Chapter Text
Buck first experienced symptoms of a mental health condition when he was fourteen years old, although he didn't realise at the time that the tightening in his chest when he thought about going home from school was anything but normal. Why would anyone feel anxious about returning home yet experience relief at the thought of going to school? He was well liked among his fellow ninth-graders, and although his parents only paid attention to him when he hurt himself, even then Evan shouldn't have felt anxious about going home. It wasn't as though he was being abused.
In the early 2000s, high schools rarely discussed mental health. They barely addressed sexual health, and students who sought help from school counsellors were often labelled “crazy” or “nuts”. Buck, or rather Evan, was neither. Therefore, when Dr Copeland asked Buck about his first memory related to mental illness, he recalled his high school years, though he would prefer never to think of them again.
Buck’s next significant memory is the day he crashed his bike. It occurred not long after he had started college, when he was riding home to collect his clothes before his parents discovered that he had dropped out. He recalls thinking, “Would anyone even care if I just rode my bike into oncoming traffic?” At the hospital, the nurse contacted a member of the psychiatry team to assess whether he was suicidal, even though he insisted that he hadn't actively attempted to kill himself. Years later, he realised that the reason the team had been called was because he'd used the word “actively”.
When Buck first began working with Dr Copeland during the pandemic, she explained that although Buck hadn't been actively attempting to kill himself in certain instances, such as during his bike crash, he was nevertheless passively suicidal, meaning he hadn't taken steps to prevent his own death.
Buck was thirty years old when he received paperwork to evaluate whether he had any mental health conditions and to obtain an official diagnosis of ADHD. The ADHD diagnosis wasn't a surprise to him. During high school his parents had been asked to give the school nurse permission to contact his family doctor for a possible assessment. However, they decided he didn't need testing and simply needed to behave better in class. When Dr Copeland officially diagnosed him and explained how his parents had failed him, Buck was shaken to realise that he'd never been a “naughty child”. Rather, his brain functions differently and he doesn't learn in the same way as others.
This understanding also helped Buck recognise similar behaviours in his stepson, Christopher. Christopher has a multidisciplinary team of specialists working with him. However, because he has cerebral palsy, a condition that can include symptoms of inattention and hyperactivity, his ADHD wasn't identified during the first eight years of his life. Buck and Eddie are grateful that his symptoms were recognised while he's still young enough to benefit from early intervention.
The surprising part was not Buck’s ADHD diagnosis but rather his diagnosis of borderline personality disorder. His initial reaction was disbelief. He acknowledged that he could be intense at times, yet he didn't believe he had an underlying personality disorder. True to form, Buck engaged in extensive research, which ultimately clarified many aspects of himself that he had previously disliked. According to the Diagnostic and Statistical Manual of Mental Disorders, an individual must exhibit at least five of the nine diagnostic criteria for borderline personality disorder, and upon honest reflection he recognised that he met seven.
Fear of abandonment.
Buck recognised that even an hour without a response from his husband could make him feel as though Eddie disliked him or intended to leave him. He also recalled his reaction when Bosko temporarily replaced him while he was recovering from the ladder truck bombing. He knew his response had been excessive, yet he was terrified that her presence meant he'd been permanently replaced and would have no job to return to.
Unstable relationships.
Buck observed that his relationships rarely felt secure. Even within marriage he continued to doubt whether Eddie genuinely wanted to remain with him. Similarly, in his professional life he often forgot that Bobby cared for him, misinterpreting being kept off duty as rejection rather than concern.
Unclear or shifting sense of self.
Buck realised that referring to himself as “Buck 1.0”, “Buck 2.0”, and so on was a method of masking his identity because he did not fully understand who he was. His aversion to being called “Evan” also reflected rejection of his former self rather than an expression of his current identity.
Impulsive or self-destructive behaviours.
According to Dr Copeland, one of the first indicators of borderline personality disorder in Buck was his recklessness, both professionally and personally. Although he neither used drugs nor abused alcohol after joining the fire department, he had previously engaged in risky sexual behaviour. Before his marriage he'd been dismissed from several jobs for workplace affairs, and he even jeopardised the firefighting position he valued most by engaging in inappropriate relationships during work hours and, on one occasion, by stealing the fire engine.
Self-harm and suicidal behaviours.
Buck maintained that he'd never intentionally harmed himself. However, upon reflection he recognised that during childhood he had deliberately injured himself in order to gain his parents’ attention. Dr Copeland later reminded him that his pattern of passive suicidality also fulfils this diagnostic criterion.
Extreme emotional swings.
Although Buck would not describe himself as someone whose mood changes rapidly, he recognises that he often exhibits an all-or-nothing mindset. This pattern, referred to as black-and-white thinking, is commonly associated with borderline personality disorder.
Chronic feelings of emptiness.
Buck realised that although he does not label it as such, his habitual response of “I’m fine” when asked how he is may reflect an underlying sense of emotional emptiness. He often feels either overwhelmed by emotion or entirely numb, leaving him uncertain how to describe his state. Dr Copeland explained that this experience is related to his difficulties with identity formation.
Explosive anger.
Buck's confident that this particular criterion does not apply to him, as he rarely experiences anger and when he does it develops gradually rather than impulsively.
Suspiciousness or dissociative experiences.
Buck's pleased to note that he does not exhibit this characteristic. He remains grounded in reality and humorously observes he might have benefited from more suspicion, as he was a victim of identity theft during his probationary year.
Dr Copeland is optimistic that, through a combination of therapy and medication, Buck will be able to reduce the extent to which borderline personality disorder affects his daily functioning. He already knows he will begin treatment for ADHD and then his borderline personality disorder, introduced gradually rather than prescribing multiple new medications at once. The doctors explained they would have preferred inpatient monitoring, but with Eddie being a paramedic they felt satisfied he would be well cared for at home.
Both Eddie and Buck have been granted at least a week off while Buck adjusts to his ADHD medication, as one of the common side effects of Adderall XR is drowsiness during the initial adjustment period. Eddie will remain with him because, in rare cases, the medication can trigger psychosis or seizures. When Buck begins his antidepressant, it will also be introduced gradually to ensure compatibility and minimise adverse reactions.
Buck is confident that his husband will review the accompanying medication information sheets, but he also wants to understand what physiological effects he may experience. He plans to use his time off to learn more about his recent diagnosis, explore ways to adapt his work while on the new medications, and reflect on how his conditions have influenced his professional behaviour. He hopes to reduce the impulsive risks he tends to take, behaviours that often cause significant anxiety for Eddie and Christopher.