Personality Disorders: When Someone You Love Is Hard to Understand
Learn how personality disorders affect families, why misunderstandings are common, and what loved ones can do to support healing without losing themselves.
When the Person You Love Doesn’t Make Sense Anymore
Imagine loving someone very much—your child, your partner, your sibling—but no matter how hard you try, your connection keeps unraveling. You feel blamed, dismissed, manipulated, or chronically confused. One day they seem warm and connected; the next, they're cold, explosive, or detached. You wonder if it’s something you did. Or worse—maybe you’re the one going crazy.
These are the private agonies families often endure when someone they love has a personality disorder—a long-standing, inflexible pattern of thinking, feeling, and behaving that causes serious problems in relationships and self-image.
What Is a Personality Disorder?
Personality disorders are not about having a "bad personality." They are deeply ingrained ways of relating to the world that usually begin in adolescence or early adulthood. These patterns can make it difficult for a person to maintain healthy relationships, regulate emotions, or develop a stable sense of self. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies ten personality disorders, grouped into three clusters:
Cluster A (odd or eccentric): Paranoid, Schizoid, Schizotypal
Cluster B (dramatic, emotional, or erratic): Borderline, Narcissistic, Histrionic, Antisocial
Cluster C (anxious or fearful): Avoidant, Dependent, Obsessive-Compulsive
Cluster B Personality Disorders and the Family
Among these, Cluster B personality disorders—Borderline Personality Disorder (BPD), Narcissistic Personality Disorder (NPD), Histrionic Personality Disorder (HPD), and Antisocial Personality Disorder (ASPD)—are most often associated with intense family conflict and cycles of emotional volatility.
While each disorder has a distinct core feature, their symptoms can overlap in confusing ways—especially for families. Mood swings, interpersonal chaos, impulsivity, manipulation, and difficulty with empathy are common threads. However, understanding the main theme of each disorder can help families make sense of what they’re seeing:
Borderline Personality Disorder (BPD): The core feature is emotional instability rooted in an intense fear of abandonment. Relationships are often marked by extremes—idealization followed by devaluation—and impulsive behaviors (like self-harm or sudden anger) are common responses to perceived rejection.
Narcissistic Personality Disorder (NPD): The defining trait is grandiosity and lack of empathy. A person with NPD may appear confident or charming, but often reacts defensively or cruelly to criticism, prioritizes their image over relationships, and struggles to recognize others' needs or feelings.
Histrionic Personality Disorder (HPD): The central theme is emotional excess and attention-seeking. People with HPD often feel uncomfortable when they are not the center of attention and may use charm, flirtation, or dramatics to stay in the spotlight. Their emotions may seem shallow or rapidly shifting.
Antisocial Personality Disorder (ASPD): The hallmark is disregard for others' rights. This includes deceitfulness, impulsivity, manipulation, and sometimes cruelty or criminal behavior. Unlike the others, ASPD typically involves a pattern of violating social norms without guilt or remorse.
Families often find it difficult to distinguish between these disorders because the behaviors can look similar on the surface. For example, someone with BPD may lash out like someone with ASPD, but their motivation is usually rooted in fear and emotional pain rather than manipulation or disregard. Likewise, both someone with NPD and HPD might seem self-centered, but the narcissist seeks admiration, while the histrionic individual seeks approval and attention.
Learning to recognize the driving force behind the behavior—whether it’s fear, shame, need for control, or lack of empathy—can help families respond with more clarity and compassion.
The Family’s Struggle: “What Is Happening to Us?”
Families often sense something is wrong long before a diagnosis is made—if one is ever made at all. They experience:
Walking on eggshells: Small triggers lead to outsized emotional reactions.
Chronic confusion: The person’s perception of events can seem distorted or inconsistent.
Role reversal: Parents feel parented by their child; spouses feel more like caretakers.
Push-pull dynamics: Intense closeness followed by sudden withdrawal or rage.
Blame and guilt: The family is often blamed for the person’s distress.
What makes it even harder is that personality disorders can masquerade as willful behavior. Families may hear: “They’re just manipulative,” or “They’re so self-centered,” which oversimplifies what’s often a deeply rooted psychological wound.
Why Understanding Is So Difficult
Personality disorders can be especially bewildering because:
Symptoms are relational. Unlike depression or anxiety, which can be more internally experienced, personality disorders play out between people.
The person often lacks insight. They may genuinely believe their perceptions are accurate and struggle to see the impact of their behavior.
Families may feel “gaslit”. When confronted, the person may twist facts, deny events, or accuse others of wrongdoing.
The rules keep changing. Boundaries that were acceptable one day may be resented the next. Families feel destabilized.
This lack of clarity keeps families in a painful cycle of trying harder, getting blamed, pulling away, and then feeling guilty.
The Emotional Toll on Families
It’s not uncommon for families to experience:
Chronic anxiety or hypervigilance
Depression or caregiver burnout
Fractured family systems as members disagree about how to respond
Isolation and shame, particularly when the community doesn’t understand
A deep grief for the relationship they hoped to have
The emotional labor is enormous. Families often feel they must choose between protecting their loved one and protecting themselves.
What Families Can Do
While there’s no simple solution, there is a path forward. It starts with:
1. Educating Yourself
Understanding the disorder reduces personalizing the behavior. Books like Stop Walking on Eggshells or Disarming the Narcissist offer practical insights. Therapy or coaching with someone who understands personality disorders can help make sense of patterns.
2. Validating, Without Enabling
You can show empathy without abandoning your own needs. Try statements like:
“I can see this is really painful for you, and I want to support you—while also taking care of myself.”
3. Setting Boundaries
Clear, consistent boundaries are not punishments. They are how you protect the relationship and yourself. Expect pushback—and prepare for it kindly but firmly.
4. Regulating Yourself
You can’t control their behavior, but you can control yours. Staying grounded, not escalating, and maintaining emotional distance in high-conflict moments are key.
5. Building Your Support Team
Don’t go it alone. Whether through therapy, peer groups, or coaching, find people who understand this terrain. You deserve support just as much as your loved one does.
Holding Two Truths
One of the hardest parts of living with a personality disorder in the family is holding two truths at once:
They are suffering.
Their behavior causes harm.
You can have compassion and hold limits. You can love someone and protect yourself. You can hope for change and grieve what hasn’t changed yet.
Final Thoughts
When someone you love has a personality disorder, your world can feel upside down. You may not know what to trust anymore—your instincts, your memories, even your love.
But with the right information, boundaries, and support, families can move from helplessness to clarity. The goal isn’t perfection or even peace all the time—it’s to find a path forward that honors both your loved one’s humanity and your own.
Because healing doesn’t just belong to the person with the diagnosis—it belongs to the whole system.