# Mental health question: what would this person be diagnosed with? **URL:** \ **Category:** Factual Questions\ **Created:** [November 27, 2010, 2:23am UTC](https://boards.straightdope.com/t/mental-health-question-what-would-this-person-be-diagnosed-with/562037 "2010-11-27T02:23:49Z")\ **Posts on this page:** 13\ **Page:** 2
**Author:** ![Silver\_Tyger](https://avatars.discourse-cdn.com/v4/letter/s/fbc32d/32.png) [@Silver\_Tyger](https://boards.straightdope.com/u/Silver_Tyger)\ **Post date:** [December 2, 2010, 7:33pm UTC](https://boards.straightdope.com/t/mental-health-question-what-would-this-person-be-diagnosed-with/562037/21 "2010-12-02T19:33:47Z")
> [@SayTwo](#): > > What would he be diagnosed with? I’d say Every Guy Syndrome, to be most damning. > > Most of what you describe is just regular people-type stuff, certainly not indicative of a mental illness. However, you offer up “Anyone who even slightly threatens her is likely to die, unless she says otherwise”… If that’s meant to be literal, then you are dealing with a horror story and not a mental illness. Actually that is literal. I can pull out quotes. I’m not a mental health expert, but from what I’ve read a lot of mental illnesses are normal problems taken to extremes. Depression? (which I’ve dealt with) Hey, it’s just being sad or lethargic taken to life-ruining levels (depending of course, on how bad it is). Social anxiety? (the other one I’ve dealt with) It’s just shyness taken to unreasonable levels. When do normal problems become mental illnesses? According to a friend of mine who is a mental health professional, it’s when they can no longer deal with or fit in normal society. WR is not normal. Normal people don’t kill their parents, even if they’re abused. Normal people don’t kill their bosses because they got talked to for talking back (admittedly both parties involved are criminals…). Normal people don’t blow up fireworks factories because they think it’ll be cool. Those are all things I’ve written WR to do. Which is why I started to thread to get expert opinions from people who actually know what they’re talking about. If there isn’t a DSM entry for it, I’m going to ignore that response. ---
**Author:** ![HMS\_Irruncible](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hms_irruncible/32/7394_2.png) [@HMS\_Irruncible](https://boards.straightdope.com/u/HMS_Irruncible)\ **Post date:** [December 3, 2010, 1:40am UTC](https://boards.straightdope.com/t/mental-health-question-what-would-this-person-be-diagnosed-with/562037/22 "2010-12-03T01:40:41Z")
> [@Silver Tyger Girl](#): > > When do normal problems become mental illnesses? According to a friend of mine who is a mental health professional, it’s when they can no longer deal with or fit in normal society. WR is not normal. Normal people don’t kill their parents, even if they’re abused. Normal people don’t kill their bosses because they got talked to for talking back (admittedly both parties involved are criminals…). Normal people don’t blow up fireworks factories because they think it’ll be cool. Those are all things I’ve written WR to do. A lot of what you’ve written is sociopathic (killing people, acting without regard to others), narcissistic (thinking the world revolves around himself), and some of it is alcoholic or child of alcoholic (poor impulse control, thrill-seeking behavior, blackouts). The sociopathic and narcissistic angle no longer are believable when you explain how devoted he is to his inner circle. All together, it’s really not a believable set of symptoms… not unless he’s lying when he’s talking about how much he cares about his wife or friends, or unless maybe the apparent sociopathic/narcissistic actions are more justified than it first seems. ---
**Author:** ![Silver\_Tyger](https://avatars.discourse-cdn.com/v4/letter/s/fbc32d/32.png) [@Silver\_Tyger](https://boards.straightdope.com/u/Silver_Tyger)\ **Post date:** [December 3, 2010, 4:35am UTC](https://boards.straightdope.com/t/mental-health-question-what-would-this-person-be-diagnosed-with/562037/23 "2010-12-03T04:35:36Z")
> [@Cosmic Relief](#): > > A lot of what you’ve written is sociopathic (killing people, acting without regard to others), narcissistic (thinking the world revolves around himself), and some of it is alcoholic or child of alcoholic (poor impulse control, thrill-seeking behavior, blackouts). The sociopathic and narcissistic angle no longer are believable when you explain how devoted he is to his inner circle. All together, it’s really not a believable set of symptoms… not unless he’s lying when he’s talking about how much he cares about his wife or friends, or unless maybe the apparent sociopathic/narcissistic actions are more justified than it first seems. **Pravnik** ’s, **IrishGirl** ’s, and **Kolga** ’s suggestions seem to fit quite well with my overall idea. ---
**Author:** ![Ranchoth](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ranchoth/32/1066_2.png) [@Ranchoth](https://boards.straightdope.com/u/Ranchoth)\ **Post date:** [December 3, 2010, 12:45pm UTC](https://boards.straightdope.com/t/mental-health-question-what-would-this-person-be-diagnosed-with/562037/24 "2010-12-03T12:45:42Z")
Perhaps you might want to make his problems more _neurological_ than strictly psychological (I mean, to the extent you can separate the two!)? Maybe his abusive parents hit him in the head a few times, or his Harry Potter bedroom had a carbon monoxide leak, and/or something. Adding psychological trauma on _top_ of that might create a unique form of crazy for your character. ---
**Author:** ![HMS\_Irruncible](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hms_irruncible/32/7394_2.png) [@HMS\_Irruncible](https://boards.straightdope.com/u/HMS_Irruncible)\ **Post date:** [December 3, 2010, 11:51pm UTC](https://boards.straightdope.com/t/mental-health-question-what-would-this-person-be-diagnosed-with/562037/25 "2010-12-03T23:51:57Z")
> [@Silver Tyger Girl](#): > > **Pravnik** ’s, **IrishGirl** ’s, and **Kolga** ’s suggestions seem to fit quite well with my overall idea. Well yeah, just about anything will fit into a kitchen-sink category that includes just about everything. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [December 4, 2010, 3:27am UTC](https://boards.straightdope.com/t/mental-health-question-what-would-this-person-be-diagnosed-with/562037/26 "2010-12-04T03:27:42Z")
> [@irishgirl](#): > > …if your character was real he’d probably have had several different diagnoses from several different psychiatrists, depending on what he chose to focus on as his main issue at that time. This bears repeating. I’m by no means an expert, but I just spent a few weeks doing a rotation on the Aggressive Men’s floor of a hospital Psych Unit. I read a lot of charts. I didn’t see a single one with only one diagnosis. They’ve all got two or three, depending on who signed the sheet of paper you’re looking at. My last guy, who was not at all unusual, had Schizoaffective Disorder, Bipolar and Major Depressive with Auditory Hallucinations. Now, did he really have all those conditions? Probably not. But each person offering a diagnosis did so after a conversation with the man where he talked about some things, but not others, and exhibited some behaviors that he didn’t display other times. That’s the nature of mental health diagnosis - there are no lab tests for these diseases, you have to go with what you see and hear. Patients change what they say and change their behavior, so nailing some of these diagnoses is like nailing jello to a wall. So don’t worry too much about getting the one right diagnosis. Chances are, his doctors haven’t. ---
**Author:** ![pravnik](https://avatars.discourse-cdn.com/v4/letter/p/8edcca/32.png) [@pravnik](https://boards.straightdope.com/u/pravnik)\ **Post date:** [December 4, 2010, 4:50am UTC](https://boards.straightdope.com/t/mental-health-question-what-would-this-person-be-diagnosed-with/562037/27 "2010-12-04T04:50:12Z")
Another point is that there’s currently a great deal of overlap and comorbidity between personality disorders so that the same symptoms can receive several different diagnoses, a problem the DSM-V committees are attempting to clarify. The same behavior can be characterized by one evaluator as Antisocial Personality Disorder with Borderline features, another as Borderline Personality Disorder with Antisocial features, and another as Personality Disorder NOS with Antisocial and Borderline Features, and so on. None of them are actually disagreeing with the others, it’s partially a judgment call on what features predominate, and partially different ways of saying much the same thing. ---
**Author:** ![Slow\_Moving\_Vehicle](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slow_moving_vehicle/32/291_2.png) [@Slow\_Moving\_Vehicle](https://boards.straightdope.com/u/Slow_Moving_Vehicle)\ **Post date:** [December 4, 2010, 4:58am UTC](https://boards.straightdope.com/t/mental-health-question-what-would-this-person-be-diagnosed-with/562037/28 "2010-12-04T04:58:02Z")
You could also throw in ADD - although ADD in your character would be like halitosis in a leper. ---
**Author:** ![anomynomous](https://avatars.discourse-cdn.com/v4/letter/a/a183cd/32.png) [@anomynomous](https://boards.straightdope.com/u/anomynomous)\ **Post date:** [January 17, 2011, 8:59am UTC](https://boards.straightdope.com/t/mental-health-question-what-would-this-person-be-diagnosed-with/562037/29 "2011-01-17T08:59:02Z")
you said he had a bad childhood. that right there answers your question. his symptoms are likely due to ptsd. ---
**Author:** ![AHunter3](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ahunter3/32/368_2.png) [@AHunter3](https://boards.straightdope.com/u/AHunter3)\ **Post date:** [January 17, 2011, 10:03am UTC](https://boards.straightdope.com/t/mental-health-question-what-would-this-person-be-diagnosed-with/562037/30 "2011-01-17T10:03:05Z")
> [@Silver Tyger Girl](#): > > I have a character who has some serious mental problems (actually there’s several of them, but…). We’ll call him WR. I’m leaning towards anti-social personality disorder as the most likely diagnosis, but, obviously, I’m no expert in anyway… > > So what would he likely be diagnosed as and what sort of therapy / treatment would they give? I’m not looking for ‘cures’, just what the doctors would do to try to get him, um, socially acceptable, I guess. Your question presupposes a lot of inter-rater reliability for the psychiatric profession. That’s not a valid assumption. (In other words, what **IrishGirl** , **WhyNot** , and others have said). ---
**Author:** ![BigT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bigt/32/12044_2.png) [@BigT](https://boards.straightdope.com/u/BigT)\ **Post date:** [January 17, 2011, 12:48pm UTC](https://boards.straightdope.com/t/mental-health-question-what-would-this-person-be-diagnosed-with/562037/31 "2011-01-17T12:48:53Z")
I’d use [dialectical behavior therapy](http://en.wikipedia.org/wiki/Dialectical_behavior_therapy) (DPT) in your story, even if you have to have the psychologist not knowing for sure what the disorder is. There is definitely a trend just trying treatments if you can’t diagnose on symptoms alone. And DBT is pretty interesting in its own right. ---
**Author:** ![BigT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bigt/32/12044_2.png) [@BigT](https://boards.straightdope.com/u/BigT)\ **Post date:** [January 17, 2011, 12:51pm UTC](https://boards.straightdope.com/t/mental-health-question-what-would-this-person-be-diagnosed-with/562037/32 "2011-01-17T12:51:11Z")
> [@Cosmic Relief](#): > > A lot of what you’ve written is sociopathic (killing people, acting without regard to others), narcissistic (thinking the world revolves around himself), and some of it is alcoholic or child of alcoholic (poor impulse control, thrill-seeking behavior, blackouts). The sociopathic and narcissistic angle no longer are believable when you explain how devoted he is to his inner circle. All together, it’s really not a believable set of symptoms… not unless he’s lying when he’s talking about how much he cares about his wife or friends, or unless maybe the apparent sociopathic/narcissistic actions are more justified than it first seems. I believe you are incorrect, as those personality disorders do not have to be absolute, especially if the devotion to one’s inner circle is based on selfishness and/or trying to appear normal. ---
**Author:** ![PandaBear77](https://avatars.discourse-cdn.com/v4/letter/p/edb3f5/32.png) [@PandaBear77](https://boards.straightdope.com/u/PandaBear77)\ **Post date:** [January 17, 2011, 1:12pm UTC](https://boards.straightdope.com/t/mental-health-question-what-would-this-person-be-diagnosed-with/562037/33 "2011-01-17T13:12:39Z")
Another vote for DBT. If he didn’t love his wife and friends he’d be a textbook sociopath. I like **Ranchoth’s** idea a LOT. A few blows to the head in childhood can do all sorts of stuff to a developing brain. On top of the PTSD and personality disorder your character has, damage to his frontal lobe could explain his lack of impulse control and yet still give him the ability to love SOME people. [Previous page](https://boards.straightdope.com/t/mental-health-question-what-would-this-person-be-diagnosed-with/562037.md?page=1)