Diagnosis

I’ve been thinking a lot about diagnoses recently. I’m not ready to talk about all of mine yet but since I just had my last psychiatrist appointment I do want to talk about that.

In one sense my psychiatric treatment has been very successful. I’ve been prescribed a medication that seems to be working. I’ve been able to make decisions about my creative path and stick to them. I’ve been much more productive, and I have’t been nearly as upset or depressed as usual about those times when I wasn’t productive.

On the other hand I don’t really have a useful diagnosis. I asked for a referral because I felt that I had ADHD and I was hoping for treatment. I did also wonder if I might be on the autism spectrum but didn’t seem as good a fit to me. My question was based partially on how well my experiences line up with other adults with ADHD/ASD and partially on how many other people in my family have one or both of those. The Psychiatrist said no. She thought I had Prader Willi Syndrome, or maybe Oppositional Defiance Disorder.

Prader Willi Syndrome is a chromosome disorder. The most well known chromosome disorder is Downs Syndrome which is caused by Trisomy 21 (having three copies of chromosome 21 instead of two). Prader Willi Syndrome is caused by having a missing chunk of one copy of chromosome 15.

I was absolutely sure that I didn’t have Prader Willi Syndrome. I already knew a bit about it because it causes constant hunger and I knew that I didn’t fit the profile. I tried to treat her suggestion seriously and I did some more reading about PWS but the more I found out about it the less likely it seemed.

Typical symptoms of PWS include short stature (the average height of adult women with PWS is 4’10”), developmental delays, delayed puberty, infertility, low IQ, small hands and feet, temper tantrums, repetitive behaviour, sleep disturbances, and unusually pale skin. I’m 5’6″ and while I do have fairly small hands I have size 9 feet (US size 11). I hit every developmental milestone, started puberty at 12 and have two children. I have a temper but it’s under control. My sleep patterns are trash but that’s a symptom of practically every form of mental illness and neurodivergence. I’m pale but not much paler than my brothers. I would hope that it’s clear from my writing that my IQ is fine.

The wonderful thing about Prader Willi Syndrome is that because it’s a chromosome disorder there’s a blood test for it. Guess who has two thumbs and 23 pairs of normal chromosomes? πŸ‘πŸ‘

So I think this means my diagnosis is either *shrug* or Oppositional Defiant Disorder. I’ve always been sceptical of ODD as a diagnosis. I think it’s quite often attached to kids with ADHD and narcissistic parents. The main difference between ODD and ADHD in kids seems to be that ODD kids do incredibly annoying and disruptive things specifically to upset the adults around them while ADHD kids do the same things through a combination of distraction, boredom, inattention and just not thinking ahead. You can see how a narcissistic adult would interpret an ADHD kid’s behaviour as being all about them, leading to an ODD diagnosis.

Adults with ODD display patterns of negative, hostile and defiant behaviour including at least four of the following symptoms.

  • Often loses temper
  • Often argues with family and coworkers
  • Actively defies or refuses to comply with rules and laws
  • Deliberately annoys people
  • Blames others for his or her mistakes or misbehavior
  • Easily annoyed by others
  • Angry and resentful
  • Spiteful or vindictive

That really doesn’t sound like me. I am often angry but with very good reason. I apologise for everything, even things that couldn’t possibly be my fault. I’m not pretty, privileged or charismatic enough to get away with being that kind of arsehole. But then I would say that, wouldn’t I? If I really do have ODD then I could be blaming other people for arguments and insisting that my anger was always justified. It’s really down to the people who know me.

Am I like that? My spouse says no. The niggling voice in the back of my head is convinced that I’m a monster and they’re too scared of me to be honest.

One thought on “Diagnosis

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