What a 2-days! I’m not sure what to say or who to tag. This is mostly just “me processing", with a little related to other posts people asked things.
@Jynx Why can’t I do anything emotionally dysregulating currently? Blood pressure.
Yesterday morning was good, with only 1 mild stress that I put to the side without needing to worry about yet. However even “good news” is emotionally dysregulating in a way, and I ended up in ED again - but this time purely due to my blood pressure. 😅 I didn't want to go to ED, I was told I needed to go to ED for stroke-risk and heart-attack risk.
On the “up side” I didn’t have to wait at ED at all 😅 they triaged me within 1 minute and then walked me straight to a bed for an ECG, bloods, etc. (Still don’t like being in the ED, for so many sensory and communication reasons.)
But my heart is good! All tests were fine. I reckon my fibromyalgia is making the sharp pains heightened, so I notice the BP symptoms that I’m not used to ‘earlier’ than others do — which is great, because it draws me to realise my BP is spiking into dangerous levels and I need to be careful to lower it. But its then hard to know how much pain is “fine” and how much is “emergency”.
I am seeing a doc tomorrow to get blood pressure meds 😅, because it’s getting too dangerous/constant during waking hours. We can always stop them later in the year if my BP settles down.
@AuntGlow @tyme @Jynx
I forget who I’ve discussed BPD and misdiagnosis with before (although I think that was within the context of trauma rather than autism being the root cause). I know @tyme has a lot of experience with BPD, so possibly yourself, or you may be interested.
I’ve often in the past “related to” a number (not all) of BPD “symptoms”, and felt fortunate I never had been labeled as BPD - I presumed because I was rational and controlled and didn’t act-out, or because I focus on behaviours and not the individual as rejecting me.
… what I learned today … Apparently a past psychiatrist in my earlier years did suspect BPD based on my dysregulation with social injustice (they didn’t know it was due to injustice, they just saw it as “people I was angry with having done things") and my incongruent affect vs thoughts (i.e. come across pleasant and outwardly able to smile and laugh, but had chronic SI an SH thoughts without identified triggering events).
Of course, very autistic of me!
But I can only wonder if this psych either later decided (after their initial assessment letter) that I wasn’t BPD, because they certainly never told me anything about BPD or referred me to a DBT program. However, I will never know. I saw them for over 4 years, so I assume they would have talked about BPD with me if they had ended up concluding it.
But it makes me wonder… how does one clinically differentiate between BPD and AuDHD, unless they explore the full AuDHD profile.
Both have difficulty regulating emotions; social interactions/conflicts; impulsivity…
I have this evening seen briefly that there are whole articles published on this misdiagnosis problem between BPD and autism in mental health. This one was one of interest around the impacts: https://staff.sussex.ac.uk/news/article/65452-study-reveals-harrowing-experiences-of-misdiagnosis-of-borderline-personality-disorder-in-autistic-adults “Harmful treatments and masking” range particularly true for me. The number of times I have tried to explain that having to make adjustments all the time leads to burnout.
The problem is… that psych then viewed events through a BPD lens. E.g. a comment attributing an increase in my SI to a doctor retiring?! No, I was in burn-out from work and workplace-communication is why I was deteriorating! I was happy for that doctor to be retiring - she was a great doctor and had reached retirement age and deserved to enjoy her years before ill-health sets in. Had the psych ever asked me how I felt about the doctor retiring she would have realised it was not any fear or upset with them at all.
But the reason I don’t complain to doctors/people and self-advocate is that I have always feared people will interpret it as BPD-like aggression, when all I want is to be heard calmly and logically — even if they still disagree with me.
… I wonder now if that is perhaps why she did on-refer me (and the referral never contacted me) once she felt there was ‘nothing more’ she could offer to help my SI… did she perhaps put in that referral something that indicated “too hard”, which I know is something many with BPD have been told they’re declined as patients due to. It would make sense if that’s why that waitlist place never eventuated. But if that was the case, I don’t think she would have referred me to a colleague in the same practice? If she had genuinely wanted to distance from me, she would have referred back to the GP for a re-referral or a DBT program. So I do think the odds are that she realised after getting to know me that it wasn’t BPD (perhaps after the change of meds she put me on treated the undiagnosed ADHD and thus reduced impulsive/frustration behaviours?) But she never realised it was autism. But this was over a decade ago, and awareness/training wasn’t what it is now.
And it would make sense of how she did change in her affect towards me after the first 6 or so months… she became more personable and open slowly. Perhaps that was in response to when (if) she decided I wasn’t BPD as she has started to understand more about why I think things? 🤔
I have a report from when I was 18 (prior to the above psych) noting my feeling/behaviours of needing to withdraw from people, and also my reserved nature of keeping my feelings to myself ( @Jynx similar to what I was saying about not wanting to force people, I guess?), but without increased interpersonal sensitivity and the lowest-possible self-focused range, and below-average self-criticism. To me, that doesn’t sounds very BPD; but I also don’t know that much about it other than what I read.
It’s sad to see my chronic history and the varying levels of which doctors/providers made appropriate referrals or ignored the referrals recommended in the reports. I still don’t understand why some doctors ignored the recommended referrals for addressing comorbid impacts. I still dislike that my GP of the past many years would ignore most specialist recommendations in reports (the one exception was my insulin resistance, they did on-refer me to an Endocrinologist at the request of the Rheumatologist) and never even told me he had received a letter/report or followed up on after-care for any of them (including the Endo and Rheum). 😓.
And I know I am not alone in this experience. And that’s even worse.
But I can be glad that I have now found doctors who listen and ask questions. Who I feel safe talking to because I can be open about why I struggle to be direct about my needs. Who understand that if I do assert a need that I am doing it despite how hard that is for me to do and my fear of being interpreted/influencing as manipulative, which actually means its really important.
It’s reassuring in a way that my MH GP is stunned that none of the psychiatrists who treated or assessed me every considered autism or explored it as a possibility. I’d be interested on her take of the “suspect BPD” comment from a psych early on, and whether or not she thinks it is possible or just autistic traits. I guess if I remember next time I see her and there is nothing urgent to discuss then I might bring it up. I suspect she is of the opinion of the latter, as she picked up on the autism the first time we met and didn’t raise any questions about BPD. But then again, perhaps I just somehow had really good self-management of BPD traits yet a high level of control/management through CBT+DBT that I had learned from earlier psychs? How would you know if the symptoms & treatments are the same?
It begs the question.. where is the definition of a “personality disorder” vs a “personality due to neurotype, which is normal within that neurotype”.
