The teenage years are historically difficult–emotionally fraught, temperamentally challenging, and characterized by extreme mood swings.
However, the theory that teens are “just going through a phase” or it “must be hormones” when they’re struggling might be doing them a major disservice.
There’s a distinct chance that a young adult who’s displaying patterns of erratic and/or self-destructive behavior might have an emerging personality disorder, which is defined as a mental health issue that could lead to behavioral dysregulation and serious relationship problems.
What exactly are personality disorders?
Personality disorders are a group of mental health conditions characterized by inflexible patterns of thought, emotion, and behavior. The exact causes of personality disorders are not fully understood, but they are believed to originate from some combination of genetic, environmental, and social factors. Dependent personality disorder, for example, often has roots in childhood trauma but undoubtedly develops (either for the worse or for the better) based on relationships later in life.
Identifying traits of emerging personality disorders is the first step of the treatment journey. Without treatment, personality disorders can persist over an extended period of time, often causing interpersonal distress and daily functioning issues that can lead to isolation, substance abuse, and in the most extreme cases, even suicide.
What are the different types of personality disorders?
The DSM-5 and ICD-10 have identified eleven recognized personality disorders. Symptoms vary from person to person, and ongoing research is being conducted to better understand the difference between the following personality disorders:
- Dependent personality disorder
- Emotionally unstable personality disorder (EUPD)
- Borderline personality disorder (BPD)
- Narcissistic personality disorder
- Paranoid personality disorder
- Schizoid personality disorder/Schizotypal personality disorder
- Avoidant personality disorder
- Obsessive compulsive personality disorder (OCPD)
- Histrionic personality disorder
- Antisocial personality disorder (ASPD)
- Impulsive personality disorder (a subtype of BDP)
For the purposes of this article, we’ll focus on the first three disorders listed, as their defining symptoms tend to be more prevalent in teens and young adults. However, many people who live with personality disorders often have more than one in addition to mental health issues like depression, anxiety, and bipolar disorder.
Dependent personality disorder in teens and young adults
Dependent personality disorder (DPD) is a mental health condition characterized by an excessive need to be taken care of in a general sense, closely related to codependency, which presents as an unhealthy focus on one or more specific individuals.
This excessive need can manifest in a number of ways, such as a desire to be constantly reassured by others, persistent fear of abandonment, and difficulty making decisions without outside input or validation.
For teens, extreme abandonment issues and over-reliance on other individuals can curtail the necessary growth, development, and independence needed for a smooth transition to adulthood. Hence the term “dependent” in “dependent personality disorder” directly ties to this deep-seeded over-reliance on others. (Think “failure to launch.”)
Dependent personality disorder can show up in romantic relationships too, even for teens. Clinginess or forsaking personal beliefs and/or needs to accommodate their partner’s are just two of many ways a dependent personality disorder can impact romantic relationships. Young adults who are struggling with a dependent personality disorder may also find themselves in toxic or abusive relationships that they protect at all costs for fear of abandonment.
Dependent personality disorder is generally thought to originate from a combination of environmental and genetic factors. It’s more common in women than men.
Possible triggers of dependent personality disorder
- Childhood trauma and neglect
- Family dynamics
Individuals with a history of abusive relationships have a higher risk of a DPD diagnosis
- Biological factors, particularly in the areas involved in decision-making and emotional regulation
No single factor can cause teen dependent personality disorder; it’s typically the result of a complex interplay of various mitigating factors. However, through a combination of cognitive and talk therapy, those who live with DBD can develop the confidence and tools to help alleviate symptoms.
Symptoms of dependent personality
- Problems making everyday decisions without outside advice
- Constant need for reassurance from others
- An overwhelming feeling of being anxious, bored, or helpless when alone
- An urgent need to find someone new when a relationship ends
Narcissistic personality disorder in teens and young adults
In the past few years, there’s been a noticeable rise in narcissistic personality disorder (NPD) in teens and young adults.
Common traits of NPD include a grandiose self-view that is often not supported or mirrored by the outside world, causing those who live with a narcissistic personality disorder to become overly dependent on outside validation. Not only that, but symptoms of NPD can severely disrupt adolescent development and mental health.
These symptoms include low levels of empathy, manipulative behavior, an extreme reaction to criticism, and a lack of acknowledgment of personal boundaries.
There are many strains of research around the development of teen narcissistic personality disorder that identifies “excessive deviations from childhood rearing” as a potential factor. For some parents, the inability to see their “true child,” and project an unrealistic image of the “ideal child” onto their kid can contribute to NPD.
Childhood trauma is also common in people with NPD. Some young people might even start to view their trauma as a defining personality trait, believing that they deserve more specialized treatment than their peers because of it. This can also lead to a sense of isolation, which may in turn worsen mental health.
How do emerging personalities show up in teens?
All of these personality disorders tend to arise in the teen years and young adulthood first. This means that education and empathy around the topic on the part of caretakers and educators are critical. However, diagnosis typically occurs after an evaluation of long-term patterns of behavior disruption and is harder to officially diagnose in teens because their personalities are still developing.
If you believe a teen or young adult is displaying symptoms of personality disorders, here are a few that the DSM-5 lists:
- Unstable self-image
- Frantic efforts to avoid perceived abandonment - whether real or imagined
- Problems maintaining interpersonal relationships
- Impulsivity and difficulty regulating or managing anger/rage
- Patterns of self harm
- Dissociation or paranoid ideation
A large part of the awareness, empathy, and understanding of personality disorders is a greater understanding of the contributing factors.
Potential causes of teen personality disorders
- A family history of personality disorders
Some research suggests that personality disorders may have a genetic component, meaning that they may be passed down from parents to children. One recent study has indicated that one particular gene’s malfunction may even contribute to obsessive compulsive disorder.
- Surviving childhood abuse and trauma
People with borderline personality disorder have overwhelmingly high rates of sexual trauma in their past.
- Environmental factors
Lack of social support or exposure to stress or adversity in childhood may also play a role in the development of personality disorders. Studies have shown that verbal abuse during childhood is a major contributor to various personality disorders.
Not every caretaker, educator, or concerned adult can be fully cognizant of someone’s background or emotional history. Moreover, it’s important to not assume that people who have a family history of personality disorders, survived abuse, or had a challenging childhood will inherently present with, or develop a personality disorder.
However, if you, or someone you know, is concerned that a young adult or teen could be suffering from a personality disorder – it’s important to have awareness of certain symptoms consistent with emerging personality disorders.
The connection to social media
Scientific and academic investigations into the effects of social media and teenagers who grew up as digital natives have become more and more prevalent. One major concern has been how social media might contribute to narcissistic personality disorder, or exacerbate existing symptoms.
Why? Studies have posited that social media rewards narcissistic behavior and self-image obsession with their “likes” fueled algorithms.
However, social media is a huge part of daily interactions, particularly for teens and young people. It’s not possible to assume that teens whose main social outlet is the internet to abandon it altogether.
But understanding why teens and young adults might present narcissistic tendencies is a key factor in prioritizing help for those whom social media has negatively affected, or made existing symptoms worse.
Virtual IOP for personality disorders at Charlie Health
If you’re a young person, or are close to a young person, who’s struggling with mental health, you’re not alone. Talking to someone who understands what you’re feeling can be the first step towards meaningful change. Charlie Health’s team is available 24/7 to help you, or someone you love, locate the help they need. The largest provider of virtual IOP treatment programs, Charlie Health navigates mental health challenges for teens, young adults, and families.