2:29am June 7, 2014

Autism, Bipolar, ADHD and OCD (and possibly BPD) Misdiagnoses

Diagnostically, there definitely seems to be a vague venn diagram-like crossover when it comes to certain external trait presentations amongst the disorders listed above.

For example take an extended burst of high energy over 24 hours:

An autistic person spends 24 hours working on a painting because they are in “hyperfocus” mode and they feel a compelling urge to finish before they can sleep. They paint frantically for 24 hours until they feel it is a satisfactory product.

A Bipolar person spends 24 hours working on a painting because they are in “mania” mode and they feel a compelling urge to paint as much as they can before they can sleep. They paint frantically for 24 hours until they feel they have finally run out of energy and cannot paint anymore.

An ADHD person spends 24 hours working on a painting because they cannot sleep. Painting keeps them focused and gives them a creative outlet for their energy. They paint frantically for 24 hours until they feel they have exhausted themselves enough to get to sleep.

An obsessive-compulsive person spends 24 hours working on a painting because they are in “perfectionist” mode and they feel a compelling urge to paint as much as they can before they can sleep. They paint frantically for 24 hours until they feel they have finally run out of energy and cannot paint anymore and they have produced a product that is satisfactory enough to allow them to sleep.

A Borderline person spends 24 hours working on a painting because they are going through an emotional “upswing” and painting helps them process their emotions. They paint frantically for 24 hours because they have poor impulse control and cannot manage their time or their emotions effectively.*

In autistic individuals it’s known as “hyperfocus”

In bipolar individuals it’s known as “mania”

In ADHD individuals it’s known as “hyperactivity”

In OCD individuals it’s known as “perseveration” or “perfectionism”

In Borderline individuals it’s known as “impulse control problems”*

These can all be potential symptom descriptions for the same thing.

These traits and characterists can easily overlap with different diagnoses. There are variations in mood and presentation (the bipolar person in mania mode might be painting more “happily” because they are simply expending energy while the OCD person might be painting more “fearfully / angrily” because they do not want to get it “wrong”)

Depending on who is diagnosing you, they may choose one or more than one of those listed to describe the same traits and behaviours. The important difference is the context of the event. What takes place before the state of 24-hour painting and what comes after. This will help you and your doctor to figure out which diagnosis is the most applicable.

This doesn’t mean that the diagnoses are 100% interchangeable, just that there are definite overlaps in similarities. A diagnosis of one is often not too far away from a diagnosis of the other, because of the clustering effect of symptoms. This is neither good nor bad. If you feel you have been misdiagnosed, keep track of the symptoms you think more closely fit a proper diagnosis and discuss this with your doc.

Also note. As I explained before with Sundae Theory, it is absolutely possible to be more than one “thing” at the same time. It’s also possible to have different “strengths” of diagnosis at the same time.

It’s possible to be “mostly autistic with a little bit ADHD”. It’s possible to be “equal strength Bipolar, equal strength OCD”. Diagnosis is not restricted to one single disorder where you have to fit ALL of the criteria and symptoms. If it makes sense to consider two or more diagnoses, then that’s what describes YOU better.

*Notice how the borderline description is far more negative than the other more neutral ones? The symptoms are all describing the same thing, yet borderline is the only one listed as “problematic”. Psychology can be incredibly dickish.