Over the years, I have witnessed an increase in the diagnosis of "Bipolar
Disorder" (formerly called "manic-depressive" illness) in people
who primarily have an antisocial personality disorder. What I believe has happened
is that well-intentioned professionals who do not regularly interview or treat
antisocial individuals are deceived. The antisocial person thinks in extremes.
He is number one or he is a zero. There is no middle ground. He has very unrealistic
expectations of himself and others. So long as he can prop up a very shaky image
of himself as a powerful and unique person, he seems on top of the world. When
that image is threatened and things are not working out as he ordained, he slides
into a depression. For the antisocial person, the "best" antidote to
feeling like a nothing is to show you are somebody -- thus another assertion of
his power and control, often with others being injured in the process. The antisocial
person's peaks and swamps of emotion are very different from a person who suffers
from a mood disorder and who may genuinely merit the diagnosis of "bipolar."
Return to Dr. Samenow's Homepage