View Full Version : Does "personality disorders" actually mean anything?


midnightstar
07-13-16, 06:18 PM
Or is it a nonsense label the professionals stick on you just for something to say you have "wrong" with you and say there's no cure so bye bye we can't do anything for you with that? (they gave me an OCPD diagnosis as one of the things I apparently have wrong with me and they said when they diagnosed me there's no cure and pretty much left me to get on with it)

Fortune
07-13-16, 06:24 PM
There are a lot of problems with personality disorders as a category. The DSM-5 changed things in the US so they're axis-1 disorders instead of axis-2, which is a good change, although I am not sure what that will mean - if anything - for people diagnosed with PDs.

Several of the PD diagnoses are valid, some are questionable, and the idea that they're untreatable is probably false. BPD, for example, is quite treatable. OCPD can be treated with cognitive behavioral therapy, medication, and relaxation training.

midnightstar
07-13-16, 06:34 PM
So it's just in the UK that they're all like "it's untreatable off you go blah blah"? Mental health help in the UK is utter crap.

Fortune
07-13-16, 06:38 PM
So it's just in the UK that they're all like "it's untreatable off you go blah blah"? Mental health help in the UK is utter crap.

It's not just in the UK, no. There are professionals who do treat it and professionals who act like it's not treatable at all, but that's old dogma.

midnightstar
07-13-16, 06:41 PM
It's not just in the UK, no. There are professionals who do treat it and professionals who act like it's not treatable at all, but that's old dogma.

So the professionals here and both places I used to live are talking out of their backsides :rolleyes:

:grouphug: Fortune

Fortune
07-13-16, 06:45 PM
Basically.

If you can find someone who does CBT they can probably help you with your symptoms. If they treat your symptoms instead of your diagnosis, that is.

Fuzzy12
07-13-16, 06:45 PM
So it's just in the UK that they're all like "it's untreatable off you go blah blah"? Mental health help in the UK is utter crap.

Funnily enough I think if you look up personality disorders on the nhs websites it does list ways of treating them through therapy like dbt or meds like anti depressants.


Uggh...the ignorance of some professionals makes me just so angry. I mean they should know at least as much as the nhs Web pages shouldn't they? ??

http://www.nhs.uk/Conditions/Personality-disorder/Pages/Treatment.aspx

( not sure if they specifically mention ocpd though)

Fortune
07-13-16, 06:45 PM
If they focus on your diagnosis they might just be all "No treatment works" which is not helpful.

Little Missy
07-13-16, 08:57 PM
So it's just in the UK that they're all like "it's untreatable off you go blah blah"? Mental health help in the UK is utter crap.

Maybe if you pursued it a bit more aggressively, some type of help could be offered to you. I don't really know, but if you continue making appointments and keep on about your struggles possibly?

Donny997
07-15-16, 07:22 AM
So it's just in the UK that they're all like "it's untreatable off you go blah blah"? Mental health help in the UK is utter crap.

Sure sounds like it. But there's some truth to it as personality in general is so hard to change. I think you can never totally change your personality, you are who you are. But you can modify it and learn to integrate other opposing traits to balance your personality. And in the case of personality disorder, you can learn to bring your personality style to the normal level of adjustment, i.e. there are many "normal" OCDPs. These things are tremendously hard work, though, and it probably requires more than a lifetime to fully change and undo the effects of personality disorder, but it doesn't mean people can't move in the direction of health.

Fortune
07-15-16, 02:19 PM
That's part of the problem - the idea that personality disorders are so difficult to treat - which is not true, at least not for all of them. OCPD is fairly treatable.

Fortune
07-15-16, 03:37 PM
I mean there's a reason personality disorders are no longer axis 2.

Unmanagable
07-15-16, 03:45 PM
I still chuckle (albeit a bit angrily) when I think of how perplexed the psych docs seemed to be with my supposed pd that they couldn't seem to nail down and ever specify, yet they continually set aside and ignored all of the trauma related info openly shared with them, and never discussed ptsd, while they steadily threw a slew of meds my way for depression, anxiety, adhd, and insomnia.

Perhaps I have a buffet variety. A little bit of everything all rolled into one. Ha! Imagine that. Their ideas and methods of treating all of their various diagnoses of me were damaging enough to make me seek relief elsewhere, luckily. Their widespread and perceived incompetence ended up being the silver lining to my ongoing and worsening clouds of misery, repeatedly.

Not sure what that means in the grand scheme of things as far as opinions go, be it professional or otherwise, but I sure feel more relief on this particular path, more so than I've ever felt in pursuit of wellness via most typical means, so I'll stick with it, until it no longer works, lol, then I'll figure it out again, and again, and again, with any luck, quite painfully, I'm sure, and with or without their labeling guesstimations.

Cyllya
07-17-16, 06:55 PM
I feel like psychiatric diagnostic labels are pretty flaky in general (i.e. they're all real problems, but the line drawn between one disorder and another doesn't always make sense), and I suspect that it's even worse for personality disorders.

It seems like executive dysfunction (e.g. ADHD, ASD) + trauma + associated anxiety would almost certainly make you end up with pretty much the exact set of traits of OCPD. (So would ADHD + OCD.) The diagnostic criteria requires that the problem isn't due to another health problem, but will they count mental health problems for that?

A key trait of PDs (and what separates OCPD from OCD) is that they are usually supposed to be ego-syntonic, meaning the patient considers them correct and healthy. That would explain why it's considered hard to treat: it's usually not feasible to treat something the patient doesn't want treatment for! But if you're actually looking for treatment, that wouldn't apply to you. Even if OCPD is still a good diagnosis for you in spite of it being ego-dystonic, it means you've got a more treatable variant of OCPD, and they should acknowledge that.

I found this from Wikipedia (https://en.wikipedia.org/wiki/Obsessive%E2%80%93compulsive_personality_disorder) interesting:

There are considerable similarities and overlap between Asperger's syndrome and OCPD,[19] such as list-making, inflexible adherence to rules, and obsessive aspects of Asperger's syndrome, though the former may be distinguished from OCPD especially regarding affective behaviors, worse social skills, difficulties with Theory of Mind and intense intellectual interests e.g. an ability to recall every aspect of a hobby.[20] A 2009 study involving adult autistic people found that 40% of those diagnosed with Asperger's syndrome met the diagnostic requirements for a co-morbid OCPD diagnosis.[21]
I like how the parts that distinguish AS from OCPD are also what distinguish AS from ADHD. Pretty sure inflexible adherence to rules and especially list-making are related to executive dysfunction. I wonder what percentage of people with primarily inattentive ADHD meet the requirements for a co-morbid OCPD diagnosis.

But there's some truth to it as personality in general is so hard to change. I think you can never totally change your personality, you are who you are. But you can modify it and learn to integrate other opposing traits to balance your personality. And in the case of personality disorder, you can learn to bring your personality style to the normal level of adjustment, i.e. there are many "normal" OCDPs. These things are tremendously hard work, though, and it probably requires more than a lifetime to fully change and undo the effects of personality disorder, but it doesn't mean people can't move in the direction of health.

It's true that personality is hard to change, but how do the diagnosticians distinguish that a problem is part of the patient's personality and not from a normal mental disorder? Especially considering how often mental health professionals get weird interpretations about a patient's behavior and opinions.

Fortune
07-17-16, 07:03 PM
It's questionable whether personality disorders actually genuinely reflect one's personality as opposed to something else.

The "ego-syntonic" categorization is arbitrary as it seems to me that a lot of people I've dealt with who are labeled with personality disorders are not ego-syntonic at all. That doesn't necessarily mean a misdiagnosis, but I think it points toward personality disorders not being what psychology has been claiming they are for decades.

Fortune
07-17-16, 07:06 PM
I've also seen people with axis 1 (non-personality disorder diagnoses) be ego-syntonic about their symptoms, and I doubt they're necessarily misdiagnosed either.

midnightstar
07-17-16, 07:08 PM
What's the difference between axis 1 and axis 2? I'm confused Fortune :o

midnightstar
07-17-16, 07:09 PM
And the "professionals" are all a load of boring clueless farts.

Fortune
07-17-16, 07:15 PM
axis 1 is most of the mental illnesses plus lots of the neurodevelopmental disorders. Axis 2 is personality disorders. That's it, basically.

Fortune
07-17-16, 07:27 PM
Also, personality disorders were moved to axis 1 in the DSM-5, for the US at least.

MaxDemain
02-03-18, 11:50 AM
@Cyllya

Forgive my spelling. Even the computer can't help me sometimes and trying to be perfect imobilizes me.

I also wonder the % "with primarily inattentive ADHD meet the requirements for a co-morbid OCPD".

I learned I was ADD at age 28 in college. It was another student that helped me connect the dots. It wasn't the professionals. Later professionals confirmed the diagnostics. It was undetected because I am not hyper. I just loose my train of thought.

It 1st grade they diagnosed me with dyslexia. So I was in the system and in front of the professionals from the beginning. Lots of phycological testing throughout school. 20 years later another student picks up on the fact that I am ADD. Suddenly with a little retilin my grades go from D's to A's.

One pill and just for the "test" my grade goes from F to A.

Twenty more years go by and young neurologist tells me I have OCPD. The medical community only starting to figure this stuff out now.

When I explain OCPD symtoms to my friends (mostly nero diverse) they say there doesn't seem to be anything wrong with though symtoms they all seem pritty helpful.

So OCPD is very under diagnosed I suspect like you there is a higher than expected correlation between ADD(I know the DSM dropped ADD and uses ADHD, but they are different to me ) and OCPD.

Relating to "..inflexible adherence to rules and especially list-making are related to executive dysfunction..."

It might be how it starts. I also noticed people like Einstien and Steve Jobs (OCPD) both wore the same simple dark colored cloths everyday so they didn't waste time thinking about matching colors.Their clostest were full of clothes that were indistiguishable. I found it helped me to get out the door faster and on to things that I wanted to work on. I really like being productive. :)

Then I noticed that having a list and looking at it once or twice a day helped me focus on what was important. It would help me prioritize or reprioritize. (Great book: Getting Things Done).

I think it comes down to higher effientcy and productivity and gives repeatable results.

I think it was in "Driven to Distration" a book about ADD that I pickup up that we have adictive personalities. Its not joing to change so just pick your addictions. Like choose exercise or meditation as hobbies so you don't get sucked into less healthy alternatives.


Think about farming 50-10000 years ago. Make a list of things to do. Execute that list to the letter. Wait 6 moths to see the results. Make adjustment after 6 months and repete.

You have to be rigid in your execution and repetitive in your behaviour.

Problem comes in when your significant other doesn't understand why you have to have plates washed in a specific way, and placed in a specific location in the cabnet.

The trick with OCPD is to try to figure out when being perfect doesn't matter.

Its not easy to figure out when your OCPD. Everything matters.


@Midnightstar

Try to find a hot shot young neurologist. The next generation doctors are learning the new stuff. The old ones don't know anything about how our minds work.

Meditation is the one of the best medications and its free after you get the hang of it.

daveddd
02-03-18, 07:43 PM
Yes personality disorders are real and difficult to treat. What the are is still widely misunderstood. Biology? Psychology? Both?

One thing for certain they are far more common in adhd and maybe aspergers?

My current therapist is not well versed in avoidant personality and that makes me nervous. But she is studying and consulting others