What Is Mixed Personality Disorder?

Personality disorders consist of long-standing, inflexible thought and behavior patterns that are different from what is generally expected. Personality disorders can interfere with many areas of life, and they can cause poor coping skills and relationship difficulties.

Approximately 10% to 13% of the world’s population have a personality disorder. In the United States, about 9% of adults have at least one personality disorder.

Mixed personality disorder means that a person meets the general criteria of a personality disorder but does not fully meet the criteria for a specific type of personality disorder. Mixed personality disorder affects about 3% to 6% of the general population.

Types of Personality Disorders

There are 10 personality disorder types. They are organized into clusters based on common themes between them.

Cluster A - Semi-Psychotic Theme

People with these personality disorders display odd behavior, which often disrupts their relationships.

Paranoid personality disorder:

• Displays a pattern of mistrust and suspicion of others
• Believes that others are trying to demean, harm, or threaten them
• Sees others as mean or spiteful
• Does not confide in or become close to others

Schizoid personality disorder:

• Acts distant, detached, and indifferent to social relationships
• Prefers solitary activities and spending time alone
• Rarely expresses strong emotion
• Does not seek close relationships
• Appears not to care about praise or criticism from others

Schizotypal personality disorder:

• Displays pattern of unusual, distorted, or eccentric thinking, behavior, and appearance
• May have peculiar speech
• May have excessive social anxiety
• Is uncomfortable in close relationships
• May be very superstitious

Cluster B - Dramatic Behavior, Entitlement, Moodiness, Poor Impulse Control

People with these personality disorders display behavior that is dramatic (with intense emotions) or erratic and impulsive.

Antisocial personality disorder:

• Is characterized by rash, irresponsible, and aggressive behavior
• Shows a pattern of disregarding or violating the rights of others
• Has disregard for social norms and rules
• May frequently lie, deceive, or disregard others
• May act impulsively
• Lacks remorse for their actions
• May commit serious crimes

Borderline personality disorder:

• Has a pattern of instability and difficulty in personal relationships, intense and unstable emotions such as inappropriate anger, poor self-image, and impulsive (sometimes reckless or dangerous) behavior
• May have an intense fear of abandonment
• Is associated with a higher risk of suicidal thoughts and behaviors and self-harm
• May have ongoing feelings of emptiness
  

Histrionic personality disorder:

• Is marked by excessive emotion, shallowness, and constantly seeking attention
• May display dramatic, childish, or exaggerated/rapidly shifting emotional behavior
• Desires to be the center of attention
• May use physical appearance to draw attention to themselves

Narcissistic personality disorder:

• Is marked by a need for admiration, an exaggerated sense of superiority, self-centeredness, a preoccupation with success and power, and lack of empathy for others
• May have a sense of entitlement and take advantage of others
  

Cluster C - Anxious-Depressed Theme

People with these personality disorders display anxiety or ongoing fear.

Avoidant personality disorder:

• Shows a pattern of extreme shyness, feelings of inadequacy, and extreme sensitivity to criticism
• Desires social interaction, but avoids social contact due to excessive fear of embarrassment, rejection, or judgment

Dependent personality disorder:

• Is marked by dependency, submissiveness, a need for constant reassurance, feelings of helplessness, and difficulty making decisions without the input or reassurance of others
• Engages in "people pleasing," particularly with a person they are close to
• Has a fear of separation and may fear they are unable to care for themselves

Obsessive-compulsive personality disorder:

• Shows a pattern of perfectionism, inflexibility, control, orderliness, and a preoccupation with details and/or schedules
• Has a strong fear of making mistakes, often resulting in difficulty making decisions and finishing tasks
• May work excessively, leaving little time for leisure or friends
• May be inflexible in their morality and values
• Is not the same as obsessive-compulsive disorder
  

Symptoms

The criteria for a personality disorder diagnosis includes all of the following:

• Thoughts and behavior cause significant problems in daily life.
• These problems are experienced across different aspects of life.
• These problems continue for a long time, often starting in childhood or adolescence and continuing into adulthood.
• These problems are not solely caused by a substance or a medical condition.

Personality disorders affect at least two of these areas:

• How you think about yourself and others
• How you respond emotionally
• How you relate to other people
• How you control your behavior

A 2020 study found that people with mixed personality disorder showed poorer discrimination of certain emotional facial expressions compared to people without mixed personality disorder.

The study also found that people with mixed personality disorder reported poorer self-regulation of their emotions in highly demanding situations.

Causes

An exact cause for any personality disorder is not known. It's believed to be a result of a combination of factors, including:

• Environment and social circumstances: Such as an unstable or chaotic family life, poverty, discrimination, a lack of support, traumatic experiences
• Early life experiences: Such as abuse, neglect, loss of a parent, and other traumatic experiences that could cause maladaptive coping strategies
• Genetic factors: It's possible that personality disorders could be hereditary to some degree

Diagnosis

People with personality disorders often aren't aware that they have a problem. They may only seek a diagnosis and treatment when they're made aware of how their behavior is affecting those around them.

A diagnosis often begins with a primary healthcare provider. Typically, they will:

• Discuss symptoms
• Ask about personal and family medical history, including mental health
• Perform a physical exam
• Run other tests, such as blood work, to check for a physical reason for the symptoms
  

The healthcare provider may make a referral to a mental health professional who will use specially designed interview and assessment tools to evaluate a person for a personality disorder.

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). There are several types available. Which to choose depends on your needs and how well you respond to each type:

• Cognitive behavioral therapy (CBT): First, CBT helps identify maladaptive thought processes and behaviors, and then it works on changing them into healthy ones.
  
• Dialectical behavior therapy (DBT): Adapted from CBT, this therapy helps you learn to identify and control your emotions and behavior. It's particularly helpful for traits associated with borderline personality disorder.
  
• Cognitive analytical therapy (CAT): This helps you recognize and change problematic relationship patterns, including those learned while growing up, so you can cope with difficult emotions.
  
• Mentalization based therapy (MBT): MBT helps you learn how to be aware of what’s going on in your own mind and make sense of what other people think, need, or want.
  
• Psychodynamic or psychoanalytic therapy: A long-term therapeutic process, this helps people to understand and change complex, deep-seated emotional and relationship problems.
  

There is no medication specifically for treating personality disorders, and medication is not generally a first-line treatment. Medication may be prescribed to help with specific symptoms such as anxiety. It may also be given to treat conditions that are present in addition to the personality disorders.

These might include:

• Antidepressants
• Anti-anxiety medication
• Mood stabilizing medication

Prognosis

Mixed personality disorder is under-studied. A precise prognosis can't be accurately made using current research. However, one review found promising results for significant and meaningful changes after psychotherapy in individuals with mixed personality disorder.

Coping

People with any type of personality disorder should receive professional treatment, but there are self-care strategies that can help in addition to that treatment.

• Educate yourself: Learn about your condition.
• Practice healthy habits: Eating a healthy diet, exercising, getting good quality sleep, avoiding substances such as drugs and alcohol, and other healthy habits can help with symptom management.
• Get regular medical care: Have regular check-ups from your primary healthcare provider, and pay attention to your health outside of your personality disorder.
• Join a support group: Being around other people who know what it is like to have a personality disorder can be a great way to get support and share resources.
• Keep a journal: Write down your thoughts and emotions and/or take note of things that trigger positive and negative reactions.
• Practice relaxation and stress management techniques: Mindfulness exercises, such as yoga and meditation, can be beneficial.
• Stay connected: Avoid becoming isolated. Instead, spend time with and talk to friends and family.

Summary

A person with mixed personality disorder meets the criteria for a personality disorder but does not meet the full criteria for a specific type of personality disorder. Instead, they show characteristics from multiple types.

Treatment for mixed personality disorder is typically a form of psychotherapy. Medication may also be prescribed for specific symptoms or for other conditions that you have.

A Word From Verywell

The first step in improving mixed personality disorder is realizing there's a problem. If you or those around you are noticing that you're showing symptoms of a personality disorder, even if they aren't consistent with a single type, see your healthcare provider for next steps.