Why they think you’re a narcissist.

By David Joel Miller.

Have you been called a narcissist?

Proud peacock.

Narcissist?
Photo courtesy of Pixabay.com

Among the reasons that people come to counseling, conflicts with others are high on the list. When a relationship comes apart, whether that relationship is a work one or an intimate one, it’s common to blame the other person. Sometimes both people involved, blame each other. The accusations usually include calling each other selfish, self-centered, and narcissistic.

At first encounter, the narcissist looks full of self-confidence. Closer examination may reveal someone who feels insecure, and needs reassure. Counselors and coaches find people who are high in narcissism difficult to work with. They are prone to think highly of themselves while having low opinions of others. Here are some of the behaviors that may be causing others to label you a narcissist.

You have grand dreams.

Having great dreams is a wonderful thing. Beginning to think that because you are pursuing large goals, you are an important person, is the result of an exaggerated sense of self-importance. Pursue huge dreams but avoid getting a large head. If you want to accomplish great things you need to keep your ego in check.

You think there is no limit to your success.

You can be great at a few things, good at some things, but no one is successful at everything. If you start believing everything you do is better than others, you are leaving reality for delusions. Expecting to win and everything leaves you unprepared for setbacks. Believing you’re the greatest at everything alienates others around you.

You need lots of applause to keep you going.

Recognition feels wonderful, but if you begin to have cravings for admiration, you are headed towards the narcissistic addiction. Expecting everyone to recognize your greatness, and then being hurt when they fail to give you the admiration you expect, reeks of Narcissism.

You expect to be treated in special ways.

Feelings of entitlement are warning signs you are on the road to narcissism. Be careful about believing your own PR. Regardless of the position you occupy treat others the way you would like to be treated. If you start believing that you deserve special treatment, you’ll start looking down at others. Believing your superior drives others away. Your specialness may be pathological narcissism.

You believe it’s okay to get over on others.

The best deals are the ones where both people benefit. If you start believing that it’s okay to take advantage of others, others will not want to be around you. Severely narcissistic people treat others as objects there only to meet their needs. If you treat people like things, you create resentments. If you act narcissistic, people will call you a narcissist.

You can’t feel empathy.

Not being able to put yourself in another’s shoes, results in others not wanting to walk alongside you. Narcissists see things only from their point of view. They can’t understand what others are feeling.

Have you convinced yourself that other envy you?

Riding the envy Express is a fast track to loneliness. Once you convince yourself that others are jealous of you, it’s easy to start being envious of them. Hater’s convince themselves that everyone else hates them.

Your successes have made you arrogant.

Once you convinced yourself that you can do everything better than others, that everyone hates you, and that you are entitled special treatment, your thinking, your behavior, and your speech become arrogant.

People make you angry.

If you come to believe that your anger is caused by other people you have begun to take yourself far too seriously. Take ownership of your feelings. Others have their reasons for what they say and do. Don’t fall into the trap of believing that others behavior has something to do with you.

Your anger quickly turns to rage.

You start excusing your anger outbursts, and now you are going from zero to homicidal rage in seconds’ flat. Living in the land of rage points to your already having crossed the border into narcissism.

Your self-esteem has blown up like a balloon.

Rapidly expanding self-esteem requires lots of input to keep it inflated. Have you experienced complement shortage, and you are constantly fishing for compliments to keep your ego fed. If you believe that others ought to be recognizing your greatness, telling you how wonderful you are, you have left the land of reality.

You do a lot of blaming others?

As you feel more important and more entitled, you may start believing your failures are the results of others letting you down. The more you take the “it’s not my fault” stance, the easier it is to find others to blame. People who become highly narcissistic never accept any blame.

As a highly important person, you expect perfection from others.

The more your ego inflates, the more you expect perfection of others. You said impossibly high standards and those around you feel the strain. Setting impossibly high goals for others, while making excuses for yourself is the narcissistic thing to do.

More about Narcissists.

As we move through our series of Narcissism posts, feel free to ask questions and leave comments. To help you find these posts, below are some links to point you in the right direction. Keep in mind that all the posts about narcissists appeared in the narcissism category but links to future posts will not be live until future posts appear.

Narcissism category.                          Personality disorders.

Narcissistic traits.                               Psychology. (coming soon)

Narcissistic relationship partner.        Relationships.

Self-esteem.                                        Narcissistic Personality Disorder.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings, and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Advertisements

Are you dating a narcissist?

By David Joel Miller.

Can you spot the narcissist in your life?

dating a narcissist

Is he a narcissist?
Photo courtesy of Pixabay.com

Being in a relationship with a narcissist can result in long-term emotional damage. Much has been written about the consequences of relationships with narcissists. There are books about healing from the damage narcissists can do. Some people report having had multiple relationships with narcissistic others.

How do narcissists manage to appear so wonderful at the beginning of relationships? Do you know the signs to watch for to spot a narcissist? How long does it take for a narcissist to reveal they’re true nature?

People in recovery from relationships with narcissists have reported that in the early stages of dating, the narcissist is a great deal of fun to be with. On average, it took seven dates for the narcissist’s true nature to appear. Unfortunately, many people had begun sexual relations with the narcissist before the troubling aspects appeared. They often did not realize what they have gotten into in time.

It’s important to know that there are several kinds of narcissism. In psychology, sometimes the term narcissism describes people who are high in self-confidence. In mental health, pathological narcissism is called Narcissistic Personality Disorder. There’s a world of difference between being in a relationship with a strong, assertive person and having a partner who only thinks about themselves.

First date with a narcissist.

People who sought treatment for the consequences of being in a relationship with a narcissist reported that in the beginning, the narcissist appeared agreeable, competent, intelligent, confident and entertaining. The narcissist is often a very good dresser. They’re likely to surround themselves with expensive things, fancy cars, extravagant homes, luxury possessions, rather than practical items.

When the narcissistic problems appear.

By the seventh date, the problems were apparent. The narcissist began acting arrogant, overestimating their abilities, bragging and hostile. Pathological narcissists consider themselves successful with the opposite sex because of having had many serious relationships. Often they were dating and sleeping with, multiple people at the same time.

Highly narcissistic people experience more extreme emotions. While emphasizing how strongly they were attracted sexually, they had high levels of jealousy and obsessed over their partner.

Relationships with narcissists are characterized by being full of turmoil and are high in instability.

Most narcissists are men.

The characteristics that define narcissism are traits that have traditionally been valued in men. The narcissist is all about being important. The have a high need for admiration. Grandiosity and self-centeredness are other defining characteristics of narcissism. Narcissists are competitive, but for them, competition is all about winning. Some high self-esteem is a good thing, but having too high an opinion of yourself results in toxic relationships.

Women who score high narcissistic traits.

Some women score high on personality tests for some narcissistic characteristics. Rather than being important, women tend to emphasize being close. They’re likely to be overly invested in others. As a result, women are more likely to be diagnosed with borderline personality disorder or dependent personality disorder.

It’s common to find dependent people, those with low self-esteem, attracted to narcissists. In the early stages of the relationship being with this fabulous other makes them feel good about themselves. Unfortunately, they rarely realize they have begun a relationship with a narcissist until they are so deeply involved they find it impossible to leave.

More about Narcissists.

As we move through our series of Narcissism posts, feel free to ask questions and leave comments. To help you find these posts, below are some links to point you in the right direction. Keep in mind that all the posts about narcissists appeared in the narcissism category but links to future posts will not be live until future posts appear.

Narcissism category.                          Personality disorders.

Narcissistic traits.                               Psychology. (coming soon)

Narcissistic relationship partner.        Relationships.

Self-esteem.                                        Narcissistic Personality Disorder.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings, and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Narcissistic Personality Disorder (F60.81.)

By David Joel Miller.

Pathological Narcissism.

Proud peacock.

Narcissist?
Photo courtesy of Pixabay.com

When certain patterns of behavior, or your inner experience, become continuing, pervasive, and inflexible and deviates from what your culture expects, you may have a personality disorder. Narcissistic personality disorder involves an extreme need for admiration, delusions of grandeur or grandiosity, and a lack of empathy.

This particular disorder is rarely diagnosed because those with Narcissistic Personality Disorder do not believe there is anything wrong with them. Lacking empathy, the narcissist blames their problems on others. What brings the narcissist to therapy is most likely extreme impairment in social relationships or a deteriorating job functioning.

One great paradox of narcissists is that despite their beliefs in their superiority, they often are very vulnerable to challenges to their self-esteem. Narcissists need to feel they are better than others in order to feel okay about themselves. This dichotomy results in a high sensitivity to criticism. They often meet perceived attacks with rage.

Even when forced into counseling, the narcissist likely will continue to insist that the problems are caused by others. The DSM lists nine characteristics of narcissistic personality disorder. Having five or more of the characteristics is required to receive the diagnosis. I have paraphrased these from the APA DSM-5.

1. Excessive self-importance, grandiosity.

They expect that everyone will recognize their superiority to others. The narcissist boasts, brags, and exaggerates their accomplishments and are shocked when other people do not recognize their superiority. There is an exception to this if they actually are superior. As the saying goes, it’s not bragging if you can do it.

2. They live in a fantasy world of power and success.

They are preoccupied with fantasies of limitless excesses, absolute power, unrivaled beauty, and brilliance, or ideal love. Narcissists are prone to compare themselves favorably with famous people.

3. The narcissist has a firm belief that they are better than others.

He believes that he should only associate with other superior beings. They expect to attend the best schools, drive the best car, and live in the best neighborhood. Believing they are better than others, they are quick to find fault with the accomplishments of others.

4. The narcissist can’t live without the worship or admiration of others.

Narcissists are often desperate for recognition from others. They expect to be the center of attention and are shocked when others don’t notice them. Narcissists will fish for compliments and be insulted when they feel underappreciated.

5. The narcissist believes they deserve special treatment.

Because they believe they are superior to others, they expect their needs to receive the highest priority. They have a sense of entitlement and a belief that the rules should not apply to them. They see themselves as too important to have to wait for their turn or to stand in line.

6. Give the narcissist a chance he will use you to meet his needs.

Given his sense of entitlement, it’s not surprising; narcissists have no qualms about using others. Sometimes this is a lack of sensitivity, but it may also be rooted in their belief that they are more important and deserving than others. Don’t expect a narcissist to feel guilty for taking advantage of others.

7. Empathy is foreign to narcissists.

The narcissist is incapable of seeing things from others point of view. He can’t see why the feelings or needs of others should matter and expects others to be fully committed to meeting his needs. While they will talk at great lengths about their concerns, they will have no patience to listen to the problems of lesser beings.

8. Narcissists feel entitled to the most and the best.

The narcissist believes others hate him and are jealous. He believes he is entitled to the biggest and best. If someone else has something of value, the narcissist believes it should belong to them.

9. The narcissist excels at arrogance.

The narcissist criticizes everyone. They are quick to use derogatory labels such as stupid, lazy, fat, and rude.

Having read those nine characteristics, you probably have a pretty good mental picture of a narcissist. While I referred to the narcissist as he, it is possible to encounter a narcissistic she also. Some of the characteristics of this and other personality disorders sound like immaturity. To use the personality disorder label, we require that this disorder first begins in early adulthood.

In adolescents, these characteristics may not be fixed and would be described as narcissistic traits. In the adult population, it is estimated that up to 6% of the population have severe enough narcissistic traits to receive the diagnosis of Narcissistic Personality Disorder. About 75% of those with Narcissistic Personality Disorder are men. One possible explanation for the high rate of narcissism in men is our culture’s emphasis on competition and winning. More on that in an upcoming post.

Narcissistic Personality Disorder overlaps and co-occurs with depression, especially Persistent Depressive Disorder, and hypomania in bipolar disorder. People with Narcissistic Personality Disorder often also have Histrionic, Borderline, Antisocial, and Paranoid Personality Disorders.

More about Narcissists.

As we move through our series of Narcissism posts, feel free to ask questions and leave comments. To help you find these posts, below are some links to point you in the right direction. Keep in mind that all the posts about narcissists appeared in the narcissism category but links to future posts will not be live until those future posts appear.

Narcissism category.                          Personality disorders.

Narcissistic traits.                               Psychology. (coming soon)

Narcissistic relationship partner.        Relationships.

Self-esteem.                                        Narcissistic Personality Disorder.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings, and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Questions about Narcissists?

By David Joel Miller.

Has a Narcissist caused you pain?

Proud peacock.

Narcissist.
Photo courtesy of Pixabay.com

If you have experienced a narcissist in your life, you know the pain they can cause. Growing up with a narcissistic parent can affect the rest of your life. Dating a narcissist can undermine your self-esteem. Narcissists make very poor relationship partners. Narcissism was once a very rare diagnosis, over the last couple of decades, the problems of narcissism have been on the rise. Narcissists are often attracted to people with low self-esteem. This increase in the number of narcissists and the way the words narcissist and narcissism are used is creating more questions than it has answered. In this blog post, and some future ones, let’s take a look at the challenge of narcissists.

This increase in the number of narcissists and the way the words narcissist and narcissism are used is creating more questions than it has answered. In this blog post, and some future ones, let’s take a look at the challenge of narcissists.

What’s with all this talk about narcissism?

You may have noticed the word narcissist and discussions of narcissism has been coming up a lot lately. It shows up in news reports, blog posts, comments, and increasingly in the literature about relationships. From the way, the word narcissist is being used; it is clear that various people have very different ideas about narcissists. Because of the things I have read recently about narcissism I’ve been looking at the research into narcissism. The research is very inconsistent, and clearly, the authors are talking about different things.

The word narcissism appears to be the victim of both overused and imprecise use. In future posts, I want to explore what narcissism is and why it looks differently in different circumstances. Our exploration of narcissism will require a series of posts. I will work these posts in as time and space permit.

First the questions about narcissism, with a brief explanation, and then some links to help you find the variety of narcissism you would like information about.

What is Narcissistic Personality Disorder?

Narcissistic Personality Disorder is a recognized mental illness with a very specific set of criteria. This diagnosis is one of extreme, pathological levels of narcissistic characteristics. Most therapists rarely use this diagnosis. It is most likely to come up in criminal justice work where the client is also a prisoner, accused of or convicted of a serious crime. Narcissistic Personality Disorder frequently co-occurs with several other diagnosable mental illness. Other kinds of narcissistic behavior are frequently described and sometimes treated by therapists, despite not meeting the criteria Narcissistic Personality Disorder. More on this condition will be in an upcoming blog post.

What is a narcissistic relationship partner?

Some relationship or couple’s therapists use the term narcissistic partner to describe the way one person may act in a relationship. If you been in the relation with the narcissistic person, you know how painful it can be. When relationships break up, many people describe their ex as narcissistic and uncaring. The term narcissist is sometimes used as a synonym for selfish and self-centered behavior. Your partner’s behavior may range anywhere from mild narcissistic thoughts and actions to extremely high levels of narcissism. Both people in the relationship may become more narcissistic with time as they teach each other these thoughts and behaviors.

Why are people with low self-esteem attracted to narcissists?

Therapists see a lot of clients who have been in abusive relationships. Many of these people grew up in homes with a caregiver who was emotionally unavailable or abusive. As adults, these individuals often find themselves attracted to people they later described as narcissists. Many people would describe themselves as having low self-esteem and have been in multiple relationships with partners who they would describe as narcissists.

What is the connection between charisma and narcissism?

Several research studies have described the phenomena of charisma. While not all charismatic people are narcissists, when you first meet them, narcissists are often very charismatic. It can take a long time to see through the charisma and recognize the narcissism.

Why are so many middle and upper managers high in narcissism?

Narcissism in one form or another is common in managers. In the short run, narcissistic managers can produce some amazing result. Some are successful over the long haul. Very narcissistic managers can also create human wreckage, high turnover, and some spectacular failures.

What is trait narcissism?

In the field of psychology, there’s been a lot of research on a thing called trait narcissism. This trait connects to a lot of other personality characteristics. People who are low in self-esteem are low in trait narcissism. When we treat people with low self-esteem, as their self-esteem rises, so does their level of trait narcissism. What the psychology field means by trait narcissism and what mental health means by Narcissistic Personality Disorder are very different concepts.

Can narcissism be a good thing?

People who are high in trait narcissism have more self-esteem and self-confidence. Some of this research suggests that too little narcissism may be causing emotional and mental disorders. If some narcissism is a good thing, we need to know when narcissism is useful and which narcissistic characteristics are good ones.

How can you spot a narcissist?

When you’re initiating a new relationship, you can expect people to put their best foot and best face forward. Before you get into a new romantic relationship, it could be useful to spot the signs that this person is a narcissist. If you’re doing the hiring, you might want to take another look at a narcissistic job candidate before you hire them and they demolished your organization.

Can you think of any other questions about narcissists and narcissism we should ask?

More about Narcissists.

As we move through our series of Narcissism posts, feel free to ask questions and leave comments. To help you find these posts, below are some links to point you in the right direction. Keep in mind that all the posts about narcissists appeared in the narcissism category but links to future posts will not be live until future posts appear.

Narcissism category.                          Personality disorders.

Narcissistic traits.                               Psychology. (coming soon)

Narcissistic relationship partner.        Relationships.

Self-esteem.                                       Narcissistic Personality Disorder.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings, and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

What is an Adjustment Like Disorder? (F43.9)

By David Joel Miller.

When is an adjustment disorder not an adjustment disorder?

What is? Series

What is an Adjustment Like Disorder?
Photo courtesy of Pixabay.com

Sometimes people have symptoms as a result of experiencing trauma or stress.  These difficulties are sufficiently severe that we think this person needs treatment but the exact group of symptoms they have doesn’t quite fit a listed disorder.  The new DSM – 5 solves this problem by creating another name for adjustment like disorders.

Other Specified Trauma- and Stressor-Related Disorders (F43.9)

This designation gives us five more ways to categorize problems of everyday living which were caused by stressors or trauma but do not quite neatly fit the defined adjustment disorders.  Below are the five reasons you might get an adjustment like disorder diagnosis.

1. You had a stressor but your problems did not begin until more than three months after the stressor.

2. The problems continue for more than six months even though the stressor has ended but your symptoms have not turned into another diagnosis.

3. You were having an “ataque de nervious.” This particular condition is listed in the back of the DSM – 5 under cultural concepts of distress. While not recognized in the United States as a mental disorder, this particular group of symptoms is widely recognized in Spanish-speaking countries.

4. Another cultural syndrome. There are a number of cultural syndromes that are recognized in a particular geographic or ethnic area.  The cultural syndromes are understood as an inability to cope with a particular stressor.

5. Persistent Complex Bereavement Disorder. This condition is listed in an appendix to the DSM under conditions for further study.  Since it didn’t make the list of official diagnoses, researchers needed a way to code it.  The result is this condition ended up here under adjustment like disorders.

I don’t think I’ve ever seen an adjustment like disorder listed in the person’s chart nor have I ever use this particular diagnoses myself.  But when I saw it was right there in the DSM-5 I just couldn’t resist letting you all know about this.  Maybe this illustrates how learning to diagnose mental illnesses is both an imprecise science and an area for continuing learning.

As with the other things we are calling a mental illness this adjustment like disorder needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress. Otherwise, you may have the issues but you will not get the diagnoses if this is not causing you a problem. If the only time this happens is when you are under the influence of drugs or medicines or because of some other physical or medical problem this issue needs to be more severe than your situation would warrant. These other issues may need treating first, then if you still have symptoms you could get this diagnosis.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

For more on this topic see Adjustment Disorders in the Trauma- and Stressor-Related Disorders category.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

What is Post-Traumatic Stress Disorder PTSD?

By David Joel Miller.

Would you know PTSD if you experienced it?

What is? Series

PTSD
Photo courtesy of Pixabay.com

PTSD is something that we hear a lot about, but most people have only a general idea what it involves.  PTSD was first recognized in returning military veterans. It has since been recognized in children who were abused, in cases of domestic violence, as the result of sexual assaults as well as the result of other traumas. While each case of PTSD is unique, they have many features in common.  Many people with PTSD may also have one or more other psychiatric disorders, some of which are likely the result of traumatic incidents. Below is a list of the features that professionals use to identify PTSD.

PTSD involves a specific trauma.

Something has happened or there was a high risk it would happen.  This trauma involved death, possible serious bodily injury, or a sexual assault. This event needs to happen to you or someone close to you, not just be something you saw on the television.  This event was either violent or sudden and unexpected.

Also included in the definition of a trauma below, are the effects which dealing with the incident has on first responders or other emergency personnel.

This traumatic event keeps forcing its way back into your life.

Part of PTSD symptoms are the recurrent memories of the event.  You may have nightmares about what happened or things connected to that event.  Some people with PTSD experience spacing out or dissociation.  You may also experience flashbacks and in these times it can feel like the event is happening again.

These recurrent intrusive memories are easily triggered.  Both internal triggers, thoughts and feelings, and external triggers, people, places, and things, may bring back the memory.

People with PTSD try to avoid reminders.

There are all kinds of ways to avoid being reminded of something that has happened. You may avoid going to certain places or events. People may turn to drugs, alcohol or other distractions.  They may try to avoid having feelings, or other thoughts about the incident.

Sometimes the brain does this job for you.  You may find that there are periods of time for which you have no memory. Some people describe this as having a blackout or amnesia.  They may avoid activities which are in any way connected to these unpleasant memories.

Behavior changes when you experience Post-Traumatic Stress Disorder.

People with this disorder often become irritable and angry.  They may become either self-destructive or reckless.  Part of this condition is having an exaggerated startle response.  In the aftermath of the trauma, people may develop poor concentration and impaired sleep.  Someone with PTSD may stop engaging in activities that used to be fun, they detach from others and may say that they just can’t feel happy.  These behavioral changes are also characteristic of depression, and the two disorders often occur together.

PTSD can cause cognitive changes.

In the aftermath of trauma, it is common for people to blame themselves.  They may tell themselves that if they hadn’t been there, or had been more careful, it would not have happened.  Negative thought patterns may develop.  People begin to feel bad about themselves, other people, and the future.  These cognitive changes can result in developing depression.

PTSD needs to last a while and not be something else.

This condition is expected to last more than a month after the stressor.  As with the other things we are calling a mental illness this needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress. Otherwise, you may have the issues but you will not get the diagnosis. If the only time this happens is when you are under the influence of drugs or medicines or because of some other physical or medical problem we’re likely to think this is something other than PTSD.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

For more on this topic see Trauma- and Stressor-Related Disorders. 

See Recommended Books.     More “What is” posts will be found at “What is.”

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

What are the six types of Adjustment Disorders?

By David Joel Miller.

Adjustment Disorders include six types or specifiers.

What is? Series

What is an adjustment disorder specifier?
Photo courtesy of Pixabay.com

In another post, I wrote about adjustment disorders. You might want to take a look at that post.  You will find it in the trauma- and stressor-related disorders category. But to briefly recap, an adjustment disorder is a time when you experience stress and that amount of stress is more than you can handle.

The kind of things that you might find stressful, and how that stress might affect you, can vary a great deal from one person to another.  Adjustment Disorder can be very chameleon like, changing from person to person and from time to time. As a result of this variation and in order to help find the correct treatment for each person, professionals use six different specifiers for various presentations of adjustment disorder.  Listed below are the six specifiers or sub-types of adjustment disorder that are listed in the new DSM – 5.

Adjustment Disorder with Depressed Mood (F43.21).

Sometimes in addition to having difficulty coping with a stressor, as a result of this life problem, people develop depression.  If this goes on long enough or is severe enough they might eventually get a diagnosis of Major Depressive Disorder.  But until that happens treatment will mainly focus on the stressor and the depression that stressors is causing.

Adjustment Disorder with Anxiety (F43.22).

Sometimes the primary symptom that people experience when they are going through stress is an increase in their anxiety.  If this increase in anxiety is related to a specific stressor, is more severe than we expect or goes on too long, Adjustment Disorder with Anxiety is the likely problem.

Adjustment Disorder with both Depression and Anxiety (F43.23).

Anxiety and depression frequently happen to people at the same time.  If this stressor has produced both depression and anxiety, then this specifier should be added.

Adjustment Disorder with Conduct Problems (F43.24).

Sometimes the principle way we know that stress has affected somebody is that they begin to act in inappropriate ways.  This diagnosis with this specifier is most commonly seen in children who rather than show their symptoms as anxiety or depression, begin to act out.

Adjustment Disorder with Disturbance of Emotions and Conduct (F43.25).

When stress overcomes a person’s ability to cope, we may see changes both in their behavior and in their feelings.  This is often the case in children and adolescents but may also be seen in adults with poor emotional regulation.

Adjustment Disorder Unspecified (F43.20).

When the counselor knows that the problem the client has is caused by their reaction to stress but none of the other sub-types quite seem to fit, this category may be used.

As with the other things we are calling a mental illness this problem needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress. Otherwise you may have the issues but you will not get the diagnoses if this is not causing you a problem. If the only time this happens is when you are under the influence of drugs or medicines or because of some other physical or medical problem, this problem needs to be more than your situation would warrant. These other issue needs treating first, then if you still have symptoms you could get this diagnosis.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books