When You Have Multiple Mental Illness Diagnoses and Can't Tell Which Is Which

Editor’s note: If you struggle with self-harm, the following post could be potentially triggering. You can contact the Crisis Text Line by texting “START” to 741-741. For a list of ways to cope with self-harm urges, click here.

I’ve officially and unofficially been diagnosed with major depression, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), social anxiety, attention-deficit/hyperactivity disorder (ADHD), and borderline personality disorder. It depends on the different mental health providers I’ve had, as well as my own insight. It doesn’t necessarily matter that I could be diagnosed in so many ways, but it is certainly a starting point in treatment. I don’t really think about which is causing what until I’m in a depression relapse, which makes everything amplified and I can’t stop thinking about anything and everything.

When I’m tapping my fingers and count 1, 2, 3, 4, 5 back and forth, is it anxiety, OCD, or ADHD? It’s probably caused by anxiety and then the counting is my OCD trying to help calm me down, and then my ADHD may add to the movement piece. Or is it ADHD that’s making me move, then OCD which makes me count and then anxiety is being worried about being judged by that? What should be treated first?

Then, when I turn to self-harm, I might be self-harming to relieve the emptiness and worthless feelings of depression. I might be self-harming because I’m so anxious I feel like it will calm me down. So we turn to cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT) types of therapy, but should we focus on the anxiety instead of the depression/BPD?

When I cannot focus, concentrate, and motivate myself, is it depression or ADHD? This is the one I’ve been struggling with the most recently. In a medication sense, we’re treating both.

When you have one mental illness it’s common to also have others, which in my experience makes it more difficult to treat and impossible to ever dream of not needing therapy and treatment. Is it PTSD and childhood emotional neglect which has caused everything? Probably not, but I’m sure they haven’t helped. It’s hard enough to deal with one illness in any sense, but then add additional ones. It makes it feel impossible during those mental health relapses. It is a large part of who I am, and sometimes it makes me wonder if there is any part of me that is not defined or influenced by these illnesses.

If you or someone you know needs help, visit our suicide prevention resources page.

If you struggle with self-harm and you need support right now, call the crisis hotline at 1-800-273-8255 or text “START” to 741-741. For a list of ways to cope with self-harm urges, click here.

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