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ADD & OCPD together

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What is the unique challenge in having both the ADD and OCPD?

Doesn't this put two extremes of the opposite need / behavior co-existing in one mind?

And doesn't this mean the path to help with one is the opposite of the path to help the other?

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Offhand, and of course I have neither first-hand knowledge or any theoretical basis for my opinion, I wouldn't think there would have to be a problem. After all, therapy doesn't work by "pushing" the entire person in one direction or another. It helps by increasing their resilience, their ability to cope with the extremes of life. As a result, I would tend to expect therapy to enhance a person's ability to cope with both extremes you mentioned.

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Thank you Malign,

I was not very specific - I was trying to keep the post reasonable. Man I sure have a hard time figuring out how to do that. Okay - so as humiliating as it is - here are the specifics of my thinking...

ADD (untreated) can mean a life of chaos? Often the self help methods involve systemizing daily activities to help stay on track. The ADD is living with the frustration most anyone would suffer in such chaos – constantly searching for items lost, late for appointments, unfinished projects and so on. They do not however take that chaotic reality and judge it (as the person with OCPD will) against the expectation of perfectionism. Isn’t this an important difference?

Now consider the person with OCPD. This person is rigid in the rules of order. The obsessive / compulsive behavior is often seen in over systemizing. Why this person does not create the order they seek is evident in the following examples:

  • Imperfect writing can mean starting completely over in record keeping.
  • An expired food item in the refrigerator is never as easy a job as just tossing. A time needs to be set to take all expired food out.
  • Labeling an item can turn into a big job because it has to be the exact same type, font, size as all of the other labels in that particular room.

Every action can bring to awareness a perceived flaw in the routine of life and the fierce need to improve it is never ending.

This person needs to accept a less orderly method of daily living. The thought of accepting less is absolutely overwhelming. Isn’t this an important difference?

Also – they might get distracted (as does the one with ADD) but it is in answer to that specific need to improve something. They are not dealing with as varied (most anything can distract) or with the degree of distractibility as one with ADD.

So consider adding the extreme distractibility of the ADD to the OCPD situation and adding the extreme need for perfectionist expectations of the OCPD to the ADD situation – you now have what seems to be a third category! Or as in my case – A SERIOUS INNER CONFLICT!

Does it seem my logic is sound?

Doesn’t it seem that the solution for each category alone is not going to be the solution for the individual that has both? Actually - doesn't it seem there should be an entirely separate - a 3rd category - that need a unique set of solutions?

To give one example:

I was thrilled with the suggestions I found for someone with ADD. To give me full permission (sort to speak) to focus as much as I desired on getting more organized and to tell me it is for the benefit of everyone – including myself - I could not have been happier. The result was that I disappeared for years tying to perfect every system I could get my hands on. I could have lost my mind had I not finally recognized something was seriously wrong.

On the other hand – tell me to tone down the perfectionist needs and watch me actually try to implement such a thing. Holding that thought is going to be tough because (with the ADD) it is one of a zillion and they are flying at me constantly. So I would have to organize it in someway or I will forget it existed 10 minutes from now. The minute I attempt to organize it I would be gone – into that mental cycle of making the system of not being a perfectionist – fool proof.

Honestly - does it seem I am doing this to myself? Am I making it complicated? I am trying so hard to figure out how to get out of whatever this is. Am I being obsessive? or is this just a healthy desire to get the heck out of this place I am in?

Sorry again - dang it - so many words and for the life of me I do not know which ones I would take out to make this a reasonable post

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Guest ASchwartz

Hi Say Again,

It seems to me that, given what you just described about what you are dealing with, you need to enter therapy with a Psychologist or Licensed Clinical Social Worker who is trained in and able to help people with ADD and they are around. No, you are not condemmed to a life of chaos. :)What do you think?

Allan

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Thank you Allan for taking time for this.

The therapist I stopped seeing not so long ago was what you suggested, a Licensed Clinical Social Worker. One of the areas he has had experience in for the last 10 years is ADHD.

I came to him specifically for help with these issues. He is the one that pulled open his book and read the list from the OCPD and most everything on it hit true.

I really liked and respected this person.

I was pretty reserved in those therapy sessions and yet when I really tried to describe how upsetting this is for me I started to cry. I caught myself quickly but I felt he was not up to it. I was able to later share that with him. My point with that is that the most emotion he saw out of me was over this ADD / OCPD thing and yet it seemed we never really worked on it. I don't know - the entire therapy thing confused me. It felt like I needed a therapist to help me deal with my therapist.

I feel NOTHING Allan about things from childhood that should be upsetting - yet could sob over not being able to be as organized as I want to be.

It took my all to get myself into therapy. I did not have the assertiveness to get myself back out when I knew I was really getting upset and confused. I did not know if I was putting all my focus on what this therapist was not getting & not doing just to resist something. I really felt I went in there at the end of my rope - my sleeves rolled up and ready to take this on. So I do not think I was messing myself up. I was hoping I would be able to find some help on this site because I just do not have what it takes right now to get out there and try again. If I can find the names or any information on the things that are happening I might be able to put together a plan for myself.

I think one of the problems with understanding me is that I can seem fine when I am actually dying inside.

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Guest ASchwartz

Hi Say-Again,

Now I understand.

What you experienced with this therapist is a perfect example of how the alphabet after their name means a lot less than their abilities, skills and capacity to respond on a human level. There are Psychiatrists (MD) who can and cannot, there are Clinical Psychologists (PhD in Psychology) who can and cannot and the same for Clinical Social Workers, (MSW, LCSW, Phd/MSW).

How to find the right one? Reputation helps: hearing from friends and medical doctors who they have gone to or used, sometimes you have to sample a few, or read what they have written, etc. There is no easy way. I wish there was. It's hard. In fact, excellent therapists may work with one person but not another, although the really excellent ones can work with anyone because of their skill and flexibility. In my experience, going through friends can really help.

Don't give up. Keep trying to find a good therapist for yourself.

You deserve help and it is out there, believe me, it really is and I know it and want you to succeed at feeling better.

Allan :)

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What is the unique challenge in having both the ADD and OCPD?

Doesn't this put two extremes of the opposite need / behavior co-existing in one mind?

And doesn't this mean the path to help with one is the opposite of the path to help the other?

Hi Say again,

this is very interesting to me. I see the conflict of having both these disorders , and how it arrises in daily life.

My question to you is, that the ADD is a disorder that represents itself , starting in childhood. Therefore to compensate for the ADD , which IMO, may have began earlier in the school aged years.

The person struggled over the years with ADD , especially in school. The person did the best they could to cope with ADD. Therefore , learned to follow lists, because without the lists and the desire to keep control over the ADD , it would extremely frustrating to not be able to remember where things are left, appointments , schedules , what needs to be done daily. I think this would be a normal response for a person dealing with ADD, to become more organzied , and "pickier" just to be able to deal with the ADD.

However, after years of ADD, learning to deal with it the best way possible, is to establish more control over ones life, over compensating for this disorder, has then turned into anther issue .

OCPD, due to trying to deal with ADD. Making certain everything is in its place, checking and checking again, always needing to have this order, in ones life to function. Establishing perfectionism was a way to survive with the ADD.

It makes sense to me, I can see this happening easily. I am no therapist or anything, and 100% agree with Allen. Therapy , will help you with this .

I also read in one of your posts , that you had a unpleasant experience with therapy, however, again Allen is correct. It takes time to find the right therapist no matter what their degree or expertise is in.

The therapist has to be a good match with the clients needs. Keep trying to find one , that can help you.

cathy

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Guest ASchwartz

Hi Someguy and everyone,

I want to clarify something for everyone:

It is true that hording tends to be associated with OCD. However, in my opinion, this may change. A new Diagnostic and Statistical Manual is being worked on now and there are many revisions that will be put into place. It is possible that either OCD or hoarding will be separated or made a different type of diagnosis.

It seems to me, after years in this field, that hoarding is very different from the "average" OCD. In many ways, I see hoarding as a much more serious illness and one that is distinct from OCD.

Also, because there are so many variations of OCD, the way it is categorized at the present time, it is possible to have someone who is perfectionist and OCD and here is why:

People with OCD (the non hoarding type of OCD) try to keep things in tight control through ritualistic types of thinking and acting. The perfectionist does something very similar. The difference between the perfectionist and the person with OCD is that the perfectionist (Personality Disorder Obsessional) is that with OCD the person knows what is wrong and wants to stop but the Obsessional Personality Disorder has no idea that anything is wrong and does not want to change.

Allan

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Complicated subject here..

My dad has both OCD & ADD though.. It is indeed difficult to understand. He's very 'normal' on the surface & is very out-going & social. Just beneath that it's hard to follow the reasons why he does things. A lot of the time he'll get ideas & spend all day following through with them without thinking before hand about whether it trully was a good idea.. Not easy to explain that one. Often he does things like locking everything in his house out in a shed in the yard, or building a pen for the dogs when they already have one..

From what I've read OCD is described as when the mind gets stuck on somethin and can't move past.. But that doesn't really give a lot of insight in the many ways it can manifest in people..

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Guest ASchwartz

Hi Hellscion,

OCD shows itself in the need a person has to practice some ritual repeatedly or to have things organized in some way. For instance, a person with OCD may park and lock their car. However, as they leave the car, they may have the irrational thought that they did not lock it. They will go back and check it.

The trouble is that, when they walk away again, they have the same doubt and anxiety and go back a third, forth, fifth, etc. time to re check the car. They know it makes no sense but cannot stop themself.

Allan:)

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I believe this discussion has gotten off topic. I will apologize in advance for the long post and if I seem to ramble. I read over it and tried to consolidate related issues.

I have ADD and Bipolar II. My Psychiatrist mentioned he thought I had OCPD to me a couple of days ago. During my research, I ran across this discussion. I understand the original question. How can ADD & OCPD co-exist. They seem to be an oxymoron, existing at 2 ends of the spectrum. 

Sometimes I feel frozen. Unable to start or complete anything. Running in circles. I can't start anything because I can't finish it in the controlled way I need to (work at it for 20 minutes then take a break is a joke). If I start anything, I Have to finish it to my expectations. It's a vicious cycle. Add the Bipolar and it's a recipe for disaster. The need to finish things to my expectations causes other problems related to physical issues. It is also causing problems with my family. They feel like I'm being unreasonable wanting things done a certain way (kind of like I felt as a child), therefore do things their way (not unreasonable, but drives me crazy). The ADD makes me super focused on completing something to my expectations (organizing the kitchen), yet it is destroyed the next day. On top of all, I believe our daughter has OCPD. She makes lists for everything, gets unreasonably upset when things aren't done her way, doesn't make friends easily etc. Our daughter and I have always been really close, even during the dreaded teen years. She has always been my rock. Yet this seems to be tearing us apart. She is there for me, listens, tries to help with what I want and makes suggestions on how to accomplish things. Then I find out she broke down in tears to her Dad or boyfriend because it's too much. I feel incredibly alone. A year ago I was so close to ending my life (my Dad did in 2009, his mother when he was 24-before I was born). Thoughts of her was the only thing that saved me...not my husband or our son. My Bipolar medication has gotten rid of those thoughts. Now I don't even want to feel anything...but the anger that I survived with for so long. I don't even understand why my husband is still around after 30 years. I just hope I'm not the only one and just going crazy... 

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@Ladichy that sounds like a lot to deal with on a daily basis.  I am not a clinical person so I won’t even pretend to know what to do.  I will say this: if it was me I would just try everything under the sun until I found something that works.  Dietary changes, exercise, psychiatry, therapy, among other things would be on the list.  Good luck!  

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Hello, @Ladichy, welcome!

I hope that as your psychiatrist realized you also have this problem, he/she can now start to suggest new strategies to help you.

Do you see the psychiatrist only for medication or are you also in psychotherapy? I believe psychotherapy would be the best option, possibly together with some other changes, as Vic suggested in the previous post. What do you think?

Good luck!

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