How to Write (Realistically) About Personality Disorders

Personality disorders—they can be found in all kinds of media, scattered across the pages of books and the screens of our TVs.

From a writer’s perspective, they’re fascinating. Physiological problems are one thing, but getting inside the mind of a character—in this case, a mind that isn’t like other people’s—is something that can make writers and readers a little bit giddy.

But do you know what personality disorders are really like? Do you know how they’re diagnosed, what their symptoms look like, and how they can affect your character’s day-to-day life?

Don’t rely on stereotypes, preconceptions or the representations put across by popular media. Be a knowledgable novelist and make sure you know how to write about these disorders respectfully and realistically.

To Keep in Mind:

The information in this post comes from the DSM-5 (see ‘Further Reading’). Please do not use it to diagnose yourself or others. It isn’t intended to be a substitute for professional advice so do consult a qualified clinical professional if you have any questions about the diagnosis criteria. Feel free to use this information to diagnose your characters, however!

One tool psychologists use is the Diagnostic and Statistical Manual of Mental Disorders, or DSM, which lists the criteria that must be met for someone to be diagnosed with a mental disorder.

Of particular interest to us in this blog series are personality disorders. There are ten of them in all and the DSM groups them into three ‘clusters’: Cluster A, Cluster B and Cluster C. But before we get into the details of each cluster, let’s start at the very beginning...

What Are Personality Disorders?

According to the DSM-5, the latest version of the DSM, a personality disorder is:

“An enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.”

Okay, that’s the technical definition. But what does it actually mean and what should we keep in mind while writing about personality disorders? (Important words and phrases you should keep in mind are emphasised.)

• Each personality disorder has a pattern of thoughts, feelings and actions that characterises it.
• These inner experiences and behaviours are very different to the culture your character lives in—so what classifies a person as having a personality disorder in one place may not do so in another. Bear in mind the culture your character lives in when applying any diagnostic criteria.
• The pattern of your character’s thoughts, feelings and behaviours affects different areas of their life. It doesn’t come and go, depending on the situation, or only show up in certain circumstances—it’s pervasive and inflexible.
• Your character’s distinctive behaviours and inner experiences start to show up in adolescence and early adulthood (i.e., not childhood; in fact, it’s explicitly stated in the DSM that some disorders cannot be diagnosed in under-18s).
• Personality disorders are long-lasting so, not only do their symptoms reach different parts of your character’s life, they also endure over time. That means, if your character has a brief, one-off episode of certain symptoms, they wouldn’t be classed as having a personality disorder.
• Finally, personality disorders can impair your character in some way or stop them doing certain things. They can also cause psychological distress for your character. In other words, their feelings are troubled, confused or out of the ordinary—not a pleasant situation to be in.

Let’s also draw a distinction between a character with traits of a personality disorder and a character who actually has a personality disorder. In the case of the former, the characteristics of the disorder show up in some situations, like being incredibly dramatic and flirtatious around someone they like, whereas a character with a personality disorder (in this example, histrionic personality disorder) would exhibit these characteristics all the time, regardless of situation.

Can’t You Just Get Over a Personality Disorder?

Let’s be clear. A personality disorder isn’t something people can simply “get over” or “snap out of”. It’s a way of thinking that’s deeply ingrained and pervasive, just like your own personality is.

Imagine someone telling you that you need to be more outgoing. You can’t just flip a mental switch and instantly transform into an outgoing person. You can, however, take more extraverted action, like assuming a leadership role or talking to strangers. In a similar way, people with personality disorders can adapt their behaviour so that it’s less harmful to themselves and the people around them.

The thing is that people with personality disorders often don’t realise there’s a problem in the first place, just as you might not realise that your friends are becoming annoyed because you don’t like taking on responsbility and leave it all to them. Once the problem has been identified though, either by the person with the personality disorder or by the people around them, action can be taken, like seeking the help of therapy.

How Are Personality Disorders Diagnosed?

The DSM-5 has a list of criteria for each personality disorder, detailing the patterns of ‘inner experiences and behaviours’ that can be found in individuals with these disorders.

A certain number of the criteria must be present for someone to be diagnosed with a personality disorder—less than that amount and they may have some of the features of, for example, narcissism, but they wouldn’t be diagnosed with having the disorder itself.

Writing About Personality Disorders

If you want your character to have a specific personality disorder, make sure they meet the diagnostic criteria. Use the lists provided in the How to Tell If Your Character Has [X] Personality Disorder posts to decide which criteria your character matches and learn about any factors that influence the disorder.

After that, check out the Writing About [X] Personality Disorders posts to see what the diagnostic criteria actually mean and how they can be shown in your stories. Sprinkle in more research of your own. Then go out there and write to your heart’s content.