I'M GOING to go politically incorrect here, and use the terms "crazy" and "asshole." Let's begin ...
One hopes we have all forgotten about the ridiculous 2010 public drama involving Mel Gibson and his then-girlfriend, Oksana Grigorieva. Okay, I just reminded you. To refresh your memory, Mel immortalized himself in a temper tantrum that involved a demand for oral sex framed in the form of an ultimatum and a threat to burn down a house. I will spare you further details of the ongoing spat.
Normally, I'm too busy on important matters such as Lindsay Lohan to waste my time on Mel Gibson, but - alas! - the media couldn't resist linking Mel's tirades to bipolar, leaving me with no choice but to intervene. A few points:
People say crazy things when their relationships head south.
This is a normal response to an abnormal situation. Heaven help if my life were on tape - or yours. Yes, Mel said things you or I would never dream of saying, but we also know - deep inside - that there is not much that separates us. Philosophers have been debating this stuff since the first practical application of vocal chords, and Shakespeare's entire body of work is based on our dual God-beast nature.
"What piece of work is a man ... "
Bipolar is the crazy diagnosis, not the asshole diagnosis.
I have bipolar, which makes me prone to doing crazy things if I am not careful, and sometimes even if I am. But I'm not an asshole. Big distinction. I sometimes find I have to correct people who get the two confused. They see someone acting inappropriately and next thing I'm hearing the B-word used to explain that person's behavior.
No, that's not bipolar, I cut in.
Then what is it? they ask.
That's being an asshole, I reply.
There exists a whole range of personality disorders that can singularly or collectively be defined as "the asshole diagnosis." In the past, I have received angry comments along these lines: "As an asshole, I take great exception to what you say." So let me set the record straight:
We all have personality issues in abundance. The world around us is a very scary place to negotiate, particularly when we lose our sense of control. We typically compensate by distorting reality and assigning fictitious traits to others. The eastern mystics put it best when they say that life is an illusion fabricated out of our thoughts. Inevitably, things go wrong. Some of us are more skillful at avoiding life's many pitfalls than others. Others are not.
It's not easy being an asshole. It's also not easy being around one.
Crazy is not related to personality.
Just about every diagnosis in the DSM notes that the behavior in question is "uncharacteristic of the person when not symptomatic." If you are a humanitarian, then, bipolar is not going to turn you into an anti-semite. If you are a closet anti-semite, however, bipolar may affect your impulse control in a way that exposes you as a raging anti-semite you really are. Something like this happened to Mel Gibson a number of years ago. Who knows what was going on in his head. Bipolar may or may not have triggered the outburst, but his loathsome bigotry was of his choosing.
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But crazy and asshole do overlap.
There is no doubt that bipolar both complicates and amplifies the situations in our lives. Anger is often a justifiable reaction to our sense of outrage, but those of us with bipolar are skating on thin ice. We get triggered too quickly. Our vulnerable brains overload, and next thing we lose it. And once we get going, it's very hard to stop. Our racing thoughts take over.
Maybe something like this happened to Mel Gibson. Or maybe he's just being an asshole. When you're on the receiving end, you shouldn't have to make the distinction. I frequently have to remind those with bipolar that when it comes to relationships, "the bipolar excuse" simply doesn't cut it. The best we can expect are certain accommodations.
It works both ways.
Those of us with bipolar are extremely sensitive to negative situations in our lives, whether from the depressive end or the manic end or those hellish mixed states in between. Our built-in amplifier has a way of turning a barely tolerable situation into one equating to being trapped inside a burning building.
Some time ago, I had no choice but to end a personal friendship. She was the "normal" one, but she exploded on me. It was a very painful choice, but one essential to my well-being. I may be "crazy," but I don't need crazy in my life. The world is crazy enough as it is.
Personality Disorders - A Quick Overview
Diagnostic labels can be as inaccurate as they are stigmatizing. In the real world, behavior does not fall neatly into one category, nor are particular types of behavior exclusive to one diagnosis. Having said that, the following personality disorders listed in the DSM, serve as a rough guide.
Borderline Personality Disorder
Freud's successors came up with this term to describe what they saw as problem patients bordering on psychotic. "Emotionally unstable" is a far more accurate description. Nevertheless, the label borderline stuck, together with the legacy of borderline individuals being regarded as problem patients. Sympathetic hospital staff have been known to turn on individuals in distress once they have been handed this diagnosis.
Borderline made its official debut in the DSM-III of 1980, but on the surface is very difficult to distinguish from bipolar. Unofficially, psychiatry is guided by the common stereotype of the moody and often hysterical teenage girl (or people who act like one) who may have abandonment issues, act impulsively, and engage in destructive behavior such as cutting. Twice as many females are diagnosed with the illness, possibly because problem males better fit the stereotype of antisocial personality disorder.
Susanna Kayson’s “Girl Interrupted” is the classic example of borderline personality disorder. Ms Kayson describes how she was shipped off to McLean Hospital outside of Boston back at a tender age in an era when she should have been attending Woodstock and going to college.
People living with someone who exhibits borderline tendencies typically describe the relationship as akin to walking on egg shells: one minute all love and light, the next a hateful explosion or the sullen silent treatment. A borderline meltdown tends to have its roots in the individual’s lack of ability to handle the stress of any given social situation. Thus it can occur without warning. This tends to contrast with bipolars behaving badly, which typically flows in slower cycles.
(For more on borderline, check out my two articles beginning with Iorderline Personality Disorder: Part One.)
Antisocial Personality Disorder and Psychopathy
Serial killers generally fall into this class, but the diagnostic criteria is wide enough to include your abusive boss or scheming co-worker, or for that matter your brother who borrows your car and returns it without refilling the tank. According to the old joke, poor people with antisocial personality disorder are in prison, middle class individuals with this disorder are in therapy, and rich people with the label are CEOs. These are your classic sociopaths, out for number one, with no regard for others. “I’d walk over my own grandmother to re-elect Richard Nixon,” Watergate conspirator Chuck Colson once bragged. He wasn’t joking. He authored an “enemies list” of real and imagined political opponents to be singled out for special treatment, such as FBI harassment and tax audits.
Narcissistic Personality Disorder
We are not simply talking about over-inflated egos. Rather, the narcissist sees him or herself at the center of his or her own personal universe, with everyone else relegated to bit players assigned to specific minor roles. Dare to intrude reality into this individual's fantasy world and brace yourself for a narcissistic rage.
The first version of draft DSM-5 would have eliminated narcissism as a stand-alone diagnosis and consigned it to a feature of antisocial (the two share in common a pathological lack of concern for others). The second draft restored narcissism as a diagnosis by (it seems) popular demand.
Donald Trump can be described as the ultimate narcissist, which raises an interesting issue. The type of people who seem to specialize in making our lives miserable can be highly functional and successful. Delusional self-centeredness combined with lack of a social conscience and and preternatural skills in the art of manipulation can be highly advantageous traits. In another article, we explore the "successfully sinister," who appear to operate with a combination of borderline, sociopathic, and narcissistic traits. The political, corporate, and academic worlds possess no shortage of these people.
We constantly need to remind ourselves that this is not necessarily about us vs them. Yes, for our own self-protection, we need to recognize these destructive people for what they are and to stop wasting our lives trying to please them. But we also need to recognize these qualities as lurking inside all of us, as part of our own dark sides. This leaves us with two choices: We can make excuses for when things go wrong, or we can engage in ruthless self-enquiry in our never-ending quest to become better people. We don't always get it right ...
Revised June 27, 2016
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