I had to almost laugh in a sad way when the man across from me was screaming that his soon-to-be-ex-wife was "a psycho, bi-polar b**ch!" She had been sitting at the table earlier, before I separated them into different rooms due to the aggressive nature of this man, with her head down, shoulders hunched, and very quiet. She spoke calmly and quietly when answering questions as the husband seemed to get more and more angry and loud. It appeared to me if anyone was a bit "out of control," and notice I did not say "crazy" or "insane" or anything of that nature, it was the husband.
I hear it all the time now from friends and family as well, "She is bi-polar." "He is narcissistic!" "He is crazy!!!" No, not always true. Although mental illness does exist and yes, it may be a contributing cause to some issues in relationships of all kinds, most people are not technically mentally ill. In fact, it may be the accuser who has the illness.
DSM-5 criteria for narcissistic personality disorder include these features:
- Having an exaggerated sense of self-importance
- Expecting to be recognized as superior even without achievements that warrant it
- Exaggerating your achievements and talents
- Being preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate
- Believing that you are superior and can only be understood by or associate with equally special people
- Requiring constant admiration
- Having a sense of entitlement
- Expecting special favors and unquestioning compliance with your expectations
- Taking advantage of others to get what you want
- Having an inability or unwillingness to recognize the needs and feelings of others
- Being envious of others and believing others envy you
- Behaving in an arrogant or haughty manner
The manic episode may occur before or after a major depressive episode. These occurrences may cause significant impairment in life, may require hospitalization, or may cause a break from reality resulting psychosis. A manic episode includes an abnormally and persistently elevated or irritable mood that lasts at least one week and causes noticeable difficulty with relationships, school, social activities, work, etc. The depressive episode is described below.
Bipolar II Disorder
These people have not had a manic episode but have had a hypomanic episode lasting several days. A hypomanic episode is when a person has a noticeably, abnormal elevated or irritable mood that last at least four (4) days. The individual's behaviors may cause difficulty in areas several areas of their lives including relationships and work. The depressive episode is described below.
The DSM-5 lists criteria for diagnosis of a depressive episode:
- Five or more of the symptoms below over a two-week period that represent a change from previous mood and functioning. At least one of the symptoms is either depressed mood or loss of interest or pleasure.
- Depressed mood most of the day, nearly every day, such as feeling sad, empty, hopeless or tearful (in children and teens, depressed mood can appear as irritability)
- Markedly reduced interest or feeling no pleasure in all — or almost all — activities most of the day, nearly every day
- Significant weight loss when not dieting, weight gain, or decrease or increase in appetite nearly every day (in children, failure to gain weight as expected can be a sign of depression)
- Either insomnia or sleeping excessively nearly every day
- Either restlessness or slowed behavior that can be observed by others
- Fatigue or loss of energy nearly every day
- Feelings of worthlessness or excessive or inappropriate guilt, such as believing things that are not true, nearly every day
- Decreased ability to think or concentrate, or indecisiveness, nearly every day
- Recurrent thoughts of death or suicide, or suicide planning or attempt
To be considered a major depressive episode:
- Symptoms must be severe enough to cause noticeable difficulty in day-to-day activities, such as work, school, social activities or relationships
- Symptoms are not due to the direct effects of something else, such as alcohol or drug use, a medication or a medical condition
- Symptoms are not caused by grieving, such as after the loss of a loved one
These are just a couple of mental disorders that I have possibly come across as a mediator. I say "possibly" because these were not diagnosed. Just because a person does not want to be with someone does not make them "crazy," "bipolar," or "narcissistic." People all have ups and downs in life and people do sometimes get justifiably angry. A lot depends on what is done with that anger and how they react. As a mediator, I need to always remember that our sessions are confidential UNLESS someone threatens to harm themselves or others.
If you, a client, or anyone you know threatens suicide or you would like more information, please contact the Suicide Prevention Hotline at 1-800-273-TALK (8255)