BLOG No. FORTY FOUR

Welcome back to my blog on and depression. I want to thank Dr. Stewart for her wise observations in her guest blog last week. We hope to hear from her again, soon. Today I want to touch on personality disorders (PD’s). There are essentially three groups of PD’s called “clusters” in psych-speak, that clump together the basic PD’s as described in the DSMV. The DSMV is the Bible of psychologists and psychiatrists that helps to group serious psychological and psychiatric disorders. We are currently on “Bible” 5. We will spend just a few moments on the various PD’s as they are boring as hell.

The first cluster contains 1) Paranoid PD which affects 3-4% of the population. Here, patients have a pervasive distrust of others. They are always suspicious of other’s actions. 2/3) Schizoid and Schizotypal PD’s are similar and contain social isolation. They are very withdrawn and can be preoccupied with fantasy.

The second cluster of PD’s encompasses 1) Antisocial personality, which ignores social norms and holds minimal empathy for others. 2) Borderline PD has a lot of impulsive behavior and emotional instability. 3) Histrionic PD patients always need to be at the center of attention which is not terribly different from 4) narcissistic PD, known as self-centeredness.

The third cluster is dominated by anxiety. 1) Avoidant PD’s characterized by a disregard of rules. 2) Dependent PD has at its center a fear of being alone, using others to take care of us. Lastly, 3) Obsession-compulsion PD patients demonstrate a preoccupation with perfection. YAWWWWWWWN!

I just want to share with you that I have been off my OCD meds for nearly a year now! Well, 11 months 22 days, three hours and 37 seconds to be exact!

So, PD’s describe patterns of abnormal behavior that we see in people and in patients. But the American Psychiatric Association lists these PD’s as separate from other disorders like bipolar, social anxiety, etc. It is if PD’s were a world to themselves, never to coincide with other disorders. I think this is a huge mistake!

So, what is a personality? That is a difficult question to answer. Personality tends to mean our peculiar pattern of thinking, behaving, and feeling. For instance, if I feel that the people across the way are talking about me, I might actually go and confront them in anger, and make a fool of myself.

But you are telling me that my personality has nothing to do with my neurotransmitters? Really?

That statement has more crap in it than a year of political speeches! Look, you heard me say this before—all of life boils down to two things, neurons that fire and glands that squirt! Like it or not, we are products of our own neurochemistry. If our serotonin is in the toilet, we feel down, regardless of our situation. When D2 dopamine is climbing, are mood starts to destabilize.

“But we can overcome those, can’t we?” someone might ask. And I would answer, “Yes, to some degree.” But I feel that this is such a big topic, I will address it more in the next blog. But for now, I just want to posit that-

personality disorders are the thoughts, feelings, and actions of our neurochemical makeup, not a complete separate set of diseases.

Well the robot that tried to shoot me last week is gone. I sent him to Washington to find the evidence of intelligent life. Looks like he’ll be gone for a while, so I’ll just sit here and sip my Chardonnay. Until next time, this is Dr. G saying, keep the faith!