A former Utah psychiatrist says women with "borderline personality" problems pester physicians more than men do, but "flaky" males are more likely to wind up in jail.
"I always wondered why I saw more women, especially from ages 30 to 65, until my recent work with jail inmates," said Dr. Beverley Mead, a professor of psychiatry at the University of Nebraska School of Medicine in Omaha."The women seem to seek out help for their problems, while the men show up at the police station for acting out their distress," he said Thursday during the 43rd Ogden Surgical Society meetings.
Mead said borderline patients who may range from slightly flaky or crazy to manic-depressive are more numerous because of the stress of today's world.
He said a person probably is a borderline personality if he or she has five of eight main symptoms.
"Of course, the symptoms are also an accurate description of a 13-year-old," he said.
The symptoms include unstable but intense relationships, impulsiveness, mood swings, uncontrolled anger, self-mutilation or suicide attempts, indecisiveness about what one wants, frequent inactivity or periods of boredom and going to great lengths to avoid feeling abandoned.
Mead, who spent seven years at the University of Utah Medical School, said these patients usually are best managed by a primary physician and become "highly offended" if it is suggested they need a psychiatrist.
He said they typically won't get well and he suggested they be managed rather than treated or medicated, unless the symptoms are severe.
"They're the type of patients who demand medication to sleep and doctors may find it easier to say, `Here you are,' " he said.
But Mead said some of those patients may do better on a well-controlled low dose of anti-depressants or tranquilizers.
"There are people who seem to be born with a Valium deficiency," he joked.
He suggested doctors schedule borderline patients for office calls about once a month. He said they should spend about 15 minutes listening to them, then give "a pep talk" encouraging them to relax, get more involved, play golf and spend more time with friends.
Mead said that when physicians reject "slightly crazy flakes," such patients usually go doctor shopping and may be subjected to needless expensive tests.
The rejection usually makes the symptoms worse, he said.