Not long ago, I listened to someone, a non-mental health professional, lament the collapse of their long-term romantic relationship. Their former lover allegedly “two-timed” them, and upon being discovered, made no effort at repairing. Summarily, the lamenting party added, “Just no empathy, and so absorbed with so-and-so now. It’s all about them! That’s the description of a narcissist.”
The above is just one of many similar commentaries I’ve overheard in general social circles as people try to make sense of some allegedly troubling person in their life by using the current trendy pop culture psychological diagnoses.
Narcissists, borderlines, and antisocials, oh my!
Like ADHD, autism, PTSD, and bipolar disorder before them, some personality disorders have taken a seat at the table of pop culture’s ongoing buffet of misrepresented mental illnesses. Relying only on a popularized representative symptom or two, like a perception of “no empathy” to justify the diagnostic application, illusory explanations for vexing behavior via casual personality disorder diagnoses sometimes permeate social airwaves, second only to cellphone tower transmissions.
Truth be told, like how the bipolar buzz led to layperson suspicion that anyone exhibiting reactivity had a major mental illness, the majority of allegations of personality disorders by non-professionals are based on flimsy evidence at best.
I’ve wondered, too, if there is an even more devil-may-care attitude about accuracy because it is no secret that the favored pop culture personality disorders mentioned above are the most damning. They double as handy insults disguised as a clinical explanation. The person alleging their cheating ex was a narcissist flung the term about with the gusto one would deliver a colorfully described bodily function product towards their enemy.
It’s as if personality disorders become weaponized.
True personality disorders take time to identify
To be clear, even to seasoned clinicians, unless it’s an unusually flagrant case, certainty about a personality disorder diagnosis can take time. People don’t show up to treatment saying, “I have a long-standing, pervasive baseline pattern of inflexible, maladaptive inner experiences and outward behaviors evidenced by my thoughts, moods, impulse control, and interpersonal relationships, and need immediate reconstructive psychotherapy for more adaptive processes of relating.”
Much of the time, people with personality pathology request treatment for depression, anxiety, relationship issues, and the like, and a skilled clinician, over time, comes to recognize characterological components that are generating the complaints. Someone working with Charlie Brown, the poster child for an avoidant personality, if he presented for depression, would eventually discover a core belief (schema) of negative self-evaluation in comparison to others. He feels he doesn’t measure up, will likely be rejected, making it hard to have satisfying relationships, which can get him down. This schema isn’t part of the depression; it’s an ingrained belief, part of his personality, that’s generating the bad mood.
There’s probably more than meets the eye
The above isn’t to suggest that the average person who alleges a personality disorder diagnosis on someone is trying to be intentionally nefarious. It is ingrained in popular culture and easy to adopt. If this habit is familiar, it might be helpful to step back and examine what’s trying to be accomplished if one is quick to think, or worse, start rumors of “narcissist!” “borderline!” or “antisocial!” about someone.
If it is to make sense of behaviors, we still must understand that an isolated incident of a behavior that is representative of a personality disorder — or any disorder, for that matter — doesn’t justify a diagnosis. Even if the behavior is consistent, it doesn’t mean there’s a full personality disorder there.
Imagine a young woman at work who clearly has a history of self-injury. She can be moody and hard to get along with at times — two popularly recognized signs of borderline personality. Now, assume that she’s moody at times because she gets depressed. Younger people, especially, can experience depression as irritability, and, of course, some people engage in self-injury when depressed.
“I’m so tired of her borderline BS” might get muttered by someone familiar with the term after the woman “gave attitude” to them. Borderline personality disorder is sufficiently recognized by popular culture, through caricatured representations in movies like Fatal Attraction, of course, that someone hearing that might think, “She’s one of those.” Soon, in the rumor mill: “So-and-so thinks she’s a borderline.” Given BPD is considered perhaps the most stigmatized mental health diagnosis there is (Hancock, 2017; Brown, 2024), this can be damaging, and especially so to someone already prone to struggling.
Personality Essential Reads
Even someone who seems like a sociopath — who lies, steals, and fights without remorse — might instead struggle with addiction, but when sober, those characteristics inherent to getting their substance of choice aren’t there. In fact, this is specifically noted in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (American Psychiatric Association, 2013) as something to be cautious about.
How well do you know these people?
Just as it would be unethical for a psychological professional to haphazardly diagnose someone, it is just as socially unethical to suggest people have personality disorders out of the wish for a quick explanation or social discord.
Disclaimer: The material provided in this post is for informational purposes only and is not intended to diagnose, treat, or prevent any illness in readers or people they know. The information should not replace personalized care or intervention from an individual’s provider or formal supervision if you’re a practitioner or student.