Q: I have a close friend who has diabetes. He is overweight and I feel that he does not eat properly and never exercises. He takes pills and insulin shots everyday. He has a professional degree. He is very intelligent in his profession but seems not to act upon it. He is very lazy, lies a lot, blames everyone but himself, thinks he is too complex for anyone to understand. When talking to his clients, he talks himself up to be the best in the world. He has never been able to settle in any 1 job for more than a year or 2. He never pays his bills on time and has no concept of controlling money. He also tends to mentally abuse his wife and fights a lot with her over small things. Is this behaviour due to him being a diabetic and not taking care of himself or is it a sign of some mental illness? And if so, how do you get a sick person to admit it and get help?

A:Based on your description, the troubling behaviours your friend exhibits does not seem to be caused by either diabetes or by a mental illness. You seem to be describing a man with negative traits in his personality. If he were seen by a mental health professional he might be diagnosed as having a personality disorder, but not a mental illness. Personality traits tend to develop in childhood and adolescence, and persist throughout life. Some are positive; humour, generosity, honesty, interest in others, industriousness, a sense of fair play. But you describe several negative traits in your friend; dishonesty, laziness, insensitivity to others, selfishness, needed excessive attention from others, and so on. The consequence of having a personality disorder is being unable to get along well with others. Does this sound like your friend? In fact, based on your description, one must wonder why you keep him as a friend? What do YOU gain by this friendship? The basic treatment for personality problems is psychotherapy, but it is only successful if the patient is uncomfortable enough with his life to be willing to change. Is that the case for your friend?