I have one last thing to say about personality disorders tonight, and then I promise to shut up for a bit.

do you know how and why we diagnose mental illnesses and personality disorders? a better question: do you know why we don't diagnose them in everyone alive?

everyone is selfish sometimes, after all. everyone gets sad. everyone feels nervous about things every now and then. but we don't diagnose all of those people with sociopathy or depression or anxiety. why not?

here is something people forget about diagnoses: they're meant to help the people being diagnosed.

wanting attention is fine. wanting attention so badly you'll hurt yourself to get it is not. being sad happens. being so sad you can't get out of bed is a problem.

some people can get over their nerves by saying a prayer or taking a deep breath. some people can't leave the house because no matter how many times they check that they've locked the door, they keep having to go back to check one more time.

the thing about the DSM criteria for personality disorders is that almost all of them are traits everyone has. how many kids have gotten mad at their parents and fantasised about secretly being adopted? so many that it's a trope on kids' TV.

that same fantasy - that you are secretly born of or to greatness - is one of the diagnostic criteria for NPD. so why don't we diagnose every kid who's ever yelled, "I bet you're not even my real parents!" in a fit of pique with narcissism?

see, the thing about these diagnoses is that they're a framework for helping to treat people who have traits that are so pronounced that their lives are negatively affected. that's why being sad isn't the same as depression and mood swings don't make you bipolar.

I don't have a cluster b personality disorder because I'm selfish. I have a cluster b personality disorder because my inability or unwillingness to consider the feelings of others hurts me by destroying the interpersonal relationships that form my support networks.

I'm not borderline because I'm emotional or narcissistic because I think highly of myself. I'm borderline because I can't control my emotional reactions to things and I'm a narcissist because my saviour complex takes an incredibly harsh toll on my health and wellbeing.

do you know what it's like to be trapped in a cycle of thinking you have to save the world because you're the only one who can and then hating yourself because you can't save everyone and then throwing yourself into it even harder just to prove yourself wrong?

it's exhausting.

and I'm not saying that because I want your pity or even your compassion. this is just how my brain works. I think god made me special, which is fine, but I also think I have a duty to be all things to all people because of it, which is...well, less fine.

it's a disorder when it starts hurting you. and sometimes the way in which it hurts you is that you hurt other people and that sucks, but we don't diagnose everyone who hurts other people. we diagnose people who are hurting themselves.

everyone is selfish sometimes. everyone's scared of being alone sometimes. everyone overthinks things sometimes. what makes it a disorder is when you do those things to the point that you're hurting yourself - and, yes, probably the people around you, too.

my disorder isn't that I'm emotional. my disorder is that my emotions are so overwhelming that even a little bit of bad news can ruin my year. my disorder isn't that I'm cocky. my disorder is that I am so sure that I'm meant to fix the world that I refuse to accept that I can't.

I'm not depressed because I feel sad. I'm depressed because sometimes I can't feel anything, not sadness, not happiness, not anything, and I forget all the things that make my life worth living because I forget how those things make me feel.

I don't have GAD because I get nervous. I was a competitive public speaker for five years! I have GAD because thinking about what I have to do tomorrow makes me so anxious that I can't do the things I have to do today.

I'm not bipolar because I have mood swings. I'm bipolar because in the same day, I once went from manic euphoria to suicidal ideation three separate times, so that I was halfway up the mountain I was going to drive my car off when I decided to speed up the road for fun instead.

they're disorders when they start to affect your life to the point that you can't live the way you could otherwise. it's not about other people, or not primarily. like any other illness, mental illness is about how your symptoms affect you. it's about the pain you feel.

and believe it or not, people with personality disorders do feel pain because of the way their symptoms affect our lives. we feel pain and we cause ourselves pain and that's what the disorder is, not a checklist of traits that anyone can have.

i just think it's really important to remember that diagnosis isn't meant to be a condemnation of the patient. it's meant to be the first step along the road to recovery.

they're disorders because they hurt. we diagnose them so we can help people stop hurting.

and that, by the way, is why your cartoon supervillains and corrupt billionaires don't have personality disorders.

they're not hurting. it's a disorder when it starts to hurt.

anyway, folks, that's me done for the week, I think. if I've taught you something, made you think or just given you something to read on your commute, consider chucking a buck in the tip jar' http://ko-fi.com/jaythenerdkid