 Good evening everybody who is here physically, including those who are watching us virtually and we want to thank you so much for trusting us and coming to listen and also tuning in to be able to be informed. It's a privilege to be here once again this evening and I want to trust that God is going to lead us and we are going to start from where we were yesterday. We were looking at the types of mental disorders and we are making real that indeed they are disorders of the mind and I think you agree with me that it's not a myth but it is true that there are those ones and having looked at quite a number of yesterday include the mood disorders, anxiety, the psychotic, somatiform, the eating disorders and we really wanted to dive a bit deeper in the personality disorders and I have a reason why I chose at least to expound on that because sometimes it doesn't really look like it's a problem but indeed it's a problem. The personality disorders I said I think as I described yesterday is these are the pervasive enduring patterns of thinking, perceiving, reacting and relating. If you follow carefully these are areas where you are not going to diagnose by maybe taking an extra as I've already said remember it is the thinking but we talked about the mind how you perceive things and they react and relate and when you talk about pervasive it means it's out of the norm and that is why they become significant because we know all of us think, all of us perceive, all of us relate and of course all of us react to some situation, environment, to people and everything but we are talking about a situation where now this particular kind of behavior rather elements are pervasive that they are out of the norm and that you call them pervasive because they are going to cause significant distress or functional impairment. That is when now you talk about a disorder, becomes a personal disorder. As we grow these particular patterns could be existing but they are at a level that they are not causing a problem and we refer them as a trade. You know something you are carrying and it is not bothering you. Yes you might think negatively here and there perceive and relate and react but it is not a very important thing at that time especially as we grow old. Then it reaches a point where now it is causing significant distress or functional impairment. They are usually caused by a different, by a combination of genetic and mental factors as I mentioned yesterday and we note that they become less severe as you grow old. So for those of us who have joined maybe city as citizens we believe it was very bad things are now you are managing. No wonder then sometimes families go through a hell and back but as people grow then they say I think nowadays things are not so bad. Remember it could have been a personal disorder now that is coming down because of age. I think I mentioned yesterday that it is important we are talking about it because of the statistics. We say that in a general population around 9% of the general population have these problems and therefore 9% can be anybody including you and me but then it even becomes worse as you look at now those people were exhibiting mental health issues, mental health disorders that we have just looked at that among us people with anxiety disorder you will find that 50% are actually having problem with personality disorders. Therefore it is very important that we actually address this and at least get to understand. Remember that I am not here to make psychiatrist or mental health specialist but you are just here to actually be aware, accept and take action because we were told by our speaker that my people perish for what? For lack of knowledge. And indeed some families have really broken up. There are some children even as we speak are not in good terms with their parents and even within their siblings just because of maybe something like the personality disorder that we don't understand that it exists. I also mentioned that there is no clear distinction in terms of sex, socioeconomic status, race, etc. Meaning anybody can be, can suffer from personality disorder isn't it? And I want to say that your profession even if you are a doctor like me does not cushion, does not remove. The classroom does not remove that trait which we are carrying and therefore you are cushioned from a personality disorder. So it is there. There is also no much difference between male and female but a few that I will be looking at like the one we call antisocial personality disorder you find that the males are more affected than female. I am not saying anything. I have called it antisocial. So I have not said anything. It is you get it more in males in a ratio of 3 to 1. But ladies don't think that you are better. One called borderline which I will be giving the characteristics. We also dominate there where the ratio is 3 to 1. But generally majority you cannot take so much difference. It is important to note this because it is what makes us and is what is going to determine even the families as we look forward to having hope in our families. It is very important to note this because it has been demonstrated that actually the direct health costs of lost productivity associated with the amount that is used in managing this is higher than even what we are calling the other mental health disorders. Especially when you are looking at borderline which I say this more in words women and also there is another one called OCD, obsessive compulsive disorder, personality disorder. So this one actually they are very very significant. The cost in terms of productivity and the wasted time and of course the actual cost of health care is higher than costs of major depressive disorders and even generalized anxiety disorders. I just want to say that in this personality disorder they are actually 10 in total but we look at them because of their characteristics. They have got 3 groups, 3 clusters. They are not there. Don't look at those ones because they are not put there. Just get what I am saying. The first cluster is called we have 3 types we have the paranoid and this is a term that is actually used I hope you know what it means when you say that somebody is very paranoid but sometimes you use it so loosely that anxiety is not settled. That is not what it means. Paranoid, there is this one, it's a characteristics of mistrust and what? And suspicion. That's it. Is it ringing a bell? It's a family. That they don't trust you no matter how much you want to really make them trust you. Please don't be annoyed because sometimes they could be having these trades. So in paranoid personality disorders their characteristic is mistrust and suspicion. People who will never be settled, they are always suspicious either you are not using money well, either you are not showing them everything, maybe you are doing other things out there and many of those of course we know that things happen and they are for once, twice, but you need to see that there is a level that you will be able to have a trust. These people may not have that. There is another one in this cluster called schizophrenia you remember these are the disorders which have got characteristics that we are in out of touch with reality. In this particular group there are people who are always disinterested no matter how excited, no matter what you bring, hello in the family sometimes we are so excited we want to be given flowers, we bring flowers and nothing excites this person. Please accept that there could be a problem if they cannot be excited with what much you try. I really wanted to excite somebody in terms of cooking and everything but still they are not appreciating. They are disinterested in most of the time with whatever it is. There is another type one we call psychotypal they are eccentric ideas and a behavior that sometimes we refer as weird. You know when you hear of somebody having weird behaviors is whatever you expect for example if you are in a setting where you are talking about good things and everybody is excited the person is wondering why you are excited for them there is nothing to excite them. You see it is weird because if everybody is really appreciating what is going around but the person is so indifferent and is not interested many times we look at them and we love them they are very selfish nothing they don't want to participate they are so much on to themselves. Please understand that this is a type of personality disorder that these people may have. Now this is a group that is characterized by dramatic appearance emotional and erratic behavior and they are unpredictable. Have you ever come across somebody who you are just maybe conversing and things are just calm and all of a sudden the person just becomes and is wearing and is shouting and you are like wow very dramatic in behavior and you wonder what really is causing you to do this. This group of personality disorders have got this you know they usually appear very emotional. If it is crying they can really cry and you wonder what is it even you try to cry but there will be no tears but for them the tears are real. Hello very dramatic not because they have decided that there is something inside that makes them that way. These are people many a times are very unpredictable you may not know what is their next move and you know when somebody is unpredictable sometimes we even wonder can I trust you even if it is with children because you see when they are dramatic they can do anything. One of the examples here is the antisocial and this is one I said is common way yes mostly their social irresponsibility they are disorganized disoriented in many a times descentive and they are manipulative for personal gain. I'm not saying that that's all what men are but many a times I've discussed and when we have seminars with women you say no no no I think my husband is so selfish he's nothing but manipulative I hope they understand what it means to be manipulative and in little sense but then in this particular group of antisocial or personal disorders called antisocial that is what characterize them and remember these are people who don't care what you are going to think what you are going to feel as long as they are comfortable so they will do anything for their personal gains. They will even cost you to go for loans when you are you know very well that you are not but because sometimes they talk nicely and I've come many cases where you actually sit back and say how did you make such a decision and then they tell me you don't know the kind of person I am with it can be either way it doesn't mean that women cannot also be manipulative so remember at the back of your mind please find out if there is an element of that antisocial personal disorder there's another one called borderline which I talked that is common in women. This one is not a good one. Regardless of where you are and whatever you have been given you have got an inner emptiness these are guys who are difficult to actually satisfy regardless of what you give they will still always feel empty inside and of course there is a way that emptiness is shown they will always be complaining they will be always saying you know I mean I am not very very hard but I have nothing to show about I am like this you know even somebody who has really gone and you can admire their level of education they still feel very deficient emptiness in inner emptiness they usually suffer unstable relationships and therefore if you dated so many times and you get it right please remember there could have been something that missed us and if you are still dating and you find that things are not working please re-examine and go for maybe professional examination. So you find that in this kind of borderline you know what is the borderline you are almost going out completely of the calf but you are hanging in there but then most of the time you inhibit this thing of you know that emptiness that missing the goal that you know feeling that you have not really you are not where you are supposed to be there is another one in this group called histrioninic which is characterized by attention seeking and excessive emotionality hello you know I have seen some people smiling attention seeking yes sometimes we may find ourselves there but please don't do it too much when you find somebody is doing too much just think that it could be something that is inherent in him excessive emotionality you know every time nothing really is going to I mean make sense to you every time you are so emotional somebody talking something small I was in a clinic this morning and then you know the lady comes and like you know what I was only asking what is normal to this girl and you know she just fell down you know that she converges when things are not so well then the mother asks am I not supposed to say anything as a mother you are allowed to say but to extend that you need to understand that she is also going through she has a problem you know this is a place where you need to understand when somebody does something out of proportion you need to sit back and actually think is it okay and if it is going to be done many times then for sure they need help and that is why you are sitting here and you are listening that you would actually sit back and say could it be that there is a problem did it be a personal disorder and so that you can lead the people to the right place every person talk about the fourth one in this group the so called narcissistic I don't know whether people understand what a narcissist is self-grandused need for admiration and lack of empathy sure I am told that I have only three minutes this is one of the personal disorders that actually you find very common people are not understood and remember one patient and the parents who are like the guy has been in jail many times it combines and social you cannot and you see they are only happy when you are sad they see you smiling it raises a lot of anxiety in them and they will look for something to make sure that you are not feeling well the last one is about avoidant and dependent and this one avoidant you will find that they feel actually they are rejected in all ways especially if children suffer from rejection they are likely to end up with this kind of personal disorders time is not on our side but then I want to say this it is possible for you to check your personality not because you want to quit the relationship with somebody who has it but knowing is better that is what we are being told about the knowledge knowing is easier and there is even an all up which talks about which assesses personality disorders and you are either an introvert, extrovert, the way you interact with people the way you interact with them you make decisions the way you interact with the environment and indeed I hope that at the end of it all you will be able to know and please I recommend that we check so that you know the kind of person you are dealing with because it will reduce your anxiety and pain may god bless you