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Discussion in 'Psychiatry' started by OldPsychDoc, Dec 1, 2008.
College students have PERSONALITY DISORDERS!
I saw this from the AMA Morning Rounds email that they sent around. I love how they counted nicotine addiction and alcohol abuse as a personality disorder.
They dont seem to have done that.
"Personality disorders were the second most common problem behind drug or alcohol abuse as a single category. The disorders include obsessive, anti-social and paranoid behaviors that are not mere quirks but actually interfere with ordinary functioning."
They also said:
"Counting substance abuse, the study found that nearly half of young people surveyed have some sort of psychiatric condition, including students and non-students."
So they appear separating the two.
Leaving aside the study's validity for a moment. . .
Call me crazy, but I always think these overblown prevalence statistics backfire. If there is some hidden agenda to promote psychiatry through demonstrating the prevalence of mental illness, I think these results further entrench the already widely held belief that psychiatrists are a bunch of pill pushers.
. . . . perhaps we need to expand the notion of normal to include the mean.
I don't know if I'd call this overblown.
Remember, several of the personality disorders have an etiology in primitive defense mechanisms. These are college students--most of them ages 18-21.
The 18 year old cut off by the DSM to dx several personality disorders is IMHO too early a cut off. Several people don't mature for real until their mid to late 20s.
Several people in college act "out there" due to issues they dealt with growing up, and for the first time in college have the first oppurtunities to redefine themselves.
IF you take a look at the movie Trainspotting, it parallels several people in their youth. OK, yeah most people in college aren't heroine addicts, but it shows how several people in that age do things just for fun without thinking of the consequences. Then all of a sudden--after a few years of this they wake up & realize they need to be "normal" or they're going to go down a dark path during their lives.
How many of those girls in "Girls Gone Wild" have borderline or histrionic disorder?
I can think of a lot of my college buddies who had some Cluster B traits while 18-21 that they grew out of in their mid 20s. Heck I can think of a few things about myself that I out grew.
And IMHO, psychiatry (& usually medication) really isn't needed for personality disorders unless they are an on extreme where someone is going to directly hurt themselves or others. I do think though that someone with a personality disorder should seek some type of self help or counseling, though I also think almost anyone, even someone with a GAF >90 could benefit from that because counseling when things are going right in your life can keep them that way & perfect on top of what's already working.
My current health insurance allows me to go to a counselor for $15 an hour. I'm not going to one, but the idea of having some guy have to listen to my rants & try to analyze me, for $15 an hour, and maybe find something that can give me a little more insight--heck that sounds like it'd be worth a few tries just to see what happens.
Hey whopper, could you elaborate on what types of things that people grow out of? I'm just curious b/c lately I've been seeing a lot of 16 year old girls who'd probably have a borderline dx if they were 18 (I work on a child bipolar unit and we get a lot of calls from parents who have kiddos with bipolar dx who really probably have more borderline tendancies, but b/c you can't give that dx to a 16 year old, so they're called bipolar and medicated instead). I'm guessing a lot of people have milder personality traits, especially in youth, but what about when they're severe (impulsivity --> cutting and pills, sexual promiscuity, unstable relationships, mood fluctuations, etc).
Well no empirical data, but just from my own life experience here's what a lot of friends I've noticed outgrew as we left our 20s & entered our 30s.
The desire to drink alcohol like a fraternity brother from Animal House. Getting drunk & $hitfaced was funny when you're 18. Its not funny at 30.
Having a one night stand---funny & something to boast about when you're 18. Cheap & demeaning at age 30.
Wanting to be in a fraternity or sorority--the things these satisfy--the need to be in an accepting group, to socially bond, these drives lessen after the mid 20s (actually I have seen lots of data in studies backing this up).
Sexual self confidence. Several people at age 18 are still discovering themselves in this area. Some people are still in the closet, some are bi-curious & are in a homo vs heterosexual identity crisis, several virgins are insecure about their sexuality etc.
Drug experimentation--none of my friends my age want to do this. The ones that wanted to do this already did it & got it out of our system. We all did it in our late teens & 20s.
Recognizing your own mortality & the mortality of your parents. This is something that didn't hit me till about age 21, when I realized my parents were getting older. Hit my friends my age too.
These things are issues that aren't taught in a typical psychiatry curriculum, & yes they do impact several traits in the personality disorders.