5. Borderline personality disorder

In borderline PD (or emotionally unstable PD), the person essentially lacks a sense of self and, as a result, experiences feelings of emptiness and fears of abandonment. There is a pattern of intense but unstable relationships, emotional instability, outbursts of anger and violence (especially in response to criticism), and impulsive behavior. Suicidal threats and acts of self-harm are common, for which reason many people with borderline PD frequently come to medical attention. Borderline PD was so called, because it was thought to lie on the "borderline" between neurotic (anxiety) disorders and psychotic disorders, such as schizophrenia and bipolar disorder. It has been suggested that borderline personality disorder often results from childhood sexual abuse, and that it is more common in women, in part because women are more likely to suffer sexual abuse. However, feminists have argued that borderline PD is more common in women, because women presenting with angry and promiscuous behavior tend to be labeled with it, whereas men presenting with similar behaviour tend instead to be labeled with antisocial PD.

  6. Histrionic personality disorder

People with histrionic PD lack a sense of self-worth and depend on attracting the attention and approval of others for their wellbeing. They often seem to be dramatizing or "playing a part" in a bid to be heard and seen. Indeed, "histrionic" derives from the Latin histrionicus, "pertaining to the actor." People with histrionic PD may take great care of their appearance and behave in a manner that is overly charming or inappropriately seductive. As they crave excitement and act on impulse or suggestion, they can place themselves at risk of accident or exploitation. Their dealings with others often seem insincere or superficial, which in the longer term can adversely impact their social and romantic relationships. This is especially distressing to them, as they are sensitive to criticism and rejection and react badly to loss or failure. A vicious circle may take hold in which the more rejected they feel, the more histrionic they become — and the more histrionic they become, the more rejected they feel. It can be argued that a vicious circle of some kind is at the heart of every personality disorder and, indeed, every mental disorder.

7. Narcissistic personality disorder

In narcissistic PD, the person has an extreme feeling of self-importance, a sense of entitlement, and a need to be admired. He is envious of others and expects them to be the same of him. He lacks empathy and readily lies and exploits others to achieve his aims. To others, he may seem self-absorbed, controlling, intolerant, selfish, or insensitive. If he feels obstructed or ridiculed, he can fly into a fit of destructive anger and revenge. Such a reaction is sometimes called "narcissistic rage" and can have disastrous consequences for all those involved.

1. Paranoid personality disorder

Cluster A is comprised of paranoid, schizoid, and schizotypal personality disorders. Paranoid personality disorder is characterized by a pervasive distrust of others, including even friends, family, and partners. As a result, this person is guarded, suspicious, and constantly on the lookout for clues or suggestions to validate his fears. He also has a strong sense of personal rights: He is overly sensitive to setbacks and rebuffs, easily feels shame and humiliation, and persistently bears grudges. Unsurprisingly, he tends to withdraw from others and to struggle with building close relationships. The principal ego defense in paranoid PD is projection, which involves attributing one’s unacceptable thoughts and feelings to other people. A large, long-term twin study found that paranoid PD is modestly heritable, and that it shares a portion of its genetic and environmental risk factors with schizoid PD and schizotypal PD.

   Factitious disorder is a mental disorder in which a person acts as if he or she has a physical or mental illness when, in fact, he or she has consciously created the symptoms. These people are willing to undergo painful or risky tests to get sympathy and special attention

  Recognizing the Drug Abuser

Telling the difference between a legitimate patient and a drug abuser isn't easy. The drug-seeking individual may be unfamiliar to you. They could be a person who claims to be from out-of-town and has lost or forgotten a prescription of medication. Or the drug seeker may actually be familiar to you such as another practitioner, co-worker, friend or relative. Drug abusers or "doctor-shoppers" often possess similar traits and modus operandi. Recognizing these characteristics and modus operandi is the first step to identifying the drug-seeking patient who may be attempting to manipulate you in order to obtain desired medications.

Common Characteristics of the Drug Abuser:
• Unusual behavior in the waiting room;
• Assertive personality, often demanding immediate action;
• Unusual appearance - extremes of either slovenliness or being over-dressed

• May show unusual knowledge of controlled substances and/or gives medical history with textbook symptoms OR gives evasive or vague answers to questions regarding medical history;
• Reluctant or unwilling to provide reference information. Usually has no regular doctor and often no health insurance;
• Will often request a specific controlled drug and is reluctant to try a different drug;
• Generally has no interest in diagnosis - fails to keep appointments for further diagnostic tests or refuses to see another practitioner for consultation;
• May exaggerate medical problems and/or simulate symptoms;
• May exhibit mood disturbances, suicidal thoughts, lack of impulse control, thought disorders, and/or sexual dysfunction;
• Cutaneous signs of drug abuse - skin tracks and related scars on the neck, axilla, forearm, wrist, foot and ankle. Such marks are usually multiple, hyper-pigmented and linear. New lesions may be inflamed. Shows signs of "pop" scars from subcutaneous injections.

Modus Operandi Often Used by the Drug-Seeking Patient Include:
•Must be seen right away;
•Wants an appointment toward end of office hours;
•Calls or comes in after regular hours;
•States he/she's traveling through town, visiting friends or relatives (not a permanent resident);
•Feigns physical problems, such as abdominal or back pain, kidney stone, or migraine headache in an effort to obtain narcotic drugs;
•Feigns psychological problems, such as anxiety, insomnia, fatigue or depression in an effort to obtain stimulants or depressants;
•States that specific non-narcotic analgesics do not work or that he/she is allergic to them;
•Contends to be a patient of a practitioner who is currently unavailable or will not give the name of a primary or reference physician;
•States that a prescription has been lost or stolen and needs replacing;
•Deceives the practitioner, such as by requesting refills more often than originally prescribed;
•Pressures the practitioner by eliciting sympathy or guilt or by direct threats;
•Utilizes a child or an elderly person when seeking methylphenidate or pain medication.

What You Should Do When Confronted by a Suspected Drug Abuser

DO:
• perform a thorough examination appropriate to the condition.
• document examination results and questions you asked the patient.
• request picture I.D., or other I.D. and Social Security number. Photocopy these documents and include in the patient's record.
• call a previous practitioner, pharmacist or hospital to confirm patient's story.
• confirm a telephone number, if provided by the patient.
• confirm the current address at each visit.
• write prescriptions for limited quantities.

DON'T:
• "take their word for it" when you are suspicious.
• dispense drugs just to get rid of drug-seeking patients.
• prescribe, dispense or administer controlled substances outside the scope of your professional practice or in the absence of a formal practitioner-patient relationship.

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How about Gender Dysphoria?

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A few psychs have expressed disappointment in the last DSM

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What's the mental illness called that has sufferers presenting with a strong need to inform others of characteristics of mental illnesses?

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What's the mental illness called that has sufferers presenting with a strong need to inform others of characteristics of mental illnesses?

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"Cutaneous signs of drug abuse - skin tracks and related scars on the neck, axilla, forearm, wrist, foot and ankle. Such marks are usually multiple, hyper-pigmented and linear. New lesions may be inflamed. Shows signs of "pop" scars from subcutaneous injections."

Inkies!

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I found this part of that thread interesting.

I use the words "drop" and "fall" interchangeably, yes. She had me get up and I fell, but I say "dropped" sometimes because it was her responsibility to move me safely and she didn't do that.

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They didn't add "crepitus."  Crepitus is a "popcorn" sensation (best I can describe it) under the skin and a cracking/popping sound in the lungs or over a joint. When it comes to skin or subcutaneous crepitus, the cause quite often is entrained air under the skin.  I did an exam on a guy once, with chief complaint of low back pain, who had been seen by many other doctors and ER for the same.  As I did the physical exam, I noticed that the skin of his left upper arm was "crackly" like crunching down on Styrofoam or plastic bubble wrap.  Extend the exam down and I find where he was shooting up. Seems that, if he couldn't get a vein, he'd just inject whatever was in the syringe, air and all, sub-Q.  This created a buildup of air under the skin of his upper arm that crackled under palpitation.   When confronted with this, the patient left AMA--if you define "AMA" as pushing past the doc, knocking down the nurse, pushing over the Mayo stand, and running out of the facility.

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Learned what a Mayo stand's official name was today

http://www.newmaticmedical.com/images/xxl/MR-ConditionalMayoStand.jpg

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Learned what a Mayo stand's official name was today

http://www.newmaticmedical.com/images/xxl/MR-ConditionalMayoStand.jpg

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Did you Google it, because you couldn't wrap your head around the idea of a spunky little entrepreneur in a paramilitary outfit selling jars of Hellman's in the doctor's waiting room?

#metoo  

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When a girl mentions she has BPD, or exhibits any if the signs... Run. The. Fuck. Away.

They cannot be fixed.  BPD destroys everything in it's vicinity.

Thanks for the reminder, OP.  Seriously.

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Reading the part about drug-seeking behavior, and knowing that the gov is cracking down on docs who prescribe opioids, was interesting.

I'm just glad that people believed me when I had a kidney stone and were nice enough to give me the good stuff.

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Smartassaphilia.

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Incorrect. Smartass is a a super power. I’m considering writing a book about it. (No really, I’ve been taking notes and am considering writing about the power of being a smartass.)

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When a girl mentions she has BPD, or exhibits any if the signs... Run. The. Fuck. Away.

They cannot be fixed.  BPD destroys everything in it's vicinity.

Thanks for the reminder, OP.  Seriously.

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Yep

Amazing how much pain can come from such a tiny rock.

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Run from ALL of these. NPD may be the hardest to spot but you can learn.

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Locked thread on personality disorders? Someone post a link, I gotta read that one.

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Similar to subcutaneous emphysema?

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I didn't see antisocial personality disorder in there, OP. . We need to see that one.

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Yup.  It's scary shit.

I'd take a relationship with a meth head sooner than someone with BPD.  Never again.

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You really want that one in GD?

You don't talk about that here for the same reason you don't ask about college plans at the Special Olympics.

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https://www.ar15.com/forums/General/Medical-Malpractice/5-2199051/?page=4

Not so much a thread on personality disorders but more like a thread caused by a personality disorder.

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What's the mental illness called that has sufferers presenting with a strong need to inform others of characteristics of mental illnesses?

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When a girl mentions she has BPD, or exhibits any if the signs... Run. The. Fuck. Away.

They cannot be fixed.  BPD destroys everything in it's vicinity.

Thanks for the reminder, OP.  Seriously.