To be honest, I hadn't really put much thought until recently how these two diagnoses relate to each other, other than experientially. Let me try to explain. In my professional life, I have had many clients that had diagnoses of both ADD and PTSD. My focus as a T has long been to assist my clients in coping with their particular stresses and to increase their quality of life, if possible. To my mind, I look at diagnoses as an aid to increase understanding, as part of the larger puzzle that is an individual. Sometimes the pieces of the puzzle fit well, and at other times they really don't and that is an indicator that there is more there that needs to be examined. I might use a "working diagnosis" to appease the insurance companies who insist on a diagnosis for reimbursement, but I'm not necessarily convinced that this is the problem(s) we are dealing with and I operate under the assumption that the diagnosis will change and be further refined as treatment progresses. In the short run, to me it is more of a concern to address the area(s) that brought the person into treatment in the first place as this usually the area that they are experiencing the most distress, and less of a concern to address a diagnosis that may be having less of an impact on the person at that particular moment.
I have been in and out of T myself since i was about 12 years old, mostly to deal with a current distress of one kind or another. I've had a variety of diagnoses over the years, depression and PTSD are the two that have stuck for the longest. I was diagnosed with ADD almost three years ago, and so were my sons. The behaviors/symptoms were present long before the diagnosis, however it took another severe trauma for those it to be identified as related to ADD.
The ADD diagnosis came after my oldest son severely burned his legs accidentally and was hospitalized on a burn unit for 29 days. He received a lot of attention for that action - more than he wanted, I'm sure - and also had to undergo a variety of psychological interviews and testing because they wanted to ascertain his motivations for putting himself in a position where he hurt himself so badly. In short - was he a danger to himself and/or others? They found the answer to those questions were more complicated than they bargained for.
I've mentioned in other places in the forum that my sons have been dealing with PTSD for most of their lives. I won't reiterate that here. They have been in and out of T for a long time. My oldest also has been dealing with another burden since age 10 and that is he nearly died from ketoacidosis just prior to being diagnosed with type 1 diabetes. That was another traumatic event in his life that has profoundly effected they way he looks at himself and how he deals with those in the medical establishment.
So back to when he burned his legs. His blood sugar had been high for a number of months. He had been acting out. He was doing poorly in school. He admitted to smoking some pot and skipping school. He had been immersing himself in building things and reading about how to build things on the internet. He and a friend had made a type of fuel and lit it. My son was stomping it out when it flared up on his legs and burned him. That was not what they expected to happen. It was an experiment gone awry. His friend was not hurt and luckily had the presence of mind to get help. It could have been so much, much worse.
After the burns were addressed, his doctors were having a hard time figuring out precisely what was behind my son's acting up behaviors - whether it was solely a blood sugar issue, normal teenage rebellion, PTSD or other diagnosis, something else or some combination of two or more of these elements.
The doctors addressed my son's diabetes first, as it was thought that was the most immediately life threatening. They conducted psychological tests on him and interviewed him, me and my son's father. The lengthy medical and social histories that they gathered from us was something that had not happened previously, and lent support to some possible heredity issues being factors in what was going on with him. The diabetes, depression, and ADD being a couple of those factors.
It was found, eventually, that my son was not a danger to himself or others, thank goodness. The doctors identified that he has issues with dealing with his diabetic self-care, but what teenage boy wouldn't resist having to take shots four times a day? This was not news, but we were glad that he found more support in dealing with it in the day to day. The most interesting thing this experience illuminated was that they recognized that my son hyperfocusses on things that interest him. We had been saying this for years, but no one seemed to hear it until then. He hyperfocusses at the exclusion of other normal every day activities like eating. There were other indicators that pointed toward ADD as well that I won't go into here but were equally interesting. After the doctors diagnosed ADD, it started to make sense to my son why he did some of the things he did and he was able to better articulate what was going on with him. He has tried medication with some success. He has decided to go without for the time being and is supported by his T.
This diagnosis helped his brother as well. My younger son has always had difficulty with what I call "insert thought, out the mouth" - he was constantly getting in trouble for talking in class, to the teachers, classmates, for not being able to sit still. No one suggested ADD because frankly, it generally was attributed to the already identified PTSD, but every year we were going back to the school to write yet another behavior plan to address his impulsive behaviors. After his brother's burn event, the ADD was put on the table as a possible way of understanding and dealing with some of his behaviors. It really has helped reframe his school experience in a more positive way, to my mind. Medication was helpful to him as well, but then he developed some stomach issues recently that has made him stop all medication. He is conscious of the difference and wants this to be straightened out quickly.
As for me, my T watched these events unfold and come to some sort of stability, and then she suggested that we examine ADD and how it relates to me. Which we did, at length. She was able to help me see that some of my "fogginess" was not just PTSD but something else, that something else being ADD which can and is being addressed with non-stimulant medication. Seems to work for me. :)
Sorry for the lengthy response! I hope I made some sense...
