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Suffering from systemic lupus, alcoholic. Unbelievable lying, attention seeking, violence, suspicion. Cause?

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Practicing since : 2004
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I am extremely worried about my partners state of mind. My partner is a 32 year old man that has been suffering from systemic lupus for many years now, he also has a drink problem and to me what appears to be a mental health problem. My partner has always tried to act a bit gangster like telling me many stories that I just find unbelievable, he has told me that when he was younger him an two other friends of his were sitting on a wall inhaling aerosols when one of them fell backwards off the wall, hit his head and died he then told me that rather than calling the police him and his other friend buried the body! I used to live with him but had to temporarily move home due to my father being ill and he would continually ring me telling me that he was in my home town with people he knew from the area drinking in certain pubs and staying in certain hotels, he would nag me to go and XXXXXXX him but i would say no as he had done it before and he had been lying so naturally I would think it was rubbish. He would then get angry with me and tell me that he gave me the chance to go and XXXXXXX him but I wouldn't and it always turned out that I was right and he never was there to begin with. Last week he seen a message off my old boss and starting throwing a massive fit, he was calling me the c word a bitch a slag, telling me my mother doesn't love me and all sorts, this went on for about 10 hours solid, next thing I know he is sending me loads of messages off his phone that I had sent to my old boss, he told me that he had my bosses phone, I didn't believe him and told him to text me off it, 2 seconds later I had a message off my bosses phone stating a nickname that only my partner would know to call me. He then told me that he had got some of his people to find my boss and that they had given him a cheap mobile phone with only a contact number for my partner in it, he told me that these people had held a baseball bat to his head and forced him to call my boyfriend. He ex partner had previously been put into witness protection which I know is true as I have read the story and spoken to her myself which he does not know about. He has tried to convince me that my mum is an alcoholic when she is not, you very rarely see my drunk, he goes on about how he can pull these lovely women and how he has slept with previous girlfriends mums, he told me that he once cut the top of someone's finger off with a pliers, that he was a football hooligan and that he used to bare knuckle fight to earn money for food when he was homeless.... The list is never ending please could you give me some sort of clue as to what may be wrong with him as I am at my wits end.

Posted Wed, 18 Apr 2012 in Eating Disorders
Answered by Dr. Ashish Mittal 7 hours later

Thanks for your query.

Important aspects of your query are:
• 32 year old male.
• Alcohol addiction.
• Worry related to manipulative and anti social behavior of partner.

From the information it is apparent that your partner is not suffering from major psychiatric illness. But he appear to addicted to alcohol.

His behavior more related to his personality, which appear to in cluster B group of personality. I want to give information related to personality disorders so that you can understand the complexity of its assessment and concurrent need of assessment of psychiatric disorder during examination.

Definition: Personality disorders as enduring subjective experiences and behavior that deviate from cultural standards, are rigidly pervasive, have an onset in adolescence or early adulthood, are stable through time, and lead to unhappiness and impairment. When personality traits are rigid and maladaptive and produce functional impairment or subjective distress, a personality disorder may be diagnosed.

Personality disorder subtypes classified in DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders) are: schizotypal, schizoid, and paranoid (Cluster A); narcissistic, borderline, antisocial, and histrionic (Cluster B); and obsessive-compulsive, dependent, and avoidant (Cluster C).

Cluster A includes three disorders with odd, aloof features, such as paranoid, schizoid, and schizotypal.

Cluster B includes four disorders with dramatic, impulsive, and erratic features, such as borderline, antisocial, narcissistic, and histrionic.

Cluster C includes three disorders sharing anxious and fearful features, such as avoidant, dependent, and obsessive-compulsive.

Personality disorder is a common and chronic disorder. Its prevalence is estimated between 10 and 20 percent in the general population, and its duration is expressed in decades. Persons with personality disorder are frequently labeled as aggravating, demanding, or parasitic and are generally considered to have poor prognosis.

Personality disorder is also a predisposing factor for other psychiatric disorders (e.g., substance use, suicide, affective disorders, impulse-control disorders, eating disorders, depression and anxiety disorders) in which it interferes with treatment outcomes of other psychiatric disorder and increases personal incapacitation, morbidity, social complication and mortality of these patients.

Persons with personality disorders are far more likely to refuse psychiatric help and to deny their problems than persons with anxiety disorders, depressive disorders, or obsessive-compulsive disorder. Personality disorder symptoms are alloplastic (i.e., able to adapt to, and alter, the external environment) and ego-syntonic (i.e., acceptable to the ego). Persons with personality disorders do not feel anxiety about their maladaptive behavior. Because they do not routinely acknowledge pain from what others perceive as their symptoms, they often seem disinterested in treatment and impervious to recovery.

Following measures will help you:

• Personality assessment by clinical psychologist or trained psychiatrist. It may take several days to make final diagnosis. Following tests are used to assess personality which is administered by trained psychologist: Clinical interview, Sentence completion test, Rorschach Inkblot Test, Thematic Apperception Test (TAT), Minnesota-Multiphasic Personality Inventory (MMPI) and several other tests
• Psychotherapeutic treatment after assessment in form of counselling +/- drug therapy.
• Treatment of co morbid illness like: anxiety, depression or other problems.
• Improvement may take months or years depending on the case.

Hope this answers your query. I will be available for follow up queries if any.


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