Getting help for a personality disorder starts with talking to any healthcare provider you already see, whether that’s a primary care doctor, a therapist, or even a counselor at a community clinic. You don’t need to diagnose yourself first. You just need to describe the patterns in your life that aren’t working: recurring relationship conflicts, emotional reactions that feel out of proportion, impulsive decisions you regret, or a persistent sense that something about the way you relate to the world is different from most people around you. That conversation is enough to set the process in motion.
Why Seeking Help Feels Harder Than It Should
Personality disorders carry more stigma than almost any other mental health condition, and that stigma doesn’t just come from the general public. Research published in Psychiatric Services found that people with borderline personality disorder (BPD), the most commonly diagnosed type, reported being turned away by multiple clinicians. Some providers still view personality disorders as untreatable, which discourages them from making the diagnosis at all. This means the very system designed to help can sometimes feel like a barrier.
Many people also avoid seeking a diagnosis because they fear how others will perceive them. One study documented callers to a national helpline who said they suspected they had BPD but deliberately avoided evaluation because of concerns about stigma. Financial barriers and the complexity of having other conditions alongside a personality disorder, like depression or anxiety, add further obstacles. Knowing these barriers exist is useful because it means the difficulty you may encounter isn’t a reflection of your situation being hopeless. It’s a systemic problem, and working around it is possible with the right approach.
What the Diagnostic Process Looks Like
A primary care doctor can screen you and provide a referral, but the actual diagnosis typically comes from a psychiatrist, psychologist, or other mental health professional trained in personality assessment. The evaluation involves a detailed conversation about your thoughts, feelings, behavior patterns, and urges. Expect questions like: When did you or people close to you first notice these patterns? How do they affect your daily life? What have you already tried to feel better?
With your permission, the clinician may also ask for input from family members or people who know you well. This isn’t about checking up on you. Personality patterns are sometimes easier for others to describe from the outside. The clinician will compare your experiences to criteria in the DSM-5-TR, the standard diagnostic manual used in the United States. In some cases, you may be referred for neuropsychological testing, which involves structured questionnaires and cognitive exercises designed to map how you perceive and interpret the world around you.
It’s worth knowing that the international diagnostic system (the ICD-11) recently overhauled how personality disorders are classified. Rather than sorting people into rigid categories, it now uses a dimensional model that rates severity as mild, moderate, or severe and identifies trait patterns like emotional instability, social withdrawal, impulsivity, or rigidity. This shift reflects a growing consensus that personality difficulties exist on a spectrum. Your clinician may use elements of either system depending on where you’re being evaluated.
How to Find the Right Specialist
Not every therapist is trained to treat personality disorders, so finding someone with specific experience matters. A few practical ways to narrow your search:
- Psychology Today’s therapist directory lets you filter by “personality disorders” as a specialty, along with your location and insurance.
- The PSYPACT directory (directory.psypact.gov) lists over 16,000 psychologists authorized to practice across state lines via telehealth, with a filter for personality disorders. This is especially useful if specialists are scarce in your area.
- DBT directories maintained by Behavioral Tech (the organization founded by the creator of Dialectical Behavior Therapy) list clinicians and programs specifically trained in DBT, one of the most effective treatments for personality disorders.
- Your insurance company’s provider line can search for in-network psychiatrists or psychologists with relevant specializations. Ask specifically for providers who treat personality disorders, not just general mental health.
When you contact a potential therapist, it’s reasonable to ask directly: “Do you have experience treating personality disorders?” and “What therapeutic approach do you use?” A vague answer is a signal to keep looking.
Therapies That Work
Talk therapy is the primary treatment for personality disorders, and several specific approaches have strong evidence behind them. The two most extensively researched are Dialectical Behavior Therapy (DBT) and Mentalization-Based Treatment (MBT).
DBT teaches concrete skills in four areas: managing intense emotions, tolerating distress without reacting destructively, navigating relationships, and staying present rather than dissociating or spiraling. It typically combines weekly individual therapy with a weekly skills group, so you’re learning tools alongside other people working on similar challenges. MBT focuses on strengthening your ability to understand your own mental states and those of other people, which helps reduce the misinterpretations and emotional overreactions that fuel conflict.
Other well-studied options include Schema Therapy, which targets deep-rooted patterns (called schemas) formed in childhood, and Cognitive Analytic Therapy, which maps out the repetitive cycles in your relationships and helps you interrupt them. No single approach works for everyone, and a good clinician will tailor treatment to your specific personality profile rather than applying a one-size-fits-all protocol.
The Role of Medication
No medication is FDA-approved specifically for any personality disorder. Despite this, over 80% of people with BPD in the U.S. are prescribed at least one psychiatric medication, and about half take three or more. These prescriptions target specific symptoms rather than the disorder itself: antidepressants for persistent low mood, mood stabilizers for impulsivity or anger, and low-dose antipsychotics for emotional instability or brief paranoid episodes.
Medication can take the edge off symptoms enough to make therapy more productive, but it doesn’t replace the skill-building and pattern recognition that therapy provides. If a provider offers only medication without recommending therapy, that’s worth questioning. The combination of the two, with therapy as the foundation, is the approach supported by the most evidence.
Levels of Care Beyond Weekly Therapy
Weekly outpatient therapy is the starting point for most people, but personality disorders sometimes require more structure, especially during periods of crisis or when outpatient work isn’t producing results.
Intensive outpatient programs (IOPs) typically meet several times a week for a few hours per session, offering structured group and individual therapy while letting you maintain work or school. Partial hospitalization programs (PHPs) are a step up, running roughly six to eight hours a day for several days a week. Residential treatment provides 24-hour support and is generally reserved for people whose functioning has deteriorated significantly or who haven’t responded to less intensive options. The key difference between these levels is the amount of structure and supervision, not a fundamentally different type of treatment. Many people step down gradually from a higher level of care to outpatient therapy as they stabilize.
Crisis Situations
Personality disorders, particularly BPD, carry a significant risk of suicidal thoughts and self-harm. If you’re in immediate danger, calling 988 (the Suicide and Crisis Lifeline in the U.S.) or going to your nearest emergency room is appropriate. For ongoing suicidal thoughts that aren’t immediately life-threatening, the priority is getting connected to a therapist trained in managing chronic suicidality, ideally through a DBT program, which was originally developed for exactly this situation.
Repeated hospitalizations for suicidal crises provide only temporary relief and don’t address the underlying patterns. Current clinical thinking generally favors brief crisis stabilization (often overnight) followed by rapid reconnection with outpatient treatment, rather than extended inpatient stays. The exception is a near-fatal attempt or a psychotic episode, both of which warrant more thorough inpatient evaluation.
Peer Support and Community Resources
Treatment doesn’t have to happen in isolation. NAMI (the National Alliance on Mental Illness) runs peer-led support groups in most U.S. communities, including NAMI Connection groups for people living with mental health conditions and NAMI Family Support Groups for loved ones. These groups won’t replace professional treatment, but they reduce the isolation that makes personality disorders harder to manage. Hearing from people who share similar experiences can normalize what you’re going through in a way that clinical settings sometimes don’t.
Online communities organized around specific diagnoses can also be helpful, though quality varies. Look for moderated spaces affiliated with established organizations rather than unmoderated forums where misinformation spreads easily.