Personality Disorders Gender Bias
The Diagnostic and Statistical Manual (DSM) confesses to gender bias, with personality disorders such as borderline and histrionic being more common among women, while narcissistic, antisocial, schizotypal, passive compulsive, schizoid and paranoid disorders are more prevalent among men. The reason for this gender disparity may be due to culture-bound syndromes, with personality disorders reflecting biases and value judgments of the prevailing culture. Upbringing, environment, socialization, cultural mores, and genetics may also play a role in the pathogenesis of personality disorders. Ultimately, the ambiguity and equivocation of the diagnostic criteria may be the problem, with gender bias being everywhere in the psychiatric profession.
Acquired Situational Narcissism
According to Professor Robert B. Millman, pathological malignant narcissism can be induced in adulthood by celebrity, wealth, and fame. He calls this acquired situational narcissism and believes that it can be provoked by certain situations. However, it is likely that acquired situational narcissism is merely an amplification and manifestation of earlier narcissistic conduct, traits, style, and tendencies. Narcissists tend to gravitate to specific professions and settings which guarantee them access to fame, celebrity, power, and wealth.
Generalised Anxiety Disorder (GAD) Misdiagnosed as Narcissistic Personality Disorder (NPD)
Narcissists are anxious for social approval and seek narcissistic supply compulsively, which creates attendant anxiety. They require external feedback to regulate their sense of self-worth, self-confidence, and self-esteem, making them irritable. Narcissists are terrified of being embarrassed or criticized in public, and they fail to function well in various settings. It is easy to mistake the presenting symptoms of certain anxiety disorders with pathological narcissism, but the narcissist is egosyntonic, while the anxious patient is distressed and looking for help.
Narcissistic Personality Disorder Prevalence and Comorbidity
Pathological narcissism is a lifelong pattern of traits and behaviors that signify infatuation and obsession with oneself to the exclusion of all others. Healthy narcissism is adaptive, flexible, empathic, and causes elation and joy. Narcissistic Personality Disorder is diagnosed in between 2 and 16% of a population in clinical settings or between 0.5% and 1% of the general population. Narcissistic Personality Disorder is often diagnosed with other mental health disorders, and this is known as comorbidity.
Narcissistic Personality Disorder Clinical Features
Narcissistic traits in childhood may lead to full-fledged narcissistic personality disorder later in life, especially if the child has experienced abuse or trauma. Narcissists use a false self to garner attention, or “narcissistic supply,” which helps them cope with pain and feel important. Narcissists are vulnerable to criticism and disagreement, and they struggle to maintain healthy relationships. Treatment for narcissistic personality disorder includes talk therapy and medication, but the prognosis for an adult with the disorder is poor.
Addict Narcissists: Substance Abuse and Reckless Behaviors
Pathological narcissism is an addiction to narcissistic supply, which is the narcissist’s drug of choice. Other addictive and reckless behaviors such as war-camelism, alcoholism, drug abuse, pathological gambling, compulsory shopping, reckless driving, and even compulsive lying, piggyback on this primary dependence on narcissistic supply. The narcissist’s addictive behaviors take his mind off his inherent limitations and bridge the gap between his unrealistic expectations of life and his inflated self-image. There is no point in treating the dependence and recklessness of the narcissist without first treating the underlying personality disorder.
Love as Biochemical Pathology
Falling in love is similar to a mental health pathology, with changes in behavior and biochemistry resembling psychosis and substance abuse. Love is addictive and akin to cocaine and speed, with sex intended to bind partners long enough to bond. Falling in love involves the enhanced secretion of PEA, or the love chemical, which creates a euphoric high and helps obscure the failings and shortcomings of the potential mate. Love in all its phases and manifestations is an addiction, probably to the various forms of internally secreted norepinephrine, such as the aforementioned amphetamine-like PEA.
Bipolar Disorder Misdiagnosed as Narcissistic Personality Disorder (NPD)
The manic phase of bipolar disorder is often misdiagnosed as narcissistic personality disorder due to the similarities in symptoms. However, the manic phase of bipolar disorder is limited in time and followed by a depressive episode, whereas narcissistic personality disorder is not. The source of the bipolar patient’s mood swings is brain biochemistry, not the availability or lack of availability of narcissistic supply. Additionally, the bipolar patient is dysfunctional, while the narcissist is functional.
Asperger’s Disorder Misdiagnosed as Narcissistic Personality Disorder (NPD)
Asperger’s Disorder can be diagnosed in toddlers as young as three years old, while Narcissistic Personality Disorder cannot be safely diagnosed until late adolescence. However, Asperger’s Disorder is often misdiagnosed as Narcissistic Personality Disorder. Both types of patients are self-centered and engrossed in a narrow range of interests and activities, with severely hampered social and occupational interactions. The gulf between Asperger’s and pathological narcissism is vast, with the narcissist switching between social agility and social impairment voluntarily, while the Asperger’s patient’s social awkwardness is an inevitability.
Inverted Narcissist (Narcissist Codependent)
Inverted narcissists are a type of codependent who exclusively depend on a narcissist. They are self-effacing, sensitive, emotionally fragile, and sometimes socially phobic. They derive all their self-esteem and sense of self-worth from the outside and are pathologically envious. Inverted narcissists are narcissists, and it is possible to compose a set of criteria for them by translating the criteria available in the Diagnostic and Statistical Manual for the classical narcissist.