2025.01.17ブログ
境界性パーソナリティ障害、ADHDの合併している可能性は結構高い
境界性パーソナリティ障害、ADHDの合併している可能性は結構高い
今回は、境界性パーソナリティ障害、ADHDの合併している可能性は結構高いについて解説します。
BPDは対人関係の不安定さから対人的なコミュニケーションの問題を抱えがちですが、その一部には衝動性が原因でうまくいっていないことがあります。
もちろんＢＰＤの成立要件として、生来の易刺激性、気分易変性がありますが、それとは別にＡＤＨＤが合併しているケースも少なからずあります。
ＢＰＤと診断されていたりすると、もう一度生育歴をとりなおすことがないことも多く、ＡＤＨＤが発見されていないことが多いです。
もしＡＤＨＤが併存している場合、治療としてはチャンスだと思います。
なぜならＡＤＨＤ治療薬は割と効果があるからです。
内服が効果がでにくことが多い精神科領域において、ＡＤＨＤ薬は効果がでやすい方の薬だと思います。
これで衝動性が改善されると、対人トラブルはかなり減りますし、気分の波も同時に改善されることもあるので、そうするとかなり安定します。
副作用もコントロール可能なことが多いので、うまく使いこなすことができれば、精神療法の方も進めやすくなるはずです。
ＢＰＤと診断されているが、なかなか治療が停滞してしまっている方、一度発達障害が併存していないか調べてみることをおすすめします。
ぜひ当院へご相談ください。
Today, I’ll discuss the possibility of comorbidity between Borderline Personality Disorder (BPD) and ADHD, which is notably higher than commonly recognized.
1. The Overlap Between BPD and ADHD
BPD is characterized by unstable interpersonal relationships, intense emotional reactions, and impulsive behaviors. Interestingly, some of these impulsive traits may stem from undiagnosed ADHD.
(1) Shared Characteristics
Emotional Dysregulation:
Both conditions exhibit heightened emotional responses and difficulty managing emotions.
Impulsivity:
A hallmark of ADHD that can exacerbate interpersonal challenges in BPD.
(2) Biological and Developmental Factors
BPD often involves inherent traits like irritability and mood instability. However, ADHD may co-exist as an independent neurodevelopmental condition, contributing further to these difficulties.
2. Why ADHD in BPD is Often Overlooked
When a BPD diagnosis is established, healthcare providers may focus solely on treating BPD symptoms, often neglecting to reassess developmental history for ADHD.
Missed Diagnosis:
ADHD symptoms may be masked by the intensity of BPD-related issues, especially in adults.
Behavioral Similarities:
Impulsivity and emotional instability are common to both, leading to misattribution of ADHD symptoms to BPD.
3. Opportunities for Effective Treatment with ADHD Medications
(1) ADHD Medications Can Make a Difference
Treating ADHD within the context of BPD presents a unique opportunity because ADHD medications, such as stimulants and non-stimulants, are generally effective.
Reduction in Impulsivity:
This can significantly decrease interpersonal conflicts and improve emotional stability.
Improvement in Focus and Organization:
Reducing the mental chaos often associated with ADHD enables better participation in therapy.
(2) ADHD Treatment Facilitates Psychotherapy
When ADHD symptoms are managed, psychotherapy becomes more effective. Patients can better engage with interventions aimed at improving emotional regulation and interpersonal skills.
4. Practical Steps for Suspected Comorbidity
If BPD treatment seems to have stalled, reconsidering developmental history to assess for ADHD may be beneficial.
Comprehensive Assessment:
A detailed developmental history, including childhood behavior, school performance, and attention challenges, can reveal undiagnosed ADHD.
Collaborative Treatment:
Combining ADHD medication with therapies for BPD can lead to significant progress.
5. Conclusion
Comorbidity between BPD and ADHD is not uncommon and can significantly impact treatment outcomes. Properly diagnosing and treating ADHD in individuals with BPD can:
Reduce impulsivity and interpersonal conflicts.
Stabilize mood swings.
Enhance overall treatment efficacy.
If you or someone you know has been diagnosed with BPD but feels stuck in treatment progress, evaluating the possibility of comorbid ADHD is highly recommended.
Feel free to consult with us at Wako Clinic for a thorough assessment and tailored treatment plan.
