Antisocial Personality Disorder

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KEY POINTS

• Antisocial personality disorder is a condition that causes you to not care what happens to other people. You know right from wrong, but just don't care.
• This disorder changes the way you relate to others and the way you think about everyday activities. Therapy may help.
• Get emergency care if you have serious thoughts of suicide or harming others.

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What is antisocial personality disorder?

Antisocial personality disorder (APD) is a condition that causes you to not care what happens to other people. You do not feel guilty when you do things that others would consider wrong. You can be impulsive, destructive, reckless, and sometimes violent.

What is the cause?

The exact cause of this disorder is not known. Possible causes include:

• The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way you think, feel, or act. People with this disorder may have too little or too much of some of these chemicals.
• Stress plays a part. You may be at higher risk due to problems such as abuse, financial stresses, or the death of loved ones.
• Problems in your family when you were growing up may increase your risk. For example, if you were abused as a child, you may have learned to take care of yourself and to not care about the feelings of others. Your risk is higher if someone in your family has the disorder, or if your parents abused drugs or alcohol.
• People with this disorder may have physical changes in their brain. This may affect the ability to learn from reward and punishment. It may also cause trouble dealing with stress or loud noises. These changes in the brain may cause you to be impulsive and aggressive.

APD is far more common and more serious in men than in women. Women with this disorder may be more likely to "con" people than to physically hurt them.

What are the signs?

Symptoms may include:

• Breaking laws, cheating or lying to others for fun or for personal benefit
• Being impulsive and not thinking about what could happen as a result of your actions
• Being irritable or angry very often, and picking on or bullying other people or getting into fights
• Taking risks and ignoring safety
• Being irresponsible, such as not paying back money that you owe

You may seem charming, fun, and exciting to be around. However, you think only of your own needs and do not care if you hurt other people. You know right from wrong, but just don't care.

How is it diagnosed?

Your healthcare provider or therapist will ask about your symptoms, medical and family history, and any medicines you are taking. He will make sure you do not have a medical illness or drug or alcohol problem that could cause the symptoms. He or she may also:

• Ask about your relationships with family, friends, and coworkers
• Give you a personality test
• Make sure medicines are not causing or increasing your symptoms

You may have lab tests to rule out medical problems.

How is it treated?

This disorder changes the way you relate to others and the way you think about everyday activities. Therapy may help.

• Behavior therapy helps you recognize that the way you act affects others. This can help you change problem behaviors.
• Cognitive behavior therapy (CBT) is a way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new thought and behavior patterns.

How can I take care of myself?

• Get support. Consider joining a support group in your area. You may get helpful feedback from other group members to help you solve problems. You can learn and practice healthier ways to deal with other people.
• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, try to quit. Avoid alcohol and drugs. Exercise according to your healthcare provider's instructions.
• Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all the medicines, natural remedies, vitamins, and other supplements that you take.
• Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.

Get emergency care if you or a loved one has serious thoughts of suicide or harming others.

For more information, contact:

• National Institute of Mental Health
  866-615-6464
  http://www.nimh.nih.gov/
• Mental Health America
  800-969-6642
  http://www.mentalhealthamerica.net/