1. Understanding Personality Disorders

    October 3, 2013

    by Jessica Galbraith

    Personality disorders are widely misunderstood by the general public. Although an estimated 10% of people have some type of personality disorder (Mental Health Foundation), the negative stigma that is attached to them makes diagnosing and follow-up treatment difficult. There are ten major types of personality disorders, which cover a wide range of personality spectrum.

    Getting diagnosed can be a challenge in itself, and usually includes psychological testing by a registered psychologist or psychiatrist, extensive interviews, and meeting strict criteria specified by Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association. Let us explore what exactly constitutes a personality disorder, the diagnostic process, and the treatment options available to those who have been diagnosed.

    Getting diagnosed with a personality disorder can be scary, but also brings relief.

    What is a personality disorder?

    Each of us has our own unique personality which determines how we behave, process, and feel. We each react to situations differently, from social engagements to trauma. As we go through life, we learn to cope with these experiences. For someone with a personality disorder, this becomes much more difficult. They may feel isolated, misunderstood, and have a generally hard time in every aspect of life. The illness affects their relationships and how they process their feelings.

    What types of personality disorders are there?

    There are ten officially recognized personality disorders, which are categorized into three groups.

    •  Suspicious Disorders: paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder.
    •  Emotional and Impulsive Disorders: anti-social personality disorder, borderline personality disorder, histrionic personality disorder, narcissistic personality disorder
    •  Anxious Disorders: avoidant personality disorder, dependent personality disorder, obsessive compulsive personality disorder

    Depression and anxiety are often present with a personality disorder, however the severity can range from mild to unmanageable. In addition, many sufferers deal with issues such as self-harm, eating disorders, panic attacks, and substance abuse.

     on the edge of suicide

    90% of people who commit suicide have a diagnosable personality disorder.

    Diagnosing and Treatment

    Getting diagnosed is often the biggest issue in mental health. Most people don’t seek help until they are forced to by family or friends, or until their illness escalates into a serious situation. Once a healthcare professional is able to assess what the person is dealing with, they will check if they meet enough criteria to be officially diagnosed with a disorder. A large majority of people who suffer from a mental health disorder, meet the criteria for two or even three others. There is usually multiple interviews to determine if the issues are constant or only related to a recent life changing event such as a divorce or loss. Once it has been established that they are dealing with a personality disorder, a treatment plan is devised. For many years, the general consensus was that there was no cure for mental illness. This is changing rapidly however, as research and mental illness education is becoming more accepted and prevalent. Those who have been diagnosed with a personality disorder, more often than not, face a lifetime struggle trying to find a balance through medication and therapy. The goal is usually to manage the disorder as much as possible rather than fix it. Medication can help side issues such as anxiety and depression, and psychotherapy is effective in addressing feelings and concerns as they arise.

    Common Misconceptions

    Unfortunately, there are a lot of myths out there on mental illness. One of the most common is that personality disorders are not treatable. While treatment is never expected to ‘fix’ the person, it does make life manageable; many people live normal lives with families, jobs, and a functional day-to-day. Another common myth is that mental illness isn’t a real condition. This of course, just isn’t the case. Mental illness is as real as any physical illness and has been linked to genetics and other neurological factors. Mental illness is also commonly believed to be a weakness in a person, and that it is something they should be able to snap out of. These types of misconceptions do tremendous harm to those who suffer with personality disorders. It can deter them in seeking help and creates feelings of shame.

    The misconceptions about mental illness are immense, but education initiatives are slowly making their mark.  As the general public becomes more informed, hopefully the myths and stigmas attached to mental illness will fade. There is still very limited research on the long-term benefits of various treatment options, but more and more research is being done. The future for those who suffer with mental illness has never looked better; but there is still a long way to go.

    Image Credits: http://www.flickr.com/photos/mytudut/5180391961 and http://www.flickr.com/photos/h-k-d/3685379062/

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  2. On Trust, Fear, and Borderline Personality Disorder

    August 7, 2013

    Living with Borderline Personality Disorder

    From BPD patient diary:

    I have a massive issue when it comes to trust which is a major hurdle that I need to overcome if I ever want a clear shot at recovery. The mere thought of putting my well being into the hands of others sends shivers down my spine. This is something that did not appear when my breakdown occurred but probably started sometime in early childhood and is a main factor in the development of what later became Borderline Personality Disorder.

     

    Right off the bat the first people you are suppose to trust is your parents as they are responsible for damn near everything right off the bat but when certain circumstances happen this is put into jeopardy creating a sort of movement that is going to take a long time to get past. I could never figure out why the people who were suppose to love me and keep me safe would repeatedly put me into situations that caused me harm. My father who could go from fun loving dad to pissed off at the world in a heartbeat created an environment that was a long way from being safe for a child. I never knew what mood he was going to be in so it kept my anxiety level sky high and helped mold my BPD false self in order to eliminate as many factors as possible that would set him off. You cannot trust someone you fear.

     

    Both of my parents like many around the world worked full time so my primary care giver was someone outside of the home. It was my parents responsibility to make sure that all of the proper steps were taken in order to ensure my safety and well being needless to say this did not happen. I went through a number of different sitters and I would imagine some were wonderful people but the others should have picked a different occupation. Again my view of trust was distorted for how can I trust someone who is suppose to ensure my wellbeing but continues to cause harm on a way to regular basis. Too many days were spent wondering if I was going to get my ass beat at home or at the sitters or both.

     

    Depending on the year teachers were the closest thing I had to a responsible adult in my life but like everything else there were exceptions to the rule. Finally gathered the nerve to tell the teacher about the abuse I was taking outside of school to only be told if I was a better behaved child it would never happen. Basically the same situation repeated a year later and I learned a lesson that I would hang on to for years to come “The only person who I can trust with my wellbeing and safety is me for no one else cares what happens”.

     

    Doctors are a difficult group of people to trust as a whole. The first appointment they basically promise the world in terms of recovery then over the next period of time repeatedly fail to come through. I would imagine part of this is my expectations are off base but it seems every time I try to combat these negative thoughts with logic the only thing that comes to mind is examples from the past which are far from positive..

     

    Therapists and I do not have the best relationships. In a therapy setting you need to be completely open in order for the best possible result but I have found out the hard way that there is something known as too much information. After my first psych stay I was set up with a therapist who has a wonderful reputation of helping those with historical abuse issues. Everything was going well for the first couple of visits until I made a mistake in the third. She asked the typical question on any progress or setbacks since the last appointment and I admitted that I hit a rough patch where I turned to self harm. Almost instantaneously this therapist decided that I was not in a stable enough place mentally to go through therapy and that was the last time I ever saw her. She was followed by two more therapists who basically came to the same conclusion after myself harm issues came out into the open. Since then I have tried to contact a dozen more therapists but once I mention that I do have the Borderline Personality Disorder all communication is cut off and this is before any of them actually took the time to meet me in person to judge for themselves how well I may respond to treatment. I have come to the conclusion in order for me to obtain treatment in a therapeutic setting in this community I am going to have to fail to mention that I am BPD and I have a lengthy self harm history. Not sure how I am going to be able to be open with someone when I believe I need to lie from the onset in order to get proper care.

     

    Nurses. Well if you have read yesterdays post you will have a fair idea of where the relationship stands with that specific group of people. This area tends to be more separated then others as I try to figure out pretty quickly early on which are in it for the money and which are in there to help. My communication with the two groups is totally different and it has to do with trust. Very difficult to trust someone that does not look at you as a person but what is written down in a file and on paper I past the crazy line a long time ago plus that damn word untreatable is probably in capital letters.

     

    I do try to give everyone I meet a chance to show me what kind of person they are in and more than once my original assumption was proven wrong. The problem is when the little warning flags start to appear and with the way my brain works situations from the past are quickly linked which ends up putting up the walls to keep me safe. Like I said earlier this is an area I am going to have to figure out how to get around but I am basically clueless on how to do so. Take care.

     

    by Andrew R.

    Image Credit: Stefano Mortellaro

     

     

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