Concerned about friend's diagnosis

HoneyDiva,

I don't know where you read that antisocial personality disorder comes from bipolar disorder - but it is not true. Of course there are people who have both - and they are extremely troubled, often ending up in jail or worse. It also does not come from schizophrenia. Studies show that only an incredibly small number of violent offenders are suffering from a serious mental illness (like a thought disorder). People with antisocial personality disorder begin to develop their problems in their infancy. They usually started off with an "attachment disorder" which occurs when an infant is neglected or abused, or if the mother figure is using drugs or is otherwise unable to "connect" with her (or his) child and read his/her cues. Usually these children have lots of defiant behavior which gradually becomes violent. Important red flags are fire setting, cruelty to animals, and violence towards other people (though not all of these things need to be present). They typically show no remorse for they're hurtful actions although they can sometimes be very good a faking it. If not treated during childhood, it almost always progresses into adulthood. People with antisocial personality do not have a biochemical disorder (as far as we know) and if given any medicine at all, it is usually an antidepressant (because they usually feel worthless and depressed - though they may not show it).

Your friend's sister, if diagnosed properly with bipolar disorder /manic is in a whole different ballpark. Bipolar illness can usually be effectively treated with mood stabilizing medications and she should also be seeing a therapist to help her to cope with her illness. Stress and conflict can precipitate a depressive or manic episode. Drug and alcohol use can also trigger these mood swings. When people are in a manic phase they can do some very strange things that are completely out of character. They often believe their invincible, use very poor judgment, have magical or delusional thoughts (like believing they can read people's minds), and may put themselves in great danger. They can also behave with a lot of hostility and aggression, which can be very scary to those around them. This should not be mistaken for antisocial personality disorder (or "conduct disorder" as it would be called for someone under 18). I'm sure your friend will benefit from your support and understanding.

Sincerely,

Ben Schwarcz, MFT