The relationship between anxiety and personality disorders

Many people living with a personality disorder also have an anxiety disorder. For example, 80% of people living with borderline personality disorder (BPD) also have an anxiety disorder. 

While we don’t fully understand this overlap, research shows that the link between these conditions might be due to the similar ways they impact personality functioning. Sometimes, these similarities can lead to misdiagnosis. 

So if you’re experiencing anxiety that’s impacting your daily functioning, getting an accurate diagnosis is one of the most important steps in learning to manage your symptoms. Comprehensive care that addresses the full picture of your mental health can help you live a full, balanced life.    

Which personality disorders are linked to anxiety?

Borderline personality disorder (BPD) is the personality disorder with the highest rate of co-occurring anxiety disorders. BPD can cause emotional dysregulation, an intense fear of abandonment, and dissociation. On the surface, someone might mistake these symptoms for signs of an anxiety disorder. 

There’s considerable overlap between anxiety disorders and other personality disorders as well. In particular, around 40% of people with the following conditions also have an anxiety disorder: 

• Avoidant personality disorder (AVPD)
• Dependent personality disorder (DPD)
• Obsessive-compulsive personality disorder (OCPD)

Like anxiety disorders, these conditions are known to cause social inhibition or nervousness, feelings of inadequacy, and excessive worries about other people’s perceptions of them. 

We don’t know if personality disorders cause anxiety disorders, or vice versa. But we do know that having both at the same time can make your symptoms worse. That’s why early intervention and ongoing support is so important for managing these conditions. 

Anxiety and personality disorder symptoms

Co-occuring conditions can be confusing, especially if they have some similar symptoms. But remember, you don’t need to know your exact diagnosis to ask for help. 

That said, if you’re concerned about your mental health, it might be helpful to explore some of the overlapping symptoms of personality disorders and anxiety disorders. 

While there’s no replacement for a professional evaluation, you might be living with either of these conditions (or both) if you’re experiencing any of the following:

• Shyness
• Feeling inadequate
• Fear of rejection
• Lack of confidence or self-worth
• Fear of abandonment
• A strong desire for control and order
• Inflexibility
• Perfectionism
• Emotional instability 

The difference between anxiety and personality disorders

While they have some common features, there’s a key distinction between anxiety disorders and personality disorders. Understandably, living with an anxiety disorder can leave you feeling like your anxiety is part of who you are. But it’s not the same thing as a personality disorder. Broadly speaking, anxiety disorders cause intense, frequent worries that are too extreme for the situation at hand. 

Personality disorders can cause anxiety, but they also have a very different impact. Personality disorders cause thought and behavior patterns that differ significantly from cultural norms. Because of this shift in thought and behavior, personality disorders are pervasive, impacting almost every area of a person’s life. Anxiety disorders, on the other hand, tend to cause difficulty in specific situations that worsen anxiety symptoms. 

So while anxiety disorders might create unwanted thoughts or behaviors, personality disorders shape how people see themselves and relate to others. This, in turn, can create ongoing problems in their relationships and negatively affect their ability to function in their daily lives.

Comprehensive treatment for personality and anxiety disorders

Left untreated, co-occurring anxiety and personality disorders can lead to serious complications, including an increased risk of suicidality. But with comprehensive treatment that addresses each of your conditions, you can manage your symptoms and strengthen your mental health. 

Different anxiety and personality disorders require different forms of care. So your treatment experience will be based on your exact diagnosis and current needs. But typically, co-occurring anxiety and personality disorder treatment will include a combination of some of the following methods: 

• Dialectical behavioral therapy (DBT): This type of therapy was developed specifically for treating borderline personality disorder (BPD), but it has been found effective for a variety of other conditions as well. It uses mindfulness and distress tolerance to help people regulate their emotions.
• Mentalization-based therapy (MBT): This eclectic form of care helps people understand themselves and others through cognitive techniques. It also encourages people to examine the validity of their thoughts. 
• Cognitive therapies: Cognitive behavioral therapy (CBT) helps people replace unhelpful thought and behavior patterns and adopt healthy coping strategies. Cognitive analytic therapy (CAT) incorporates elements of CBT while also focusing on strengthening the therapeutic relationship, which can be particularly beneficial for those with a personality disorder.
• Acceptance and commitment therapy (ACT): ACT incorporates elements of mindfulness and prioritizes goal setting to reduce discomfort and improve functioning.
• Safety planning: Sometimes, personality disorders carry the risk of suicide and self-harm, so you and your provider may co-create a plan to keep you safe. 
• Medication: While there are no medications approved specifically for personality disorders, there are medications used to treat anxiety. You can talk to your provider about whether this option is right for you.

Find care with Rula

Living with co-occurring conditions, like anxiety and personality disorders, can be a challenging experience. And because they share some similarities, it can be difficult to tell the difference between them. Fortunately, there are effective treatments available that can help you manage your mental health, no matter your diagnosis. 

With our multidisciplinary approach to care, Rula can streamline your path to recovery and ensure that you get the right support for your needs. Whether you need individual therapy, medication management, or both, our extensive provider network is here to help. 

To get the process started, check out our therapist-matching program today. You can sift through your options, select a provider who takes your insurance, and meet with them virtually as early as this week.

Get started with Rula today