagnosis.

Personality Disorder Not Otherwise Specified (PD-NOS)

Symptoms of Mixed Personality Disorder

Most people have a fairly flexible personality that allows them to adapt to a variety of circumstances, people, and events. People with personality disorders, on the other hand, tend to get stuck in rigid ways of relating to people and events.

These rigid thoughts may affect how they think about themselves and the world around them, how they experience emotion, how they function socially, and how well they can control their impulses.

Mixed personality disorder is one of the most commonly diagnosed personality disorders. In one study looking at patients referred for psychotherapy, 18.4% met the diagnostic criteria for a mixed personality disorder.

Types of Personality Disorders

A personality disorder is defined as a chronic and pervasivemental disorderthat affects thoughts, behaviors, and interpersonal functioning. The DSM-5 recognizes 10 distinctpersonality disorders, which are arranged into three clusters.

Cluster A: Odd-Eccentric

  • Paranoid personality disorder: Paranoid personality disorder is marked by a chronic fear and distrust of other people combined with a belief that others are deceiving or exploiting them. It occurs in 1% to 2% of the population and overlaps in some ways with schizophrenia.
  • Schizoid personality disorder: Schizoid personality disorder is marked by an indifference to other people. Those with this disorder often have very little interest in forming close relationships with other people.
  • Schizotypal personality disorder: Schizotypal personality disorder, a condition that affects around 3% of the population, is marked by eccentric thoughts and behaviors. People with the disorder often engage in magical thinking, for example, believing they can read the future. They often experience tremendous social anxiety as well.

Cluster B: Dramatic-Emotional

  • Antisocial personality disorder: About 7.6 million Americans live with antisocial personality disorder, in which people may intentionally harm others and are indifferent to the pain experienced by others. A lack of empathy (lack of concern for others) combined with a lack of remorse (little conscience about their actions) contributes to the tendency toward criminal behaviors.
  • Borderline personality disorder: Borderline personality disorder (BPD) often leads to unstable and intense relationships due to anger and aggression towards others combined with a deep fear of abandonment. People with BPD often engage in risky behaviors and may engage in self-harming behaviors.
  • Histrionic personality disorder: Histrionic personality disorder affects 1.8% of the population and involves a combination of shallow emotions and attention-seeking/manipulative behaviors. Suicide gestures may be used to manipulate others (rather than as a sign of depression). Never ignore warning signs of suicide, even if you believe they are disingenuous.
  • Narcissistic personality disorder: Narcissistic personality disorder (NPD) is characterized by extreme self-centeredness, an exaggerated sense of self-importance, and a lack of empathy or concern for others. The disorder is often recognized first through the emotional damage that occurs to those people with whom the person with NPD interacts.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see ourNational Helpline Database.

Cluster C: Anxious-Fearful

  • Avoidant personality disorder: Avoidant personality disorder is characterized by extreme shyness and sensitivity to criticism from others. It is often associated with other mental health conditions such as anxiety disorders and social phobia.
  • Dependent personality disorder: Dependent personality disorder is characterized by intense fear and inability to make decisions. This disorder is the ultimate in the need to be a "people pleaser" and can result in near paralysis and inability to make the daily decisions (without the input of others) necessary for functioning well in the outside world.
  • Obsessive-compulsive personality disorder: Around 2.5% of the population is expected to live with obsessive-compulsive personality disorder at some point in their life. It is characterized by a preoccupation with orderliness, perfectionism, and control.

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Diagnosis of Personality Disorder

In order to be diagnosed with a personality disorder, a person must exhibit symptoms that meet the diagnostic criteria established in the DSM-5, including:

  • The patterns of behavior must be chronic and pervasive, affecting many different aspects of the individual’s life, including social functioning, work, school, and close relationships.
  • The person must exhibit symptoms that affect two or more of the following four areas: thoughts, emotions, interpersonal functioning, impulse control.
  • The pattern of behaviors must be stable across time and have an onset that can be traced back to adolescence or early adulthood.
  • These behaviors cannot be explained by any other mental disorders, substance use, or medical conditions.

While the DSM-5 retained the DSM-IV's categorical approach to diagnosing personality disorders, it developed an alternate model, which it suggests could be an area for future study.

Using this alternate hybrid model, clinicians would assess personality and diagnose a personality disorder based on a combination of specific difficulties in personality functioning, as well as the general patterns of pathological personality traits.

Differential Diagnosis

Before a clinician can diagnose a personality disorder, they must make a differential diagnosis to rule out other disorders or medical conditions that may be causing the symptoms. This is very important but can be difficult as the symptoms that characterize personality disorders are often similar to those of other psychiatric disorders and medical illnesses.

Personality disorders also commonly co-occur with other illnesses.

Causes of Personality Disorders

Though experts don't understand all of the causes of personality disorders, there are believed to be causes that likely underlie more than one of these disorders. Personality disorders are thought to be caused by a combination of both genetic and environmental factors. Some people may be predisposed to these disorders due to genetics and family history.

Genetic vulnerabilities may make people more susceptible to these conditions, while experiences and other environmental factors may act as a trigger in the development of a personality disorder.

Personality Disorder Treatment

Since the symptoms and characteristics of mixed personality disorder span a wide range, there is not one specific treatment that is helpful to all people with the diagnosis. The particular symptoms present are often treated as if the person does meet the criteria of one of the personality disorders described above.

For example, if a person meets some, but not all of the criteria for borderline personality disorder, one of the empirically validated psychotherapy treatments for borderline personality disorder may be pursued. In general, the treatment of personality disorders also requires that the person with the disorder wishing to pursue therapy.

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Psychotherapy

Your treatment plan will depend largely upon your symptoms but may involve the use of cognitive-behavioral therapy (CBT) or a subtype known as dialectical-behavioral therapy (DBT).

  • Cognitive-behavioral therapy: Traditional CBT focuses on identifying negative thinking patterns that contribute to maladaptive behaviors and replacing these patterns with healthier, more realistic ones.
  • Dialectical-behavioral therapy: DBT can be particularly effective at treating borderline symptoms and involves learning skills related to emotional regulation, interpersonal communication, mindfulness, and tolerating distress.

Medications

Psychotherapy is often more effective than medications, but medications may be prescribed to address certain symptoms. Antidepressants and anti-anxiety medications may be used to treat symptoms of depression and anxiety. Antipsychotic medications may be prescribed when people have Cluster A symptoms such as eccentric thoughts or behaviors.

How to Cope With a Personality Disorder

While personality disorders are fairly common, many people do not realize that they have one of these conditions. One of the best ways to improve your quality of life is to recognize the signs and find effective ways to cope with symptoms that lead to distress and impairment.

Professional support from a therapist combined with self-care can help people learn to manage their condition.

Recognize Your Symptoms

If you have mixed traits such as avoidance or dependence, consider the impact these might have on different aspects of your life including work and relationships. By better understanding these traits, you'll have a clearer idea of what you can do to work around them.

Have a Plan

Some traits can make it hard to take care of your health and home. You might do well some of the time, only to have periods where you struggle to keep up. Come up with a self-care plan that works for you and enlist the help of friends and family who can help keep you on track.

How to Cope With a Personality Disorder

A Word From Verywell

While research suggests that personality disorders with mixed symptoms are quite common, people often go underdiagnosed and undertreated. With appropriate treatment, you can learn to manage symptoms that may be having a negative impact on multiple areas of your life. Talk to your doctor if you suspect that you may be experiencing symptoms of some type of personality disorder.

Introduction to Personality Disorders

1 Source

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Verheul R, Bartak A, Widiger T. Prevalence and construct validity of Personality Disorder Not Otherwise Specified (PDNOS). J Pers Disord. 2007;21(4):359-70. doi:10.1521/pedi.2007.21.4.359

Additional Reading

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Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be.

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FAQs

What causes mixed personality disorder? ›

Dissociative identity disorder (previously known as multiple personality disorder) is thought to be a complex psychological condition that is likely caused by many factors, including severe trauma during early childhood (usually extreme, repetitive physical, sexual, or emotional abuse).

What are the symptoms of mixed personality disorder? ›

The person must exhibit symptoms that affect two or more of the following four areas: thoughts, emotions, interpersonal functioning, impulse control. The pattern of behaviors must be stable across time and have an onset that can be traced back to adolescence or early adulthood.

What are the first signs of a personality disorder? ›

Some general signs of people with a personality disorder include: Their behavior is inconsistent, frustrating and confusing to loved ones and other people they interact with. They may have issues understanding realistic and acceptable ways to treat others and behave around them.

What are the 4 types of personality disorders? ›

Antisocial personality disorder (ASPD) Borderline personality disorder (BPD) Histrionic personality disorder. Narcissistic personality disorder.

How do you control mixed personalities? ›

Treatment. Once it's established that a person has a mixed personality disorder, the healthcare provider or mental health professional will need to examine the specific symptoms, and how they interact and influence each other. The go-to treatment for personality disorders is psychotherapy (talk therapy).

Are you born with a personality disorder? ›

Personality disorders are thought to be caused by a combination of these genetic and environmental influences. Your genes may make you vulnerable to developing a personality disorder, and a life situation may trigger the actual development.

Are personality disorders mental illness? ›

Personality disorders are a group of mental illnesses. They involve long-term patterns of thoughts and behaviors that are unhealthy and inflexible. The behaviors cause serious problems with relationships and work. People with personality disorders have trouble dealing with everyday stresses and problems.

Can personality disorders be cured? ›

While there isn't a cure for personality disorders, there are effective treatment methods out there for those who struggle with these conditions, such as therapy.

What does having mixed personalities mean? ›

Dissociative Identity Disorder (Multiple Personality Disorder) A mental health condition, people with dissociative identity disorder (DID) have two or more separate personalities. These identities control a person's behavior at different times.

When do personality disorders start? ›

Personality disorders usually start to become evident during late adolescence or early adulthood, although sometimes signs are apparent earlier (during childhood). Traits and symptoms vary considerably in how long they persist; many resolve with time.

Are personality disorders permanent? ›

All personality disorders are lifelong patterns, but there is now more optimism about the more distressing aspects of borderline personality disorder. Research indicates that the symptoms of borderline personality disorder get less intense as people grow older.

Who can diagnose a personality disorder? ›

Because personality disorders often require specialized care, your primary doctor may refer you to a mental health professional, such as a psychiatrist or psychologist, for evaluation and treatment.

What is the most difficult personality disorder to treat? ›

Treating antisocial personality disorder

But antisocial personality disorder is one of the most difficult types of personality disorders to treat. A person with antisocial personality disorder may also be reluctant to seek treatment and may only start therapy when ordered to do so by a court.

Is ADHD a personality disorder? ›

Borderline personality disorder (BPD) and attention deficit hyperactivity disorder (ADHD) are both recognized mental health conditions. However, BPD is a personality disorder, while ADHD is a neurodevelopmental disorder.

What are the 7 types of personality disorders? ›

The main personality disorders in this category are listed below.
  • Paranoid personality disorder. ...
  • Schizoid personality disorder. ...
  • Schizotypal personality disorder. ...
  • Antisocial personality disorder. ...
  • Borderline personality disorder. ...
  • Histrionic personality disorder. ...
  • Narcissistic personality disorder. ...
  • Avoidant personality disorder.

How do you work with people with different personalities? ›

How to effectively engage with different personality types in the workplace
  1. Know what the differences are and avoid negative labelling. ...
  2. Recognise cultural differences. ...
  3. See people objectively, not personally. ...
  4. Embrace difference: ask questions. ...
  5. Look for the common agenda or goal. ...
  6. Respect yourself and pick your battles.

How does multiple personality disorder work? ›

Formerly known as multiple personality disorder, this disorder is characterized by alternating between multiple identities. A person may feel like one or more voices are trying to take control in their head. Often these identities may have unique names, characteristics, mannerisms and voices.

Can a person have 2 personality disorders? ›

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!

At what age is personality fully developed? ›

When we're maturing, however, these traits are still forming. By the age of 30, the majority of people have reached maturity.

Do personality disorders run in families? ›

Genetics. Some studies of twins and families suggest that personality disorders may be inherited or strongly associated with other mental health disorders among family members.

Are personality disorders caused by trauma? ›

Childhood trauma.

One study found a link between the number and type of childhood traumas and the development of personality disorders. People with borderline personality disorder, for example, had especially high rates of childhood sexual trauma.

What is the main cause of personality disorders? ›

Early life experiences

If you have been given a personality disorder diagnosis you are more likely than most people to have experienced difficult or traumatic experiences growing up, such as: neglect. losing a parent or experiencing a sudden bereavement. emotional, physical or sexual abuse.

Can a person with personality disorder change? ›

Borderline personality disorder (BPD) was long thought to be a chronic condition that affected most or, at least, many parts of a person's personality and functioning. Recent research has found that change is to be expected for many borderline patients over time—both in the symptomatic and psychosocial realms.

Is personality disorder a disability? ›

The Social Security Administration placed borderline personality disorder as one of the mental health disorders on its disabilities list. However, you'll have to meet specific criteria for an official disability finding. For example, you must prove that you have the symptoms of the condition.

What drugs treat personality disorders? ›

Anticonvulsants, antidepressants, and antipsychotics are typically prescribed to help treat and manage borderline personality disorder symptoms.

How do you treat personality disorder naturally? ›

8 Natural Remedies for BPD Without Medication [Therapist-Approved]
  1. Therapy. Psychotherapy (talk therapy) is almost always the first line of treatment for people who've received a BPD diagnosis. ...
  2. Vitamin C Supplements. ...
  3. Herbs. ...
  4. Foods with Omega-3 Fatty Acids. ...
  5. Magnesium. ...
  6. Vitamin D. ...
  7. Chocolate or Cacao. ...
  8. Stress Management Skills.
1 Jul 2022

How can you help someone with a personality disorder? ›

Talk to them compassionately and calmly – when someone is experiencing difficult thoughts and feelings, their behaviour may be unexpected or upsetting, and you may feel unsettled. Try to understand what they're experiencing and what's affecting their thoughts, feelings and behaviour – this can help you to stay calm.

How can you tell if someone has multiple personalities? ›

Symptoms of Multiple Personality Disorder

Inability to recall important personal information. Memories unique to specific identities. Distinct ways of talking and acting for each psyche.

How do you know if your child has a split personality? ›

Symptoms
  1. a sense of “losing time”
  2. confusion.
  3. exhibition of two or more personalities (alters)
  4. feelings of detachment (dissociation)
  5. memory gaps.
  6. out of character behavior.
14 Jul 2020

Can multiple personality disorder curable? ›

Currently, there is no cure for multiple personality disorder. But with treatment, it is possible to alleviate symptoms and reduce disruptions in the ability to function in daily life. Treatment usually includes a combination of talk therapy and medication.

What does having mixed personalities mean? ›

Dissociative Identity Disorder (Multiple Personality Disorder) A mental health condition, people with dissociative identity disorder (DID) have two or more separate personalities. These identities control a person's behavior at different times.

Can a person have 2 personality disorders? ›

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!

Why do I adapt other people's personalities? ›

Much personality mirroring likely stems from a desire for social acceptance, something that we can all relate to. As such, you might opt to see it and the person behind it with a kind eye – especially if that person is you.

How does dependent personality disorder develop? ›

Experts have found DPD is more likely in people with particular life experiences, including: Abusive relationships: People who have a history of abusive relationships have a higher risk of a DPD diagnosis. Childhood trauma: Children who have experienced child abuse (including verbal abuse) or neglect may develop DPD.

Are personality disorders mental illness? ›

Personality disorders are a group of mental illnesses. They involve long-term patterns of thoughts and behaviors that are unhealthy and inflexible. The behaviors cause serious problems with relationships and work. People with personality disorders have trouble dealing with everyday stresses and problems.

How can you tell if someone has multiple personalities? ›

Symptoms of Multiple Personality Disorder

Inability to recall important personal information. Memories unique to specific identities. Distinct ways of talking and acting for each psyche.

Can personality disorders be cured? ›

While there isn't a cure for personality disorders, there are effective treatment methods out there for those who struggle with these conditions, such as therapy.

What is the most difficult personality disorder to treat? ›

Treating antisocial personality disorder

But antisocial personality disorder is one of the most difficult types of personality disorders to treat. A person with antisocial personality disorder may also be reluctant to seek treatment and may only start therapy when ordered to do so by a court.

What is split personality disorder called? ›

Dissociative identity disorder is still sometimes called multiple personality disorder (MPD). This is because many people experience the changes in parts of their identity as completely separate personalities in one body.

Can multiple personality disorder curable? ›

Currently, there is no cure for multiple personality disorder. But with treatment, it is possible to alleviate symptoms and reduce disruptions in the ability to function in daily life. Treatment usually includes a combination of talk therapy and medication.

Why do borderlines mirror? ›

People with Borderline Personality Disorder instinctively 'mirror' to fit in, because without that behaviour, we have no idea what will happen. We have little or no sense of our own identity, so we can't know if that will be acceptable to others.

What is a chameleon person? ›

usually disapproving : a person who often changes his or her beliefs or behavior in order to please others or to succeed.

How do I stop mirroring people's personalities? ›

How to overcome habitual mirroring behaviour
  1. Talk to someone who doesn't share the problem.
  2. Be honest about your feelings. ...
  3. Play sport or do something creative to allow your mind to process your emotions.
  4. Remember: emotional mirroring is adding your concerns to someone facing a challenging time, and taking on theirs.
28 Dec 2018

What type of therapy is best for dependent personality disorder? ›

Treatment for Dependent Personality

Cognitive behavioral therapy (CBT) may be used to help an individual challenge negative thoughts and start engaging in more independent behaviors. Psychodynamic therapy is particularly effective for treating dependent personality.

What is the best treatment for dependent personality disorder? ›

Psychotherapy (a type of counseling) is the main method of treatment for DPD. The goal of therapy is to help the person with DPD become more active and independent, and to learn to form healthy relationships.

Who is most affected by dependent personality disorder? ›

Dependent personality disorder occurs in less than 1% of the general population in the United States. It is diagnosed more often in women, but some studies suggest it affects men and women equally. Other disorders are also often present.

Videos

1. How to Spot the 4 Types of Borderline Personality Disorder
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2. What is MIXED PERSONALITY DISORDER?
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3. What is Borderline Personality Disorder? Do I have BPD?
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4. Understanding Dissociative Identity Disorder
(Demystifying Medicine McMaster)
5. Woman conjures multiple personalities during extraordinary interview | 60 Minutes Australia
(60 Minutes Australia)
6. 8 Traits of the "Superficial Personality Disorder" (AKA histrionic PD)
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