As a result of a recently triggered enmeshment issue, I contacted my husband’s Employee Assistance Program – EAP to request therapy and started seeing a psychologist.
One session with her made more sense to me compared to the many years of therapy I had in Halifax.
Why is that?
I’ve been thinking a lot about this.
The psychologist asked me if the therapy I had over the years has helped?
I answered honestly.
I answered – yes – and no – because no-one could decide what my diagnosis was.
In my early 30’s, when I first entered mental health therapy in the public mental health system my original diagnosis by the admitting doctor was Borderline Personality Disorder – BPD. It was joked among myself and other patients who attended the mental health day treatment clinic that BPD was slapped on everyone as a starting point for diagnosis. Post Traumatic Stress Disorder – PTSD was my next diagnosis by the in-house psychiatrist. However, not much time and effort was invested in my BPD/PTSD diagnosis because a person had to be at high risk to themselves or others to get the help they needed in the overrun public mental health system.
Next, I eventually found the therapy I needed and spent 5 years at a government funded – not-for-profit sexual assault centre – meaning therapy was free. My therapist was a wonderful woman who focused on the sexual abuse. We kept hitting a wall so she referred me to a psychiatrist for a deeper look and an official diagnosis. He diagnosed me with PTSD, ADHD – Attention Deficit Hyperactive Disorder and DDNOS – Dissociative Disorder Not Otherwise Specified. I felt like a true head case. He medicated me for ADHD. I was then concurrently seeing the psychiatrist for the ADHD and DDNOS and the therapist at the sexual assault centre for PTSD. I eventually had to stop seeing the psychiatrist because of my work schedule* and the therapist I was seeing at the sexual assault centre moved to another clinic. I wasn’t allowed to continue my therapy for PTSD at the sexual assault centre because I had had 5 years and they needed to give new patients in acute crisis the therapy time. I was left feeling angry and abandoned because I still struggled on being able to be a productive member of society. My job at that time was managing a pizza shop. I couldn’t make a living there. I was barely making ends meet.
*The actual reason for my having to stop seeing the psychiatrist is too long and complicated to describe here. Let’s just say The College of Physicians and Surgeons of Nova Scotia – CPSNS – wanted me to file a formal complaint.
I did not return to the public mental health system to support my ADHD, PTSD and DDNOS because I wasn’t high-risk enough to merit immediate support – and for those who did qualify, like myself – with “official diagnosis”, the waiting lists to see a therapist were months long.
So I turned to my local doctor who continued to monitor my ADHD medication. I labeled myself as a person with ADHD, tucking PTSD and DDNOS away in my back pocket. My ADHD certified diagnosis got me government funding to go back to school, in hopes that I would become a productive member of society.
Side note – the two above mentioned psychiatrists both ran into trouble with the CPSNS. One lost his license to practice. The other was charged for obstructing justice with a reprimand put on his discipline file. Just because you’re a professional doesn’t mean it is in your DNA.
In my early 40’s I eventually found a job that offered an Employee Assistance Program – EAP. The EAP allotted me 4 or 5 appointments with a psychiatrist. I was eager to return to therapy because I was struggling to keep my head above water. Unfortunately, I did not have enough sessions for continual support but enough sessions for the doctor to disagree with the ADHD diagnosis. He took me off the ADHD medication to then diagnose and medicate for PTSD. DDNOS didn’t even have time to be discussed because all the sessions focused on moving my diagnosis from ADHD to PTSD.
I was shocked. It felt like the years I lived thinking I had ADHD was a lie. I advocated for ADHD. I understood it. I lived it. Only to find out I didn’t have it. Confusing times those were.
When the EAP psychiatrist asked about my history and how did ADHD manifest in childhood, I told him like I told the other psychiatrist that my mother kept all my report cards from kindergarten up to when I graduated from high school and ADHD symptoms were not written as teacher concerns. The EAP psychiatrist explained that ADHD has to be present in childhood to be diagnosed as an adult. I did not have ADHD. What I did present with is someone who appears to have PTSD – and can look very much like ADHD. He tested me for PTSD – I passed that test. I was not able to afford private therapy sessions with the EAP psychiatrist after our funded sessions finished. He felt bad that I couldn’t continue to see him, but money talks. I returned to my local doctor with a new but not new diagnosis of PTSD and new medication. She continued to monitor my new medication and now PTSD symptoms as best as she could. Not ideal, but it was support.
However, like ADHD, PTSD didn’t seem to fit either. I kayaked with a guy who was a tank driver in the Bosnian War. He watched children die. He suffered greatly with PTSD. Flashbacks and nightmares haunted him. Drove him into isolation. We talked a lot about PTSD when kayaking. My PTSD was nothing like his. Yet, my constant and intense anxiety, high-risk/impulsive behavior, chronic low self-worth and ability to dissociate fit on the PTSD continuum.
I did pass the PTSD test.
But I also passed the ADHD test.
Add to that, depression would, from time-to-time rear its ugly head.
Very confusing years for sure.
When I moved to Qatar I was still taking the PTSD medication for anxiety. I eventually weaned myself off because I wanted a fresh start – medication free – to see how crazy I really was.
But also happening behind the scenes was my drinking escalation. I struggled with drinking before leaving Halifax to move to Qatar as well as my entire time here in Qatar; up until 7 months ago when I quit drinking for good.
Back to the therapy session.
The psychologist asked me of all my diagnosis, which one did I feel fit the most?
That was a huge question.
I related to PTSD but never fully understood it because I had so many diagnosis. DDNOS? Well, I dissociated and could relate to the different aspects of myself that lent itself to this diagnosis but again – I had so many diagnosis – what was what? I know now that I never had ADHD because of the missing childhood criteria. BPD was never a focus in therapy. What I did know of BPD was only that which I’ve recently read online because of my reflecting on becoming 50 years old.
So which diagnosis did I feel fit me the most? ADHD, PTSD, DDNOS and BPD all look a lot alike. Honestly, I would have to say that after retelling my history to her, BPD fit the best. The psychologist agreed.
Why did she agree with me? We didn’t discuss it too much or go into depth at that time as there were many topics on the table as I explained my history; and our one hour session was coming to an end.
Some might wonder why I need to know if I have a diagnosis?
Because I need to understand 37 jobs by the time I was 37, my pattern of high-risk/impulsive behaviors, addiction, chronic anxiety, fear and guilt as well as almost 30 years of an erratic rollercoaster ride of emotional highs and lows.
I need to make sense of those chaotic, confusing times that were part of the path that brought me to where I am today.
Did I make certain choices over the years because I am a bad, reckless, selfish person?
Or is it that my brain is truly hardwired a certain way because of nature, nurture and childhood issues?
And why is it that that one appointment with this psychologist has had more effect on me than any therapist in Halifax?
Perhaps because I’m going to be 50. When I shared my history with the psychologist, I reviewed my twenties, thirties and forties. There are glaring unhealthy patterns. These patterns look a lot like ADHD, PTSD and DDNOS – but knowing what I know now – and how I feel now – BPD seems to fit the best.
The psychologist asked me what brought me to her. I explained the enmeshment issues and then launched into my history. However, I want to start our journey together by talking about BPD. Is it possible that this disorder is what I’ve been living with all these years? I have 5 more sessions funded by the EAP. But now, I can afford a good therapist and can continue with her as I make my way into turning 50.
My feature image photo was taken in an area of the Arabian Desert, Bahrain. I’m standing on a branch of the Tree of Life. I picked this photo because this tree is over 400 years old. If this tree can be this beautiful and survive after 4 centuries of life in the harsh, arid climate of the desert; I can make sense of 3 confusing decades of my life and look forward to 50 being the best decade yet!!!