Sam Vaknin
Southern Federal University, Russian Federation
Title: Misdiagnosing personality disorders as anxiety disorders
Biography
Biography: Sam Vaknin
Abstract
Anxiety is uncontrollable and excessive apprehension, a kind of unpleasant (dysphoric), mild fear, with no apparent external reason. Anxiety is dread in anticipation of a future menace or an imminent but diffuse and unspecified danger, usually imagined or exaggerated. The mental state of anxiety (and the concomitant hypervigilance) has physiological complements. It is accompanied by short term dysphoria and physical symptoms of stress and tension, such as sweating, palpitations, tachycardia, hyperventilation, angina, tensed muscle tone and elevated blood pressure (arousal). It is common for anxiety disorders to include obsessive thoughts, compulsive and ritualistic acts, restlessness, fatigue, irritability and difficulty concentrating. Patients with personality disorders are often anxious. Narcissists for instance, are preoccupied with the need to secure social approval or attention (narcissistic supply). The narcissist cannot control this need and the attendant anxiety because he requires external feedback to regulate his labile sense of self-worth. This dependence makes most narcissists irritable. They fly into rages and have a very low threshold of frustration. Subjects suffering from certain personality disorders (e.g., istrionic, Borderline, Narcissistic, Avoidant, Schizotypal) resemble patients who suffer from panic attacks and social phobia (another anxiety disorder). They are terrified of being embarrassed or criticized in public. Consequently, they fail to function well in various settings like social, occupational, interpersonal, etc.