From The Silence of the Lambs’ Hannibal Lecter to Misery’s Annie Wilkes, pop culture is packed with portrayals of terrifying “psychopaths.”

According to crime thrillers and horror films, psychopaths are cold, calculating villains with a penchant for harming those around them. But is there any truth to these portrayals?

Most people thought to have psychopathy are, when assessed, diagnosed with antisocial personality disorder (ASPD), which some consider to be another word for the same condition. Similarly to other personality disorders, there is no cure for ASPD or psychopathy, but by becoming aware of how their brains work, people with psychopathy can avoid harming others and lead successful, fulfilling lives.

What Is A Psychopath?

How do we know who is a psychopath, and how can we help these people function in society without harming those around them?

Are psychopathy and ASPD the same thing? These conditions are so closely linked they are often conflated, though some sources consider psychopathy to be a more severe iteration of ASPD symptoms. Other sources outlining how psychopathy is diagnosed suggest that psychopathy is a type of antisocial personality disorder.

People with psychopathy are more likely to engage in behaviors other people see as wrong or harmful, like manipulation, lying, cheating, or stealing. They might have problems with aggression, and even get in trouble with the police as a result. You might say that psychopaths lack the mental barriers, like guilt and empathy, that prevent us from committing those acts society finds unacceptable.

In order to be diagnosed, a person needs to be over 18, and needs to be evaluated to ensure their symptoms aren’t the result of a mental illness. For example, someone who acts impulsively and aggressively as a result of untreated schizophrenia isn’t eligible to be diagnosed with psychopathy. Several treatable mental illnesses can cause similar behaviors and symptoms, so if you’re worried, be sure to explore all possible avenues to an answer!

Symptoms of Psychopathy

How would you know if you or a loved one was a psychopath? Someone with one or two of these traits is no cause for concern, and sometimes a mental illness could be the cause of a few others. But if you find yourself relating to an increasing number of the symptoms on this list, or if several of these traits sound like someone you know, psychopathy might be the answer.

• The individual is superficially charming and generally well-liked by people who don’t know them well.
• The individual might have a “shallow” affect, and appear not to grasp the nuances of human emotions.
• The individual is very arrogant, grandiose, and has an overinflated view of themselves and their abilities.
• The individual is often bored and seeks out risky but stimulating activities, such as drug use and casual sex.
• The individual craves “action” and may deliberately cause chaos around them to relieve boredom.
• Despite their elevated view of their own abilities, the individual lacks a solid life goal and/or a plan to achieve it, or they might hold goals so lofty they are laughably unrealistic.
• The individual may live as a “parasite,” leeching off of partners, friends, and family until cut off.
• The individual engages in violent or criminal behavior.
• The individual is enraged at real or perceived slights, and retaliates mercilessly when they feel they’ve been wronged.
  
  • The individual lies, cheats, steals, and manipulates those around them.
  • The individual completely lacks guilt or remorse when confronted with the fact that they’ve harmed someone.
  • The individual lacks empathy—they don’t understand why it’s wrong to harm someone else for their own benefit.
  • The individual is irresponsible and struggles to take orders from others, resist impulses, hold down a job, and conform to societal expectations.
  • The individual often got in trouble as a child, and may have been involved with the juvenile justice system.

  Unique Features of the “Psychopath” Brain

  It’s generally understood that people without psychopathy will “mellow out” as they age—clubbing and doing shots on the weekend is all well and good at age 20, but at 40, most of us would rather grab a drink with a couple friends or have a nice dinner at home. But it doesn’t work that way for psychopaths. According to a new study, their symptoms stay the same or even worsen as they grow older.

  The study was conducted by interviewing the relatives, spouses, and close friends of 993 people with diagnosed ASPD or psychopathy. Overall, 1,215 people associated with one of the 993 diagnosed individuals participated in the study—not a bad turnout, considering the stigma around psychopathy!

  The study participants had a lot to say. Many of them said they assumed that their loved one with psychopathic traits would calm down as they aged, as most people who act out in their youth do, but they were sorely disappointed. Of all respondents, 93% said the behavior of their loved ones was just as severe, or even got worse, after age 50.

   

   

  According to the study’s findings, as a result of their loved one’s antisocial behaviors, 68% of respondents lost money, 43% went into debt, and 26% were physically harmed. When it came to the mental toll, 88% of the respondents suffered from depression and anxiety while 76% said they suffered from PTSD as a result of the situation.

  So, how can we ensure that the partners, family members, and friends of those exhibiting psychopathic traits can be safe, and that people with this condition can lead fulfilling and productive lives without harming those around them?

  As always, arming ourselves with knowledge is the first step!

  What’s Unique About the Brains of Psychopaths?

  Why do most people become less impulsive and less action-seeking as they age? While there are probably social factors at play—for example, you don’t want to be hungover in the morning when you have to go work to support your family—there’s also a neuroscientific answer.

  The frontal lobe is one of the most fascinating parts of the brain. It plays a central role in the development of our personalities and choices, and houses brain structures linked to rational thinking, impulse control, and planning for the future.

  When we enter puberty, the frontal lobe undergoes a massive growth spurt, developing millions of new neurons we didn’t have as children. These neurons aren’t fully covered by myelin sheaths, which allow them to quickly and effectively share information. This essential fatty tissue grows in after the neurons themselves, helping us to get better and better at making decisions as we mature (the development of the frontal lobe continues until the age of 25)!
  

  When a young teenager steals money out of their parent’s wallet, they’re not thinking about the future; they just want to go out with their friends and need cash. But if they face consequences when they get caught, they learn to think ahead and control their impulses by adulthood, a time when the frontal lobe is more developed.

  An adult with psychopathy in their 50s stealing money from their elderly parent won’t grow out of it, because, in this case, an underdeveloped frontal lobe isn’t the cause. Therefore, a different approach is needed to control such behavior.

  Psychopathy isn’t caused by a chemical imbalance, as mental illnesses like depression are; the brains of psychopaths are unique at the structural level. For instance, the ventromedial prefrontal cortex (VPC), part of the frontal lobe, is poorly connected to the amygdala in the brains of psychopaths. Furthermore, psychopaths and people with damage to the VPC have issues with decision-making, suggesting that the VPC of psychopaths might be impaired.

   

   

  The ventromedial prefrontal cortex is linked to feelings of guilt, remorse, and empathy. This part of the brain causes most people to “feel bad” when they see that they’ve harmed someone else. The amygdala is linked to fear, emotions, and decision-making; it helps us look forward, anticipate how our decisions will later make us feel, and incorporate that information when we make choices.

  In most brains, these two structures communicate extensively. It’s thought that this communication helps a typical person avoid doing things to harm others.

  Imagine you’re really, really angry at your sister who loves to paint and puts a lot of work into her art. You might briefly picture yourself destroying her work, but you know that would really hurt her, and that you’d feel terrible as a result, so you don’t actually do it.

  Psychopaths don’t have that mental barrier, thanks to the differences in their brains we talked about above. Without that anticipation of guilt to stop them from doing certain things, they may just pour paint on their sister’s masterpiece in anger!

  In other words, when psychopaths do things that harm the people around them, they aren’t necessarily suffering from a lack of impulse control, but a lack of empathy and guilt.
  

  Final Thoughts

  So, if psychopaths don’t have the typical mental barriers that stop us from doing harm, does that mean they’re all doomed to be violent criminals? Not at all! Most psychopaths never commit a violent crime, and what the media shows us doesn’t reflect what these people’s lives typically look like! What the results of the study show us is that psychopaths require a special approach to learn how to get along in society.

  For example, some people diagnosed with psychopathy or ASPD work out clear rules about what they will or won’t allow themselves to do. This lets them fill in the gap: They don’t naturally feel guilt or empathy, so they need to consciously stop themselves from doing things that are harmful.

   

  

  Other people with these conditions work with their doctors to find a medication or therapy routine that helps them stay on top of things. Medications exist that help control aggression and stabilize mood, allowing the individual to calm down before acting on anger. Therapy can help teach which behaviors are and aren’t acceptable while taking the unique features of the psychopathic brain into account.

  Overall, the complicated issue of psychopathy shows that while our brain structures have a major influence on our behavior, they don’t have to determine our destiny. Learning about how the brain works is the first step to overcoming the challenges it presents.

  Whether you’re diagnosed with psychopathy, ASPD, or if you struggle with something entirely different, you have the power to take control of your life! All it takes is a little knowledge and determination to succeed.