Four ping pong balls in different colors wearing different emotions.

In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there are ten personality disorders in three separate clusters: Cluster A, Cluster B, and Cluster C. Each cluster is organized by a common thread of similar symptoms. Personality disorders are based on unhealthy, maladaptive behavior and thought patterns. Individuals with personality disorders may exhibit elevated anxiety or distress.

What are Cluster B personality disorders?

Cluster B personality disorders are a sect of all personality disorders: Cluster A, Cluster B and Cluster C. Namely, personality disorders under Cluster B are characterized by dramatic and unpredictable behavior, according to Mayo Clinic.

The four Cluster B personality disorders are:

  • Antisocial Personality Disorder
  • Borderline Personality Disorder
  • Histrionic Personality Disorder
  • Narcissistic Personality Disorder

Each personality disorder within Cluster B is different, yet they all involve a level of unpredictable emotions.

Antisocial Personality Disorder

Antisocial Personality Disorder is characterized by the disregard of other people’s feelings, safety and boundaries. People with antisocial personality disorder have a high tendency to partake in illegal and/or harmful activities.

Symptoms include:

  • Disregard to others’ feelings
  • Impulsive behavior and speech
  • Frequent lying
  • Stealing
  • Violent behavior
  • Disrespecting others’ physical and emotional boundaries
  • Little to no remorse for harmful behavior

Borderline Personality Disorder

Those with borderline personality disorder are known to have unstable relationships, due to the instability of their emotions and behaviors. Another term for borderline is emotional dysregulation disorder.

Symptoms include:

  • Risky and sometimes dangerous behavior
  • Paranoia
  • Feelings of hopelessness
  • Fear of abandonment
  • Anger episodes
  • Poor self-image
  • Suicidal ideation and/or behavior

Histrionic Personality Disorder

Histrionic personality disorder is primarily characterized by dramatized attention-seeking and a rapid change in emotions. Rapid shifts in emotion may result in inappropriate or dangerous behavior.

Symptoms include:

  • Dramatic displays of seeking attention
  • Changing emotions
  • Fixation on strong opinions
  • Obsession with physical appearance
  • Desire to be the center of attention
  • A false sense of where relationships stand

Narcissistic Personality Disorder

Intense desires for admiration and feelings of superiority are two hallmarks of narcissistic personality disorder. However, this disorder can be difficult to diagnose, due to the person usually rejecting that anything is wrong with them.

Symptoms include:

  • Elevated sense of self and self-importance
  • Disregard to others’ needs or space
  • Inability to accept criticism
  • Constant need and desire for admiration
  • Grandiosity
  • Extreme desire for power and success


Personality disorders have two known causes: environment and genetic disposition. Most personality disorders are believed to develop under a combination of the two factors.

Environmental factors that can lead to the development of personality disorders include:

  • Living in a disordered and/or abusive home during childhood
  • Experiencing a traumatic event
  • Experiencing abuse of any form

Genetic factors that can lead to the development of personality disorders include:

  • Disordered brain chemistry
  • Brain development problems
  • Family history of mental health disorders

Speaking to a mental health professional can help better understand the reasoning behind individual cases. mental health professionals will then be able to set up the proper treatment plan based on an individual client’s experiences and needs.

Treatment Options

Treatment for Cluster B personality disorders may look different from person to person. The two most common forms of treatment are therapy and medication. Obtaining a proper diagnosis is a critical component of treatment.


Therapy is a type of treatment mental health professionals use to treat many kinds of mental health disorders. Some people even seek therapy short-term for help in making difficult decisions or resolve small conflicts. However, therapy can also serve as a long-term tool to treat trauma, anxiety and difficult circumstances that may relate to a personality disorder.

The most common form of therapy used to treat personality disorders is referred to as talk therapy. During talk therapy, the therapist works with a client to help them talk through their problems in a safe, goal-oriented manner. In talk therapy, counselors can use Cognitive Behavioral Therapy (CBT), where they help the client name unhealthy thought patterns and ultimately reframe them into healthy ones.


General practitioners or psychiatrists can prescribe medication to individuals with personality disorders. On the other hand, some doctors may recommend a combination treatment involving both therapy and medication. In some cases, medication can make talk therapy easier for the client.

Common medications doctors prescribe to treat personality disorders include:

  • Antidepressants
  • Mood stabilizers
  • Antipsychotics

Physicians will be able to discern the best medication dose, based on symptoms and the patient’s response to side effects. Some doctors may recommend starting with a small dose and gradually increase the dose as needed.

Note: If you are taking medication prescribed by your doctor to treat your condition, you should never stop taking the medication without their notice. If you feel the need to stop taking your medication, first talk with your doctor to create a safe plan to come off of it.

Final Thoughts

People with Cluster B personality disorders may have a difficult time seeking or accepting treatment. The bottom line: it is ultimately up to them to decide if they will get help. With the help of friends, family and a mental health professional, though, these individuals can have the opportunity to repair relationships and harmful thought patterns and behaviors.

In severe cases, people with personality disorders may express depression symptoms, suicidal thoughts or admit to suicide attempt(s). If this is the case, it is imminent to seek help immediately.

If you or a loved one has thoughts of suicide, call the U.S. National Suicide Prevention Lifeline at 1-800-273-8255.

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