Suggest Treatment For Bi-polar Disorder And ADHD In An Elderly Person

Question: Yes Hi....I'm a man of 59 who is in a relationship with a woman (60 ) who I feel may have undiagnosed Bi-Polar. Her mother was diagnosed bi-polar and so not going too far....that is one bit of evidence I'm working on. The biggest reason I have however in my own thinking on this....is that I have ADHD myself. The brief of this for me. I went undiagnosed until I was in my late forties and have spent a great deal of time in CBT and research and education to be pretty up to speed on myself....my previous denial symptoms (no longer the pattern now) and my mostly predominently hyperactive...but combined type ADHD which is mostly implusive in nature and less inattentive though...I have some inattentive too. I am a pretty even mix now on Adderall for the last 8 years which is working well and stabalized and I'm mostly functioning well all things considered. I never had real problems in school, learning or memory and mostly had relationship issues in my past with a previous divorce. What appears to me in my girlfriend....almost mimics my ADHD in a lot of ways including my past denial symptoms currently which are really a problem right now but....she has started CBT herself with some good results already. The only thing that no one is talking about (the elephant in the room) seems to be what's behind the denial behavior and that is what I looking for clues in and a possible anecdotal opinion base just on these facts. Her unwillingness, moodiness, irritability, self defeating poor self esteem, cyclical ups and downs along with depression and some self medicating with Marijuana and mild alcohol use (daily as it seems a need more than a want on both parts) appear to point to Bi-polar using Occams Razor here as my only means to self diagnose her with what I know of myself? I want her to get help (specific treatment and medication ) but this discussion is tenuous due to her denial. There's a lot of anger and interrupting, rapid shifts in conversation and some rather child like emotional reasoning for a person of pretty average or above intelligence. That and a lot projection and accusations any time I get near the subject with her. I see the denial right now as the biggest problem as it was for me in my past which the CBT seems to be addressing...but that still leaves whats behind the denial and I thinking myself.....this is it?

My father was diagnosed postmortem Narcissist possibly ASPD on some level so I am familiar with personality disorders as well as BPD for a wife. Unfortunately....this can go with the territory being raised with one parent like this which did set me up for being attractive to others later on in life. I have worked through this myself with my psychologist so my radar is pretty keyed into this now.

My girlfriend is actually a social worker and she does not respond like a BPD and has the capacity for empathy however.....as I well know myself having ADHD....not being able to see yourself as others see you is a difficult thing to finally get a grasp on. Others do mirror you as if you have the plague sometimes (LOL)...but that's only because of how they perceive our inability to switch gears and get really hyper focused (and miopic) sometimes that makes us appear not very caring...especially when we do things that look like Narcissism when in reality....it just being very attuned and checked out sometimes (as others see us).

The reason I said this is because the other possibility which I have no real experience with....is that she is ADHD inattentive and is in denial herself. Those denial behaviors alone can look pretty Narcissistic but without the denial...that seems to dissipate quite a bit. I know this since I've really moved quite a bit away from that in my past and realize just how self absorbed and oblivious I must have appeared simply because I had no idea I had ADHD until I got divorced and discovered what the problem was.

For the moment....I'm going to skip past personality disorders only from my own experience with it as I've said....but back to Bi-polar or possibly female ADHD and wondering what make you feel that Bi-polar is not the issue. All the projection and defensiveness appears more to do with the denial of what ever it is....than being the source of the problem to me? The denial behavior looking like a personality disorder so I understand why you might say that. Her pattern of depression, alternating with periods of being Okay....but with these outburts of sudden anger (emotional lability) looks so similar to ADHD to me from what I know of myself that if it's not ADHD....then wondering why not Bi-polar due to her mother being this way. I'm not questioning your suspicions only wondering why not Bi-polar? She just doesn't act the same as the BPD that I was married too since she lacks that more callous disregard ....on/off light a light switch and never suddenly turned on me from I love you...to I hate you over night? Or predatory either? More just oblivious to herself yet very aware and actually highly conscious of her inability to get along well with others and her socially abrasiveness at times. More just socially inept with seemingly poor social skills that you would think that a person of her age would have a better handle on that for an educated woman...kind of argumentative and almost ODD in her behavior. Blurts things out before she thinks about them that are offensive and rather inconsiderate but is very ashamed and will actually apologize and acknowledge that she knows she does this but with seemingly no control of her emotions and doesn't like to be told what to do. Seeming a lack of good common sense or ability to negotiate, problem solve and compromise? Just gets overwhelmed and then over reacts (very reactionary and hyper sensitive to criticism ) out at you if you call her out on her behavior? Her mother was an alcoholic if that makes a difference?
I'm not trying to talk you out of your first impression and I'm do want to know if it's likely what you said but given the extra bits of background here...I very curious about this now?