Borderline, Autistic Traits, ADHD or Just a Bloody Difficult Woman?

Dr Helen Read 10 Feb 2023

Just read a super interesting article about the differences between borderline and ADHD. I’m a psychiatrist, psychotherapist, personality disorder and ADHD expert with a lifetime of experience, so please don’t trouble yourself to send me quotes from DSM 5. I know that stuff, I just don’t agree with it. I don’t think real people fit so neatly into boxes, I think that shock horror we are dealing with different overlapping dimensional traits expressed differently and filtered through the sticky morass of the human condition. Let me explain why….using myself as an example.

I came from a broken home but that is just the start of it. Moving between two totally different family situations gave my family an unfair advantage in the traumatise your child competition. It is far quicker to list the types of abuse I didn’t suffer (serious physical abuse, death of a parent) from both sides of my family, and guess what, I would certainly have ticked all the BPD criteria except self harm when younger. I had lots of therapy and became a therapist, but it didn’t affect the day to day difficulties of living with ADHD.

I’m autistic enough to see through the conventional wisdom of many things, and cling on stubbornly where I’m clearly not wanted, but not enough to get the diagnosis. Seeing through the bollocks, but not understanding the social rules which mean you need to be a nice girl and not announce that they are bollocks can make for a very confused, angry and overwhelmed bunny, I can tell you…

Being neurodiverse gives me an ability to question rules and categories, being highly intelligent has enabled me to survive as a doctor, and being female has I believe contributed to the “negative countertransference” that most doctors tend to experience when I open my mouth.

Let’s save the long list of “disorders” which male doctors through the ages have come up with to invalidate difficult women for another time.

And ADHD diagnosis and treatment has transformed my life and enabled me to mine my dark and chaotic life for pure treatment gold…and to save my three beautiful boys…all of whom are neurodiverse but amazingly show no sign of personality disorder whatsoever.

Ultimately I think it doesn’t matter what box you put people in, except that unless the box has ADHD written on it, you may be taking someone’s chance to have literally life changing treatment….and giving them only instructions for how to sit quietly in a small dark box and stop giving the men trouble.

Feel so much better to have got that one out, hope it didn’t upset anyone (simpering fake smile). Just off to stroke some kittens and bake a few cakes for the menfolk. Till next time y’all.