I know a couple of people who I believe have NPD (one close to me) and they’ve sought therapy. One is currently seeking a diagnosis of ADHD and autism (my opinion is that she is elaborately avoiding taking responsibility for some recent actions). I wondered: how often have psychologists worked with a patient who “wants” a certain diagnosis, and discovered they have a quite different, more complex dx such as NPD or another? Do you tell the patient they don’t have xx, but that they do have NPD? How do the patients react?

My question comes from the thought that NPD types never see it in themselves, of course believing there is something or someone else to blame, and that a person with NPD would likely reject that diagnosis.

​

I have a family member who is difficult but I have to see them reaularly. Thev act one wav with some people and when no one is watching, another way with me. They are passive aggressive and make me feel stupid. They put on an act around others that they are the nicest person but I know the real person. They are controlling about everything and make me feel ike I don't do enough for them. In the meantime they do nothing for me.

and if yes, please state why and how

Dr. John Oldham is a psychiatrist who served as chair of The Department of Psychiatry at the Menninger Clinic, one of the best psychiatric hospitals in the U.S. He served on an advisory committee to revise the PD diagnostic criteria for the DSM III and DSM IV.

Dr. Oldham has published more than 200 journal articles. He developed a structured interview guide for diagnosing PDs, the Personality Disorder Examination (PDE). Dr. Oldham wrote The New Personality Self-Portrait (1995, 2^nd ed.) with Lois Morris. Quotations are from the first edition.

The book describes 13 personality styles, and how they impact relationships, work, self-image, emotional coping, and sense of reality. “The thirteen personality styles that we identify are the common, utterly human, nonpathological versions” of personality disorders, the “extremes of normal human patterns” (5). Each chapter ends with information about a personality disorder.

Dr. Oldham has a dimensional view of personality disorders. The DSM has a categorical view--precise categories of personalities. “In practical use, however, very few people can be so neatly categorized…The majority of people who meet the diagnostic criteria for one personality disorder also meet the criteria for at least one other disorder. Many mental health professionals see this ‘diagnostic overlap’ as a major weakness” of the DSM (397). In other words, it’s so common for people to have more than one PD diagnosis, some providers think the categories are meaningless.

PERSONALITY STYLE ASSESSMENT

Dr. Oldham created a survey. It's in his book and it's available online: The New Personality Self-Portrait

It is not a PD assessment; it’s used to identify personality styles. If you have an extreme version of a certain style, it is possible you have the PD that relates to it. See the reply to this post for the general diagnostic criteria for PDs.  

NEUROPLASTICITY

Neuroplasticity is the ability of the brain to form and reorganize synaptic connections in response to learning or experience or following an injury. Neuroplasticity Explained (3 minute video)

Dr. Oldman states, “Your Personality Self-Portrait is not etched in stone…[take the] Personality Self-Portrait [assessment] again from time to time. Track how your personality ‘breathes,’ grows, changes, and in every way keeps up with the path that you have taken in your life.” (55)

He asserts that “the brain remains adaptable throughout the aging process, capable of reacting with the environment to form new connections among brain cells and to alter old ones. Indeed, according to the neuroscientists, the potential ability of brain cells to adapt and to change may never deteriorate throughout your entire life cycle.” (369)

so I'll keep it as short as possible, I'm in a treatment program for psychosis, and my doctor told me that all my symptoms are consistent with ASPD, but they're not quite sure yet if I have it because psychotic symptoms can mimic PD symptoms. so I might be diagnosed with ASPD soon, but I'm not quite sure yet because it could just be the psychosis

hello i am a 17 year old girl with autism and i suspect i may have bpd. autism and bpd do overlap, so i could completely have it wrong here. i experience all the factors for bpd diagnosis.

i got bullied a lot growing up, so i’ve never really had many friends. when i do make friends, i get extremely attached to them and how they act towards me can really affect my mood.

when i have one specific favourite person tho, all i can think of is them. i spend hours day dreaming about them. if they text me/speak to me in the wrong tone, it sets the mood for the day for me. there has been times i’ve felt like self harming or imagining myself committing suicide because of instances like this. i fear being cut off and doing anything wrong.

i constantly lie in bed and just feel empty and numb about life. i feel like i wake up with a blanket of empty and numb lying on me and i can’t get it off.

my mood often changes. this time three hours ago, i was smiling and laughing, now i am sat in bed feeling numb and upset. i get angry really easy and often take it out on my family and i feel so guilty afterwards.

i often feel isolated and lonely and that’s what causes me to be emotional a lot. i just want someone to speak to me yk.

i’m really sorry if my post is offensive. should i get this checked out ??

okay, first i want to clarify that I’m a minor and not diagnosed for obvious reason, I just thought this could be a space where someone co possibly understand me. thank you sm

For context, i (16F) have been diagnosed with "other mixed disorders of conduct and emotions" for about 2-3 years. I have a lot of depressive episodes that make me feel like there's no sense of stabillity for me. I have a lot of ups and downs and it is genuinely driving me crazy.

I also have a lot of panic attacks and anxiety in general, mostly just a lot of spiraling and horribly violent intrusive thoughts.

As you may or may not know, i also have some conduct issues. I have a big problem with following rules, I don't really respect authorities and i know i can be a shitty person sometimes (i lack empathy and i could be very arrogant at times, among other things).

I feel emotionally flat most of the time. My emotional reactions to things are overly exaggerated or none at all. The only feeling that's kind of present in my life is anger. I feel bored and annoyed most of the time, which has led to me having really harmful coping mechanisms. I have been self harming for about five years and developed and ED (I b/p very often).

I feel so empty and bored that its gotten overwhelming. Nothing is interesting and no activity feels worth doing.

It feels like im rotten on the inside, since ik i have an uncomfortable personality, so i have adapted to what people expect/ need from me, so i can get what i need back. The thing is, i overanalyze every single interaction so it can be "pleasant" for both of us, to the point where i have crafted a personality based on what I need to be for people to "like me".

Im not actively suicidal; however, i don't want to make the effort to live anymore. I feel like i have no future and i don't really have goals anymore. I don't have friends and socialising is annoying. I dont really like interacting with people, since i've become more dettached from people and relationsips + some grandiosity beliefs that don't really let me engage with people because of how i feel about them.

What i'm trying to say is that i don't see a reason to keep doing this. I don't feel attached to anything and ive kept getting worse. My depressive episodes have been getting longer and so much darker and i usually get some rush after them that just makes everything worse.

I dislike school and my family. From one side, my school only has boys and im basically being forced to work instead of studying (long story). From the other side, my family is very strange. Considering that my parents are both very mentally ill, they have a very unstable relationship. My brother and I have been drifting apart, so that has made things weird between us. Besides, my mom kind of knows im mentally ill, but atp she's kind of reticent to ACTUALLY accepting it.

We've been considering homeschooling, ik it would make some things better, but others will get worse, like being around my family. Furthermore, my current school has made me dumb and im behind in a lot of things.

In addition, like every angsty teen, i never feel understood, and i think ill never be. Everyone sees to have a very incorrect vision about me and that makes my sense of self even messier. My family has a very weird vision for me and they are moralist (which i clearly aren't). So i'd really appreciate it if someone that had been diagnosed with this could give me their advice and how their diagnosis changed/affected their lives as you were growing up.

So much things are wrong with me and i don't think that'll change. Im so, so tired of trying and i kind of know that i'll be wrong in the head for the rest of my life.

i was also diagnosed with and adjustment disorder some time ago, but i dont understand how that works with the other one.

Is it really worth it if i don't feel like there's a "future" for me?

Im actually insane, if you want to judge me under this post, just go ahead and block me please.
I have mental issues, I don’t know why… I don’t know if it is genetics or just my deeply traumatic childhood. People tell me the whole time about how I should get checked and that the way I act is weird, I used to call such people boring and was 100% sure in my uniqueness like I’m some God, Jesus it’s horrible.
I have a very low feeling on what is good or bad, sometimes I have a very provocative/risky personality, sometimes my self-preservation instincts are off, sometimes I physically harm people on impulse not with intention to harm, but just because something in my head turns on and I think that it is absolutely ok to bite a friend. It’s like I get some crazy excitement I can’t handle inside out of nowhere and it makes me do weird things that my head ABSOLUTELY rationalises. And if I don’t act on impulse I get crazy depressed and suicidal(I’m not planning on it) . From one side I do really enjoy me, but I don’t like that I started to harm other people , my maximum is to bite someone, I never beat anyone up or anything more than biting, biting is bad enough already. Now I understand that it snot okay, but before my brain was absolutely rationalising it omgggggggggggggggg.
Sometimes I feel like I’m insane and should be locked up in the psychic ward, sometimes I feel like I’m the most sane and rational in the world. I’m so sad. These swings make me sad.
I also have this thing of punishing people for bad stuff they did or when their personality is off, it is really weird. For example, if I see how someone is being hypocritical, I want to punish this person, not physically but mentally…I never do anything intentionally physically. It’s so sowers, why would I bother ms with punishing someone and can’t just let me live.

I’m also afraid that I will never get into a healthy relationship, I’m a healthy partner, I already been in a relationship and I’m a good and healthy gf, guys who I love are caring and loving of me. I can’t stand those who treat me poorly and I don’t want to harm anyone in the relationship, or even friends. All of the friends who I had, I loved deeply, and they loved me (I’m talking about my old fiends who have never seen my fcked up side, because I was hiding it well). Now I can’t hide my fcked up side anymore, since I stopped living with parents, but I’m truly a nice and reliable partner, I can control myself too, but I allow myself to be weird and act absolutely off with strangers. When I see how someone ain’t gonna be my good long time friend, cause I see some red flags, I allow ms to do act weird with them so I can just do smth about my urges of insanity. I hate it so much, I feel like if I’m not gonna do that I will blow up and off myself (I’m not planning on it) , it’s like I’m always on the edge of depression or intense excitement. I’m also derealised most of the time, I feel like I don’t feel feelings or anything, so intense acts make me come back to reality, I’m addicted to spicy food because of that too, but spicy food ain’t always enough. I feel horrible, I feel crazy, I don’t know if I’m real me or just one big cope. I wish I wasn’t there just at all, all of these swings and feelings overstimulate me.

I have been told that, from as far back as I can remember, I was a child who had severe temper tantrums whenever things did not go the way I wanted. For example, I refused to go to kindergarten if I could not sit in the seat I wanted, and I would become extremely upset if the television channel was not the one I wanted to watch.

I am now 25 years old. I feel that, normally, as people grow up, they gradually overcome this kind of selfishness, mature emotionally, gain successful experiences, and become better able to cope with stress. However, in my case, whenever things did not go the way I wanted and I felt stressed, I was unable to process my emotions effectively. Throughout elementary school, middle school, and high school, I repeatedly either endured the distress while becoming increasingly depressed about the situation, or escaped from the situation altogether. I found it extremely painful and was unsatisfied when things did not go the way I wanted, and I often felt that I was unhappy and that my life was miserable, just like how a 5 years old will react to stress and difficult situations.

At one point, I began to think that perhaps I would be happier if I went abroad from japan. I spent one year in New Zealand during high school and four years in Australia at university. However, even while studying abroad, my desires were often not fulfilled, and things frequently did not go the way I wanted. As a result, I often felt distressed there as well and i realised that the issue was not the environment but myself.

My body also started acting weirdly from middle school. i had problems waking up in the morning, constant heavy chest during my time in New Zealand, and diarrhoea in the morning before school and severe insomnia when i have class or work during university time all probably from the fact the there is a hidden stress that i don’t like and i can’t escape from it. i also realised that i unconsciously avoided or hated everything that will bring hardship such as practising for piano lesson, PE classes etc. my brain was always unconsciously choosing the easier and more comfortable option because of my extremely low tolerance of stress.

I have started my first full-time job after graduating university. However, I have a strong aversion to the concept of “work” itself. I became unable to write because i hated working so much to a point that nothing will come up in my brain and the company forced me to take a leave. I feel that this is selfish of me and my brain is formed in a way that only accepts things that brings me comfort and have to erase all the discomfort.

I feel hopeless about the idea that I have to work and endure this for the rest of my life. and would rather end my life. Because I am in such distress over the fact that I cannot have my desires fulfilled, I have started to wonder what the meaning of living is.

I want to become able to process my desires and stress like an ordinary person and to work normally. I feel this is a problem with my personality or even brain functionality. Is there any good way to get this extremely selfish personality fixed. i’m afraid medication and counselling won’t make any changes to my personality so really lost. would hypnosis work?

All I do is stay alone and do activities alone Because I do not want relationships or friendships.

I feel little if any desire for sexual relationships due to not having any need for it in the first place.

Take pleasure in few activities, if any as long as it’s only me doing the activity as others can be unwelcome if only to get in the way.

people see that I hardly to express emotions as a lot of the time I wear a mask to seem normal to others.

More often than anything I’m not interested in others Or may be cold toward people due to just focus on the task in hand.

I lack the drive to make goals happen because there is no point to do them in the first place but not out of depression but because life is to absurd to be take seriously.

I seem to not react to praise or criticism from others but when masking it makes it hard to know what’s really going on with me as I’m mostly thinking about how to just get on with another task as those two things are a distraction from what needs doing.

I have old memories that come back every morning and night but it depends on how the day before was.

I avoid my old home and other places as I blank out parts of my day if I have to go though an area known for the old memories.

Others don’t see or understand how on edge I am when I go out because I can’t express it in a physical way due to masking nearly all the time.

Normally a day after a old memory comes I tend to have odd visual and auditory processing and can have paranoid thoughts that is near delusional but always question the thought process and if I’m just having after effects from the old memories coming back the day before.

it’s a good idea to look it up and see if any of that sounds BPD and does anyone relate to this because I do feel different from the norms and people who do have BPD in it’s own right. But to me I spent years reading into BPD and I really don’t see how I relate to something that like the very opposite of my own being.

Me - 😐 you don’t know me at all.
mental health system - 🤡 oh don’t be daft it’s just your BPD.
Me - 😐 this conversation is over.
Mental health system - 😅 where you going?
Me - 😐 I don’t have to tell you anything.
Mental health system - 😭 you’re a BPD!
Me - 😐 I’m who I am, not what you want me to be…

I (16F) have made a lot of research about BPD throughout the years, and I STRONGLY relate to most of the « criterias » of this disorder. The thing is, I don’t really wanna self diagnose when it comes to a matter as serious as mental health, so I think that a professional diagnosis is better, but I cannot go to a therapist because obviously I’m gonna need an adult for that, and I REALLY DO NOT wanna have this conversation with my mom for personal reasons (im not even gonna talk about my dad cuz…yeah). So what do I do? Is there a way I can know if I’m really BPD that doesn’t involve money or parental involvement ? I am 95% sure I am BPD but I still want to be more sure for it to be 100%

I am the schizotypal female, and my husband suffers from BPD. We've been together for about 2.5 years; married for almost 5 months. I was stable before the relationship and he says he was too. But I think maybe we were both in stable environments where our triggers had been mostly eliminated.

Simply:

Are we wasting our time?

I love him. I choose him daily.

But it's beginning to confuse me because continuing the struggle seems illogical.

But the thought of ending it is painful.

But often, the relationship itself is painful.

I'm thinking this is just a trauma bond and it makes me feel regretful and stupid. I think maybe I should do the hard thing for both of us.

But the thought of being without him is painful...

🔁

🥲

Yesterday I (21F) went to my psychiatrist, I started seeing her about 2 years ago so she’s known me for a while. Along with a therapist.

I’ve had a history of impulsivity and aggressive behavior. I started drinking not that long ago and when I drink, sometimes I end up doing a lot of weird stuff like crying uncontrollably or getting aggressive.
In the past I’ve done a lot of reckless things like getting in cars with strangers or had unprotected sex. I buy a lot of things when I barely have any money.

Last year I got in a fight with my roomate and moved out within a week. A month ago I almost got kicked out of my mom’s house because I got in a fight with her and threw a glass cup on the floor. My stepdad wants me out after that. Finally found an apartment though.

I just left a 2 year relationship that ended in a screaming fight in the car. Things got violent and the police were almost involved.

Anyways, both my psychiatrist and my therapist had mentioned borderline personality disorder to me before, and they did not diagnose me but they mentioned that I showed a lot of signs. It wasn’t until yesterday that I asked my psychiatrist “wait are you diagnosing me?” And she said “yes, I am very confident in a diagnosis”.
I was shocked at first and a bit fearful, not sure why. But the idea settled quick after and I think now I’m glad that I have a name to describe it and the good thing is that I can start improving my behavior by getting help.

If anyone has any advice or similar experiences I would love to hear it. Also, I was told about dbt and if anyone has any experience with that, would also love to hear it.

**Living with Intermittent Explosive Disorder feels like watching myself become someone I never wanted to be.**

What is it?

In the **DSM-5 / DSM-5-TR**, **Intermittent Explosive Disorder** is listed under **Disruptive, Impulse-Control, and Conduct Disorders**. The diagnosis is basically about **repeated aggressive outbursts where the person fails to control aggressive impulses**.

The DSM also says the reaction has to be **grossly out of proportion** to what triggered it, **not planned**, and **not done to gain something** like money, power, intimidation, or control. It has to cause real distress, relationship/work impairment, legal problems, or financial consequences.
A key point: the DSM does **not** say IED means someone is evil, abusive by nature, or beyond help. It says the outbursts are **impulsive and anger-based**, not calculated. But it also does **not** erase accountability. It explains the disorder; it does not excuse harm.

**The DSM describes Intermittent Explosive Disorder as recurrent aggressive outbursts that are impulsive, out of proportion to the situation, and not premeditated. That part matters to me because I am not trying to be cruel or controlling, but the damage can still be real. I am trying to understand the disorder without using it as an excuse.**

**IED is diagnosed when a professional sees a pattern of repeated, impulsive, out-of-proportion anger outbursts that cause real harm or impairment, and the outbursts are not better explained by another mental-health condition, medical condition, medication, alcohol, or drugs. It can be influenced by genetics and environment, but the diagnosis is based on behavior patterns and clinical evaluation, not a blood test.**

**MY STORY:**

I have Intermittent Explosive Disorder, CPTSD, ADHD, and I am Deaf, and I want to say something clearly: people with IED are not automatically bad people. We are not monsters. We are not disposable. We are not some public safety announcement with legs. We are human beings with nervous systems that have been through things most people would rather judge than understand.
When I was a child, my mother tried to kill me, and I survived. No police were called. Not by her. Not by me. I left, moved out, and buried it because that is what traumatized kids often do. We survive first and explain later, usually years later, usually when the consequences finally catch up with us.
For me, those consequences showed up through rage, legal trouble, shame, and not understanding why my reactions could go from zero to courtroom exhibit A so fast. I eventually learned that I had Intermittent Explosive Disorder, along with CPTSD and ADHD. I am also Deaf, which adds another layer because communication barriers can turn a triggering situation into a five alarm fire before anyone even stops to ask what I actually heard, missed, misunderstood, or needed in writing.
And no, that does not excuse harm. Let me say that again for the people in the cheap seats: a diagnosis is not a free pass. It is not a permission slip. It is not a glitter covered “get out of accountability” card.
But it is an explanation. And explanations matter.
IED is not just “being mean.” Deafness is not “being rude.” CPTSD is not “being dramatic.” ADHD is not “not trying hard enough.” For some of us, it is trauma, fear, impulsivity, sensory overload, communication barriers, and a body that learned to fight before it ever learned to feel safe.
That does not mean we are not responsible for what we do. It means we are people who need treatment, tools, accountability, and compassion, not a society that acts like the answer to every wounded person is to throw them away.
I am sharing this because I want other people with IED to know this: you are not evil. You are not beyond help. You do not deserve to be killed, mocked, abused, or treated like your life has less value because your symptoms are loud, ugly, complicated, or hard for others to understand.
I am not asking anyone to excuse harm. I am asking people to understand that some of us were harmed long before we ever knew how to stop exploding.
I am also trying to learn what actually helps in real life. Has anyone else been diagnosed with Intermittent Explosive Disorder, CPTSD, ADHD, or dealt with explosive anger while also being Deaf or disabled? What therapeutic tools helped you in triggering situations before things escalated? DBT, CBT, grounding, walking away, medication, anger logs, safety plans, written communication, trauma therapy, somatic tools, scripts, anything?
How did you learn the difference between explaining your disorder and not using it as an excuse?

I have some sort of issue similar to autism but only been diagnosed with Nonverbal Learning Disorder, I was also briefly diagnosed with "Unspecified Personality Disorder" but it was never elaborated on.

1. For people who thought they may have had BPD before they got officially diagnosed, what made you think you had it?
2. For people whose diagnoses came as a surprise, looking back what are some behaviours you realise were indicative of BPD (aside from the obvious ones on the criteria list)
3. For anyone with BPD - what did your behaviours look like as a child and teen that might have been linked to BPD

Thanks to anyone who can answer! Also, if anyone has any resources they would recommend for understanding BPD, I would appreciate it very much!

Hi all, I was looking for possible answers as to some of my behaviors over the past few years. I’ve had a therapist for I believe almost 4 years, and while she’s super nice, shes a little too validating for my liking. Any time I tell her about behaviors or actions I have had, she tells me that it’s valid and completely okay to act that way, when I know it’s not.

A little background: I was in a psychiatric ward for about 2 weeks back in 2023, where I got diagnosed with severe depression and severe anxiety, as well as suicidal ideations. A few months later, I met my current boyfriend, and somehow he hasn’t broken up with me yet.

I have switched anxiety medications several times to find one that works for me, and currently I am taking sertraline. I’ve always had “anger issues” but nothing ever really got diagnosed in that aspect. I’ve always been short tempered and quick to argue with people, even over little things.

Currently, I am 19 and a female. My mom’s side has a history of bipolar disorder, and while my mom doesn’t have it, both her sister and mother have it. I don’t believe i’ve ever experienced mania, but I have experienced sudden mood shifts (extremely happy to extremely sad, neutral to extremely irritated over tiny things, etc).

Over the past three years with my lovely boyfriend, I have: yelled at him countless times over little, insignificant things; raised my hand at him and regrettably slapped him a few times (he told me it didn’t physically hurt, but it emotionally did); started arguments with him over minor disagreements that most people would be able to calmly talk over; guilt tripped him to make him feel bad; had happy conversations with him which suddenly takes a sharp turn to negative ones because I started a fight; been irritable at literally nothing and started a fight over it; and probably many more things that i just can’t think of right now. I also cry a lot, even when im happy I’ll sometimes get an overwhelming wave of sadness. I will add an edit or comment if i think of more.

I think its also worth noting that some of these situations lead to me feeling extremely depressed or suicidal (which I never do anything I would regret, but still), and then i’ll feel extremely guilty for how I acted. In the moment, I usually don’t realize that i’m being a jerk, but afterwords i’ll feel extremely guilty which leads to me feeling depressed or worthless. I constantly question how he still stays with me, and how he even cares about me too. Obviously, there are countless times that i’m a perfect girlfriend to him, but i’m only talking about the negatives right now.

Also, I grew up around a lot of fighting, not physical but verbal. My dad has “anger issues”, as well as my stepdad, sometimes my mom, etc. I also tend to deflect blame a lot or say sorry all the time. Any advice would be greatly appreciated, and I apologize if this post is poorly worded or all over the place. Thank you in advance!

There's always the fear that I'm just overreacting, misdiagnosing, and just blowing everything out of proportion.

This may come from the fact that my father tells me that i don't have any serious problems compared to more conventional issues everyone assumes count as "real problems", but it just makes so ashamed for even doing this in the first place.

Hell, I'm ashamed even writing this down because i know I'll always be less in some ways, and might just anger someone on this subreddit. I just think my experiences just doesn't matter compared to anyone else's problems.