Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
Good morning (or for you, afternoon).
I have read your query... lots of very useful information.
To clarify, what question(s) can I try to address today?
Feel free to contact me when you're ready.
Obviously i know it is not possible to make a diagnoise but does this seem to fit the Histrionic disorder?
What course of action is best to help her?
How would i go about getting help i.e what would be the first port of call?
Hi. Thanks for writing back.
1. As you note, it is impossible (and unethical) to diagnose through a 3rd party without having done (at minimum) a diagnostic history and clinical interview. Nevertheless, your description may be consistent with one of the "Cluster B" personality disorders (which includes Histrionic Personality Disorder). Other Cluster B disorders include Antisocial PD, Borderlinr PD, HPD (as noted), and Narcissistic PD. It is worth noting that Personality Disorders are classified on Axis II of the DSM system unlike most mental disorders (like, say, Depression or Anxiety, or ADHD). It is also worth noting that there are some mental health professionals (MHP) who do not believe in Axis II disorders. There are also some MHP who do not believe in the concept of "personality" in general.
2. Unfortunately, "treatment" of an Axis II disorder is, traditionally, lengthy and rarely effective. Why? Well, you'll note that I reported that some MHP don't believe in Axis II disorders because you're essentially trying to change something (the personality) which either cannot be changed as it is likely permanent (for those who believe in personality) or which doesn't exict (for those who do not believe in personality). There are no medications available to treat personality. And while some traditional "talking therapies" (typically insight-oriented/psychodynamic therapy) claim to be able to make structural changes to individual's "personality" there is no proof of this whatsoever.
3. So, does this leave you stuck? No. Rather than hopping down the pessimistic trail of looking at a personality disorder, why not consider a mental health disorder (Axis I) that is treatable. Is it possible that this woman's bizarre and annoying behavior is the result of underlying anxiety or depression? Both of these are entirely treatable conditions! You mention some drug use... those who are substance dependent can appear to be liars, manipulators, and monopolizers of your time and energy. There is treatment for substance abusers too! While I don't think it's likely, is it possible that this woman has an underlying neurodevelopmental problem (such as an Autism Spectrum Disorder) whereby she has absolutely no clue whatsoever about appropriate social behavior, reading social cues, and the like? There are treatments for this as well.
4. But, your friend has to be willing to explore treatment... preferably with a Cognitive-Behavioral Therapist (CBT). A CBT will provide targetted interventions to address specific thoughts (cognitions) and actions (behaviors) which prevent your friend from maximal functioning... Traditional "talk therapy" would not only be ineffective and inefficient with your friend, I suspect that it would "keep her stuck" in her self-obsessed, manipulative, lying behavior pattern... it might even make things worse. CBT can also help with substance abuse issues... but she may also benefit from consultation with a drug/alcohol counselor.
5. Finally, the question remains: If your friend has a personality disorder (or mental health or substance abuse disorder), may or may not have any clue about how her behavior impacts you and others, may have antisocial thoughts and behaviors, and clearly makes you agitated and confused and worried... why are you sticking around? I don't mean that just in a rhetorical sense... there must be some REASON why you are still around a person who may very well be unhealthy FOR YOU. This may be worth exploring for yourself! :)
I hope you found this helpful... please feel free to write back if you have other thoughts or questions.
Please accept response unless you require additional information. Thanks.
In brief i am aware that i may have co-dependant issues, which i am working on to resolve. I have had issues with relationships in the past due problems in earlier life. I can relate to some of this girls behaviour, because i know i was emotionally distant, uncaring etc in previous relationships, but i also know that i was conscious of this and it was more a case of not being bothered about my actions and the pain they caused. The lady in question does not seem to be conscious of her behaviour or its effects on others. I have undergone sessions with a physcologist for some years which has enabled me to deal with my problems/issues. So i can see both sides of the coin to a degree and have been trying to help this women do the same with limited success. I do love her very much hence the lengths i have gone to.
I have one more question that i would like you to answer. I am aware that i took the decision to get help in my situation. It was not suggested to me but more of an accident initially. Is it possible to help this women get help? Or am i fighting a lost cause until she decides to get help herself? I.e does she have to get to a point that she "crashes and burns" before she will admit that she may need help? And if she does admit she needs help, where should her first port of call be? I know the GP's in the UK my not recognise these particular problems etc. I am just concerned that she would end up on a "merry go round" and not be pointed in the right direction.
I apologise for my long winded enquiry. And if you could just address the issues above that would be great. Many thanks
Well, I'm sure you would agree that it's very difficult to predict if/how an individual will get into therapy and/or respond to therapy. I know that, generally speaking, when someone gets into therapy "because of someone else" it doesn't work. Therapy has to, to a degree, a selfish thing. The individual has to want to get better for themselves.
As to the first "call of port," I'm not certain if, in the UK, you're required to go thru your GP to get to a mental health professional. If this is the case, ask the GP to be certain to refer to a CBT therapist (not a traditional "talk therapist"). If you're not required to go thru the GP, then I would simply google CBT in your area... or check with the local university/college Psychology Department. Many psychologists who work in academia know CBT folks.
Best of luck to you and your friend.
Many thanks for all your input and help