Category: Personality Disorders

Personality is defined by the set of traits or characteristics that shape an individual’s identity. This extends to the way an individual thinks, feels, and behaves. A person’s personality is a collection of their own unique experiences and inherited traits. A diagnosis of a personality disorder typically occurs when an individual’s personality begins to deviate significantly from the norm and turn into an unhealthy pattern of functioning. Personality disorders are usually organized into these three clusters: Cluster A, Cluster B, and Cluster C. Cluster A personality disorders are typically defined as eccentric and abnormal thinking. Some examples of disorders that fall into this category are paranoid personality disorder and schizoid personality disorder. Cluster B personality disorders are associated with dramatic and emotional behavior. This cluster encompasses diagnoses like antisocial personality disorder and narcissistic personality disorder. Cluster C personality disorders are established by anxious and fearful behaviors. Disorders that fall into this category typically range from behaviors like clinginess to avoidance of people. 

The three major types of Cluster C personality disorders are Avoidant personality disorder, Dependent personality disorder, and Obsessive-compulsive personality disorder. Avoidant personality disorder is defined as a group of conditions that mainly include nervousness and fear. People with Avoidant personality disorder tend to be hypersensitive to judgement by others and have a fear of rejection. It is hypothesized that this disorder develops because there is a genetic basis along with a prevalence of shyness during childhood. People with Dependent personality disorder usually have a profound need for people close to them whether it is emotionally or physically motivated. Those with Dependent personality disorder tend to avoid a sense of personal responsibility, have trouble being alone, and are often indecisive. Causes of this personality disorder are thought to be attributed to abusive relationships, childhood trauma, or certain familial traits or environments. Obsessive-compulsive personality disorder is explained by a chronic state of anxiety with a cycle of unwanted obsessions and compulsions. This personality disorder is believed to be caused by dramatic changes in one’s life, low levels of serotonin, overactivity in the brain etc. 

The majority of the time, Cluster C personality disorders go unnoticed because the actions associated with them will seem natural or normal to those who have these disorders. A diagnosis of a Cluster C personality disorder will include a physical exam, a psychiatric assessment, and a review of disorder criteria by a mental health professional or a doctor. This will then be referred to another specialist who will oversee treatment and confirm the diagnosis.  The most common way to treat a Cluster C personality disorder is by psychotherapy or medication. Psychotherapy entails working with a mental health professional and working through an individual’s thoughts and emotions. Social skill training may also occur individually or in a group setting. Medications that are prescribed to people with personality disorders typically are antidepressants, mood stabilizers, antipsychotic medications, and anti-anxiety medications. 

The personality disorders that are categorized in Cluster C have many overlapping symptoms. People with a personality disorder should be treated mindfully and supported throughout their diagnosis. 

References

Avoidant personality disorder: Symptoms, causes & treatments. Cleveland Clinic. (n.d.). Retrieved October 30, 2021, from https://my.clevelandclinic.org/health/diseases/9761-avoidant-personality-disorder.

Dependent personality disorder: Definition, symptoms, treatment. Cleveland Clinic. (n.d.). Retrieved October 30, 2021, from https://my.clevelandclinic.org/health/diseases/9783-dependent-personality-disorder.

Mayo Foundation for Medical Education and Research. (2016, September 23). Personality disorders. Mayo Clinic. Retrieved October 30, 2021, from https://www.mayoclinic.org/diseases-conditions/personality-disorders/symptoms-causes/syc-20354463.

Obsessive compulsive disorder (OCD): Symptoms & treatment. Cleveland Clinic. (n.d.). Retrieved October 30, 2021, from https://my.clevelandclinic.org/health/diseases/9490-obsessive-compulsive-disorder.

Osborn, C. O. K. (2018, August 18). Cluster C personality disorders: Types, traits, treatment, support. Healthline. Retrieved October 30, 2021, from https://www.healthline.com/health/cluster-c-personality-disorders#how-to-help.

WebMD. (n.d.). Cluster C disorders: What they are and how to treat them. WebMD. Retrieved October 30, 2021, from https://www.webmd.com/mental-health/what-are-cluster-c-personality-disorders.

Narcissistic personality disorder (NPD) has been argued to be the most problematic of all personality disorders and clusters. NPD is defined as a mental disorder where people feel an embrace of their own importance and excessive need for attention and admiration. A narcissistic person can share no empathy for others, have a mask of extreme confidence, and high regard for themselves. There are distinct forms of narcissism which cause conflicts in relationships and daily life and activities between family and friends. We have all dealt with a narcissist one way or another in our lives. One may ask, how does a person evolve to become so narcissistic? Where does it begin?

No one really knows for sure what the onset of narcissistic personality disorder truly is. Information retrieved from research and case studies conclude that there are many factors that contribute to the rise of narcissism in an individual. The factors that seem to be the most influential to the development of narcissistic personality disorder is the connection between the brain and behavioral thinking, inherited genetic characteristics, and environmental settings the narcissist had shared with a parent or relative (Mayo Clinic, 2017). 

Since many are unsure of what the direct cause of NPD is, research has explored the origins in an individual’s childhood development and certain emotions that play a significant role in the growth of narcissism. Parents who are overprotective or display excessive adoration in one’s childhood can inflate the sense of self-esteem. Even forms of major criticism can cause one to desire attention and admiration since it was not received in the period of childhood. Traumatic or abusive environmental settings in a child’s experience can create fragile self-esteem and a feeding for constant approval from others. As the individual grows older, they begin to develop great confidence in order to mask who they truly are. 

A person who is narcissistic tends to show a high sense of entitlement and belittles anyone who is deemed inferior to them. They try to take advantage of others and expect special treatment in any kind of situation. They tend to have a very jealous nature where they envy others or believe others envy them because of their fabricated status. They demonstrate a strong unwillingness and inability to recognize and value another person’s emotions and needs.  

The manifestations of narcissism have been strongly believed to stem from the emotions of shame and rage one has felt in their lifetime that arose from a traumatic experience. At one point in someone’s life, everyone may feel shame or rage in an embarrassing or humiliating encounter. However, a narcissistic person who has felt a sense of shame that proceeds with a feeling of rage or extreme hostility will generally want to destroy the person who they think wants to diminish their strong self-image (Martens, 2005). This is referred to the shame-rage dynamic and is often intertwined with narcissistic behavioral beginnings. 

For a person who is narcissistic, it may be surprising to hear that they tend to internalize failure. However, they feel programmed to do so in an unhealthy and toxic manner. The internalization of failure will lead to shame, thus having these types of individuals externalize blame elsewhere and be filled with rage. Narcissistic people who can’t seem to avoid the shame felt after a personal failure will tend to experience a conflicting inability to self-analyze the situation. This form of shame is often felt like they have been rejected and their self-importance has been dismissed with a feeling that they are unable to impress others with their self-image. 

The emotional roles of shame and rage can account for a lot of analytical aspects towards building a gradious perception of an individual. These feelings of shame proceeded with rage can account for the realization of a weak self-structure. Narcissists will be aware and fear their poorly developed self by constantly devaluing others, possibly entering a self-destructive pattern. Their cover up of grandiosity is the primary choice of protection to avoid questioning their judgment and perspective. They lack a sense of reality because they are living in their own bubble and would not let it be popped because someone points out they are wrong. In their book, they are never wrong.

From discussing the vulnerability of shame and rage in narcissistic behaviors, one can clearly see where manifestations actually begin. A vital rule of thumb when understanding personality disorders is how emotions and patterns of thinking play a fundamental role in behavior. Most known personality disorders find psychotherapy and cognitive behavioral therapy (CBT) as gold standards for treatment. In today’s society, it is not uncommon to come across grandiosity within a person. We like to live in a world where we desire to impress others. Whether it be a reward from our work, looks, and status. The world is bound to be filled with some narcissistic behaviors. Narcissistic behaviors can be controlled if the right therapeutic measures are taken. All it takes is to take a really good look who you truly are in front of the mirror.  

References

Narcissistic personality disorder – Symptoms and causes. (2017, November 18). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/symptoms-causes/syc-20366662

Martens, W. (2005). Shame and narcissism: therapeutic relevance of conflicting dimensions of excessive self esteem, pride, and pathological vulnerable self. Annals of the American Psychotherapy Association, 8(2), p.10.

In the society we live in today, people find out what’s going on in the world through the touch screen of a smartphone. With society currently facing a pandemic, most people are isolated, working from home, and are unable to engage in one-on-one human interaction.  It might be the new norm to notice your screen time to be more than 6-8 hours per day. It is not uncommon to meet people who would rather be a homebody than go spend a night out. Has the pandemic led to the birth of more introverts? Or has society accepted a new level of antisocial behavior?

There have been some misconceptions brewing about introverts and antisocial behavior for quite some time. The mental stigma and judgment behind someone who might be seen as an introvert or considered antisocial are pretty similar. This is considered to be the first misconception, that someone who is introverted is automatically assumed to be antisocial. However, that is not the case. There are many distinct differences between what is considered introverted and antisocial, and especially, antisocial personality disorder. So what is it exactly? Let’s find out.

So, what is an introvert? What does it mean to be antisocial? Can you be introverted and antisocial at the same time? Yes. Can someone be one or the other? Yes. Can you be introverted and extroverted? Yes, and by the way, there is a term for someone who exhibits both, it’s called an ambivert. There are many variations an individual can display and should not be simply judged for what they choose to be. 

More importantly, what behaviors underlie antisocial personality disorder? All these questions arise and are necessary to know so that the affiliation between the two personality dimensions of an introvert and antisocial behavior can be severed.  

An introvert and extrovert are the two major forms of personality traits society likes to use to describe an individual. Typically, an introvert is someone who likes to spend their time alone rather than be in large groups of people. Introverts tend to see events involving large groups of people as draining and unpleasant. In contrast, an extrovert is basically the complete opposite of an introvert. Extroverts are seen as social butterflies who make conversation with most that come their way and tend to like gatherings or events filled with people. 

An individual who does not like to be around others, or initiate a conversation does not meet the criteria for antisocial behavior. The term, antisocial has a much deeper meaning; especially in terms of categorizing a personality disorder. Being antisocial is considered to be a clinical condition, whereas being introverted is truly just a personality trait. Antisocial personality disorder or ASPD is a mental health condition that commonly consists of behaviors where one chooses not to follow society’s norms, total disregard for what is right and wrong, and a cunning lack of remorse for others. ASPD has been linked to forms of sociopathic behavior and patterns of thinking. 

According to the Diagnostic and Statistical Manual of Mental Disorders (5th edition), or DSM-5, categorizes antisocial personality disorder under the second cluster of personality disorders, cluster B. Cluster B generally involves emotional, melodramatic, and unpredictable types of personality disorders. People with ASPD may be portrayed as an individual who does not like to play by the rules and would rather play by the rules they created fit for their world. 

An established and defining feature of ASPD would be social irresponsibility. They don’t like to conform or obey any federal laws, display difficulties in sustaining employment, and are often unable to maintain stable relationships (Fisher & Hany, 2020). This brings light to another misconception often seen between introverts and someone who is clinically antisocial. Introverts are completely capable of having healthy relationships, while someone with ASPD juggling through relationships constitutes probable as a symptom. They may act recklessly, impulsively, or hurtful towards others for personal gain. General characteristics of an individual displaying ASPD are deceitful, lacking remorse, and aggressive. What separates ASPD from other personality disorders is that ASPD is not diagnosable during childhood. It is not uncommon for individuals exhibiting ASPD to be involved in criminal activity. 

The etiology or cause of antisocial personality disorder is not relatively known. However, research has shown that the possible etiology of ASPD could be three interconnected factors such as environmental influences, inherited genes, and abnormal brain anatomy (Harvard Health Publishing, 2019). An environmental influence could be an example of growing up in a chaotic and unstable household which can kickstart the onset of this personality disorder. Inherited genes are one of the profound factors in ASPD. The frontal lobe also appears to look differently for individuals with ASPD. The frontal lobe of the brain region controls cognitive skills such as judgment and planning.

An antisocial personality disorder is a difficult personality disorder to diagnose since there are no laboratory tests to help in the diagnosis of this condition. The diagnosis of ASPD usually occurs after some type of harm has been done to others or the individual has gotten involved in some form of criminal activity. The onset of symptoms tends to begin after the age of 15, especially more prominent to begin in boys than girls. 

Unfortunately, there is no cure or prevention for ASPD like most other personality disorders. However, many individuals who have been diagnosed with ASPD have found that cognitive-behavioral therapy (CBT) has been the most effective in terms of establishing a treatment plan. Other forms of family and psychotherapy are also considered to be useful techniques. 

A central focus for patients with ASPD is to alter destructive behavioral patterns and teach them how to build stable relationships with family and friends. The difficulties that tend to occur during therapy, which are typically hard to grasp at first, are being aware and considerate of other people’s sensitivities and feelings. If forms of psychotherapy and strategies taught in CBT do not deem to be effective, medications commonly used for aggression and impulsivity are other treatment options that could be utilized. 

From digging deeper inside the world of antisocial personality disorder, one can clearly differentiate what it is to be an introvert and antisocial. In society, we are often careless in how we think certain terminology may not have profound effects on particular individuals. Society has a strong ability to shape and alter the definition of a simple word. It is important not to blindly characterize an individual without properly knowing how words can affect someone, and to realize that not all things are similar.    

References

Fisher, K. A., & Hany, M. (2020, December 8). Antisocial Personality Disorder – StatPearls – NCBI Bookshelf. NCBI. https://www.ncbi.nlm.nih.gov/books/NBK546673/

Harvard Health Publishing. (2019). Antisocial Personality Disorder. Harvard Health. https://www.health.harvard.edu/a_to_z/antisocial-personality-disorder-a-to-z

Paranoid personality disorder (PPD) is a mental health condition where an individual has deep mistrust and suspicion in others, even if there is no prominent reason to. The unwarranted suspicion can be so intense that it gets in the way of everyday thoughts and daily activities. Individuals who display paranoia tend to not confide in others and believe family members or loved ones are unfaithful and deceptive. A common reason why people who exhibit PPD do not confide in others is because of the unfounded fear that the information they share will be used against them. There is consistency in feelings of constantly being lied to, exploited by others, and potential harm coming their way (Cherry, 2020). Habitually, they tend to distrust others so much that it often results in them not sharing how they feel which fosters their suspicions for a longer period of time.

People who are diagnosed with PPD present cardinal features such as a strong sensitivity to criticism and judgment, hypervigilance, and aggressiveness. Their internal aura tends to be serious, cold and filled with skepticism or even jealousy. They are not the type to be forgiving or to forget insults and events they found to be malevolent to them. They can react angrily towards any remarks they consider demanding or threatening. It is not uncommon for an individual with PPD to experience an outburst of anger due to deception from another individual. 

Their hostile nature may lead them to speculate that there are hidden messages or meanings in other’s body language or gestures. In relationships, they can display an overbearing controlling figure in order to avoid manipulation from a spouse or partner. People with PPD can be seen as holding negative views of other people, overreacting to feedback, and find difficulty in trying to relax and calm down. 

The causes of paranoid personality disorder are unknown. Due to its primary symptoms of not trusting others, people who have PPD do not tend to seek medical help and guidance to cope with the difficulties that come with the disorder. From research and case studies collected, two factors that may contribute to the onset of PPD are genetics and psychological factors (Cherry, 2020). It is estimated that about 4.4% of the population are diagnosed with this particular personality disorder. This type of personality disorder commonly appears in males more often than women. 

There has been some evidence to what links or causes the onset of paranoid personality disorder. Unsettling early childhood experiences or related trauma may play a prominent role in the development of PPD. It has been discovered that if there is a family history of schizophrenia present, it may pose a greater risk for individuals with PPD. Other risk factors that seem to have a correlation with paranoid personality disorder are anxiety, depression, substance abuse, and agoraphobia. Agoraphobia is an anxiety disorder that involves the irrational fear of being unable to escape a situation or place (Star, 2021).  

Treatment options for PPD do not encourage medication because it may increase the risk of chronic paranoia, however, if treatment is not sought out, there is a strong potential for paranoia to increase. It is typically recommended that there be a treatment plan discussed with a medical health professional so it is tailored uniquely to the individual suffering from PPD. If daily functioning is affected and there is potential for self-harm, medication is usually suggested. A common form of therapy that seems to be the most effective is cognitive-behavioral therapy (CBT), which aids individuals in learning and identifying destructive or disturbing thought patterns to manage paranoid personality disorder. 

Since there is a strong reluctance to seek out help for PPD and a lack of research upon the disorder, there may be a possibility of feeling misunderstood. However, with the proper treatment plan and developing coping techniques, there is a stronger possibility to live life without fear and create successful relationships with others.  

References

Cherry, K. (2020). How to Recognize If Someone Has Paranoid Personality Disorder. Verywell Mind. https://www.verywellmind.com/paranoid-personality-disorder-2795448

Star, K. (2021). How Agoraphobia Is Diagnosed. Verywell Mind. https://www.verywellmind.com/agoraphobia-101-2584235

A riveting flush of seduction, charm, and flirtation passes her by while she’s sitting in a coffee shop. She uses her body to cover up the shallowness that lives inside her. Her power to draw everyone’s attention is compelling to everyone around her. She thrives off of a constant pool of approval and admiration from others. Her hunger to feed off from the attention of others gets in the way of her work and priorities. 

This is a typical textbook gender framing description of a woman we have all seen once or twice in a film. It is quite common in the realm of the film industry to portray women in a seductive manner, getting too caught up in relationships and over exaggerating their reactions to minor situations. The gender stereotyping that continues to take place in cinema brings light to the world of personality disorders. Most commonly what is seen portrayed in the film industry is borderline personality disorder (BPD) or narcissistic personality disorder. Another particular type of personality disorder that seems to be overlooked, rarely discussed, but very apparent in cinema, is histrionic personality disorder, or HPD.  

Regina George, an iconic character portrayed in the movie Mean Girls, demonstrates histrionic personality disorder as the story antagonist. She walks the hallways of her high school as the queen bee and has a posse who sees her as a goddess. She tracks every carb she eats since she is afraid to lose the figure she possesses. She plays with her boyfriend’s hair and kisses him in a vulgar manner in the school cafeteria to warn the protagonist, Cady Heron that she has the hottest boyfriend in school. Regina thinks everyone is below her and theatrically downgrades any students who cross her path. 

A downfall of Regina George in the movie starts to take place when Cady Heron becomes more well-liked among her peers and takes over her throne as queen bee of the school. It is evident Regina experiences a rapid shift in emotion and becomes too invested in a silly popularity battle. The movie depicts this popularity battle as Regina’s only responsibility in life and that she is nothing if no one admires or approves of her. The main conflict in the movie is when Regina tries to take back the attention of the whole school by exposing Cady Heron’s lies. 

Histrionic personality disorder is categorized as part of cluster B personality disorders, and these types are considered to be dramatic, emotional, and erratic. The basic underlying symptoms this personality disorder often displays are an overbearing sense of emotionality, acting out to be the center of attention, dressing inappropriately or provocatively, and varying emotional expressions such as being vague or shallow; this leaves individuals to appear as insincere or dishonest.

A distinct symptom that tends to landmark HPD is an extreme level of confidence which seems to be the source of their behaviors and actions. Someone with HPD may tend to be uncomfortable with the idea that they are not seen as the center of attention. They feel it is their duty to constantly reevaluate their physical appearance if it means bringing more attention to themselves. Regina is in a constant state of mind to watch everything that she eats in order to maintain her figure because she is well aware that it is her skimpy clothing and figure that gets the attention of everyone at school. 

Another common feature of HPD is they often consider meaningless flings with others to be more intimate than they actually are (Cherry, 2020). In the movie Mean Girls, Regina is very intimate with her boyfriend, Aaron Samuels in public anytime she thinks others are looking at her. Regina and Aaron have only been dating for a few months. In her head, she has the perfect prince charming that fits her fantasy for that moment in time. Regina quickly moves on to another relationship when Aaron finds out that she has been cheating on him with someone who has been giving her more attention than he is currently giving her. 

Unfortunately, there is not much research into what causes someone to have HPD. Only 2-3% of the general population have this type of personality disorder. By having such a small diagnostic percentage, researchers have revealed two strong factors that can contribute to the onset of HPD: genetic inheritance and environmental aspects. Personality traits from parents can be passed down through genes to children, and a person’s environment can allow someone to embellish negative behaviors (Cherry, 2020). 

People with HPD are often undiagnosed and don’t find that this disorder gets in the way of their life. However, HPD can cause toxicity in relationships with loved ones, family, and friends. HPD falls into the category of manipulative and shallow patterns of behaviors which are common in causing weak and disingenuous relationships. Key issues that arise with someone who has HPD can be low levels of self-esteem and difficulty in controlling emotional reactivity. 

With regards to seeking help or obtaining treatment, there are not any FDA medications for histrionic personality disorder. Research has stated the most successful techniques in coping with the disorder are psychotherapy, group therapy, and family therapy. Holistic techniques such as mindful meditation and yoga are extremely effective in signaling one’s inner feelings to control triggering emotional reactions and desiring attention-seeking behaviors.  

It is important to bring awareness to personality disorders as they are often misconstrued and people find themselves constantly being judged instead of receiving support and professional help. People should be encouraged to talk about the symptoms amongst their friends and family. Without seeking professional help, it can be a burden to live with HPD and symptomatic behaviors can continue to take a toll on present relationships. There is definite hope for people to improve their relationships and take control of their life by reaching out for help and by learning to better understand themselves. 

References

Arabi, S. B. A. (2017, August 7). The Histrionic Female Has an Insatiable and Destructive Desire for Attention. Psych Central. https://www.psychcentral.com/blog/recovering-narcissist/2017/08/the-histrionic-female-has-an-insatiable-and-destructive-desire-for-attention#1

Cherry, K. (2020, September 17). What Is Histrionic Personality Disorder? Verywell Mind. https://www.verywellmind.com/histrionic-personality-disorder-2795445

DSM-5: The Ten Personality Disorders: Cluster B. (n.d.). Mental Help. https://www.mentalhelp.net/personality-disorders/cluster-b/

Personality disorders consist of three main clusters: cluster A (which is characterized by “odd, eccentric thinking or behavior), cluster B (which is characterized by “dramatic, overly emotional or unpredictable thinking or behavior”) and cluster C (which is characterized by “anxious, fearful thinking or behavior”). Avoidant Personality Disorder (APD) is part of cluster C, along with Dependent Personality Disorder and Obsessive-Compulsive Personality Disorder (Mayo Clinic, 2016). Those with APD harbor a sense of social anxiety and fear of rejection, which manifests itself in avoidant behaviors and social isolation. 

Social situations are extremely anxiety-inducing for those with APD, and they can therefore come across as very shy and timid within these situations. It’s important to acknowledge that people with APD do not wish to avoid fulfilling friendships and relationships; rather, their anxiety and fear makes them feel compelled to avoid all social situations, leaving them with feelings of loneliness. They consistently feel as if they are being judged by others and that others view them in a very negative manner. While many people can feel shy and judged sometimes, those who have been diagnosed with APD exhibit patterns of behavior that are severely negatively impacting their everyday lives and relationships. 

Just like those with APD, those with DPD experience feelings of low self-esteem, but this low self-esteem manifests itself in an extreme dependence upon others and fear of abandonment. While people with APD avoid social situations and therefore find difficulty building relationships, those with DPD are often afraid of being alone, and can therefore develop unhealthy, codependent relationships. Unfortunately, they are also more susceptible to falling into toxic and abusive relationships, because their fear of being alone means that they are more likely to put up with abusive and harmful behavior (Cleveland Clinic, 2020).

So, how do people with APD and DPD receive treatment? Oftentimes, those with APD will seek out treatment themselves, because their patterns of behavior are causing such intense feelings of isolation and emotional pain. However, people with DPD will likely have more difficulty understanding that they need help, since they can still develop relationships with others that may feel fulfilling despite their codependent nature. Since people with both disorders have low self-esteem and thought patterns that are so deeply ingrained within them, it’s important for them to become involved in therapy and work closely with a therapist to resolve their issues and aim to change their behaviors and raise their self-esteem. 

What this means is that more awareness must be brought to personality disorders in general; people dealing with APD and DPD will have much less difficulty receiving help if they are able to name what they’re going through. Because personality disorders have to do with traits and behaviors that are deeply ingrained into someone’s personality, people with personality disorders might believe that they are unable to change their patterns of behavior. With consistent therapy, however, they will be able to address their issues head-on and receive the help that they need to develop happier and healthier relationships with others. 

References

Cuncic, A. (n.d.). What Is Avoidant Personality Disorder? https://www.verywellmind.com/avoidant-personality-disorder-4172959 

Dependent Personality Disorder (DPD). (n.d.). https://my.clevelandclinic.org/health/diseases/9783-dependent-personality-disorder 

Personality disorders. (2016, September 23). https://www.mayoclinic.org/diseases-conditions/personality-disorders/symptoms-causes/syc-20354463

Borderline Personality Disorder (BPD) is one of the more commonly known personality disorders, and is characterized by “difficulties regulating emotion,” meaning that those with BPD “feel emotions intensely and for extended periods of time” (National Alliance on Mental Illness). This makes it more difficult for them to properly navigate relationships and social interactions.

BPD is overwhelmingly more common in women than in men. According to the DSM, “there is a 3:1 female to male gender ratio” (Sansone, 2011). Why is this the case? And what does this mean for our general perceptions of BPD? Firstly, doctors are more likely to diagnose women with BPD, possibly because the symptoms of BPD align more closely with a stereotypical perception of women, especially women with mental illness. We can see this concept even in the media we consume. There’s a whole genre of movies depicting the “Manic Pixie Dream Girl,” an emotionally unstable young woman whose flighty and immature characteristics are idealized by a man who perceives himself to be average and boring in comparison. This results in mental illness in women not being taken seriously. 

If we glorify these damaging traits and behaviors, women who suffer from BPD are less likely to see their symptoms as damaging and harmful, and will therefore not seek help. But even women who know of their mental illness and are seeking help can run the risk of entering into a relationship with someone who enables these symptoms that are glorified and simultaneously shames them for the symptoms that are perceived in a negative light. How are women supposed to juggle this, especially in their most intimate relationships? For centuries, there has been a fascination with women who are mentally ill. In the 19th century, women who were diagnosed with “hysteria” were turned into a spectacle, with male doctors performing public experiments on them; even today, around 69 percent of mentally ill women have experienced some form of domestic violence (Rodriguez-Cayro, 2018).

Additionally, BPD has been seen to develop as a result of abuse in childhood, as around 40 to 70 percent of those with BPD experienced childhood sexual trauma (Rodriguez-Cayro, 2018). Unfortunately, women who are mentally ill are more likely to exist within cycles of abuse and trauma throughout their lives. And not only do they suffer from the stigma that comes with being mentally ill, they suffer from the sexism that has resulted in the negative perception of women’s intelligence and emotional stability for centuries. 

So, how do we combat this? If we can more properly educate people about BPD and mental illness in women, we can limit the preoccupation with mentally ill women in popular culture, and perhaps movies will more accurately showcase what it’s like as a woman to struggle with mental illness. It should be clear that mentally ill women are not just interesting love interests that compound the emotional suffering of the male main character. They have their own stories and struggles and complex inner lives. If we aim to help women who have suffered from abuse and developed mental illness instead of demonizing or idealizing them, we can help these women develop healthy relationships with others and live happy, fulfilling lives.

References

Borderline Personality Disorder. (n.d.). https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Borderline-Personality-Disorder 

Littman, E., Littman, E., & Panel, A. (2020, June 25). When Women Battle ADHD and Borderline Personality Disorder. https://www.additudemag.com/adhd-and-bpd-women-borderline-personality-disorder/ 

Rodriguez-Cayro, K. (2018). Please Stop Using My Mental Illness to Fulfill Your Fantasy. https://www.healthline.com/health/mental-health/sexist-crazy-woman-fantasies-hurt-borderline-women 

Sansone, R., & Sansone, L. (2011, May). Gender Patterns in Borderline Personality Disorder. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3115767/

Personality disorders, because they do not seem to fit our typical understanding of mental illness, often go ignored and unmentioned, leaving those with these disorders unable to name what they’re going through, and therefore without the knowledge that they can get help. A specific personality disorder that goes largely undiscussed is Histrionic Personality Disorder (HPD), in which a person exhibits “a long-standing pattern of attention seeking behavior and extreme emotionality” (Grohol 2020). Those with HPD often act out of a sense of insecurity and low self-esteem, basing their self-worth on the opinions of others. 

But don’t many people—especially in their younger years—suffer from low self-esteem and feel the need to act out? How are we to tell the difference? In order to become diagnosed, a doctor will “begin an evaluation by performing a complete medical and psychiatric history” (Casarella 2020). There are cases in which physical illness can cause symptoms similar to those present in people with HPD. Therefore, if there seems to be no danger of physical illness, patients will be referred to a psychiatrist/psychologist who will perform a thorough assessment of the patient in order to determine whether to diagnose them. Additionally, HPD has been shown to run in families, indicating that some genetic component is involved.

The low self-esteem and desire for validation of those with this disorder can be extremely damaging for their personal life and day-to-day interactions. Maybe you have a friend you deem to be dramatic, and you criticize them harshly for this. But those with this disorder who haven’t yet sought treatment and don’t know how to properly deal with their symptoms often cannot control their attention-seeking actions. This need for attention is so deeply rooted within their personality that it’s incredibly difficult for them to actively work against it. A big problem lies in the fact that those with HPD often don’t believe that they need therapy; they “tend to exaggerate their feelings and to dislike routine, which makes following a treatment plan difficult” (Casarella 2020). They might only seek help if they truly feel that their life is being significantly impaired by the disorder, which can be very difficult for them to admit and acknowledge. 

The more knowledgeable we become about personality disorders as a whole, the more likely people with HPD are to acknowledge their symptoms and seek treatment. You’ve likely only heard of very few personality disorders, and the rest go largely unexamined and invisible within society. The more often we can recognize the signs and symptoms, the less likely we are to harshly judge our dramatic friends or berate them for symptoms of their personality that can very well be out of their control. If you suspect that a friend of yours is acting out due to low self-esteem and seeking attention in a way that seems irrational and far too grand, it’s important to suggest therapy so that they can seek help. Even if that friend isn’t diagnosed with HPD, therapy can still be very beneficial for them. As the stigma behind seeking mental help continues to be dismantled, we can all learn the benefits of working to dismantle our negative behaviors and perceptions of ourselves.

References

Casarella, J. (2020, September 27). Histrionic Personality Disorder Symptoms, Causes, Treatments. WebMD. https://www.webmd.com/mental-health/histrionic-personality-disorder 

Grohol, J. M. (2020, January 14). Histrionic Personality Disorder: Symptoms & Treatments. Psych Central. https://psychcentral.com/disorders/histrionic-personality-disorder/ 

Tartakovsky, M. (2020, January 9). Histrionic Personality Disorder Treatment. https://psychcentral.com/disorders/histrionic-personality-disorder/treatment/.  

When we think of psychopathy, we often think of a coldhearted killer, a person with no sense of remorse or empathy, someone we might deem to be “crazy.” We think of someone dangerous, cruel, and cunning, someone almost entirely non-human in their apathy and propensity towards violence. Perhaps the most famous example of psychopathy in popular culture is Patrick Bateman, protagonist of the novel—and eventual film adaptation—American Psycho. Bateman is pristine, obsessed with order and control, ambitious and incredibly power-hungry. He attempts to charm his way into power positions, shows little regard towards the women in his life, and becomes extremely angered when things don’t go his way. 

This paints a picture for us: psychopathy is the wealthy white man in a business suit who treats women as if they’re disposable and will stop at nothing to climb the corporate ladder. But is this an accurate representation of psychopathy? What does it really mean to be a person with psychopathy? 

Those who suffer from what we know as psychopathy or sociopathy actually suffer from antisocial personality disorder (APD), in which a person harbors “an ingrained pattern of behavior consistently disregard and violate the rights of others around them” (Sussex Publishers 2019). But what does it mean to have a personality disorder? Personality disorders largely go unmentioned within the larger discussion of mental illness and mental health. A personality disorder can be described as “an enduring pattern of personal experience and behavior that deviates noticeably from the expectations of the culture” and is persistent over one’s lifetime and severely impacts their everyday livelihood (Sussex Publishers 2019). Psychopathy and sociopathy exist as an extreme version of APD, but why is there a distinction between the two? 

The main difference between them is that people with psychopathy are considered to have “little or no conscience,” while people with sociopathy experience “a limited, albeit weak, ability to feel empathy and remorse” (Purse 2020). Therefore, people with sociopathy and psychopathy both exist on the very extreme end of antisocial personality disorder, though the only cases of APD showcased in popular culture seem to be characters who suffer from these extreme forms of the disorder.

Why is this the case? Why does popular culture seem so fixated on showcasing only the violent, coldhearted killers who descend into complete madness by the end of the story? The problem with how mental illness is conveyed in forms of media is that a character’s mental illness is often used as a prop to make the character more interesting, without any regard for how people in real life suffering from mental illnesses may feel about this. We are taught not to sympathize with these characters, not to feel for them or hope they get help, simply because they are portrayed to be crazy as opposed to genuinely suffering from something out of their control that can be helped with awareness, medication, and/or therapy. 

Bateman as a character exists as a perfect example of the misleading portrayal of mental illness within popular culture. We cannot and most definitely should not feel sympathy for him. He killed (or at least intended to, depending on your interpretation of the movie) people simply for the sake of his own pleasure and gain. His violence and complete lack of remorse show that he is suffering from the absolute worst case of APD: psychopathy. But why is popular culture so fascinated with psychopathy, so fascinated with displaying characters with mental illness who are so difficult to sympathize with? Why are we being taught not to sympathize with those suffering from mental illness?

Ultimately, though American Psycho is made for entertainment purposes, it’s important to examine the harmful themes being displayed in the movie and the lack of awareness about mental illness. Why is it deemed uninteresting to portray characters suffering from mental illness that we can actually sympathize with?

References

Collin, R. (2020, April 24). American Psycho is masculinity at its most grotesque – only a woman could have directed it. The Telegraph. https://www.telegraph.co.uk/films/0/american-psycho-masculinity-grotesque-woman-could-have-directed/ 

Purse, M. (2020, June 15). How Sociopaths Are Different from Psychopaths. https://www.verywellmind.com/what-is-a-sociopath-380184 

Sussex Publishers. Antisocial Personality Disorder. Psychology Today. https://www.psychologytoday.com/us/conditions/antisocial-personality-disorder