# Narcissism-no longer part of the DSM, why? **URL:** \ **Category:** Factual Questions\ **Created:** [June 27, 2011, 7:02pm UTC](https://boards.straightdope.com/t/narcissism-no-longer-part-of-the-dsm-why/587052 "2011-06-27T19:02:49Z")\ **Posts on this page:** 4\ **Page:** 2
**Author:** ![Leo\_Bloom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/leo_bloom/32/10377_2.png) [@Leo\_Bloom](https://boards.straightdope.com/u/Leo_Bloom)\ **Post date:** [June 29, 2011, 2:21am UTC](https://boards.straightdope.com/t/narcissism-no-longer-part-of-the-dsm-why/587052/21 "2011-06-29T02:21:43Z")
> [@purplehorseshoe](#): > > **Rigamarole** , why do you think treatment = pharmaceuticals? There are non-Rx approaches to many aspects of mental health care. Why immediately jump to hysterical hand-waving about Big Pharma and cash cows and huge, colossal, earth-shattering $$$? > > Do you think people with mental health problems should do without “treatment” entirely? Concur. Plus, there’s a reason pharmaceutical companies are “big,” and it has little to with rapaciousness or some vast exploitation of the body politic. ---
**Author:** ![monstro](https://avatars.discourse-cdn.com/v4/letter/m/ba9def/32.png) [@monstro](https://boards.straightdope.com/u/monstro)\ **Post date:** [June 29, 2011, 3:17am UTC](https://boards.straightdope.com/t/narcissism-no-longer-part-of-the-dsm-why/587052/22 "2011-06-29T03:17:29Z")
> [@BigT](#): > > Uh, very few of the disorders in the DSM have medicines for them. None of the personality disorders do–seeing as they aren’t even thought of as a problem with brain chemistry. Actually, this isn’t true. Borderline PD is starting to be viewed as a form of rapid-cycling bipolar disorder, due to the huge mood shifts and impulsivity characteristic of this disorder. There have been studies showing that there are neurochemical and hardwiring differences in people with diagnosed with BPD compared to other people. Because this disorder is often used as a catch-all, it may be that some borderline individuals actually suffer from something else (or a combination of things). But it is not true that brain chemistry has not been implicated as a cause. Schizoid and schizotypal personalities both have a biochemical and genetic link to schizophrenia, and the evidence is compelling. Approximately 30% of people diagnosed with the latter PD will go on to develop psychosis and be diagnosed as schizophrenic, and these folks tend to show up in families where cases of schizophrenia cluster. In retrospective studies, it has been shown that schizophrenics often have schizoid personalities in their prodromal phases (you cannot be diagnosed with any of the eccentric PDs if you currently have schizophrenia). Furthermore, people with these two PDs have been shown to have abnormalities in dopamine. Schizotypal individuals often have awkward body movements and bizarre mannerisms, which are indicative of having too much dopamine. Schizoids, who tend to have more negative symptoms, have been helped with drugs like Wellbutrin, which increases dopamine levels. Out of all the PDs, schizotypal individuals are probably most likely to have developed the disorder due to biological reasons rather than environmental. Like borderline individuals, they are especially prone to suicide, and it is not uncommon for people to get a borderline with schizotypal features (or vice versa) diagnosis. While there aren’t drugs specifically marketed for the treatment of PDs, people with PDs are prescribed tons of drugs to treat individual symptoms. Just like people with developmental disorders are prescribed drugs to help with their problems (see autism spectrum disorders). For instance, a person diagnosed with avoidant PD will often be given anti-anxiety medication because they usually experience some degree of social phobia. I think schizoid PD is being broken up into its individual components because it is hard to distinguish from avoidant PD and schizotypal PD. In my opinion, after researching the subject upon receiving my own diagnosis, I believe “schizoids” who are poor at expressing their feelings and who are anxious around people but too alexithymic to recognize it are probably avoidants. “Schizoids” who are weird but savvy enough to hide it and have more negative symptoms than positive ones are probably schizotypal. Unlike the other two PDs, it takes a good while to figure out schizoidy-ish people because these individuals tend to be aloof and hard to read, even to themselves. So it’s easier to drop the label and acknowledge the individual traits as they reveal themselves. ---
**Author:** ![Leo\_Bloom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/leo_bloom/32/10377_2.png) [@Leo\_Bloom](https://boards.straightdope.com/u/Leo_Bloom)\ **Post date:** [June 29, 2011, 5:01am UTC](https://boards.straightdope.com/t/narcissism-no-longer-part-of-the-dsm-why/587052/23 "2011-06-29T05:01:59Z")
> [@monstro](#): > > Actually, this isn’t true. > > Borderline PD is starting to be viewed as a form of rapid-cycling bipolar disorder, due to the huge mood shifts and impulsivity characteristic of this disorder. There have been studies showing that there are neurochemical and hardwiring differences in people with diagnosed with BPD compared to other people. Because this disorder is often used as a catch-all, it may be that some borderline individuals actually suffer from something else (or a combination of things). But it is not true that brain chemistry has not been implicated as a cause… Serious Bipolar 1/Mixed and BPD here. Concur. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [June 29, 2011, 3:29pm UTC](https://boards.straightdope.com/t/narcissism-no-longer-part-of-the-dsm-why/587052/24 "2011-06-29T15:29:29Z")
> [@BigT](#): > > It’s just a paradigm shift into functional disorders. If your life is not being impaired, you don’t have a disorder. If this wasn’t the case, half the Dope would have OCD, and the other half depression. I suspect there is overlap here. I would have something profound to say about the DSM and narcissism, but I’m far too important to bother with it. [Previous page](https://boards.straightdope.com/t/narcissism-no-longer-part-of-the-dsm-why/587052.md?page=1)