Do people recover from personality disorder?

Written from a lived and living experience perspective.

Person on bench

The most straight forward answer is – yes! People can and do recover from having a personality disorder.

Recovery can be defined in many different ways. Some people may define recovery as an absence of symptoms, while others may describe recovery in a personal way that is more about improvements to the whole of one’s life and not just about measurable symptoms.

Remission and recovery

Often, the words remission and recovery are used interchangeably, and are used to describe an absence of symptoms of personality disorder. However, these two words may mean different things to different people.

For example, the word remission is often used to describe an absence of diagnosis specific symptoms, or no longer meeting the clinical diagnostic criteria. The word recovery might mean achieving remission of symptoms as well as a certain level of improvement in social and vocational abilities.

We could also describe recovery as moving towards a satisfying and meaningful life, enjoying greater wellbeing, having improved relationships and self-identity, in addition to a reduction or elimination of clinical symptoms.

Clinical recovery and personal recovery

Recovery might also be defined in two ways:

  • Clinical recovery: this usually focusses on remission, where remission means no longer meeting the diagnostic criteria for a diagnosis of personality disorder. Sometimes clinical recovery focusses on improvements to certain life factors, such as finding meaningful vocational activity (e.g., paid employment, caring, studying, or volunteering) and stable relationship(s).

  • Personal recovery: this can be described as a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful and contributing life, even with limitations caused by an illness. Personal recovery is ‘about improvements in the person’s whole life rather than strictly about measurable symptoms’. Ng et al (2016).

The CHIME Model of recovery

One way we could think about recovery from personality disorder is by using what is known as the CHIME Model. The CHIME Model is a framework that was developed to understand personal recovery from mental ill-health. It comprises the following five domains:

Connectedness:

Having good relationships and being connected to other people in positive ways. This may include peer support (from people with lived experience of mental health issues), as well as relationships with family, friends and others. Connection to community is also a factor.

Hope and optimism about the future:

Hope and optimism are widely acknowledged as being essential to wellbeing. There can be great improvement to our experiences when we believe that a better life is both possible and attainable. Hope and optimism can be characterised by:

  • belief in recovery

  • support and motivation to change

  • hope-inspiring relationships

  • positive thinking and valuing success, and

  • having dreams and aspirations

Identity:

Regaining a positive sense of self and identity, overcoming stigma and being recognised as a whole person instead of being defined by an illness or diagnosis.

Meaning in life:

Living a meaningful and purposeful life, as defined by oneself (not by others). The way we find meaning varies; some may find spirituality important, while others may find meaning through employment or the development of stronger interpersonal or community links. Many people describe the importance of feeling valued and contributing as active members of the community.

Empowerment:

Focusing on strengths, taking personal responsibility and control of one’s own life. Empowerment is supported by the inclusion of people with experience of mental health issues in our communities and in decision-making about treatment and support.

'A life worth living'

What we can safely say is that meaningful recovery from personality disorder is accompanied by improvements to a person’s biological, psychological, social and cultural wellbeing. This contributes to a person having what has been described as a 'life worth living'. It can involve having meaningful employment, fulfilling relationships, improved social and cultural connections, and essentially feeling as though life can overall be satisfying and enjoyable.