I am here for myself

Personality disorder is a recognised mental disorder that can cause significant stress and difficulties for both the person suffering and those close to them. If you have received a diagnosis of personality disorder or suspect you have one, know you are not alone. It is estimated that around 6.5% of the Australian population experience these types of problems at any given point in time.

Project Air is one of a network of national and international groups committed to improving the understanding and treatment of personality disorder. While you may be experiencing dark times at the moment, know that with the right treatment and support, recovery is probable. Indeed, research evidence suggests that psychological therapies for personality disorder help most people to feel better and improve their work and relationships into the future. Most people who receive the right support can expect to not have these problems ongoing.

All personality disorder presentations share common features. These can include difficulties with:

A - Affect - such as suffering from negative feelings and big overwhelming emotions 

I - Identity - such as feeling confused and unsure about yourself and what you want in life

R - Relationships - such as experiencing ongoing relationship conflicts with others

The most commonly diagnosed personality disorder is Borderline Personality Disorder (BPD). This is diagnosed when a person has most (at least 5) of the following challenges:

1. Fears of abandonment or being left alone.
2. Unstable or intense relationships that are short-lived
3. Feeling like you don't know yourself, who you are, or what you really want.
4. Having problems managing impulsive behaviours that are harmful, such as drug and alcohol abuse, binge eating, driving too fast, overspending, or getting into unsafe sexual situations
5. Feeling suicidal or regularly self-harming
6. Being troubled by intense moodiness, irritability or anxiety
7. Feeling chronically empty inside like you feel like a nobody or nothing
8. Finding yourself often getting intensely angry or loosing control of your temper
9. Feeling very suspicious or feeling out of touch with reality, like feeling paranoid about others, or feeling very spaced out or dissociated

As can be seen in the diagnostic criteria, BPD is a combination of difficulties in managing intense affect, experiencing a stable sense of identity, and maintaining satisfying long-term interpersonal relationships. There is substantial variability in how people display their underlying confusion with how to be in the world and how to be with other people. 

Personality disorder ranges from mild to moderate to severe. Severity often fluctuates depending on whether there are real or perceived triggers or threats to safety in a person’s environment or interpersonal relationships.

Everyone has a personality and it is always in development. However, there are key moments in childhood and young adulthood that help shape our personality. People with personality challenges have often experienced difficulties in those key moments that have resulted in them not feeling comfortable in their own skin or safe in their relationships. When these challenges are significant and interfere with almost all areas of their life they become a personality disorder.

The likelihood of these developmental challenges leading to a personality disorder is influenced by:

• Biological or genetic factors (inherited from family) including extreme sensitivity to emotions
• Relationship with caregivers in early childhood that was problematic
• Traumatic early life experiences (e.g., abuse, neglect, death of parents, peer-victimisation)
• Ways of thinking and coping with feelings – often learnt during childhood and through experiences with other people
• Stressful social circumstances – financial, work, relationship, or family

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At Project Air we advocate for a relational model of treatment. This model is both integrative and collaborative, focusing not only on the person being treated, but also considering those close to them, including the broader community including health and education services.

The relational model of treatment sees personality disorder as stemming from a series of problematic and dysfunctional relationship patterns that have developed over time. These relationship patterns are both within you (how you relate to yourself, including your feelings and thoughts) and in your interpersonal relationships (how you relate to others). The relational approach aims to help you understand and modify these relationship patterns in order to more effectively meet your needs. It might include validating past difficulties you have gone through. It can also importantly focusing on what you can do today to help you put together a plan for a better future.

Seeking immediate support

If you need immediate help or support, please contact your local health services in your local area or your country's crisis services.

If you are in Australia, call Emergency Services (dial 000) or telephone a Suicide Prevention Service. 

The Mental Health Support Services Information Fact Sheet may also be helpful. 

We are also pleased to provide an Australian & New Zealand referral directory of personality disorder services. This list is compiled from information provided to us and people using this directory are recommended to seek their own independent advice in determining the service that will best meet their needs. In general we have provided information on specialised integrated programs rather than solo practitioners who may also be providing evidenced based treatment. 

If you would like to add your service to our directory, or update your listing, please email info-projectair@uow.edu.au.

While psychological treatment is essential for the ongoing treatment of personality disorders, there are several activities and practices you can do on your own to manage your current difficulties and work on ways to improve your day to day living.

Review our self-help fact sheets for further information.