What are cluster C personality disorders?
Cluster C personality disorders involve persistent patterns of anxious thoughts and fearful behaviors. Someone with one of these personality disorders often acts in a way that negatively affects their relationships, work, and sense of well-being. They might have a strong desire for reassurance and an intense fear of rejection, which leads them to either avoid others or cling to them. Or they might be so fearful of doing things “incorrectly” that they repeatedly check their work, leading to unnecessary delays.
The three cluster C personality disorders are:
Avoidant personality disorder (AVPD)
Avoidant personality disorder is marked by lasting feelings of inadequacy and hypersensitivity to criticism. Someone with AVPD may often feel extremely shy and fear embarrassment, so they tend to avoid social interactions. They often desire relationships but are held back by their intense anxieties.
Dependent personality disorder (DPD)
Dependent personality disorder involves a pattern of submissive and clingy behavior. People with this disorder have an excessive need to be taken care of, so much so that they struggle to make decisions independently. They may go to great lengths to gain and maintain the support of others, even if that means enduring mistreatment or abuse.
Obsessive-compulsive personality disorder (OCPD)
Obsessive-compulsive personality disorder involves a fixation on orderliness and perfectionistic behavior. Beneath their rigid behavior is a desire to always do things “correctly.” People with this personality disorder are often inflexible and controlling.
While personality disorders involve stubborn and often extreme behaviors, they can be managed. Understanding the traits and symptoms of cluster C personality disorders is the first step toward coping with the problematic behavior and improving the quality of your life.
Cluster C personality disorders traits and symptoms
Fears and insecurities are a part of life. Many of us feel insecure the first time we try out a new sport, for example, or we may occasionally fear that a romantic partner could leave us for someone new. However, when these anxieties are chronic and drive you toward unhealthy behaviors, you may be experiencing a personality disorder.
Symptoms of personality disorders, including those in cluster C, tend to emerge in early adulthood. Common traits include:
Interpersonal issues. All of the cluster C personality disorders can affect your relationships with others in different ways. If you have AVPD, you’ll likely avoid social interactions or hold back in communicating with others, while dependent personality disorder can lead you to be overly reliant on others. You may feel paralyzed when you need to take action on your own, and your neediness can leave loved ones feeling suffocated. If you have obsessive-compulsive personality disorder, you likely hold others to strict, often unreasonable standards. You may force your partner to follow a rigid cleaning routine every day after work, for example, a routine that leaves them feeling stressed out.
Difficulty managing emotions. You may be consistently overwhelmed by your own feelings and discouraged at how out-of-control your emotions seem to be. The thought of being abandoned can grip you with terror, and you may be convinced you won’t survive without another person by your side. Or the opposite can be true: You’re convinced that any social interaction will lead to painful rejection, which results in intense anxiety. You may feel stressed about performing daily tasks, worrying obsessively about getting even the minor things right and angry if you fail to reach your own high standards.
Rigid behaviors. If you have OCPD, you may be especially rigid in your actions. A desire to be precise and orderly can prevent creative problem-solving—such as adapting to a sudden change in plans—or make you appear overly formal or even cold toward others. People with AVPD or DPD can also exhibit their own rigid behavioral patterns. If you have AVPD, your fear of embarrassment might be so high that you avoid trying new hobbies or talking to new people. You stay “safe” by limiting your exposure to new circumstances. If you have DPD, you might also limit your actions, only taking up a new hobby if someone else agrees to do it with you.
Cluster C vs. clusters A and B personality disorders
Cluster C personality disorders are grouped together because they all involve chronic anxiety that affects a person’s way of living. The disorders in clusters A and B also share common symptoms:
Diagnosing cluster C personality disorders
An early diagnosis of a cluster C personality disorder allows you to find the resources and treatments needed to manage your condition. Mental health professionals diagnose these personality disorders using the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
A comprehensive evaluation typically involves structured clinical interviews and a review of your medical history. Self-report inventories, such as the Minnesota Multiphasic Personality Inventory (MMPI), may also be used to help an expert reach a diagnosis.
Cluster C personality disorders often present overlapping symptoms and may co-occur with other mental health issues such as anxiety, mood disorders, and eating disorders. A thorough evaluation reduces the risk of misdiagnosis and helps identify any co-occurring conditions.
Causes and risk factors
The exact causes of cluster C personality disorders aren’t fully understood. They likely involve a mix of genetic and environmental factors. Evidence from research points to all three personality disorders having some degree of heritability. If someone in your family has a cluster C personality disorder, you’re more likely to have one as well.
Environmental factors, including early childhood experiences and parenting styles, can raise the risk of personality disorders in general. For instance, it’s possible that overprotective parenting can increase the risk of dependent personality disorder, as the child has a harder time developing a sense of autonomy.
In addition, the three cluster C personality disorders might be linked to insecure attachment styles. Insecure attachment styles result from inconsistent care from a caregiver during infancy. For example, your parents might have been emotionally unavailable at times when you were a baby. Those early experiences influence how you approach relationships later in life.
Cluster C personality disorders treatment
Cluster C personality disorders can’t be cured. However, the symptoms can be managed with professional help. Research shows that psychotherapy (talk therapy) can be particularly useful for dealing with these conditions.
Talk therapy
Depending on your specific needs, a therapist might suggest one of the following types of talk therapy:
Cognitive-behavioral therapy (CBT) is a common approach to managing cluster C personality disorders. Cognitive-behavioral therapy involves drawing connections between thoughts, feelings, and behaviors, and then making changes to improve your well-being. For example, you might have an “all-or-nothing” mentality that leads you to spend excessive time reviewing your work. Learning to challenge those thoughts can help reduce your anxiety and avoid constant rechecking.
Dialectical behavior therapy (DBT) focuses on four areas: mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation. Each of these aspects of dialectical behavior therapy can become a tool for managing emotions in high-stress situations. For instance, if you feel overwhelmed by the thought of leaving the house by yourself, you might use mindfulness to keep yourself grounded in the present and accept the temporary discomfort.
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Prescription medication
Certain drugs might be used to treat specific symptoms or co-occurring issues.
- Anticonvulsant medications might act as mood stabilizers in people with OCPD.
- Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are types of antidepressants that might be used to ease social anxiety if you have AVPD.
- SSRIs might also reduce perfectionistic behavior if you have OCPD.
Challenges in treating Cluster C personality disorders
Resistance to change can be a hurdle in treating any personality disorder. The idea of change can be daunting. Perhaps you think, “I’ve always been this way,” or “I can’t and shouldn’t want to change my core personality.”
Treatment also involves being vulnerable, which can be difficult for people with cluster C personality disorders, especially avoidant personality disorder. If you fear you’ll be judged or betrayed, opening up to a therapist can feel unsafe, so you may hold yourself back from exploring your deeper thoughts and feelings.
Co-occurring disorders can also make your treatment more complicated. For example, a depressive episode can sap your motivation to practice coping skills. Or an anxiety disorder can amplify the symptoms of your personality disorder, making it even harder to seek help.
Supporting loved ones with Cluster C personality disorders
Caring for a loved one who has one of these personality disorders can be an emotionally difficult experience. It may be hard to live with a spouse who grows sullen at the slightest hint of criticism, for example, or frustrating to cope with a sibling who can’t make minor decisions without first consulting you. Despite these issues, you have their best interests at heart and want to see them thrive. Here are a few ways you can help:
Tip 1: Learn about personality disorders.
Educating yourself about these disorders can help you better understand, communicate with, and support your loved one.
Look for reputable sources. Books, podcasts, and other material can help you learn more about your loved one’s personality disorder. First-hand accounts and interviews with people who have personality disorders can also give you a better understanding of how the symptoms can manifest.
Explore online communities. You’ll likely find no shortage of online forums where people share their experiences. It’s harder to fact-check these types of posts, so practice skepticism. However, you might also uncover useful tips and coping strategies.
Get to know your loved one’s perspective. In addition to learning about personality disorders in general, aim to better understand the person you’re supporting. Do they seem aware of their disorder and how it affects their functioning? What seems to trigger their anxieties? What seems to help calm them down?
Tip 2: Foster a supportive environment
In a supportive environment, your loved one will have an easier time coping with their symptoms. Here are ways you can create a comforting space for your loved one:
Be patient and empathetic. You’ll likely feel frustrated if your loved one seems unable to decide what to eat on their own, or their obsession with keeping the car vacuumed might stress you out. Remember that their behavior is the result of feeling anxious and overwhelmed.
Give them space to talk. Encourage your loved one to share whatever’s on their mind. Listen without belittling or criticizing them. For instance, if they say, “I feel terrified of taking public transit,” let them know that it’s okay to feel uncomfortable. Even if you don’t experience the same level of anxiety, you can validate their feelings so they don’t feel so alone.
Keep their triggers in mind. Maybe your sibling with DPD struggles with panic attacks when they’re left alone in unfamiliar settings. Or perhaps your spouse with AVPD is extremely sensitive to criticism. When you’re mindful of their triggers, you’ll have an easier time finding an appropriate way to respond.
Empower them with self-help techniques. Suggest practices like yoga, meditation, and journaling—all of which may help your loved one better manage or explore their emotions. Consider joining them in the practice if it helps them to get started.
Tip 3: Encourage professional help
Self-help techniques are useful for your loved one, but they’re not replacements for professional treatment. Similarly, while your emotional support is important, you can’t expect to fill in for a therapist.
Suggest treatment. You might frame therapy as a potential way to manage specific issues, such as social anxiety. If possible, cite concrete ways in which they might benefit from talking to a professional. For instance, “A therapist might have some tips on how to self-soothe when you’re alone.”
Expect pushback. Oftentimes, people with personality disorders deny having any issues. Your loved one might simply not see the need for therapy. Although this can be frustrating to hear, remember that you can’t force them to pursue change.
Share your experiences. If your loved one is anxious about talking to a therapist, consider opening up about any experiences you’ve had working with mental health professionals. What did you like? What didn’t you like? What surprised you? The idea of therapy can seem less daunting when someone knows what to expect.
Tip 4: Care for yourself
It’s easy to lose track of your own wants and needs when you’re caring for someone who has a personality disorder. However, when you don’t make time for self-care, you put yourself at risk of burnout.
Keep up hobbies and interests. It might not always be easy, but keep time on your schedule to enjoy your hobbies. Whether you enjoy crocheting, biking, or writing poetry, hobbies allow you to unwind and find a creative outlet.
Stay connected. You might feel a duty to spend all your time with your loved one—especially if they’re struggling with AVPD or DPD. However, it’s important to engage with your wider social circle as well. Make time on your calendar for regular meetups with friends and family members.
Look for support groups. You might find support groups that cater to caregivers or people who have loved ones with personality disorders. Either in-person or online sessions can help connect you with people who understand what you’re going through.
Set boundaries. Boundaries exist to reduce codependent habits and ensure your wants and needs are respected. For instance, when you feel crowded by a spouse with DPD, you could set limits on what tasks you do for them. Or perhaps you let a friend with OCPD know that you won’t tolerate being yelled at when they’re feeling irritable.
Help for cluster C personality disorders
People with cluster C personality disorder often overlook the ways in which their condition impacts their lives and relationships. However, if you’re self-reflective enough to acknowledge your problems, you’re on your way to making healthy changes.
These changes might include building social skills, so you’re empowered to find more social support. You might also look for stress management strategies and practice addressing negative thoughts so you’re better able to self-soothe.
Tip 1: Improve social skills
Personality disorders often affect your social skills. Maybe your intense social anxiety or desire to be perfectly articulate makes it hard for you to speak up. Or perhaps you’re so dependent on others that you struggle to convey your own opinions. Here are a few steps that can help you:
Set goals. Have a specific idea of what social skill you want to build and how you’ll measure your progress. For example, if you want to tackle social anxiety, you might decide to talk to one stranger each day of the week, even if you just make small talk.
Practice. Take the actions necessary to move you toward your goals. Accept that things won’t always go exactly as planned or as smoothly as you hope. Maybe you feel intensely nervous when talking to a stranger or fail to get the right words out.
Build on what works. Rather than dwelling on what went wrong, focus on what went right. Perhaps you found that it’s easier to carry a conversation by taking a genuine interest in the other person and asking more questions.
Give yourself credit. Accept that skill-building of any kind involves gradual improvement, so little steps matter. Applaud yourself for stepping out of your comfort zone and finding the motivation to change.
Tip 2: Seek support
Going through life with a personality disorder can leave you feeling lonely and isolated. You might often feel misunderstood, even by the people who are closest to you. Know that you don’t have to manage your symptoms on your own. In fact, loneliness may increase the severity of symptoms over time. Finding support is a crucial step.
Expand your social support. If you have DPD, you might spend much of your time attached to one trusted person. And if you have AVPD, you likely find it difficult to get close to anyone at all. Aim to build support, starting with people who are already in your life. You might consider reaching out to a family member you haven’t spoken to in a few years. Remember that relationships take time to deepen, so don’t feel discouraged if interactions initially feel superficial.
Join support groups. In support groups, you’ll connect with other people who struggle with personality disorders. Hearing their stories and sharing your own experiences can help you feel less alone in what you’re going through. In addition, you might pick up coping tips that you hadn’t thought of before.
Find connections through volunteer work and hobbies. Another way to expand your social circle is to volunteer for activities that you’re passionate about. You might meet a new friend while working at a community cleanup event or while taking a poetry workshop.
Tip 3: Manage stress
If you have a cluster C personality disorder, you may endure a lot of stress on a daily basis. Much of the stress can come from all that internal chatter. You may constantly fret about being rejected, being abandoned, or not being good enough to meet your own high standards. Knowing how to manage stress and unwind can help improve your quality of life.
Pay attention to sleep hygiene. Cluster C personality disorders can have a negative effect on your sleep. You might ruminate on embarrassing social interactions or little missteps you made throughout the day. Those types of thoughts can keep you tossing and turning in bed at night, and then adding your stress levels the next day. Taking steps to improve sleep hygiene—such as keeping a consistent bedtime and darkening your room—will increase the odds that you enjoy restful sleep and lower stress.
Create a list of go-to relaxation practices. Mindful breathing and body scan meditations are two possibilities. Both exercises can soothe your nerves and foster a more focused and accepting mindset. Hobbies like painting, making music, or dancing can also be ways to relax, and they give you an opportunity to express yourself as well.
Develop an exercise routine. Physical activity can defuse stress and increase your overall mood. It can also boost your self-esteem, so you feel more confident and capable going forward. Find a routine that doesn’t feel like a chore. For instance, if you enjoy being outdoors, cycling or hiking might be enjoyable forms of exercise.
Tip 4: Adjust negative assumptions
Automatic negative thoughts, or cognitive distortions, often drive anxiety.
- You might catastrophize the results of performing a task alone: “If I try to cook breakfast without help, I’ll start a fire.”
- Or maybe you jump to conclusions without evidence: “I shouldn’t bother going to this event because no one there wants to talk to me.”
- Black-and-white thinking—”If I can’t finish this task perfectly, I’m a failure”—is another example of a cognitive distortion.
By learning to recognize and challenge these thoughts, you can take big steps toward managing your symptoms.
Catch the thought. You might think, “If I don’t get this room spotless, people will think I’m sloppy.” Or “If I try to figure this out on my own, I’ll mess up as usual.”
Challenge the thought. Will people notice if the room isn’t spotless? And if they do, will it actually change their opinion of you? You can also bring in counterexamples as you challenge your distorted thinking. For instance, think of a few times when you solved a problem on your own, and everything turned out okay.
Replace the thought. Try shifting the negative thought to something more neutral or positive. “The room is clean enough. Very few people will notice.” “Even if I don’t figure this out immediately, I can grow from the experience.”
Keep a recording. Consider writing out the most frequently occurring cognitive distortions. You could keep a list of distortions on one side of a page and the corresponding neutral or positive thoughts on the other side.
Understanding cluster C personality disorders
If you have avoidant, dependent, or obsessive-compulsive personality disorder, you might feel as if fear and anxiety run your life. It can seem like every action you take is driven by worry—worry about not being good enough, or worthy enough, or capable enough. Those fears can often spiral out of control and adversely affect your relationships and livelihood. But with the right self-help steps and professional treatment, cluster C personality disorders can be managed and your life improved.
Last updated or reviewed on April 21, 2025
