Recently diagnosed - a few questions

[patrick639]

Hi all,

I'm 35yrs and was diagnosed with ADD by a psychiatrist a couple weeks ago, who I went to as a 2nd opinion after a psychiatric nurse practitioner said I did not have enough symptoms for ADHD. I don't think I've really accepted it yet, but in my gut I know I really struggle with many classical ADHD problems. In particular, focusing on work has been excruciatingly difficult for the last 15 years. It's great to find this online community and read about other experiences that I can relate to.

So here's the thing: the nurse practitioner who I saw originally put me on Bupropion (Wellbutrin) rather than a stimulant because she wasn't able to give me an ADHD diagnosis. The psychiatrist I found is not in my insurance network I have to pay out of pocket for more meetings and medicine, so is a bit expensive. A few questions I have are:

- Does anyone have experience with Bupropion AND one of the stimulants (adderall etc)? I've seen some improvement with bupropion, but I'm curious if stimulants could help even more.

- Any tips on finding in-network psychiatrists? I live near Boston, so there should be a lot, but nobody seems to like to take my insurance. Or is this normal, and do a lot of people just suck it up and pay out of pocket?

- I still feel like an imposter... Like I said, in my gut I know I struggle with attention and focus. I've left the gas stove burner on three times in the last year... and getting work done is next to impossible on many days unless the work is off-the-charts interesting, in which case I can hyperfocus for days. Having the nurse practitioner say I don't have ADHD followed by a psychiatrist saying I do is also confusing. I'd like to feel confident about addressing my challenges with medication and not feel like an imposter. Is this a common feeling and when does it go away?

- For those taking stimulants, how often do you need to go in for appointments for medicine checks? I think I'd have to pay ~$100-150 per visit out of pocket, so it'd get expensive pretty fast depending on the frequency.

Thanks for reading.

Patrick

[cjnolet]

RE: medicine appointment checks.

As many ADHD people find out, I am one of the people who was mis-diagnosed with bipolar. I'm 34 years old, and that happened when I was a teenager. Because of that wretched experience (it rather ruined a lot of my teenage years taking medications that were MAKING me bipolar, until I turned 18 and finally told my psychiatrist to take a hike).

As a result, I was recommended a psychiatrist in January (I was just recently diagnosed as an adult as well) who's good with bad reactions to medications, but he doesn't take insurance. I've seen him twice so far since the beginning of January. Once for the intake and diagnosis, which was $600 and once last week just to check in after I had a chance to let my medication settle in (I'm on Vyvanse 60mg daily).

I don't another appointment until October. Originally I was quite worried that the Vyvanse prescription was costing me $240 a month but I've just recently reached my deductible on my health insurance and now I pay $15 a month- totally different.

Also- not sure why you'd feel like an imposter. Do you mean maybe that you are now hyperfocused on knowing that's a neurological disorder? I've had imposter syndrome recently as well but that's mostly related to my doubting myself and my abilities too much (I'm in grad school and have had a pretty successful career so far, so for someone to tell me that I have a learning disability was quite a shock to me... until I began looking back at my past.). I was an ADHD diagnosed child in 3rd grade... so u can only imagine..... That was our generation though.

[iBusyBrain]

Google "SPECT imaging". You get that done--either you have it, or you don't. The image results are irrefutable. Often times...the doctors find co-occuring brain disorders and get help for many, if not, all of them.

[Hidden]

Hi Patrick, In your case I would go and see another nurse practitioner, preferably a psychiatric nurse practitioner since that seems to be covered by your insurance. Usually psychiatrist that you have to pay out of pocket, want to see you every month, so they get paied every month, but also because they are prescribing you stimulants (a controlled substance) if you have ADHD and want to monitor you. In your case I think it would be good to get third opinion since you feel that you struggle with focusing.

The gas stove 😕 sorry to hear. I have the same problem, I now have electric stove, so leaving it on is less dangerous than the gas stove. I left my oven on recently for almost 24 hours. The plates on the stove, I check it at least once a day, just to make sure. But I’m in my kitchen quite a bit and I stay home.

I was diagnosed as hyperactive kid in the late 1970’s and I never really knew what it meant. I was just a kid and didn’t want to accept that there was anything wrong with me, although I have always sensed that there was something different about me. Later on I was misdiagnosed as bipolar and of course I was constantly getting off my meds because they didn’t really work, just made me mostly more depressed. I’ve finally been diagnosed with ADHD at 55, so I logged on here to learn more about it and for the first time the diagnoses made sense to me. The description of ADHD and the struggles people write about there seem to be exactly like mine. But the most important thing is that you get a professional to identify the right diagnosis. There is a lot of life lost and wasted it you wait til 55.

[patrick639 in reply to Hidden]

Thanks for your reply. I incidentally have a physical with my primary care doctor this week. I'll ask him whether he can prescribe or get tips on where to go to find some ADHD specialist in-network.

About the stove -- glad I'm not alone! This was the thing that led to me finally getting tested for ADHD. I now have a system where there's rubber bands around all the stove knobs. Before turning it on, I take the rubber band off and put it around my hand. And I don't put it back until I've confirmed everything's off. So far impossible to forget. My wife's anxiety about the whole situation seems to be much lessened as well

[anndee1971]

I take Adderall and its my lifeline to get anything done. I also get it prescribed by my primary Dr and do not got to a psychiatrist. Every 25 days I request a refill and it goes directly to my pharmacist and I go pick it up when it's ready. I'm in California, so maybe its different in other states? I would check with your primary to see if that person can write you the prescription. If you move over to Ritalin or Adderall, just know that overtime you will need higher doses. I recommend only taking during the week and detox on the weekends. If you have long weekends or go on vacation, stop taking.

[patrick639 in reply to anndee1971]

Good advice. I'll check with my PCP this week. I feel like I might need the specialist for a while though, to find the right meds and dose. But once it's stable, maybe I could get my PCP or someone else to write it going forward? Has anyone had luck "transferring" a diagnosis and prescription from one doctor to another? I really hate to get retested, especially from a non-ADHD expert.