ADHD

[sunshineplease]

I have a friend who's an ADHD coach (for parenting kids with ADHD), and she was showing me some of her materials. One of them is a great sheet on "perceived challenges" that you can choose to look at as strengths (in context). For example: Having little awareness of time can be viewed as a plus in the workforce: Unfettered intuitive flow.

What struck me was how similar so many of the traits are to BPD traits: Black-and-white thinking, weak follow-through, lack of impulse control, procrastination, super-intense concentration on negative thoughts, overwhelm... .

I'm aware there's tons of comorbidity with BPD. But I found myself wondering if BPD and ADHD are actually the same thing. Three times as many boys as girls are diagnosed with ADHD (the hyperactive part, no doubt). And three times as many girls are diagnosed with BPD -- the NIH thinks it's sampling bias. www.ncbi.nlm.nih.gov/pubmed/14686459

Just curious as to anyone else's thoughts on the topic.

Thanks.

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[charred]

Doubt they are the same... been dx ADHD myself, and dealt with it for 44 yrs now... .still medicated for it.

However... I would not be surprised to find out that ADHD and avoidant/anxious attachment are the same. Seems like the anxiety level in everyone I have known with ADHD was high and they were hyper vigilant and really and truly... showed the same signs as high or very high stress anxiety.

Saw a T for something completely unrelated to ADHD (r/s with a pwBPD)... and he had me do mindfulness exercises... and to my utter amazement... when I was present in the here and now, and not ruminating or worrying about the future... didn't have anxiety, fidgeting or any ADHD symptoms.

Can someone with BPD also be ADHD... certainly... and a lot of kids are quickly diagnosed ADHD and given medication (if you believe the news stories of it)... so it isn't doubtful that a lot of misdiagnoses occur.

Abandonment and a non-validating environment (BPD inducers)... are not necessarily the case for ADHD... but maybe close to same.

When people are anxiety ridden, they act just like ADHD... fidget, can't concentrate, prefer physical movement to staying still, can't stay on tasks, bounce around without a clear string tying one comment to another... .all of which are unpleasant. It doesn't take being abandoned or having a hyper gene to end up with ADHD or anxious/avoidant attachment... can come about even with a mother that is attentive. My mom was there for me... but she is waif BPD and my dad NPD... and while she was present... she deals with people as objects... a kid to her is a crying demanding noisy thing... not a being ... and even as an adult... never feel like I or anyone else... actually connects with her. That kind of thing (which is very common unfortunately)... is all it takes to make a kid anxious.

[trytrytry]

My DD28 has traits of many things including BPD and ADHD.  Now  she's only medicated for anxiety (gets street drugs) cause she has no medical insurance.  It's a mess.  Best wishes in your struggle

[sunshineplease]

Thanks, Charred. That makes sense: Anxiety is the common thread. And, oh, trytrytry, I'm so sorry about your daughter's insurance situation. Awful not to have options!

[pessim-optimist]

My DD28 has traits of many things including BPD and ADHD.  Now  she's only medicated for anxiety (gets street drugs) cause she has no medical insurance. 

Some states have local clinics that treat patients on a sliding scale - based on their income, and even have some partners that they refer out to that honor that sliding scale.

Also, under this program, even though one has to pay a bit for doctors' visits and most medications, if one qualifies, some expensive medications come free: the pharmaceutical companies have programs like that for low-income individuals/families. Something worth checking into... .

[ziniztar]

A litle off-board here but I think I can relate from a different perspective . My boyfriend (28) was diagnosed with ADHD first. Then, when they got to thought patterns and twisted thinking, it became clear his were a lot more negatively skewed than the others in the ADHD group. I believe they walk through 7 or 8 patterns and he had to mark them all from 1 (not applicable to me) to 5 (extremely applicable to me). He asked me 'how do you think I scored?' and I answered '5 on all of them', and I was right.

They decided to deeper dive into his issues and ended up diagnosing him with BPD as well.

For me it's been a struggle to find out 'what is the ADHD and what is the BPD?'. Also, I've been trying to find some explanation for the fact he developed into BPD as his family is quite warm (albeit a little overprotective) and stable.

The ADHD was always there. It has caused him to be bullied and harassed in elementary and high school - which I think, together with emotional instability, has resulted in the development of his BPD. The main schemas he scores on are the ones of shame, not fitting in, not being worthy enough, all related to ADHD and being bullied.

He's been on ADHD meds for a month now. Where I think ADHD and BPD differ is:

- the severity of the negative thought patterns. ADHD have all of them, some are strong, some not, depending on a persons experiences. Someone with BPD is negative on nearly all of them.

- the instability in relationships, the push-pull. People with ADHD can have attachement issues due to not fitting in, being rejected etc, but any person can have that. I even do. But not in the way a BPD fears and needs the attachment in the same time.

- the hyperactivity

- the way you cope with emotions. I know very insecure people with ADHD but they do know how to deal with all types of emotions.

I think there is some discussion going on changing the name of BPD into emotional regulation disorder. Emotions are heavier and take longer to fade away. Now my bf is on meds, I notice he can turn around his negative and positive spirals better. Together with therapy, his cognitive regulation is being improved. Also having ADHD - being distracted all the time, not being able to focus -did definitely not help him in structuring his thought patterns.

One remark on the sample bias: BPD is often developed when there is a form of emotional instability already present (hereditary), in combination with early childhood trauma. That can be abuse, molestation, assault etc. Is is naiv of me to assume that more women are sexually abused than men, which could result in the development of BPD in girls more than in men?

[HealingSpirit]

Dear Sunshineplease,

What a great question!  I think Ziniztar and Charred did a great job explaining the distinctions.  My DD17 was diagnosed with AD/HD as a youngster and has recently been dx with BPD and several traits of Histrionic Personality Disorder.  I've seen a lot of the same characteristics in my DD as Ziniztar described in her BF. 

I do have a couple of things to add though.  The T we had when DD was in elementary school told me AD/HD is ALWAYS comorbid with another condition:  giftedness, learning disability, anxiety, Aspergers, etc.  She said it was never a condition by itself.  In my own experience based on people I know who have AD/HD, I have found that to be true.

My AD/HD husband has no BPD traits, and our AD/HD  DD17 also has BPD/HPD.  I believe the major distinction lies in their ability to regulate emotions combined with fixation on negative thinking/feelings.  My DD has been extremely emotionally sensitive since she was an infant.  Her current T describes it as having no "dimmer switch" for her emotions.  They're either full on, or off.  DH is the opposite, as he has Aspergers, and alexithymia (absence of words for emotions).  I am the only "neurotypical" one in my little family.

Our DD grew up in a loving home with both parents, but she was so sensitive, she was traumatized by things "normal" people were not.  A teacher passing out tests in grade order, with As first and Fs last would humiliate and traumatize our DD to the point that she didn't want to go to school the next day.  Often, she'd develop a "stomach flu" overnight in order to stay home when something upsetting happened at school the day before.  That's NOT AD/HD.  That's emotional dysregulation.  The AD/HD makes it harder for her to focus and concentrate on taking tests, and her emotions also cause further distraction.  I wish I'd known about DBT a long time ago.  I never realized until very recently that my DD lacks the skills that I take for granted.

I've also read that being born with intense emotions, combined with trauma or abuse is what causes BPD.  But I know firsthand that not EVERY trauma stems from abuse. In my DD's case, I believe her emotional intensity and negative thought processes together CREATE trauma out of circumstances where most people would not be traumatized.  She still does this!  She misinterprets and misunderstands a lot of things people say or do.  It is her internal self talk and her misinterpretation of an event that traumatizes her, not necessarily the event itself.

[jellibeans]

I just wanted to add that I follow an online magazine for ADHD and they often have webcasts... .it is very helpful and informative.

ADDitude magazine <Newsletter@additudemag.com>

I have always noticed the similarity between ADHD and BPD... .gret online resource too.

[sunshineplease]

Thanks, everybody. FANTASTIC responses and help with clarity.

It's interesting: I think my daughter's inability to focus is actually the result not of ADHD, but of emotional sensitivity so intense that it leaves no brain space for anything else. Yes, she was born sensitive (likely hereditary: I actually think I'm on the sensory-sensitivity spectrum somewhere, given my extreme tactile, olfactory, and auditory sensitivity). But the cancer trauma at age 3-5, along with the social issues that being bald and absent created at school, sealed the deal.

Best to all.

[SeaSprite]

I have two girls, 16 and 20. D16 is likely uBPD, dx with anxiety and depression. Absolutely no ADHD, she has always been able to focus and get the job done (and is very bright and capable when not in crisis) until she hit her teens and the anxiety and depression and other runaway emotions started getting in the way and she started self-harming and making poor choices behind our backs (different than your average teen poor choices, they looked to be motivated by self-destructive out of control feelings rather than things she really wanted to be doing). She will lie even when it makes no sense to lie, and when she's upset she needs someone (usually me) to be at fault making her so unhappy.

D20 has always lived with ADHD, dyslexia, dysgraphia, anxiety, depression, sensory issues, and has a recent diagnosis of mild OCD, but few to no BPD symptoms. D20  is able to admit to and own her feelings, name them, ride them out, and move on. She tells her fiancé that when she's overly emotional, he doesn't need to fix or do anything other than give her a hug, give her space, and try not to take her feelings personally because they are about her not him.

I think that's the biggest difference that I see between BPD and other related issues: the blame-throwing.

[theplotthickens]

My suspicion is that BPD is really a pre-disposition plus 'trauma.'  Trauma is the big buzz-word right now, so I almost hate using that term, LOL!  My dd is super-sensitive, and was also traumatized by things that others would brush off.  She was also bullied mercilessly by other girls because of her impulsive ADHD behaviors, which led to trauma from never fitting in or really having friends.  All the neighborhood kids refused to play with her and banded together to make sure NOBODY would.  They also said mean things to her when they got a chance, and this was pretty much her experience in most settings.  Girls are sure nasty to the ones who don't quite fit.

I imagine bipolar, schizophrenia, ADHD, and many other mental and developmental problems are due to an underactive portion of the brain.  That is why there is so much overlap in symptoms such as impulsivity, emotional dysregulation, motivation problems and the like.

If you are interested in a 2-minute presentation of brain anatomy, check out this: https://www.youtube.com/watch?v=DD-lfP1FBFk  I have found so much of Daniel Siegel's work helpful - he is widely available on YouTube.  Great stuff!

I do believe that the initial problem of BPD is brain-based, and the trauma happens because of society's reaction to the inappropriate behaviors and the BPDer's extreme sensitivity to these behaviors.

We are still in the infancy stages of understanding the brain!   We don't even know WHY or HOW medications work for certain symptoms.  It is mostly trial-and-error and guessing at this point.  

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[sunshineplease]

Thanks for the responses, Seawalker and theplothickens. (I've been offline, then away.) Blame is an interesting component to all this, isn't it? And I'm grateful for the reminder of the one-two punch (sensitivity + trauma). In my child's case it was likely sensitivity + trauma (itself an insult) + social reaction to trauma (making it worse). So many factors.

DD off to college soon. Am hopeful... .