So someone important in my life has self-diagnosed themselves with avoidant personality disorder, and looking at how they behave and how they act, I can’t really disagree with the diagnosis. I… don’t really know how to deal with this. At all. I don’t know how to act - they seem to often drift into despair or depression very easily, and at simple things like me forgetting to call them before going to bed. Then there’s the whole “total social isolation at school” thing which only makes it worse. This person has become straight-up misanthropic, commonly assuming the worst of people and taking the worst from any encounter.
Does anyone have any experience with this? Any advice on how to deal with them? This person is a large part of my life right now, and I feel utterly helpless. They cut occasionally, and I don’t know how much of a red flag I should consider that. A few days ago, they said they wanted to kill themself but couldn’t because they were afraid, and I don’t know how to deal with that ether - I don’t know how seriously to take it, if I should tell someone… It doesn’t help that their legal guardian considers psychology a waste of time, and even if they didn’t there’s not a whole lot of options in terms of getting therapy due to location.
I just… I don’t know what to do. If anyone has any advice for me, please, please help. I want to help this person as much as I can, and avoid hurting them as much as possible. What can I do?
Always take talk of suicide seriously. That is way way more important than any personality disorder diagnosis.
It’s difficult to discern your relationship to this person, is this a friend at school? I think you are quite young, yes? Is this something you could talk to one of your parents about? Or a teacher/staff member at the school?
I’ve asked my mother, but she has no advice for me. She doesn’t know much about this kind of thing. Same with my dad. As for staff members, this person has explicitly asked me not to do so, under the stipulation that whenever her family tried that, things only got worse… And I’m honestly not sure how to breach the topic. Or what they could do about it.
And I have left my relation to this person explicitly vague because of past experience talking about this kind of thing on this board.
Self-diagnosis for stuff like this…I wouldn’t recommend it. Based on your description alone, APD isn’t the first thing to come to my mind. Could be that she’s actually got something else or a combination of something else’s, and she’s simply latched onto a diagnosis that is not as fraught with stigma.
Well, what I did was, when they told me what they thought they had, I went to the wiki page, looked into the symptoms listed, and went down saying, “check… check… check…” Then I looked at the things likely to correlate with it… Bad home life not so much, but bullying? Before I stepped in last year, they were getting regular beatings from classmates. Things got slightly better, but they’re largely isolated and bullied, and have been since 4th grade or so.
There was a time when I thought had AvPD too. Because I had a superficial understanding of myself at the time. And all the other options was too scary and horrible. Then I actually took the MMPI and had a year’s worth of counseling sessions and some light was shed on the situation.
I’m not saying she doesn’t fit the criteria. But there’s a reason why people spend years studying this stuff. And someone with a disordered personality, by definition, lacks significant insight.
I really hope this isn’t another high school chick, BPC. All the talk about bullying and beatings from classmates and legal guardians isn’t making me think of a mature 20-something in college. So if we are indeed talking about a teenager, then I’m wondering just what the hell is wrong with your personality. If I’m completely off-base, apologies in advance.
Yeah, I understand that. I just want to help, and I don’t really know what to do. They think this is the problem, I think that at least to a certain point the pathology works… I know there’s a lot of room for error, but what am I supposed to do? I’ve been trying to get them to go to a psychologist for several months now and I can’t make it happen.
She really need professional help and your not it. If you have a school guidance counselor talk to them about her, confidentiality be damned, cutting and serious thoughts of suicide needs to be taken seriously.
In trying to convince her to seek help, try telling her about your own worries and fears about her. Sometimes people will think that seeking help for themselves is selfish, but will do so if they can see how much their not seeking help is affecting others they care about.
I would strongly disagree with the first part of monstro’s suggestion. Yes, sometimes tough love is a way to shock someone into taking action, but further isolation is the last thing she needs right now.
On the other hand, I agree strongly with his second statement. You can lead the horse to water but you can’t make her drink, and so you can’t blame yourself if she doesn’t. In the end she’s the one who has to do the work. You can encourage her and do your best to support her, but its really on her shoulders. Remember that no matter what happens.
I have avoidant personality disorder. I deal with it by taking lots of drugs and sometimes go to therapy (not currently, although I’m thinking of restarting). The main thing for me is learning to recognize my own behavior, so that when I start doing avoidant stuff again, I can say, “hey, you’re doing that thing again” and try to act differently. I’ve found cognitive behavior therapy to be a big help with that.
For me being avoidant is sort of like being both introverted and extroverted at the same time.
As for what you can do, it’s pretty limited. You need to be clear with yourself that it’s not your responsibility. You didn’t cause it and you can’t fix it. I would recommend providing your friend with the phone numbers of the suicide hotline and the local health center in the area. They would be able to direct your friend to the services that are available. Personality disorders are the sort of thing that really need a professional to check out - especially if there’s any sort of medication involved.
You and your friend might consider reading some cognitive behavior books, just to see if it sounds helpful. Like I said, it helps me but everyone’s different.
Other than that, maybe just give her her space. Let her decide if she wants to talk or not, or go out or not. It will probably vary. If you can relax and play it loose, it will help her from getting overwhelmed (which doesn’t mean you should be a doormat, of course.) Just remember - it’s not about you. You didn’t cause this. You can’t fix it.
They’ve been to see him on several occasions and found him unhelpful. From my experience at this school, that’s pretty accurate - he’s a lot of fun, but I wouldn’t want to have to discuss serious issues with him.
Mother.
Thank you for the response. I’ve been doing my best to detach myself from it, to say “not my problem”, but from my experience it’s a fine line between that and being cold and unhelpful, and I know on which side I’d rather be. So I often just do my best to pay attention and act invested, and try to point out when there’s a problem. I let her decide when she wants to do things, although judging from your post it seems she’s either got something else or is a lot milder… Hmm. Got any recommendations as to which books I should read on the subject?
As for professional help, she agreed to see a psychiatrist when she moves in a few months. The problem now is just that she doesn’t have the time or the transportation to see one regularly, or really much at all. So there’s that.
If your ‘friend’ is under the age of 21 or so, then tagging them with a personality disorder is not the way to go. Fact is, they don’t have enough of a set personality to be disordered. I would hope that no reputable therapist or psychiatrist would treat someone who still of an age to still require a legal guardian for a PD.
Additionally, what monstro said is quite correct; self-diagnosis is bad juju. The reason they tell folks studying to be therapists not to closely read the DSM is because it’s easy as hell to identify your behavior in all kinds of things. Everyone displays all sorts of criteria for almost every one of the diagnoses contained within the big book; the point is not how many you hit, the point is how much of a negative impact it has on your functionality. If you’re unable to drag yourself out of bed, chances are you have depression that should be looked into. If you’re sad sometimes but still go to work/school every day, sleep well, eat regularly and well, and have good interpersonal relationships, then you’re probably just sad sometimes- even if you want to tag yourself with depression (see: most of the folks who shop at Hot Topic). With AvPD, if you simply look at the diagnostic criteria, it pretty much paints an excellent picture of the average teenager.
Encourage her to call a confidential hot line if she’s thinking of suicide and cutting, don’t allow manipulation tactics like “I fall into despair when you don’t call me,” and stop trying to play armchair therapist. The school counselor may appear useless to her (and you), but if she goes in with the attitude of “I want to talk to someone outside of school, give me a recommendation of someone local” then he can actually be quite helpful. So can a religious figure, if she’s into that kind of thing.
So basically, you are dating a mentally unbalanced high schooler (again?) and you want advice on how to “save” her. How about you let her Mother deal with it.
I assume it’s the same mentally unbalanced high schooler that he’s been shacking up with on weekends, much to the immense disappointment of said high schooler’s brother.
Things got slightly better, but they’re largely isolated and bullied, and have been since 4th grade or so.