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.
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.
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.
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.
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.
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).
I’d use 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.
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.
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.