I was a hyper-active, impulsive, and obsessive child. Early on I was prone to outbursts, often wound like a top, and dismissive of risk. Around the age of 5 my pediatrician, after listening to my parents describe my behavior, informed my parents I might have ADHD. Though by the time I was somewhere between 7 and 10 this wound-up hyperactivity was no longer readily evident. Hyperactive was my younger brother who practically bounced off the walls when he missed taking his Ritalin. It was obvious I was not like that.
As a teen and throughout my adulthood I have been depressed, angry and short of temper, at times suicidal, and a whole laundry list of negative and dysfunctional behaviors. Not that I was completely aware of this. Ultimately, I just knew I was “fucked up”. I said to myself, this is the way I am, this is who I am. This was the tidy package which allowed me to ignore all those messy details.
So it came as a surprise when a psychologist I was seeing to explore medication options for lifelong irritability diagnosed me with ADHD. I was floored. “But I’m not overly wound-up. I’m highly organized. I don’t exhibit those traits”. This was a misunderstanding, she explained. There were two types of ADHD, hyperactive, and inattentive. She said I have the hyperactive type, along with the dysthymia I was already treating. She went on to explain how the patterns and behaviors in my life were classic examples of hyperactivity. Speaking with Erin later in the day and telling her of the diagnosis she said, “Makes some sense. You’re one of the most neurodivergent people I know”.
This was all news to me. And it was unsettling.
What I experienced with the diagnosis knocked my self-understanding off balance. I had already been two years into counseling, working through issues, on medication which alleviated depressive symptoms I’d had my whole life. Then this came out of left-field like a smack to the face. Did this little journey of self-discovery and healing get more complicated?
I was filled with a low-burn sadness. If this was true then how much of my life had been disrupted by this? How much of the difficulties in my life could have been avoided had I known this and been properly treated? I found myself walking old mental paths, retracing steps, seeing some of the mishaps from the past in a new light.
This was all fine except it didn’t sit comfortably with me. I told Erin on numerous occasions I wasn’t sure about the diagnosis. It didn’t feel accurate. As if a diagnosis should be going by feels. I know. But it didn’t. It also did not help that this psychologist made some choices I came to see as amateurish, which included giving me two mood altering medication changes at the same time. This eliminated any way to understand which was affecting me when I went from feeling fine, to dropping back into the depression I hadn’t experienced in almost 2 years.
So what did I do? I put it in the back of my mind of course. I pulled it out once in a while to think about, and always came away with the feeling the diagnosis was wrong. Though instead of doing actual legwork and digging into it, I ignored it. What did it matter anyway? I had a new med manager, some adjustments were made to my medications, and I felt really damn good.
Balanced. Calm. Complete.
But why let sleeping dogs lay? I mean, this has been a two year journey of self-discovery, might as well keep the chapters coming, right? So with some unexpected free-time on my hands today I decided to look up ADHD. Combing through multiple sources reinforced the feeling this was not me. Sure, I was obsessive, and maybe there was some overlap, but the predominant symptoms of hyperactive ADHD were not what I experienced. So how the fuck did they come up with this diagnosis?
There happened to be a source which touched on the diagnosis determination from the DSM-5. It laid out overlap disorders many with ADHD experienced. This little rabbit hole led me to open numerous pages of disorders. Then my reading brought me to one disorder where just about every symptom, and common cause, fit like a glove.
Out of right-field came another smack to the face: Borderline Personality Disorder.
I get the unreliability of self-diagnosis. It is a real problem doctors experience on the daily. Just look at where our country is right now with a roided out lunatic who doesn’t believe in germ therapy and vaccines. All you have to do is a quick Google search and you’ll have a myriad of sources to piece together your issue at hand. You can go to your doctor armed with misunderstanding and argue you now know more than they do.
I trust expertise. I rely on it. I have a healthy skepticism, but I respect domain knowledge and put a decent amount of trust in doctors. Why? Because my experience, again and again, is that their diagnosis has been right. They have helped me, cured me, cut me up and sewn me back together and provided me with good, knowledgeable outcomes. But this psychologist left me hesitant. That healthy skepticism had been heartily ringing the bell and I’ve begun paying attention.
This isn’t to discredit medical professionals or mental health care. Not at all. This is one limited example in a lifetime of good care. And who knows…I could be completely wrong about this little self-diagnosis. But I’ve a hunch I’m right. I shot this info over to Erin and we had the following conversation:
E: Holy shit
J: I just emailed you a link.
E: I read it - would fit your dad as well.
J: Yep. Had the same thought.
E: Emotionally you guys are/were probably very similar but you are on a healing path and he never did. So interesting. Omg I think you nailed it.
J: You see it? It’s way more accurate.
E: Yeah. But I think you get super hyper fixed and obsessive. I still think you are neurodivergent, you have to be in order to deal with all of us weirdos. Also, you get very overstimulated and are sensitive to noise. I think you are both. Somewhere in the ND umbrella and borderline.
Of course, I’m not going to run with this and call it truth. Not yet. I’ll be consulting with my counselor and psychologist and going from there. But all of the sign posts are there. They add up. They make sense. It’s an outline of so many aspects of my former life.
Borderline Personality Disorder. It sounds so serious. What does it actually mean? From The National Institute of Mental Health:
Borderline personality disorder is a serious mental illness that affects how a person feels about themselves and others and makes it hard to function in everyday life. The disorder often involves difficulty regulating emotions, leading to impulsivity, an unstable or often changing sense of self, and troubled relationships with others.
That’s a pretty basic breakdown. It’s a bit more complicated than this. You can read more about it if you like. I don’t want to spend words just re-writing the article, but I do want to touch on one item from the above link, and that is comorbidity. Insofar, from my reading, there are often a lot of overlapping comorbidities when it comes to borderline personality disorder. For example, a few common comorbidities include depression, anxiety, and ADHD. This can make a diagnosis of borderline personality disorder prone to error. This could explain why my former psychologist diagnosed me with ADHD instead of BPD. Or, I could have both. Or both plus other disorders. I certainly have depression, something that has followed me throughout my life. At this point, it’s the sad partner that will always be there.
Why make this easy? See, between the paragraph above and this sentence, a number of weeks have passed. And during this time I saw my counselor and told her about the possibility of borderline personality disorder. She nodded, noting it was interesting. And then she said, “Or it could be complex PTSD. Complex PTSD is often misdiagnosed as BPD. You should take a look at that as well”.
Okay, okay, for fuck sake, what is Complex PTSD? From Wikipedia:
Complex post-traumatic stress disorder (CPTSD, cPTSD, or hyphenated C-PTSD) is a stress-related mental disorder generally occurring in response to complex traumas (i.e., commonly prolonged or repetitive exposure to a traumatic event (or traumatic events), from which one sees little or no chance to escape).
In the ICD-11 classification, C-PTSD is a category of post-traumatic stress disorder (PTSD) with three additional clusters of significant symptoms: emotional dysregulation, negative self-beliefs (e.g., shame, guilt, failure for wrong reasons), and interpersonal difficulties. C-PTSD's symptoms include prolonged feelings of terror, worthlessness, helplessness, distortions in identity or sense of self, and hypervigilance.
So you could check a good number of those boxes as well. And this just complicates it all. This feels similar to nailing down a music sub-genre with its myriad of definitions, names, and classifications. This is the moment I throw my hands up and say, “Fuck if I know”. Erin doesn’t feel this one fits. Like I said, fuck if I know. Reading a description is vastly different than understanding a disorder. There could be so much more underlying the words in those descriptions. My definition and life experience of some of these symptoms could potentially pale in comparison to the reality of the disorder. It’s why leaning on someone with the expertise and understanding is important.
Will it make any difference if I have some diagnosis stamped on my ass? I mean, sure, it could mean a different approach to medication and therapy, but I believe I'm currently on the right path. Initially I had a sense that knowing could bring understanding. Though this is so mentally vague I don’t even know what it means. I cannot picture what “understanding” would entail. “Understanding” is like some rose-tinted vision of the future, yet the vision is empty except for the rose tint because I don’t even know what understanding would add to my life.
There is a point I get to where I have to ask myself, who is it I’m trying to become? My journey has brought me to a place I never imagined, but what more am I trying to achieve? Is there some ideal person I’m trying to manifest? What I mean is, am I trying to replace the “who” of my “am” with something else? There has to be a place reached where you look around and say, this is pretty nice. I’m fortunate to be here, and I like the person I am and that is enough. Reaching for a definition is not going to add anything more.
Author: Jason Jacobs
Jason Jacobs is an artist, project manager, and frontend web designer living and working in Boise, Idaho. Beyond work he spends his time with family, as well as reading, writing articles for Uhmm, and working on his art. All words and opinions, etc., are his and do not reflect the positions or beliefs of anyone other than himself.