Posted by Dinah on February 18, 2002, at 9:47:13
In reply to Treatment resistant depression/Axis II disorders?, posted by Anna Laura on February 18, 2002, at 2:18:06
How about a little of both.
Certainly too many psychiatrists assign a personality disorder diagnosis out of frustration towards a patient who isn't responding to meds as expected or out of anger towards a patient they just don't like.
I've seen a lot of quite convincing literature (don't ask me where - I couldn't possibly remember) that sees personality disorders as a manifestation of another disorder. In other words, borderline personality disorder is a manifestation of an underlying mood disorder. Obsessive compulsive personality disorder and avoidant personality disorder are manifestations of underlying anxiety disorders. Schizoid and schizotypal personality disorders are manifestations of mild Asperger's (or schizophrenia, depending on the researcher). This group of theorists believe that if the underlying disorder is treated, the personality disorder will diminish or disappear. I would guess, however, that since personality disorders represent pervasive and habitual ways of perceiving and relating to the world that therapy to address distorted ways of thinking and unproductive ways of acting would be as important as medication under this theory.
Have you asked what personality disorder he thinks you might have? Have him pull out his diagnostic books and go over the criteria with you, telling you how they fit you. And if he thinks you don't really want to get better (I HATE that one) have him tell you in what ways he thinks you might be getting benefits from remaining ill. If he brings up these ideas it's up to him to explain them fully. You shouldn't have to guess what he means. Don't let him use these things as an excuse for not exploring better medication options.
poster:Dinah
thread:94483
URL: http://www.dr-bob.org/babble/20020215/msgs/94490.html