My previous post addressed the need to call out unhealthy, misleading, and at times, entirely inaccurate, stereotypes of common mental disorders. For this post, I wanted to focus entirely on personality disorders; Specifically, Borderline Personality Disorder and Antisocial Personality Disorder. Let’s jump right in!
Mental Disorder: Borderline Personality Disorder
Stereotype(s): Those with BPD are mean, manipulative, and untreatable.
Breaking the stereotype: Overall, BPD is widely misunderstood and tends to get heavily criticized in public perception. Let’s review diagnostic criteria for BPD before diving in to breaking down these stereotypes.
To be diagnosed with Borderline Personality Disorder, you must experience at least 5 of the following symptoms:
- Avoiding real and/or imagined abandonment (typically through personal relationships with friends, romantic partners, and family)
- Unstable interpersonal relationships in relation to devaluation and idealization
- Unstable self image/sense of self
- Reckless impulsivity in at least 2 areas, such as through sexual practices, gambling, substance abuse, etc.
- Recurrent suicidal behavior, such as ideation, self-harm, or suicidal threats
- Unstable affect, such as extreme irritability or anxiety, that impacts daily function
- Chronic feelings of emptiness
- Difficulty controlling anger and/or inappropriate anger
- Dissociative symptoms
Those with BPD have a pattern of unstable relationships, self-image, and overall affect, as well as marked impulsivity in adulthood. Due to lessened ability to control and regulate emotions, those with BPD may appear to be mean and short-fused. Those with BPD also struggle with self-worth, which intertwines in their personal relationships as well. Due to the (possibly) irrational fear of abandonment, those with BPD may also be more likely to become more overly attached in their relationships. As a result, the overall stereotype of those with BPD as being mean, manipulative, and untreatable began.
As discussed in my most recent blog about breaking down stereotypes for other disorders, I mentioned that when anxiety is heightened, our ability to control our emotional responses tends to diminish. Taking this into consideration, it helps to understand what some are struggling with on a daily basis. Another interesting aspect to BPD is the notion of manipulation. While some with BPD may show some manipulative tendencies, it’s important to see the reasoning behind the actions. If you fear losing something you love, do you fight for it? Hold on for dear life, in hopes that your fear doesn’t come true? That fear tends to be a daily battle for those with BPD, because those with BPD live in ‘extremes.’ That all-or-nothing thinking is commonly present, resulting in certain outlandish behavior if they don’t see an alternative. Does this make someone with BPD untreatable? No! Everyone can become more self aware of their behavior, actions, and overall sense of self. When we become more self aware, we can bring about real change. I truly believe everyone can benefit from therapy, but in regard to personality disorders, I will say it’s highly important to seek therapy. Gaining awareness about why we act the way we do and why our mind thinks like it does allows anyone to start to regain control over their mental disorder and no longer let themselves be defined by it.
Mental Disorder: Antisocial Personality Disorder
Stereotype: Those with Antisocial Personality Disorder grow up to commit crimes.
Breaking the stereotype: When traumatic events occur in society, such as a mass shooting, people want an answer. “Why?” Antisocial Personality Disorder tends to get mentioned immediately following traumatic events and it has built this stereotype that anyone with Antisocial Personality Disorder cannot be a law abiding citizen throughout their lifespan.
With accurate recognition of symptoms and appropriate treatment, Antisocial Personality Disorder is treatable.
This particular stereotype is emotional for me because while there are extremes to this disorder, there is a spectrum that some simply forget. When you read “Antisocial Personality Disorder”, what comes to mind? Before I became a therapist, I’d probably say: a loner, someone who hates people, that person that everyone avoids at school because they’re scared of him/her/them. After becoming a therapist and gaining better understanding of this disorder and personality disorders in general, I’d say what comes to mind is 1) Lack of social skills 2) Inability to form lasting relationships, and 3) Physical and mental recklessness, such as engaging in dangerous activities for the thrill/adrenaline boost, impulsivity, as well as not conforming to socially acceptable norms (obeying speed limits, paying rent on time, showing up to work). Here are the summarized symptoms:
- Ego-centric outlook on life
- Lack of empathy/concern for others
- Incapacity for intimacy
- Manipulative tactics, such as being deceitful and use of dominance/intimidation as a form of control
- Hostility and/or vengeful behavior
- General irresponsibility in regard to social norms, as discussed above
- Reckless impulsivity, as discussed above
Something important to note in regard to personality disorders is that one must meet criteria for a personality disorder prior to meeting criteria for a specific personality disorder. Personality disorders, in general, have their own list of diagnostic criteria outlined in the DSM V. Another important note is that you cannot be diagnosed with Antisocial Personality Disorder if you’re under the age of 18. We’ll typically see conduct disorder diagnoses surface prior to meeting full criteria for Antisocial Personality Disorder as an adult.
Another important notation regarding APD is that it is connected to sociopathy and psychopathy. Generally speaking, APD is the umbrella, while sociopathy and psychopathy fall underneath that umbrella. My next post will dive into the differences between a sociopath and psychopath, as those terms are thrown around far too much on social media and news outlets.
But even though we have seen the extremes and severity of this disorder, there are many with APD that experience more mild symptoms. They may appear difficult to get to know, while others are extremely charming. Please remember that not one diagnosis looks the same for each individual. ✨There are many with APD that live relatively normal lives, free of crime. This particular disorder gains a lot of attention during traumatic events, which feeds into the overall stereotype that anyone with APD is dangerous and unlawful. My next post will dive into this further as we discuss the aspects of sociopathy and psychopathy.