Personality Disorder Pathological

[Loner_in_Hiding]

I have been in mental health sector all my life since adolescence, I am totally screwed up and consistent dysthymia and major depression reactive to adverse life events ie. non-melancholic depression.

This past year or so I came to acute realisation that all my problems have only been manifestation of the core issue, that is, a personality disorder which I am very hesitant to name because this particular PD is so reviled, sensationalised and misunderstood. It always features as villainous.

You may have guessed what it is already although my pathology manifest in less known way, the way coined 'vulnerable', 'hyper-vigilant' or 'covert'.

I hate, ashamed of myself ,and tormented, for possessing such psyche of this personality disorder. I cannot deceive myself unlike so many others apparently unaware of their PD.

I have drifted lower and lower , more and more isolated (vicious depressive cycle) since I left Sydney about 8-9 years ago, going further away from capitals and lost professional psychiatric support. Only just existing by looking after my very demanding dog: the only family/friend I have got.

She has heart ailment now that numbers her days- lucky if she stays for another year.

I am in a desperation now knowing what would become of me when she finally goes.

I am so tired of my life which best described as a total failure.

Since I am famililess/friendless and a total stranger to a regional town where I live now who cares if I go? I have never been such a thing as valued community member.

Since every expenses are paid automatic direct deposit and my DSP coming in the same account, nobody would even know.

[geoff]

Hello Loner in Hiding, thanks for your post, however I think that you would get a better reply from Dr.Kim, and there is a thread called 'Ask Dr Kim', so if you like to type in Dr Kim in the search box above, it will appear. Geoff.

[Loner_in_Hiding]

Thank you for your input Geoff.

I think I scared ppl off.

[Guest8901]

Hi Loner. No, not scared off! And can I say "welcome" to this fabulously supportive site.

Just dont have any experience or knowledge in your personality disorder. Whatever it may be? I'm sure you are able to disclose exactly what it is, if you would like to? Villainous? You certainly dont sound it, and I would welcome further information if you're comfortable to provide it. You wont be judged here Loner. We all have our own MH issues and, although yours may not be as well understood as some others, its still very important that you have a voice and somewhere supportive to come and talk. I applaud you for having come here. And by you having the courage to talk about it here, it will help fellow MH sufferers and the wider community, better understand your particular personality disorder.

I hope you feel safe enough and confident enough to come back and say more.

I too love my dog. I have a Tenterfield terrier, by the name of Charli. She's the best mate you could ask for. She is aging now though, being 9yo, and I honestly dread the day I lose her. So far, touch wood, she's in good health. But I certainly can understand and feel great empathy for you at the thought that you will lose her soon. My heart goes out to you.

I would welcome further discussion with you, if you would like to. Like I said, I cannot offer any specific advice regarding your PD. But I do feel for a fellow human being who is obviously suffering. And I understand feeling vulnerable, hypervigilant, shame, self hate, as well as feeling isolated, depressed and SI. I experience both anxiety (from PTSD) and depression, so although the diagnosis is not the same as yours, many of the resulting symptoms are common between us.

Kindest

Amanda

[Loner_in_Hiding]

I haven't energy to explain well right now and my English is limited.

The thing is,... Eating Disorder, Body Dysmorphia, Obsessive Compulsive rituals, severe anxieties, BPD along with permanent Dysthymia overlayed by major depressions I have all had them since very young age. But can not help myself knowing they have only been the symptoms of my core issue which is the PD I dare not name but you know which.

I became very ashamed and hating myself by the time I was 15 I locked myself up in my house and never set my foot out side for 2 years then long hospitalization-

What I am getting at is, I am acutely introspective to the point of puritanical to know the psyche of this PD festering inside myself which stops myself acting in the way this PD is usually known for.

Regular run of the mill psychologists in a regional town I currently reside can not see this PD in me - I have to spend months of counseling to educate the last psychologist with academic papers from the net because she just could not understand. I subsequently left this practice because it was out side her capability.

I am now desperately seeking somebody to work on my core issue probably in the form of psychodynamic therapy. I have to travel Melbourne way to get proper help and I am so tired because of depression.

I have only been treated for the said symptoms in which I have stated in the past because they were immediate and pressing but never the core problem. I came to the realization that unless it is properly recognized and dealt with, I would never find a solace in my life. The emptiness, feeling of defectiveness are eating me up leaving a huge hole inside me.

I have drifted down, away from cities and more and more isolated (vicious depressive cycle) - and older I get, less possibility of turning my life around.

So that is my justification for being here however I have got my indictment from lack of response that I do not even belong here.

[Loner_in_Hiding]

Thank you so much for your kind words Amanda.

It's Narcissistic Personality Disorder.

Have not yet been officially diagnosed although the psychiatrist I had in Sydney mentioned 'cluster B' in his records of me and I was Borderline for years - which made me look into this personality cluster further in recent years in desperation and came to the conviction.

It pains me to explain to when I contact new therapists because it is not known for NPDs to be aware of their own pathology.

I appreciate your effort to connect with me Amanda, wishing you and your dogs well also.

[Guest8901]

Thanks for your response Loner. As for your English, I read nothing in your posts to indicate that English was not your first language. All good.

Firstly, I want to provide the following information for the benefit of other readers. I don't want anyone thinking you're some sort of a monster, when you're clearly not (:

It's true that Narcissists are often spoken of unfairly and critically. It's important for everyone to know that it's a MH issue, just like any other MH issue spoken of here and in real life. You do belong here.

To be diagnosed with narcissistic personality disorder (NPD) a person must meet five or more of the following traits:

• A grandiose sense of self-importance
• Preoccupation with fantasies of unlimited success, power, brilliance or beauty
• Belief they're special or unique and can only be understood by, or should associate with, other special or high-status people
• Require excessive admiration
• Have a very strong sense of entitlement
• Exploitative of others in order to achieve their own ends
• Lacks empathy and unwilling to recognize or identify with feelings and needs of others
• Often envious of others or believe others are envious of them
• Regularly shows arrogant, haughty behaviours or attitudes

Most PD's require a long-standing pattern of behaviour in order to be accurately diagnosed, and NPD is no different in that regard. So it's typical that your official diagnosis is yet to be made, despite being well into adulthood. Interestingly NPD is more prevalent in males than females, and research shows it affects around 6% of the general population. It's far more common than most people realise, and often undiagnosed.

Are you aware that NPD symptoms typically decrease in intensity with age? By the time they reach their 40's or 50's, many find the extreme symptoms reduce somewhat. Perhaps this offers you some hope?

It's not known what causes NPD, though its believed to be due to a combination of biological, genetic, social and psychological factors. Treatment of NPD usually involves long-term psychotherapy with a therapist with appropriate experience. Medications are often prescribed to help with specific symptoms.

Yes it is highly unusual for someone with NPD to admit or accept they have it. The fact that MH professionals appear in dispute about your diagnosis must be frustrating for you. I have some experience with narcissism, in fact I live with one. I love my husband despite that.

I will talk further when I can, if you'd like?

Amanda

[Loner_in_Hiding]

Hi Amanda, it has taken me while to respond to you -first of all, I appreciate your kindness to defend me for this wicked PD, but I am in a conundrum.

This being still official, it is no fault of your own at all to site these definitions. How would you to know or even care, it's not even about yourself at all but YOU Actually CARE.

I do not know if your beloved husband is a good fit to DSM-5 but because the definitions ignore vulnerable aspect or manifestations of NPD it is incomplete. and in itself fueling and perpetuating to create the commonly held view of NPDs : it only focuses agrressive exhibitionic aspects of NPD completely ignoring vulnerability, lack of self esteem and depleted aspects/manifestations of the NPD.

It does paint the picture of a narcissist whom one must run as far away as possible from.

I am not saying they are wrong, and many indeed may fit the definitions but it is Many arguments have been presented for years to improve the diagnostic manual of NPD and this exerts below from paper published by the American Journal of Psychiatry titled 'Narcissistic Personality Disorder: Diagnostic and Clinical Challenges ', is one of such arguments:

Diagnostic confusion surrounding narcissistic personality disorder reflects the disorder’s highly variable presentation and the wide range of severity that can characterize narcissistic pathology. Individuals with narcissistic personality disorder may be grandiose or self-loathing, extraverted or socially isolated, captains of industry or unable to maintain steady employment, model citizens or prone to antisocial activities. Given this heterogeneity, it is far from self-evident what such individuals could have in common to justify a shared diagnosis.

[Loner_in_Hiding]

Continued:

The DSM-5 criteria (Table 1) to some degree sidestep this question by providing a rather narrow and homogeneous definition of narcissistic personality disorder characterized by a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, entitlement, and lack of empathy. However, while these criteria capture important aspects of narcissistic pathology, they provide inadequate coverage of the broad population of individuals who receive the diagnosis in clinical practice (9–11), and they fail to cover core psychological features of the disorder, including vulnerable self-esteem; feelings of inferiority, emptiness, and boredom; and affective reactivity and distress (11). Furthermore, because DSM-5 criteria are, a priori, limited to observable features of psychopathology, the description of narcissistic personality disorder in Section II of DSM-5 does not address underlying psychological structures or dynamic constellations that can be seen to organize and unify the various presentations of the disorder.

I apologize with all these excerpts. It must be boring if there is no relevance to you.
More later with a Proposed Criteria for NPD and regarding NPDs in later years also on causalities. Got rather long sorry again must exhausting to read and I am exhausted.
Kind Regards,
LiH.

[Guest8901]

Hi Loner, and thanks for responding. Yes, I do care! And I appreciate you enlightening all of us to the lesser known aspects of NPD. Obviously there are many variants to a person who has NPD. As is the case with many MH and personality disorders, no two cases are exactly the same. And when it comes to MH, there is so much the so called experts are still mystified about. Its not nice being put into a pigeon hole and told that its where you belong, when you dont logically (or typically) fit the perceived or better known criteria.

I'm glad you are making the effort to educate all of us, and I thank you for doing so. Perhaps in the process, you may be helping yourself?

No need to apologise for your excerpts. I do not find the discussion boring in any way. I very much appreciate your perspective. Who better to discuss it than someone who is experiencing the disorder?

It is true that throughout the forums you do find a lot of discussion where narcissistic personalities and tendencies are criticised. I guess its understandable given the public and common perception on what a NPD person is. But generally it comes from people who have only the commonly held and highly critical views. Sadly, out of frustration, I have been critical too.

Clearly this is a highly distressing disorder for you to cope with, judging from the fact that you have isolated yourself and withdrawn from the world. Was there any particular point where you decided to do that, or was it a succession of things over time?

If you'd like to concentrate on any of the other related/unrelated (?) issues you have, I am happy to do so as well. For example, I too suffer from OCD. A coping mechanism I've been told, developed to cope with PTSD related symptoms. And having PTSD, I also experience anxiety all the time, often severe. I also go through periods of deep depression. So if you'd like to discuss any of this, please go right ahead. I also realise you may be keen to educate readers about your particular pathology with your NPD. So I look forward to hearing more from you about criteria and causalities. With regards to my husband and his narcissism, he is typical of the list I provided above, very much typical. 😞

Anyway this is your thread Loner, and you have the freedom to discuss whatever aspect of your MH that you choose to on any given day. You may get comments from others however, if you discuss some of the more common MH issues, eg anxiety and depression.

Hope to talk again.

Amanda