Personality Disorders – Cluster B

Personality disorders describe a wide range of mental illnesses that have unique symptoms, signs and impacts on a person’s life. They are generally broken down into three groups or “clusters” (A, B and C), and each cluster has a few personality disorders that fall within it. The differences between each cluster are significant, and every person experiences mental health issues a little differently.

It’s important to remember that identifying mental health issues, like cluster B personality disorders, can be tricky. Most of the time, people don’t fit neatly into “categories”, “clusters” or “definitions”. Everyone has “personality”, so you may see behaviours and feelings described here that everyone has at times, but it doesn’t mean they have a disorder.

What are Cluster B Personality Disorders?

Cluster B personality disorders are a group of mental health conditions characterized by pervasive patterns of emotional dysregulation, impulsivity, and interpersonal difficulties. People with these disorders often act in ways that are dramatic, unpredictable, or focused on gaining attention. These conditions usually begin in the teenage years or early adulthood and can affect how a person thinks, feels, and interacts with others. They often make it harder for individuals to maintain stable relationships, manage stress, or respond consistently in social situations.

People with cluster B personality disorders may appear to be very emotional and dramatic in social situations and react to feelings with impulsive behaviour.  These may include:

Antisocial Personality Disorder

• Antisocial personality disorder (ASPD) is defined by a persistent disregard for the rights of others, deceitfulness, impulsivity, irritability, and aggression. Someone experiencing this may ignore and overstep the boundaries of others while struggling to feel remorse or acknowledge the consequences of their actions. They may also feel irritable or behave in a way that is aggressive, violating social norms and laws.

Borderline Personality Disorder

• Borderline personality disorder (BPD) is characterized by intense and unstable emotions, impulsive behaviours, and fear of abandonment. They may may engage in self-harm or suicidal behaviours. People experiencing this may struggle with relationships and self-image. They may also be very impulsive, experiencing rapid mood shifts and chronic feelings of emptiness.

Histrionic Personality Disorder

• Histrionic personality disorder (HPD) is marked by excessive emotionality, attention-seeking behavior, and a desire for approval or reassurance. People experiencing this may feel and behave in a way that is highly emotional and dramatic in social situations, often struggling with maintaining deep, stable relationships. Others may view this behaviour as being insincere.

 Narcissistic Personality Disorder

•  Narcissistic personality disorder (NPD) is characterized by a pervasive pattern of grandiosity, need for admiration, and lack of empathy for others. People experiencing this may feel a strong sense of self-importance and rely on admiration from other people to feel good. They may also struggle with feelings of envy and find it difficult to feel empathy for other people at times.

Like all mental health issues, personality disorders are complicated. A mixture of biological and environmental factors can cause some people to develop a cluster B personality disorder.

There is some evidence that suggests genetics may play a role in personality disorder development, but environment and life experience are also factors. People who experience trauma, abuse or have unhealthy relationships as children are at a higher risk of developing a personality disorder.

Personality disorders are diagnosed when the way a person thinks, feels, or behaves impairs their ability to live a healthy life, or when it causes extreme distress for them or the people around them.

The signs and symptoms of group B personality disorders can be explained by a number of factors or other illnesses, and anyone at some point or another may feel or behave in these ways whether they have a mental health issue or not.

Personality Traits vs. Cluster B Personality Disorders

The difference between experiencing these symptoms and having a personality disorder is how extreme the symptoms are, how often they happen, and how much they affect your life or the lives of those around you. Everyone has “personality”, so you may see behaviours and feelings described here that everyone has at times.

Because most personality disorders are defined by how one relates to the people around them, the signs and symptoms are usually about how a person’s behaviours are affecting their relationships. Symptoms of a cluster B personality disorder usually emerge when a person is in their teens or early adulthood.

Common Symptoms of Cluster B Personality Disorders

People with a cluster B personality disorder may show some of the following symptoms:

• A pattern of not caring about the safety of self or others.
• A pattern of lying and manipulation.
• A pattern of behaviours/efforts to avoid being (or feeling) abandoned.
• A pattern of self-harm and/or suicide attempts.
• Feeling “empty” or struggling to feel emotions.
• Exaggerated or “dramatic” emotional expression.
• A strong need to be the centre of attention in social situations.
• A strong need for praise and attention from others.
• A pattern of feeling or behaving in a way that seems “arrogant”.

Because there are many types of personality disorders, the signs and symptoms of cluster B personality disorders vary widely.

Note: Substance use/abuse can commonly occur alongside personality disorders, as well as mood, anxiety and eating disorders.

Personality disorders are treatable mental health conditions. For type B personality disorders or any other mental health concern, if signs or symptoms are interfering with your life in any way, it’s time to seek help.

For instance, if sleep patterns, eating, relationships, school, work, or enjoyment of life is being negatively affected, it’s a good idea to talk to someone. That someone could be a friend you trust, a teacher, your family doctor, a crisis line, or counsellor.

Because of the nature of cluster B personality disorders and how much they can affect one’s ability to interact with, trust and/or relate to others, it may be particularly difficult to recognize when help is needed and for a person to take the required steps to seek help.

Helping a Friend with a Cluster B Personality Disorder

If it is a friend you are concerned about, they may resist help or not even recognize that they need it. They might need you to take the first step towards getting professional help.

As always, if you feel like you or a friend might hurt him/herself or someone else, it’s time to call emergency services.

Visit the Help Section to find out how to get help for yourself or a friend.

The term “cluster B personality disorder” describes a number of different types of issues. How they are experienced will differ from person to person. Because each case is unique, the treatment will likely be unique for each individual.

Counselling and Psychotherapy

In the case of personality disorders, getting help may include group or individual counselling or psychotherapy, learning coping strategies and/or ways to have more healthy and productive interactions and relationships with others. Because of the nature of cluster B personality disorders and how they affect relationships and how one interacts with others, it may take time to find the right mental health professional and treatment strategy.

Medication

Medication may be prescribed to help treat other symptoms or complications of a personality disorder, like depression, anxiety or psychotic symptoms.

Family and Support-Based Interventions

A person living with a personality disorder, like any other person, will benefit from maintaining wellness and having good supports in their life. Family members of someone who has a cluster B personality disorder may participate in therapy, support groups or benefit from learning about it and ways to support their loved one at home.

Supporting someone with any type of serious illness can be challenging, but some of the behaviours and symptoms of cluster B personality disorders can be particularly hard to understand and cope with.

Ways to help and support a friend or loved one who is living with a dramatic or erratic personality disorder include:

Take Care of Yourself

When supporting someone with a personality disorder, it’s important to practice good self care, and set some boundaries for yourself. Make time for activities that help you relax and recharge, and don’t feel guilty about setting limits.

Know the Signs & Symptoms

Learning about the common signs and behaviours associated with cluster B personality disorders can help you understand what your friend might be going through. It allows you to respond with empathy rather than frustration, and to notice when symptoms seem to worsen.

Encourage Professional Help

While support from friends is valuable, professional treatment is often necessary for managing personality disorders effectively. Encourage your friend to reach out to a qualified mental health professional (see Help Section), and remind them that seeking help is a sign of strength, not weakness.

Remain Supportive

Remember treatment is a process for personality disorders and it takes time. People with personality disorders may struggle to express emotions clearly. So, listen carefully to the emotions someone is displaying over their choice of words. Try to really make them feel heard.

Stay Calm

Stay calm and don’t take things personally. Sometimes personality disorders can really distort how someone perceives conversations or situations. How someone reacts or communicates when they have a personality disorder may be confusing, distressing or even hurtful at times. They may be feeling overwhelmed and acting out, and it’s probably not about you.

Ask How You Can Help

Ask your friend how else you can help. Everyone’s needs are different. Whether they need space, company, or assistance finding resources, letting them guide you helps build trust and ensures your support feels meaningful.

Provide Simple Distractions

Doing something simple can help build relationships, trust and create calm. For instance, shared activities like watching a movie, going for a walk, or doing something creative can help shift focus away from distressing emotions.

See the Help Section for more info about helping a friend and self-care.

Find more on Personality Disorders.

The information on this page about cluster B personality disorders are is a simple overview of a complicated health issue. For more in-depth information, please visit these resources and references or speak to a medical professional.

Ontario – call ConnexOntario to find out where there are mental health supports in your community.

Crisis – in any situation where someone is at risk of hurting themselves or others, call 911 or a local crisis line. You can find resources near you on the free and confidential Be Safe App.

Please see the Help Section for more information and resources.

References

1. Centre for Addiction and Mental Health (CAMH)
2. Canadian Mental Health Association (CMHA)
3. Personality Disorders CMHA British Columbia
4. Diagnostic and Statistical Manual of Mental Disorders (DSM) Library