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Is Neuropsychological testing in an ADHD Evaluation Important?

Awuamarine profile image
22 Replies

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.

22 Replies
Learning101 profile image

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

Awuamarine profile image
Awuamarine in reply to Learning101

Thank you!

ADHD33 profile image

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!!

dede2012 profile image

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.😊


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!!

Redpup profile image

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!!

pammers profile image

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!😊

her42 profile image

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 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 That’s great you found this and that it’s changed your life . Very encouraging! Thank you.😊

Lisa9122 profile image

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!!

doraemm profile image

A brain map will tell you what is the problem. I thought my daughter has anxiety. The brain map showed she has anxiety and ADD. My son's brain map showed he has OCD. Anxiety could lead to depression. The brain map will tell you the source,

HidinginSight profile image

@doraemm what is a brain map?

QuothTheRaven profile image

Get a second opinion - from an ADHD expert. But, also, look into your own motives. Depression can look a lot like ADHD and vice-versa. Are you seeking and ADHD diagnosis for medication trial/support, or therapy? A good therapist/life coach/ADHD coach can help you with the symptoms, that you are trying to manage, without having a firm diagnosis of ADHD. A primary care physician can prescribe ADHD medications; however, they are often hesitant to do so. Most importantly, there are medications (i.e. Wellbutrin) that are effective in treating both depression and ADHD, giving you medical treatment without the necessity of and ADHD diagnosis. Feel free to respond with questions or comments, if this wasn't clear/helpful

emiL1234 profile image


I was checked by 5 different specialists and groups of specialists and never received the same opinion twice. I became obsessed and read on ADHD for 2 years, I tried 4 different medications and never saw anything different, except unnecessary suffering. I f I could go back in time, I would NEVER search about that stuff. A total loss of time. I have recently spent an hour with a psychiatrist to find out he knows fuckall about adhd. I lost confidence in each and every health professional.

Healthnerd1 profile image

Hi there so I am not sure why they are recommending this, when truly if you meet criteria from the dsm v then you meet the criteria. I am a clinical mental health counselor, and have adhd myself. I myself was recently asked this by a psych nurse about my past history....

First thing is first. MEDICAL DOCTORS DO NOT PROVIDE THIS --ADVANCED ASSESSMENTS OR TESTINGS FOR ruling out and providing adequate reports for DIFFERENTIAL DIAGNOSTICS OR CO-OCCURRING disorders, personality disorders, and LEARNING DISORDERS ETC AT ALL. I myself am seeing a new nurse practioner for my psych meds and she recently asked me, " Did your psychiatrist provide you with advanced assessments and testings?" I was very shocked by her asking me this, because that let me know she has no idea which medical vs mental health professional is which? That is scary to me, when it is coming from a medical or mental health professional period. BECAUSE THEY SHOULD KNOW BETTER.

I know it all can be confusing for the general public, but most certainly it shouldn't be confusing to any medical or mental health professional. I am hoping that this response will help many in clarifying each professional title and in understanding what they provide and can bill for services to patients.

Psychiatrists and neurologists both have MEDICAL DEGREES, but they have specialized education that ONLY pertains to mental health disorders, and how the neurons, work in the brain and they understand how medicines work with neurology and makeup of chemicals in the brain, such as serotonin, how the brain chemicals do factor and play a role in mental health disorders. NOW the difference between psychiatrist and Neurologist is that neurologists are more trained into neuropathy- they better manage pain. Can assist into mental health as well as things like having whiplash- a neuralgia disorder, and often do assist Traumatic Brain Injured patients more. They have more knowledge into the nerves of a patient.

They are specialists---- they understand way more psychology and the brain---plus meds and proper diagnostics for mental healths more any regular general drs, or other specialized physicians, nurses, and physician assistants. Although some do say that they provide therapy to their patients ---they are not trained for mental health talk therapy, nor are they trained in advanced assessments or screenings.

Insurance companies normally do not let regular physicians, MDS really prescribe the whole gammit of mental health meds, nor can they diagnose with more than depression disorder. INSURANCE DOES limit what they can prescribe regarding psychiatric medications, out to their patients. That is for a very good reason, because they truly are not the specialists, and should be referring their patients out to see psych professional instead of trying to treat themselves. Sometimes they often do have a normal PHQ for major depression disorder in their intakes, or assess teens for suicidal thoughts, but thats it, they mainly look out for depression and suicide.

They normally can prescribe patients simple antidepressants for depression and try to help with just that.

NURSE PRACTIONERS which that is whom I see now, they too have solely medical degrees and the ones in psych normally have specialization for psych in their backgrounds. Normally all psych professionals see you for initial intake 45minutes to an hour 1st time- then after that take about 15 minutes. They only talk about your functionality at home work school, and medications and if having side effects.


However a Licensed mental health clinical counselor, LMHC, Licensed Professional Counselor, LPC, Licensed Clinical Social Worker, LCSW, or a mental health professional, MHP can provide some semi advanced assessments, but normally do not because it is a lot of extra work, for no extra pay. They are not able to bill insurance for these assessments to happen, so a lot of time. Counselors only do these to ensure progresses made, or not, or they do them to understand history, or to ensure accurate diagnostics but solely do them for their own records and understanding. They dont normally provide the results to clients or provide a document analysis of their findings, like a psychologist would.

(PSYCHOLOGISTS- to a degree----) some of them are more on assessment taking services, others are a mix counseling, assessing, and research. Some are more on research and assessments only without providing counseling. It depends on the provider. Just double check when reading their profiles, and or call to confirm on what their sole focuses are.

LMHC, LPC, LMHP, LCSW typically see patients for 45 minutes, 53 minutes, and sometimes to 90 minutes depending on individiual, family, or couples issues needing to be addressed. They typically do not see their patients any less time than this, and are clinically trained to provide talk therapy- many methods of clinically peer reviewed and evidence based researched progressive talk therapy methods that are proven to provide patient relief and help improve their lives by helping clients identify the best ways to cope with stressors and help them manage best. Typically depending on the diagnosis therapist see patients anywhere with Major depression disorder from 8-16/20 visits for CBT therapies. Once alleiviated then they close therapy sessions and encourage clients to practice the skills learnt in sessions. They help per issue the patient presents as a problem.

A PSYCHOLOGIST- is someone whom is better equipped for advanced assessments, and they can be paid through your health insurance for providing them, which means they bill for this service to be provided. They are the experts at this. Most people get all the terms mixed up, it can be hard to understand so that is why I am clarifying. If you are concerned about co-occurring diagnostics there are advanced assessments for that, and psychologists have access to them, as well as can send them out for accurate results, and interpret them in a document and analysis. So if you wish to see a psychologist you can do this. However it is not a must to do. Psychologists often are researchers as well, as professionals for advanced testing, that is why so many are known to work for school boards because they use them to test kids in their schools for learning disabilities etc. They also can provide therapy, but again, not their sole function, so I do condone all going to each mental health provider, one for meds a psychiatrist or nurse practitioner, for testing a psychologist-or if someone is in need of having someone sign off on federal documents ---to apply for disability for mental health disorder----such as filling out the whodas, for disability. That would be the professional to see for that.

I hope this helps yall. Good luck on your mental wellness journeys.

Knitting20projects profile image

keep trying. I’m 50 & saw a psychiatrist for 20 years for MDD/GAD, & I didn’t even consider ADHD as a possibility until my now 12 year old son was diagnosed at age 4 & was so severe he had to start Ritalin at 4 y 9 m to avoid being expelled from daycare. I was a straight A student, no behavior issues ever in school, honors graduate from college, etc, & several professionals said I was “too academically successful” to have ADHD. Well, they never watched me procrastinate until I was motivated by major time pressure because I couldn’t manage my time. Etc. I could go on. It ultimately took me almost 7 years to get a diagnosis.

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