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Is Neuropsychological testing in an ADHD Evaluation Important?

Awuamarine profile image

I'm an (undiagnosed for ADHD) 57 yr old woman. On my own I have taken several online tests for adult ADHD Inattentive Type and executive functioning and scored high and was directed to see a professional. I've read several books on women with ADHD and it explains so much about my life. I can recognize myself throughout them all.

My adult daughter was diagnosed with ADHD in high school along with a niece and nephew. I've been taking 2 antidepressants for several years. (Celexa 10mg and Effexor 37.5mg) . I also am on hormone replacement therapy ( for help with brain fog, insomnia and depression).

I recently went through an evaluation with a neuropsychologist which included an interview and neuro psych testing (a few hours long). The psychologist said according to the neuropsych tests she doesn't believe I have a disorder. Her diagnosis is depression (dysthymia). I told her that I had recently read that 80% of people with ADHD also have comorbidities such as depression and/or anxiety. She seemed a little annoyed that I said that and said sometimes depression can look like ADHD. She said I did score on the low side for organization and slow reaction time but that its probably the depression. She believes my organization problems are "developmental and not everyone is good at organization." I am SHOCKED she didn't think I had ADHD along with my family. I've waited several years to finally take action and pursue an evaluation. I feel like she based her diagnosis only on the testing because the interview I gave had several examples of lifelong inattentiveness and problems with executive functioning . Do I accept this even though I believe she's incorrect? Will my primary care doctor or any other professional even listen to me about this after I've had a thorough evaluation with a neuropsychologist at a reputable medical center? I'm not sure what I should do next. I'd appreciate your thoughts.

Thank you for reading my post.

16 Replies

That’s just her opinion. You can always get a second opinion (and a third and fourth). Well, I guess it is limited by your insurance and time and money. Diagnosis is not an exact science. My belief is you know yourself better than she does

Thank you!

If you disagree you should absolutely get a second opinion. I’ve switched psychiatrists a few times (private providers, no insurance… so the process is a bit different) but I’ve never needed a neuropsych consult to be diagnosed. They each evaluate my history independently and very thoroughly (through a conversation) to confirm the diagnosis at my consult visit. I come to the consult with a thorough understanding of the diagnostic criteria and specific examples (along with any coping strategies I’ve employed) dating back to early childhood. On the other hand, my current therapist did not understand how I can be diagnosed without formal testing and even called my psychiatrist to ask about it. I’ve found that I’ve had to educate her a lot on current understanding and treatment of ADHD. There is a lot that many health providers do not know about it and you can definitely educate and advocate for yourself. If at all possible research the psychiatrists in the area and see if you can find one that has a specialty in adult ADHD (published articles, etc) because it can make the process significantly easier for you. Good luck!!

Awuamarine profile image
Awuamarine in reply to ADHD33

Thanks so much!!

yes, definitely get a second opinion, i got my neuropsychology testing done, looked for the provider myself and it was out of town and it was worth it, i also have depression, anxiety, and adhd, and the neuropsychology testing is a confirmation for adhd, check distraction podcast by dr ned hallowell, he explains it, only you know what symptoms or issues you have, doctors nowadays are not the same as years ago, i got tested for adhd 4 months ago and i knew something was "going along" all these years in addition to my depression, I'm 54 and you know when something does not add up, yes definitely look for another doctor

Awuamarine profile image
Awuamarine in reply to dede2012

I will definitely get a second opinion. Thanks for taking the time to reply.😊

Awuamarine,

The two most common misdiagnosis for mature women who actually have ADHD are depression and anxiety, and those comordities stem from the ADHD, not the other way around. Treat the ADHD and the other two become moot. Just keep that in mind. Find an expert if you can, who specializes in diagnosing ADHD in perimenopausal/menopausal (mature) women, and I bet you they will see things very different from your current clinician. Best of luck to you.

Awuamarine profile image
Awuamarine in reply to

Thank you!!

Get a second opinion. My primary scoffed at the ideas that menopause has brought out ADHD. I have been masking it all my life, but now that I have no estrogen that doesn’t work anymore. I myself am needing to get another person to screen me. I am not letting it go, neither should you. I am completely aware that doctors have bias and have days when they are in a bad mood. That can completely guide your outcome. I am in meetings with providers and have heard them give their true feelings in meetings. Be aware of this. Even though they take an oath, they are still human.

Awuamarine profile image
Awuamarine in reply to Redpup

I appreciate your reply!!

Oh, I can hear your frustration and totally understand it! I'm 56 and had no idea I had ADHD until last year - it was kind of a shock to realize that my depression and anxiety were all from the ADHD (not the other way around, like your Dr. said - who, might I say made some broad assumptions by saying you just probably aren't very good at organizing anyway. Seriously??) I I finally put it all together when I started a project with my counselor and wrote down everything about me that I couldn't understand. I had a huge list of things that accumulated over a few weeks - my hyper-focusing on crazy things but not able to focus on basic tasks; extreme procrastination; my inability to comprehend time and how long it will take me to do a project; horrible memory, and so on. I then read that list to my primary Dr. and she was the one who said "I think it's ADHD." She started me on Adderall and said I would know if I had it by my reaction to the first pill I took. If I was hyper and crazy energetic, I wasn't. If my reaction was to be calm and Not crazy energetic, then I did. And I did. The list was the best thing I did - mostly because I would always forget all my 'symptoms' the minute I talked to my Dr and then we didn't get anywhere. And the funny thing, I have started to do these types of lists for all sorts of things like an upcoming counseling appt (I would get upset a week before an appt and then get to the appt and feel fine and couldn't remember what I was so upset about - ugh). It sounds like you are going to get a second opinion - go prepared, don't let them take charge of your appt. It's your life they are dealing with and you deserve to find out the best treatment for you!

Awuamarine profile image
Awuamarine in reply to pammers

Thanks so much for the encouragement!😊

I recently had the same thing happen. The neuropsychologist also greeted me with "make sure you don't lay it on thick during the test"!!! In other words, we assume you are drug-seeking and pretending to have ADHD to get some. I was devasted when I got my test results, but I did not give up. After doing some research on the doctor, I found that he specializes in drug addiction and also had multiple complaints about the same treatment I received. I went to my neurologist to discuss the results and advocated for myself. She looked over the notes from the test and said there were many signs of ADHD in them and was really upset that the doctor treated me this way. She agreed that I get a second opinion with a psychiatrist and not even mention the testing. I couldn't find anyone local that specialized in adult ADHD and would take my insurance. Diagnosing women is also dismissed as anxiety or depression often, even though they go hand in hand. Finally, I made the decision to try an online specialist and made an appointment through this organization donefirst.com. I had a tel appointment within a few days and after an hour conversation about my history and current behavior, I was prescribed medicine. I did have to pay out of pocket for the appointment and have to pay a monthly fee, but it is well worth it. The first month is about finding the right dose and then it's regular treatment with an on-call service where your doctor responds to your message within 24 hrs. I expected this to be some kind of scam, but it's not! My life has changed and I am so grateful!!! Hopefully, the word will spread about this organization, and people won't just give up and suffer for the rest of their lives. Research and support for women with ADHD are much needed. Stay strong!!!

Awuamarine profile image
Awuamarine in reply to her42

Thank you so much for taking the time to reply. I will look into donefirst.com. That’s great you found this and that it’s changed your life . Very encouraging! Thank you.😊

Hi..just read your post late last night. I’m a 57 year old woman who was told last night by my 23 year old son, who has ADHD, that I have ADHD. My nephew, 30 and also ADHD, has told 2 of my kids he thinks I have it too. I have suspected it for years based on many things but when I tried to talk to my GP about it she laughed and told me I just have depression and anxiety. Which I totally do—but maybe it’s related? I am at the beginning of this whole thing. This after trying to resolve other emotional issues through analysis etc for years! all to end up at a different square one. I’m frustrated that all of my efforts in that direction could have been because of ADHD. Not sure what my next move is but just wanted to say it was comforting to know I’m not alone. I just feel so silly.

I think you should keep going until you find the answer you are looking for. I’m looking to get evaluated.

Have a good night..

Awuamarine profile image
Awuamarine in reply to Lisa9122

Hi Lisa9122,

Thanks for replying. It is comforting for me too to hear your story and know that I"m not alone...and I know what you mean about feeling silly.

I just saw my primary care physician at my physical and she had just seen my evaluation from the neuropsychologist with the diagnosis of persistent depressive disorder and not ADHD. I told her I did not agree with the assessment concerning the ADHD and would be looking for a second opinion. Without her saying much, I got the sense that she thought I was being ridiculous. It's so disheartening to wait so long for an evaluation and diagnosis and be right back to square one.

My daughter keeps saying the neuropsychologist was wrong. I think the people that know you well and know the signs of ADHD are a good judge, especially if they are diagnosed themselves.

I hope you can go for an evaluation soon. I also read from one of the ADHD experts (Russell Barclay, I think) that neuropsych testing doesn't show how you are in real life everyday. They say an in depth interview is enough to diagnose especially for adults.

That's too bad your GP laughed at your suggestion of ADHD. I have read that undiagnosed ADHD can lead to depression and anxiety and that it goes together more often than not.

Thanks again for your reply and good luck!!

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