Maintaining friendships with delusional disorder and ADHD

I have experienced mental illness to the point where I have experienced hallucinations and delusions while sober, yet I’m stable enough to still function in society (well, I have a job…). Unnoticed for what it is for decades (or at least years), my mental illness insidiously destroyed friendships, relationships, and jobs.

I knew I had ADHD, predominantly inattentive type since grad school. At least that was when I was diagnosed officially. ADHD is known for being taxing on friendships and especially on work relationships. Unaccommodated, ADHD wreaks havoc on work productivity and thus, one’s career. Same goes for psychotic disorders, generally speaking. I was diagnosed with delusional disorder only about two years ago.

Good thing for the Americans with Disabilities Act, giving those of us living with mental illness the legal protections at work that we need in order to maintain employment. The Job Accommodation Network does a good job of explaining accommodation needs for those with ADHD, as well as how to accommodate an employee with schizophrenia.

This tip sheet by the University of Massachusetts School of Medicine provides a chart to help you think through the pros and cons of when to disclose to your employer, if you choose to do so.

But how can we seek accommodation for a mental health condition in our personal lives? It hurts to lose friendships and relationships.

Understanding friends and family are saints. I find that some people can intuit my needs, while others need to be communicated with. Unfortunately I couldn’t provide a full disclaimer until recently.

Accommodating friends

Phoebe had understanding friends.

How to accommodate a friend with ADHD is already somewhat documented. Patience is key, in my book. In her article, “How to Support Someone with ADHD“, Bridget Freer suggests that “studying up” on ADHD, including learning about its symptoms, is essential for supporting someone with ADHD because “these symptoms can easily lead to misunderstandings, frustrations, and resentments building up between you.” Well, they can’t “study up” on something they don’t know is present.

When it comes to parents and other close loved ones, they already know you’re “different”. However, when it comes to new friends and colleagues, disclosure of the condition(s) is necessary (or they will find out the hard way). Finding out the hard way is how resentments build up.

Is it worse to be “the person who self-disclosed as having [mental health condition]” (and whatever that means to them), or, “the person that is always late/ unprepared/interrupting/laughing inappropriately/spaced-out, etc.” (for whatever reasons they can only imagine)?

When it comes to friends/family, of course I’m going to self-disclose about my ADHD. But, disclosing to colleagues is trickier – especially when it comes to disclosing a psychotic disorder to boot. This is largely because of the stigma, which is worse for psychotic disorders than ADHD, in my opinion.

How to accommodate a friend with delusional (or other psychotic) disorder: there is some info on this available, mostly pointing at how to gently guide them towards professional help. BrightQuest Treatment Centers offers some tips on caring for someone with delusional disorder, including, importantly, educating yourself on the condition.

This would lead me to believe that one of the most important things we can do, whether it be in a professional or personal context, is to simply disclose the diagnosis. Understanding the diagnosis is preliminary to adjusting ones behavior and expectations accordingly – and sometimes people need a “why” in order to make sense of what they’re being asked to do.

Even when faced with employment termination otherwise, disclosure takes courage, given the stigma associated with mental health conditions (if for no other reason). Friendships don’t have a written disciplinary procedure they must follow like my employer does. So I can’t wait until they call me into their office to disclose my conditions. I need to do it before the symptoms show, to avoid resentments and misunderstandings.

Finding a non-awkward time to bring it up is not necesarily going to happen, so I just do it, ideally when I find time alone with the person. I usually feel relieved after I say it, and I feel it brings me closer to people the more I talk about it with them.

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