The thrust of DSM-5 was designed to usher in a system of classification wherein mental disorders exist along a spectrum.
Within each of these categories there exists a spectrum. At the extremes of the spectrums problems emerge.
The question facing clinicians now becomes not “does a person have bipolar disorder or not,” but rather “how much bipolarity does a person have?.” Everyone has some degree of bipolarity, for example, when overtaken by a surge of creativity, artistry, spontaneity, energy, sociability, talkativeness, and excitement. It is only when these features are “out of control” or produce negative consequences that a person enters the realm of what DSM-5 considers a “disorder.”
The shallow, indifferent individual will tend to engage in limited or no introspection. Such a person might have difficulty learning from their mistakes. In contrast, the deeply despairing person tends to engage in an endless brooding sort of introspection.
The middle is the domain where we profit from our losses and regrets without becoming overwhelmed by them.
Toward the low end of the spectrum, toward “zero”, a person possesses very low energy. Such a person tends to lack creativity, and they can be perceived as boring or flat.
The 2 extremes comprise this spectrum, Carelessness versus Anxiousness. Here the question becomes “how much vigilance do you have?” The more vigilance a person displays, the more likely they are to progress to clinical anxiety at some point.
The far left side of the spectrum involves almost no vigilance at all. This is highly problematic. Such a person is reckless and lacks the ability to properly evaluate risk.
A certain level of anxiety is important. Anxiety is a warning system for our body and mind that something dangerous may be at hand.
A fundamental feature of personality disorders is the tendency people with these disorders have to externalize blame or causation for their symptoms. Individuals who suffer personality disorder have problems conducting the daily affairs of their lives and often have problems relating to others. When something goes wrong, they immediately locate the source of their problems outside of themselves (this can also be described as having an external locus of control).23 In contrast, the right side of the scale depicts individuals who an earlier version of the DSM (II) described as neurotic. At the extreme left end of the scale, the neurotic end, individuals ascribe exaggerated and excessive cause or blame to themselves for anything that goes wrong. People with personality disorders are also characterized by rigidity and inflexibility in the way they live and the way they relate to others. They do not learn from their experience and they do not change; they do not adapt. Repeated experiences that should demonstrate to the sufferer that they have a role in their own struggles fail to inform them. Instead, when a pattern of problems repeats they interpret it as further evidence that others are to blame for their difficulties. This is the meaning of maladaptive. Clinicians may find such patient’s defenses to be almost impenetrable. It can prove helpful to keep in mind that their inability to recognize their own role in their problems and the turmoil that surrounds them is a pivotal feature. A certain amount of quirkiness and idiosyncrasy is to be expected across the range of normal human personality function. However, personality disordered individuals display an exaggerated amount of idiosyncratic thought, perception, and behavior. If it were possible to measure their behaviors along a normal distribution they might be expected to fall beyond 2 standard deviations from the mean. At either extreme of the scale outlined below, an individual is likely to have problems. Individuals located at the extreme left side of the scale locate the source of their problems in life within themselves. These are not people who know healthy guilt. Their guilt tends to be excessive and misappropriated. This excessive guilt can be erosive.
Personality consists of those traits that are stable and persist over time. Personality Disorders are defined by persistent traits that are maladaptive.
Life demands of each of us a willingness to accept our role in matters that go wrong without yielding to an exaggerated degree of self-reproach or self-criticism. When that balance is struck, a person learns from their mistakes, they cultivate a forgiving attitude toward themselves and others, and they develop the capacity to deal with the role that others play in their misfortunes.
To some extent, everyone can be understood to have features associated with the 8 Primary Spectrums of Mental Illness.
The centerpiece of this disorder involves the extent to which the patient experiences distressing feelings, thoughts, or behaviors out of proportion to what might be expected from a condition.
Depression, "How much SORROW do you hold?" Shallow and Indifferent >> Empathic and Deeply Caring >> Deep Despair and Hopelessness.
Bipolar, "How much CREATIVITY do you have?" Boring, Stuck-in-the-Mud >> Full Mania
Anxiety, "How much VIGILANCE do you have?" Reckless >> Robustly Enjoying Life >> Fear, Anxiety, Panic
Psychosis, "How strong are your DREAMS and VISIONS?" Boring, Uninspiring >> Inspiring and Vision-filled >> Visions have broken through reality into psychosis
ADHD (Can't sit still or focus) >> OCD (Obsession)
Addictions, "How much PLEASURE do you seek?" Ascetic monk with no possession >> healthy enjoyment of wine and song >> Drug addiction
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