I was recently diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and bipolar mood disorder. Is this a possible combination or is the doctor simply fumbling about with hard words? He also seems very impressed by my first-class honours degree in computer science.
The simple answer to your question is yes. Not only is this a possible combination, but it is also a common one for several reasons, including the possibility that the inheritance of the two might be via genes that are close to one another.
In your case, and just to spice up the discussion, some people link some mental disorders with high intelligence, but this is a discussion we might have another time.
Two years ago, a 30-year-old man was brought to us by his young wife of a few years who was contemplating leaving their marriage.
As she put it rather dramatically, “Either he is married to me or to his friends…. he cannot handle both of us.”
As the drama unfolded, it became clear that this young couple was navigating a difficult territory, hitherto unfamiliar to either of them and in the process creating havoc for both parties.
From the early days of their courtship, the wife was concerned about his drinking and socialising habits and told him as much.
Changing this behaviour was a condition precedent to their getting married. He loved her enough to change as requested for a while, but soon the old habits crept back in.
At first, he only drank heavily on Fridays but within a few months of their marriage, he went out daily and drank as heavily as before.
Soon the drinking was out of control and led to many arguments at home related at first to wastage of money, frequent road accidents, as well as his sexual dysfunction.
Prior to marriage, all who knew this couple had described them as made for each other. She was a rather shy, intelligent church-going homely sort of girl who loved to spend time at home cooking or reading and at times listening to gospel music.
She did not drink and had a successful career as a banker. She was a bride straight from the church choir. Later, she confessed that part of her loved her husband in the hope that she could change his self-destructive ways.
As though to contrast her personality, he was a big and loud rugby fan who had many friends, and enjoyed large amounts of expensive whisky to push down the large amounts of nyama choma he took as he told funny stories to his many casual friends.
He was mostly away from home and was best described as a restless soul who became bored easily and in his impulsive moments would on a whim drive 300 kilometres at break-neck speed to watch a rugby game in another city with a friend who called him that morning.
Though he had a good job, he was also known as a master procrastinator who did all his work at the last minute, nearly always after consuming large amounts of cannabis which he had used for many years, to enable him to tame his racing mind about which he complained of poor concentration.
He often said that without the cannabis he was a total wreck on account of the unsettled mind.
A few days into his hospitalisation, and as he was given medication to treat Attention Deficit Hyperactivity Disorder (ADHD), another aspect of his life revealed itself.
In high school, he was a top performer and was well-liked for his ability to combine exceptional performance in class as well as the sports arena.
He had, as his school reports would reveal later, academic brilliance, enthusiasm on the football pitch, and magnetic charisma.
However, his poor interpersonal skills saw him in many arguments with teachers and fellow pupils. Some of the teachers pointed out his poor concentration and organisational skills.
Copies of his medical records made it clear that in addition to the symptoms of ADHD, our patient had, since adolescence suffered from several episodes of mental illness some depressive as well as at least two in which he was manic and had had to be hospitalised for several weeks. One attempt at suicide at the age of 19 had resulted in another period in hospital.
With the foregoing history, we were confident in making a diagnosis of bipolar mood disorder, and on a mood stabiliser and medication for ADHD, he did well. He has also cut down on cannabis and alcohol and he and his wife are happy in the relationship.
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