In looking at all the threads we’ve had about borderline personality, it’s pretty clear that people with BPD can be generally unpleasant to be around. But when looking at unpleasant people with mental disorders, how much of that behavior can be attributed to the disorder and how much to the personality? With BPD, it seems that the personality pretty much is the disorder. It seems unfair to reject someone for factors they can’t help or control, though there’s often little other option.
The Charlie Brown thread from a while ago also got me thinking, especially this exchange:
Obviously, no one wants to be cruel to someone with depression. But if someone’s depression is causing them to act in negative, unpleasant ways, eventually they may drive away the people who care about them.
Can we distinguish someone’s mental disorder from who they are as a person? Does it make a difference? Is rejecting them for unpleasant behavior when it’s due to a mental disorder really all that worse than just rejecting them for any other reason?
It’s an interesting question. I work with The Most Unpleasant Person in The World. It seems like there has to be some sort of mental illness involved: her unpleasantness, self-absorption, and general delusions about her relationship with the world and how others perceive her are so far outside the range of normal that they simply can’t just be “personality”. But no one is kind to her, though most people are civil. She’s simply too unpleasant to stand for very long, and everyone runs away from her as quickly as possible: If I were trapped in an elevator with this woman, I would claw my way out with my bare hands.
I wonder, sometimes, what my ethical responsibilities are to her. I can’t “get her help”: she doesn’t think anything is wrong (I think she thinks she is generally liked and respected) and she’s a lady I work with, not a friend. But at the same time, when I make a bullshit excuse to get away from her whenever we meet in the hallway, I feel like I am a snotty 10 year old girl avoiding the unpopular kid. It’s not her fault she’s unbearable, but does that mean I am obligated to bear her? I don’t know.
It’s often a matter of degree. It’s a personality trait until it interferes with that person’s ability to function in their life. Then it becomes a personality disorder.
Their personality’s impact on you isn’t what makes it a disorder.
Wouldn’t it be easier to just kill her? I mean, if her presence is sufficiently annoying, why risk injury from taking on the elevator mechanism? Then if you meet someone nice at her funeral, and want to meet that person again, you could just kill another co-worker…
Sorry, that’s my sociopathic personality disorder talking.
You know, this reminds me. One time in 5th grade, my little brother was in a spelling bee with a autistic kid. The autistic kid would always make obnoxious sounds and noises, but in the end he proved himself to be intelligent or at least a hard-studyer when he won the Spelling Bee. Anyone else have a real life example?
The autistic kid example wasn’t quite what I was talking about. It’s not about how smart the mentally ill person is. I was thinking more about how to untangle the mentally ill person’s personality from their illness, and in some cases, is it ever possible.
Of course, even personality is pretty stable and highly genetically determined. It does seem pretty unfair that so much a person’s life outcomes are based on things he has no control over - personality, intelligence, social intelligence, height, looks…and being free of diseases physical or mental.
The solution, I think, is not so much to try to draw a line between things that are “your fault” and “not your fault,” but to think about these factors in a way that’s actually consistent with how deterministic a lot of life is. I think that we as a society tend to be fairly insensitive to the fate of those who lose the genetic lottery in these regards - even as we are, relatively speaking, extremely sensitive to inequalities in things like money or racial affiliation.
Personality disorder and mental illness are not the same thing. Very simplisticly, personality disorders are part of who the person is, mental illnesses are not. So, if someone’s depression is affecting their personality, it will change back when the depression is treated, but if someone has Histrionic Personality Disorder, that is basically who they are. Doesn’t mean that they can’t learn to moderate their behaviour though, but it won’t go away.
Yes, I was thinking about this tonight, too, athelas, and it occurred to me that even someone who’s not diagnosable with any disorder can be obnoxious for a variety of reasons. I think it’s often easy to think that there’s control over how you present yourself but sometimes, as you say, things are pretty deterministic.
I’m usually kind to people because it makes them more pleasant to deal with. I don’t really care about fault. I will be nice to someone even if they are genuinely an asshole, as long as it could make them behave better.
It all comes down to a cost benefit analysis. I’ve met people with autism and schizophrenia, and I had no trouble being kind to them.
With BPD or sociopathy, kindness wouldn’t work. People with these disorders usually take advantage of someone who was nice to them. I wouldn’t deal with them at all.
I’ll be nice when I can, but I’m not bending over backwards. There comes a certain point where if I know my kindness won’t do any good, I’ll just have to stop being kind.
[ol]
[li]Depends on the disorder. Mood disorders? Autism? Sure. Personality disorders? Not so much.[/li][li]I think the critical factor is the degree to which the disordered person drags their loved ones through the shit. We all have an obligation to be kind to one another, but nobody has an obligation to throw themselves on the pyre for someone who makes their life a living hell.[/li][li]In the case of personality disorders, I don’t know if there’s much daylight between someone with BPD/NPD/whatever and a garden-variety undiagnosed asshole. If the asshole’s unpleasant personality is just as intrinsic as the person with BPD, then are we obligated to not reject them, too?[/li][/ol]
I’ve known several individuals who were probably undiagnosed Asperger’s Syndrome. They weren’t difficult to work or associate with once I figured out their quirks. In fact, to a certain easier degree they were easir than many so-called “normal” people because of their predictability.
I’m not sure that BPD is treatable. While I can be sympathetic towards those that have it…I don’t have to continually subject myself to their behavior. Normally, they will find ways to cut you out anyway.
Some BPDers can change. Basically one has to educate them about their behavior and show how it causes difficulty in their lives, due to their interactions with others. Then alternative behaviors need to be substituted. Motivated BPDers have been known to show sustained behavior improvement.
Unfortunately, such successes are the exception rather than the rule. By quite a degree. I’d not advise anyone to stick with a BPDer based on the assumption that they’ll change, because the odds are against it.
But if they do change for the better, it’s great for all involved.
I was treated for depression. Then I was labelled with Schizoid Personality Disorder. I don’t know if that’s correct, but there is something more wrong with me than mere depression.
I don’t really have any close friends IRL. I only made the connection last year that my depression making me miserable made me miserable to be around. I started feeling better for a while and was making strides in the friendship game. I’ve regressed since I lost my job.
Most of the time I prefer to be by myself. That might be SPD or just normal introversion. Many folks mistake introversion or shyness and aloofness. That may be turning people off too.
I don’t expect anybody to treat me differently because of my mood or personality disorders. It’s up to the person with them to seek treatment. If they refuse to do so, well the world isn’t going to change to accommodate them.
It’s a little bit different with BPD, which is nearly untreatable, and a whole nother brand of crazy.
Who are they as a person? Mental disorders are the product of a number of different processes going awry for an individual. To distinguish mental disorder from “who someone is as a person,” you’d have to say that there is a distinction between how someone thinks, feels and behaves and who they are as a person. That just makes no sense to me.
Personality disorders are no different, although they tend to be less well-defined or well-established as diagnostic constructs than other disorder. Nevertheless, they describe a constellation of behaviors and maladaptive cognitive and affective processes that show up in conjunction with one another often enough to serve some purpose as a nosological category.
Not really, in my opinion. People aren’t saints, and being shat upon is being shat upon, regardless of the reasons why. Some people have more patience or tolerance for this than others, and that is certainly laudable. Some spouses of people with bipolar disorder, for instance, may have to endure some periods of distress but may find much of the rest of their time with their spouse rewarding enough. It just depends on the context and individual differences.
At the same time, some of the motivation for change has to come from the feedback one gets from others and the circumstances one’s behavior creates, so just excusing everything would remove some motivation for change.
This doesn’t make any sense to me. Episodicity doesn’t define mental illness from not mental illness. Otherwise we would say that Dysthymic Disorder is just how a person is, in contrast to Depression. Depression also is a function of how people think about things, and treatment involves working on changing that through volition. Does that make it more or less of who a person is?
I just don’t get how someone is “who they are” outside of the way that they act, feel and think? Personality disorders are more enduring and pervasive than other disorders, but they are also changeable, and they are also all very much mental disorders.
I was told otherwise when I was having psychiatric treatment. My understanding, and experience, is that depression is treatable - that is, with the right combination of drugs and therapy, it can go away. Personality disorders are different - with the right therapy one can work round them, but the actual issue never goes away.
There are of course many grey ares.
If someone is acting unpleasantly because they are ill with the flu, for example, would you say that they are an unpleasant person and that’s that? I would say not, and that the same applies to some mental issues
