What Is a Sociopath?

Sociopath is a term that many people use to describe others who may lack empathy or whom they believe to be evil. It is not a true psychiatric term, but rather a synonym for someone who has been diagnosed with antisocial personality disorder.

This is a very serious mental health condition that causes patterns of thoughts and behaviors that are not normal and that make it difficult to function like other people do, at home, at work, or in relationships.

Someone who is referred to as a sociopath may actually have a mental illness called antisocial personality disorder, or ASPD. This is a type of personality disorder, a condition that causes a person to think, behave, and perceive the world in abnormal and unhealthy ways. There are several types of recognized personality disorders, grouped into three different clusters.

ASPD belongs to cluster B, with those personality disorders characterized by behaviors that are overly emotional, erratic, or dramatic. Someone with ASPD usually refuses to conform to social norms and expectations and disregards other people’s rights or feelings. They may manipulate other people, lie, cheat, steal, and generally treat other people badly while showing no signs of remorse for it. Criminal behavior is common in people with ASPD, and the ability to function normally at work, in school, or in relationships is severely compromised.

The DSM-5, the manual that is used by mental health professionals to make diagnoses, lists the criteria someone must meet to have ASPD, or to be a sociopath. First, they must have impairments in personality and the ability to function with other people. These can include being egocentric, seeking personal gratification, lacking empathy for others, and being unable to develop intimacy with other people. A person must also have several abnormal personality traits:

• Manipulativeness
• Deceitfulness
• Callousness, or a failure to be concerned for the well-being of others
• Hostility and anger
• Irresponsibility
• Impulsivity, or acting without thinking
• Risk-taking

Some people may show signs like these of ASPD, and be called a sociopath by others, but still not meet all the criteria to be diagnosed with the condition. The traits and behaviors have to be consistent over time and not associated with a developmental stage, like adolescence. They also can’t be caused by drugs or alcohol.

Only a mental health professional can make a diagnosis, but if someone you care about acts in ways that make you think of a sociopath, it helps to know more about this personality disorder. In addition to the criteria listed by the DSM-5 there are some more specific signs you can watch for and that may indicate a person has ASPD, such as he or she:

• Ignores or doesn’t care about what is right or wrong
• Lies or deceives other people often
• May be charming or nice but only to manipulate others and for personal gain
• Is arrogant
• Is highly opinionated
• Is disrespectful of others
• Often fails to plan ahead and acts on impulses
• Doesn’t feel bad about hurting others
• Struggles with relationships and intimacy
• Has regular problems with the law
• Is often angry, irritable, or violent
• Intimidates others
• Takes unnecessary risks, sometimes putting others in danger
• Is consistently irresponsible

As with other personality disorders, most people with ASPD won’t seek professional help because they don’t think there is anything wrong with how they think or act. They tend to think other people are wrong, not them. Most people with ASPD who get treatment were urged to do so by loved ones.

Treatment can be challenging because of this persistent inability to see one’s actions and behaviors as abnormal. However, ASPD can be treated with therapy. Therapy for ASPD often includes very practical strategies and goals, like anger management, relationship therapy, and empathy training. Treatment is most effective when an individual sticks with it for the long-term and is closely monitored.

The outcomes of treatment for ASPD will depend on the severity of symptoms and a person’s willingness to participate and make positive changes. It is important to seek out a diagnosis and treatment, because living with untreated ASPD can have serious consequences, including incarceration or injury or death from violence. If someone you know shows signs of ASPD, urge them to see a professional as soon as possible.