I know the conventional wisdom that personality disorders are caused by trauma in the first couple years of life. And that may be true. But there's also a substrata of very respected doctors who believe that they are genetic or biological in origin--exacerbated by trauma, but not caused by them. For years ausbergers was considered to be caused by 'refrigerator moms', cold and aloof, frightening their children into themselves as a defense. We know that's hogwash now, but how many women suffered years of self doubt and anguishing guilt because of that? It's possible that personality disorders are created by brain physical structure or electrical functioning rather than some other mental illnesses by chemical imbalances. My ex husband was narcisstic personality disordered, and an alcoholic. He had a non traumatic early childhood (altho his father fell apart after his own mother died when X was about 12 and started beating his wife and kids every weekend). His older sister by 14 years told me once that X didn't smile until after his second birthday. This was a baby that had an adoring, mother, grandmother, and old sister in the house and a proud father. The dad didn't start his violent rages for another dozen years (sister knew the exact date). They were so excited with X first smiled. So why wouldn't X smile as a baby when he had loving people trying for two years to coax one out of him? What is biologic? The only other person I know for sure who has personality disorder is our difficult child. He did have a traumatic beginning--altho not horribly traumatic, just a few very bad days among mostly calm ones. He also likely has a strong family background in genetically based mental illnesses. I think in many cases the mental illness and the personality disorder feed off one another. In such cases does the mental illness produce the personality disorder or the other way around or do they just sort of exist aside and independently of one another? difficult child's mother is a bipolar II, sometimes diagnosis'd as schizophrenic, with major chronic psychosis. She can however be helped amazingly with drugs. When she takes her drugs--and she won't--she's as normal as anyone. Except for what seems to be mild personality disorder. She's just plain selfish and unempathetic to others. And never able to take responsibility for herself. But not mean and able to have friends and a social life and work. She's likeable. But when my husband was her husband he once cut off the top of his finger; not only would she not take him to the hospital, she wouldn't pick him up afterwards (and she was an ER nurse). Why? Because she had to work the next day. Personality disorder. She didn't get the mental illness and psychosis until she was 32, which is really late for the initial presentation of schizophrenia and bipolar. (Her two brothers were the same: initial presentation of schizophrenia at 28 and 32). The finger incident was before she ever got sick with the mental illness. So it seems a mild personality disorder existed before the mental illness. I have no conclusions: just random thoughts. I think a lot of people here have a lot of experience with personality disorders and mental illness and the conjunction of the two problems, and wonder if you all had any thoughts or observations on the subject. A lot of times lay people know more than the 'experts'.