Mental Disorders and the Second Amendment

Thursday, August 8, 2019
By Paul Martin

By Peter A. Olsson MD
August 8, 2019

Psychiatrists, psychologists and other mental health professionals deal with and diagnose a wide spectrum of conditions from mild anxieties, substance abuse, learning disabilities, mental retardation, and marital-family-vocational relationship problems, to severe mental illness. Severe mental illness can be well-treated, not treated well, or not treated at all. Some psychological treatments like “anger management classes” help angry persons without established psychiatric diagnoses, but don’t cure them, or completely cure potential for violent behavior. The messiest and most dangerous of mentally ill persons are adolescent or young adult males with severe personality disorders.

The Spectrum of Mental Illnesses: A Brief Introduction

The typically anxiety neurotic person, is keenly aware of their psychic pain. Their psychological pain, like the pain of a severe medical disorder, frequently brings them to a physician, clergyperson, or therapist. Significant numbers of military veterans and civilians suffer from trauma-related PTSD which requires medication and psychotherapy. Their treatment is often more complicated if there is concurrent substance abuse. However, effectively treated anxiety neurotic persons are not a huge danger for gun violence.

A psychotic (Schizophrenic, Bipolar or Psychotically Depressed) person, like Jared Loughner who shot Arizona congresswomen Gabrielle Giffords, is in massive denial about his disorder. The denial of a psychotic person like Laughner is the result of their brain chemistry’s disarray. In addition, the psychotic person often refuses to take medication and stay with counseling. Psychotherapy and judicious medication prescription can help psychotic persons have clearer thought processes enabling them to work and relate more normally to other people. Well treated and followed-up psychotic persons are no more prone to gun or other violence than the normal population.

Severe Personality Disorders: The Most Messy and Dangerous Mental Ill-Heath Situations

Persons with a personality or character disorder are commonly in denial about their offensive, cruel, selfish, un-empathetic, anti-social, disrespectful, inordinately dependent, or destructive thoughts and behavior. They in essence are unaware or barely aware of the psychological skin in which they have lived in for most of a life. Persons with personality and character disorders only acknowledge a problem when their behavior causes pain or difficulty for others. When confronted, they often blame the messenger who presented the bad news to them. According to people with severe personality or character disorder, the police who confront them, the boss who fires them, or spouse that leaves them, are the problem

People with Severe Personality Disorders readily assume that their view of the world is the only true or important view. They are often the last to recognize if ever their destructiveness or dangerous potential for lethal violence. They are very hard to engage in therapy or treatment programs.

Severe Personality Disorders such as: Borderline Personality, Malignantly Narcissistic, Antisocial Personality Disorder, or Sadistic Psychopathic Personality Disorder are not psychotic disorders like Schizophrenia, Psychotic Depression, or Bipolar Disorder (formerly Manic-Depressive Disorder) . Severe personality disorders are often chaotic, impulsive, suspicious, and have poor insight and emotion regulation. These severe personality and character disordered individuals are often far more difficult to treat than severe schizophrenic or depressed persons. Psychiatric medications often have limited usefulness and they tend to act-out their emotional problems rather than talk them through in psychotherapy. Just when a psychotherapist gets into the core conflicts of these persons, they flee treatment, use addictive substances, or act-out their problems into behavior, occasionally toward the therapist.

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