The dialogue around mental health

I have determined after a great deal of research that most of the information online about how to deal with mental illness and especially personality disorders is incomplete or downright inaccurate.

I read a lot about how antidepressants and therapy are the only way anyone can get better with mental health issues. And to be clear, these methods help a lot of people and I’m not knocking them or trying to say there’s a better way. We all do what we have to do and mental illness is nasty enough to live with as it is.

But at the same time, they don’t help everybody. It can be hard to figure out what will help. A lot of the stuff online is extremely discouraging, especially with regard to personality disorders. That’s even truer when it comes to the famously difficult “cluster B” personality disorders: narcissistic, borderline, histrionic, antisocial. Most of what you read about any of these would make you think that if you get diagnosed with one, you might as well give up because you’re untreatable (and by the way, you’re also ruining everyone else’s lives.) That’s what the things online say about them, but I am not sure it’s accurate.

This all started because I had a friendship with someone who was almost definitely somewhere on that spectrum. She convinced me that she was fine and didn’t need to change anything, and I was the one with the dysfunction, not her. So I set out to learn everything I could and to try to see if I fit the definition. (I didn’t meet the diagnostic criteria for any of them, but did have a couple traits on the list which I trace back to depression and emotional immaturity, both of which I’m trying to manage. I think I might have fit more of them when I was younger.)

Even though I think she may have those issues (only a professional could know for sure), I think she could get better if she put in the effort rather than denying the problem. In fact, I know this is a bold statement, but I believe a lot of people with the “Cluster B” personality disorders could get better. It comes down to having the courage to face your issues and then work on them, which is the real obstacle. But maybe if we gave people hope that improvement was possible, they might actually try.

Are there people who are truly narcissistic, who ruin their closest relationships? Yes, of course. Are there people who have been on the receiving end of this behavior and been scarred by it, even left with PTSD over it? Absolutely. The people on the extremes can be dangerous.

I do know someone who I believe to be a full-fledged narcissist (not the same person I mentioned above) who is getting worse with age, not better. It’s very difficult to have a relationship with her because it’s so one-sided. She doesn’t seem to be aware of her behavior or how she affects people. But I believe that if she was aware of them, she could get better – even if the process was slow and incremental. People like her might never be “normal” but I think they could have healthier relationships with more give-and-take if they worked on it.

But at the same time, I think we’re overusing terms like narcissistic and gaslighting and bipolar and borderline.

What we really have is a growing number of people who aren’t able to cope with the world, who don’t know how to have healthy social relationships, who are encouraged by social media to live their lives in a very shallow way. The outcomes of all of these behaviors are now very normalized in society, but many of them may look like personality disorders at first glance. But that doesn’t mean that they’re hopeless. It doesn’t mean they won’t ever get better if they really try.

I see a lot of people online who have been diagnosed with one of these infamous Cluster B personality disorders (especially at Quora) and many of them do feel bad and want to change. I don’t think the mental health community and the unqualified members of the public are helping by issuing these blanket statements that people are untreatable and will never get better.

Can you imagine hearing that? Given that one of the hallmarks of most personality disorders is poor emotional regulation (and many have suicidal impulses as well), I can’t imagine how devastating it would be to get that diagnosis and still have the courage to hold yourself together.

Maybe I’m naive or maybe I’m a Pollyanna (I probably am) but I think all people deserve better than to be told they’re hopeless. I think there’s hope for nearly everyone to get better. Even if people are difficult, they didn’t make themselves that way.

That’s not to say it’s always a good thing to be in a relationship with someone who is broken in this type of way. It can break you in the process, too, so you should definitely get away if you recognize you’re being hurt. Just because they have things to work through, doesn’t mean you have to be along for the ride.

But I think we should change how we talk about people with personality disorders and mental health issues. The most important factor, from what I’ve seen, is the person’s desire to change. If they have that, there’s hope they can get better.

Mental health is only getting worse around the world for so many reasons. And yeah, sometimes other people’s illnesses have collateral damage. But they’re still human underneath it all. So maybe we should just have more compassion for those who are struggling to overcome issues. Worldwide mental health is likely to continue to get worse from everything I’ve read.

So we need to change the dialogue. Be hopeful and encouraging to those who are trying to heal. Sometimes for our own sakes, we might have to lend that support from a safe distance. But I think we need to do a lot less telling people they have unfixable illnesses. There’s always hope that even the blindest, most destructive narcissist will come to realize what they’re doing and work on getting better. What good does it do to tell them improvement is impossible?

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