You know, it’s fun when you go on a forum about Bipolar and one of the first topics you read happens to be about someone who has received the (in)famous personality disorder diagnosis instead. *sigh* It just makes me wonder lots of things and it’s a little difficult to express things at things so this may seem a little disjointed.
I seem to be perplexed as to why things seem to not be progressing. Can’t say I’m terribly surprised because let’s face it, how quickly are things ever going to change? I know what you’re thinking, “what needs to change?” (either that or “Who gives a fuck?”), to which I reply… I don’t really give a fuck but at the same time I do. How’s that for contrariness?
Ok, let me try and narrow it down.
To begin with, we’re getting bloody stupid with the diagnosis system. I’m sorry but the whole thing is almost critically flawed and seems to screw people about no end for no reason than to just play silly buggers. Seems there are issues with the definition of “personality disorder” and also how such a thing comes about. As such you get some who think that personality disorders are genetic etc which is a great way to describe them as long as you don’t mind being completely and utterly wrong. If they were genetic or any variation of a physical precept then they would comfortably fall under the title of “psychiatric condition” which they aren’t, they’re psychological conditions.
I’ve covered personality disorders before yet I find myself covering those points once again. A personality disorder comes about due to stress incurred during the formative years of the ego which distorts the standard development of the personality. Now, it depends on a few dimensions as to the likelihood of a personality disorder being there, such as level of stressor time under stressor, and susceptibility to stressors. That last one is where we can look at genetics although we’ll save the looking for later. If I could draw a diagram it would be a radar chart with each of the points marked out and then you’d be able to see how likely a personality disorder is by how much area is covered. The standard psychology model of using life experiences and how issues manifest themselves to determine type of personality disorder would remain.
So, shall we look at the genetic component? This would be the same genetic possibility of having any mental health condition which is normally derived by a family history taken, it doesn’t matter overly what the diagnoses were, just that they were there. This history doesn’t guarantee mental illness, merely hints at the likelihood of it occuring. As such, in theory it should also give an idea as to likelihood of a personality disorder. Looking at it like that then instead of the current practise of single diagnosis, it’s going to look more likely to encourage professionals to consider a dual diagnosis. If this were the case then I think we’d end up with happier service users and possibly better tailored care plans.
Just a thought.