The Overlapping Calamities: Truth
Awakening. That's what he did. He opened his eyes and decided to make a change. First his diabetes. Then his weight. Now his ADHD. Life is falling into place for him. And so suddenly, we seem less similar than we have in a long time. What does that say about me then?
I thought I was managing. I thought I was just plucky, eccentric, or quirky. But this is more. He tells me how his mind was working before and after treatment. He told me about distraction. Hyper-fixation. Procrastination. Paralysis. Then it clicked. It was like looking into a mirror.
I scoured the research. I made appointments. I scheduled evaluations. Suddenly something made sense that didn't before. Like a secret kept from me my whole life. Whispers from the past come back to haunt us. For decades, we were passed around a giant web of pills, therapy, and evaluations. Everyone had an opinion, but nothing ever matched. Depression. Anxiety. Schizoaffective Disorder. Borderline Personality Disorder. But first, long before any of those, was a third grade teacher trying to convince my mom and family doctor that I had ADHD. No one believed her.
But suddenly it all made sense. The rate of co-diagnosis between ADHD and BPD is staggering honestly. All the times I was called lazy, or asked, "Why can't you be more like your brother?" They degraded us over time. They made us feel like nothing. Our grades. Our performance. Our health. They reflected the stigma. They reflected the consequences of those unheard whispers.
I didn't know exactly what to expect when I made my first appointment. A social worker spoke with me for fifteen minutes about my symptoms and the consequences of those symptoms in different settings of my life. I told her about my borderline personality disorder and extensive family history of mental illness. I told her that I felt like BPD was accurate but there was something else going on. There was something behind it or under it that wasn't being well managed. I told her that I thought it was ADHD. I pleaded with her, telling her that I felt like I was so close to the truth for the first time in almost thirty years.
She told me that because of my borderline personality disorder, she could not diagnose me as ADHD. She said I had several markers of each, but it was unclear if I really had both or was just in the overlap between them. She added that due to my family's history of mental illness, I would need a full psychiatric evaluation. Her last words were something about how she knew it wasn't what I wanted to hear. Then she told me that she understands that I feel like I'm close to some sort of breakthrough and that was because I WAS so close and am on the right track with my suspicions.
The following week, my telehealth provider told me they could no longer fill my atypical antidepressant due to my borderline personality disorder being out of their scope of practice. They'd filled it for over a year and all of a sudden they had a policy change. So they wrote two more fills and sent me on way, wishing me the best of luck. Of course everyone knows that antidepressants don't really treat BPD, but it has really helped manage my emotional reactivity and impulsivity.
Heartbreaking. Frustrating. I found a new therapist after regaining insurance coverage. I spoke to her about my concerns and she agreed that I was in the overlap and just as the social worker, said I would really need a full psychiatric workup to determine exactly where I fall in that overlap because according to her I'm actually in the overlap of three disorders (BPD, ADHD, and OCPD).
Getting into see a psychiatrist is going to take several more months. So in the meantime, I established care with a new primary care doctor that I recently met with. She told me that I definitely meet the criteria for ADHD and could benefit from treatment, but would still need a full psychiatric evaluation. And before we could move forward with treatment, we would need to get my blood pressure since both my atypical and stimulant therapy together have a synergistic effect and can further increase the risks of high blood pressure.
It never stops. But finally, I feel like I'm getting somewhere. I had hoped this would have more colorful language or deeper metaphors, but I just don't feel too colorful today.