On Misdiagnosis

I mentioned recently, that I used to have an official diagnosis of Borderline Personality Disorder with Avoidant and Obsessive Compulsive Personality Disorder traits. I don’t know about you but to me, that diagnosis screams autism.

Of course, it isn’t easy to get an autism diagnosis. The misinformation and misunderstandings by society alone are widespread and it isn’t just society. Many, many, many clinicians supposedly qualified for autism assessment and diagnosis hold these same beliefs. Most clinicians have no training on autism and no idea how it can present.

My being female and not presenting as the “autism stereotype” made it very unlikely that anyone would see my behavior as stemming from autism. Add to that, at the time that I received this diagnosis, I was in a state of extreme burnout and having violent meltdowns daily (or multiple times a day). Borderline Personality Disorder it is.

Now that I know that I am autistic, this brings my former diagnoses into question. Did I ever have a personality disorder (or 3?), or was it all unrecognized autism? I know that some people, after being diagnosed with autism, still identify with their previous diagnoses. They feel it still pertains to their life and mind. I’m not sure that I do.

I currently do not meet the diagnostic criteria for Borderline Personality Disorder although at the time, I did. I never did meet the criteria for OCPD or AVPD, hence the diagnosis of traits. Having just looked up the criteria for their diagnosis, I can say, quite firmly, that the reason they didn’t fully fit is because they didn’t fit at all. The symptoms my therapist was attempting to attribute to the traits of those personality disorders were all autism. So, what about BPD?

Here is where things get a little tricky in my mind. Like I said, I did meet the criteria. I was nine for nine, in fact. Not only that but I related, heavily, to the diagnosis but… I do not anymore.

If I go through the criteria and look at the ways these symptoms impacted my life, I can see how they could have been caused by being undiagnosed autistic and existing in a world not created for or accepting of my natural ways of being. To me, it seems obvious that living in a world that invalidates your very existence at every turn could lead to things like an unstable sense of self, chronic feelings of emptiness, shit, even self harming behaviors… But does that mean that I had a personality disorder? Did the trauma of being undiagnosed autistic cause a personality disorder? If so, where did it go, I don’t have a personality disorder now? Or did my autism present in a way that was similar at a time in my life where I was way beyond my limits? Does it even matter?

The thing is, autism exists physically, it is a difference in brain structure. BPD is just a construct made up of symptoms that have a negative impact on a person’s life and relationships. I could say that I used to have Borderline Personality Disorder and now I don’t. That’s technically true but I think it’s too complex, people are too complex, brains are to complex, life is too complex…I am too complex to be able to ever take a stand that is that black and white.

What I do know is that not realizing that I am autistic until my forties, living life as a seemingly failing neurotypical, has caused significant amounts of trauma (hello, can you say understatement). I do know that I am not the only one (far from it) to be impacted in this way. So, I suppose this comes back to what it always seems to come back to for me. That is the need for better education and awareness around autism and the myriad ways it presents. If you are able to, tell your stories.

What do you think? Did you have diagnoses prior to your autism diagnosis? Do you feel they were accurate or misdiagnosis? What was the impact on your life?

“That” pattern

Someone that I know died recently. I know, not really the polite way to start this but I figure I might as well cut to the chase. I don’t want to talk about this person specifically. I didn’t know them well enough. They have family, loved ones, that story is theirs to tell, should they choose. What I want to talk about is the effect that this death is having on me.

Deaths occur in the periphery of our lives all of the time. Someone we knew from school. Someone we used to work with. People we knew from various places and various times throughout our lives. Deaths we hear about in the news. Even the deaths of celebrities. These deaths impact our lives in varying ways. At least, for me, I know this to be true. Some hit much harder than others. This one has me slayed.

The first place my mind goes, anytime that I hear of a death, is the family. I imagine the anguish they must be going through. This is particularly difficult for me if there are children involved. This death is no different. As intensely as I feel all of that, it isn’t what I want to talk about. While it hasn’t been said directly, it appears that this death was a suicide. I’m triggered by this.

I’m no stranger to suicide. Having spent more then half of my life mired in suicidal ideation, and knowing others who have completed suicide… family members… Others on the periphery…

A significant number of these people had reached out to me in some way. Some to ask directly for help, others asking for support but in ways that were more subtle. This person included. I helped in what ways I could within my own limitations. I’ve experienced guilt in each of these instances. If I hadn’t let my own issues, my own fear, social anxiety, my own whatever interfere, perhaps I could have been better able to help.

Sitting here today, I realize that I am also experiencing survivors guilt. Like I said, more of my life than not, has been spent in the agony of depression, despair, hopelessness and suicidality. I have a deep and visceral understanding of what it feels like to want to die. To not be able to see your way past the pain. To want freedom but have no means of escape other than ending you own life. I know what it feels like to attempt to end your own life.

I also know what it feels like to survive. I was fortunate enough that my attempt was only that, an attempt. I am fortunate enough to have lived to see the other side. I no longer live in a state of perpetual pain, not in that way anyway. My life is far from perfect. There is a lot of shit that I deal with, especially with my physical health. That said, I have healed and thus know that healing is possible, in many ways.

I am feeling guilty for this. Why do I get to live, while these others do not? Why was I able to move past all of that? Why was I able to release myself from that hell? There’s nothing special about me. These people deserve healing, freedom, as much as I do. Why me? Why not them?

I was able to survive. Does that mean that I have some special knowledge that I could have imparted? Could I have helped? Did my own selfish focus on my problems prevent that?

I know that you cannot save another person. I do know this, but I’m feeling guilty for not trying. But what do I think I was going to do? Be such a good friend that they would no longer want to die? That’s absurd. No, more likely I would’ve given of myself to an unhealthy degree trying to ensure that they could not kill themselves. That is my pattern, isn’t it? Trying to save others, no matter the cost to myself? That is where my focus should be. Healing that is the only way that I can ever affect any real positive change. The only way that I can truly help anyone.