There are 3 things I need to untangle really. I have known I have had depression, occasionally major, and with associated GAD and panic attacks for many years. I also know if it wasn't for certain 'protective factors' I would have been more actively self harming, although that didn't stop me doing this in less overt ways (eg through self neglect). It is very likely I also have PTSD given my childhood experiences and presenting symptoms. However my score, which to a large extent poses questions I have asked myself before, suggests my situation may be more complex.

1) My mother may have had bipolar herself and I am wondering if I have this too. My depression has never really responded well to the usual antidepressants, I've tried many of the main ones and a couple of more esoteric ones like Agomelatine. The only one that made a major improvement was Mirtazipine and tbh that was largely more because it helped me get a good nights sleep and with some of the anxiety. SSRIs made me more anxious, very nervy, and messed up my sleep. I have some uncertainty though as I do not have manic episodes, at most hypomanic, and not prolonged, whereas the depression is. On the other hand I do know when I feel well on occasion it can very easily lead to me over estimating what I can do, taking on too much at work, and feeling like I can do anything I set my mind to. Sometimes I feel like my mind is just racing away, at those times I can be extremely creative at work and especially in my research. Unfortunately it never lasts.

2) There is also the question of whether or not I sit somewhere on the autistic spectrum. My autism test core is 38. My brother has Aspergers and I would say many of the males in my family exhibit ASD traits. We are all pretty geeky, don't socialise well, prefer intellectual pursuits, and find small talk extremely hard. I have an amazing amount of difficulty remembering names and faces and yet my mind recalls the smallest detail of factual information - I can read a text book and pick up the gist of it instantly and sometimes it gets annoying how easy it is for me to recall things like the botanical names of some obscure plant but not the name of a person I have met several times. I do however have good social skills (but just not social confidence or smalltalk) and am very empathic (in fact extremely so) which doesn't fit the pattern. Also I have to say my brother uses his diagnosis as an excuse for not taking responsibility for his appalling behaviour too often.

3) The third issue the test brings up is 'borderline traits'. My BPD test score is 28. I can see how my fears of abandonment and emotional fragility could fit this diagnosis but to be honest I have considerable skepticism around 'personality disorders' and feel this is often over diagnosed and that the criteria are dubious and in some respects also sexist. Psychiatry is unfortunately still in the primitive classificationist stage of development. However again I do have this resistance to anti depressants.