Hey, I'm 38 years old and when I went back to college a couple years ago I noticed it was hard to pay attention and after looking back i'm fairly sure I have adhd. It affects my work and my personal life especially my relationships. I've hesitated to go get diagnosed at this age. I have a counselor I see but I'm not sure if its best to go to her or try to see a specialist. I've looked and there dont seem to be any local places(there are a few about an hour from me).
I know if I go to a doctor I can take the test they have and get on meds but I'd really like a more in depth test with more info. What do yall suggest?
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JimRyan
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How come you want a more indepth test? If you have a watch you always know the time; if you have two watches you're never sure. Digging down into fine granular detail can lead to missing the forrest for the trees.
Is it because everyone's symptoms are different, and you're hoping that more information will lead to a treatment regime that's tailored to you? Because I guarantee that a more finely detailed test at the diagnosis stage won't do that. Doctors fixate on diagnosis as a yes/no question, and don't think about treatment until after that question is answered.
Everyone's symptoms are different, but there are certain broad-stroke things that we all experience. We all experience inattentiveness, because that's one of the defining aspects of ADHD. But not all of us experience difficulty reading books, for instance. So a broad-stroke test that asks 'are you frequently inattentive', and a fine detail test that asks 'do you have difficulty concentrating on books' will have different results. And it's the latter that's less accurate, because the former is asking about a defining aspect of ADHD, the latter is asking about a personal experience.
One of the disappointing things about being diagnosed is finding out the amount of work you have to do to find a treatment regime that works for you. And a more detailed diagnosis isn't a shortcut to a personalized treatment regime
You mention inattentiveness as the defining quality of ADHD, but by doing so, it seems to exclude approximately 25% of people with an ADHD diagnosis... Those with only the Hyperactive-Impulsive presentation.(Approximately 25% have the Inattentive presentation, and approximately 50% have the Combined presentation.)
I agree that sometimes care providers will focus too much on a broad brush or fine grain approach. However, there isn't a consensus and clearly defined diagnostic process for ADHD. There are clear diagnostic criteria, but many means of assessing that criteria.
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I was diagnosed by a certified mental health counselor via observation, assessment of my self-reported experiences, and one of the standard written assessment tests. My doctor (a general practitioner) confirmed that diagnosis via a computer-based assessment similar to the printed one the counselor had used. My doctor used the same assessment multiple times, to assess how well my medication was working.
(My doctor made a referral for me to a psychiatrist, for a full analysis. Due to the increase in requests for referrals to the psychiatrist during the first year of the COVID-19 pandemic, I was on a wait list for six months. Even if I'd gotten an appointment, it would have been at least another 3 months out. I ended up changing health plans, and thus changing doctor's.)
I'm simply guessing based on what i've looked into for symptoms that its Inattentive but until I get a dianosis I wont know for sure. Thank you for sharing how you went about getting diagnosed as i'm a bit overwhelmed on how to do so. I just know i've got to do something albeit I wish i'd started looking into this years ago and also wonder why my parents never got me tested as a kid.
I do not want to see a Dr and get a quick test and him just prescribe meds and be done with it plus my Dr does not seem to be pro medicine and I believe that is the best next step for me. I have been taking fish oil, d3, magnesium and they do help but like I said I need more help. So it sounds like you are simply saying that the key right now is to get a test done, get diagnosed, then go from there?
You make the assumption that i'm looking for a shortcut, although that is not why I'm wanting a more detailed diagnosis. Again, i do not want to just get prescribed meds based on a short test, because as you said everyones symptoms are different and the different types of adhd have different meds that work better.
As another commentor said, there's no such thing as a quick test. Depending on what standard your doctor follows, there will probably be no test at all, rather a subjective assessment made following an interview.
Now, if you feel that that interview is too broad or impersonal, that's okay. It's just the diagnosis, just a yes/no question. Finding the right meds is a journey for all of us regardless of the diagnostic test or criteria used. Personal tailored care and treatment comes after the diagnosis, not from it.
I get it. You don't want them to diagnose you, hand over the meds, and be done with it. But there's no test, indepth or otherwise, that can determine what kind of treatment/meds you need. Determining that will involve finding the right doctor, then a lot of trial and error.
Diagnoses can be broad and vague, but they're only the beginning. And unfortunately a more detailed diagnosis (if such a thing exists) won't help that. You need to manage your expectations.
I agree with MTA, and I'll add something. In my ADHD, I did things like this. Want a fine-tuned diagnosis or treatment when I wasn't getting the basics. That's getting lost in the details.
The fact is if you have ADHD and you've never been treated, you probably don't have the full language to describe your symptoms at a granular level. Starting treatment is part of the process of paying attention to your brain and how it functions. And over time you learn the language of your own variation of the condition. Getting granular information will overwhelm you and the science isn't at the point where that can help you anyway.
So let's do some direct steps here, I suggest to you. Google, find a psychiatrist that treats ADHD and go. There is no definitive test. That's a common misconception. Just show up at the psychiatrist's office and tell them your suspicion. Show up, share your observations (harder than it might seem) and you and the provider over time will come to know your symptoms better. You cannot skip from 0 to 60. You have to go in steps.
Most likely you also have depression and/or anxiety as well. So that should come up, but it might take time to notice that if you're so used to anxiety or depression.
And think about therapy as well. People with ADHD can benefit hugely from therapy.
p.s.
Psychiatrists don't agree on how to diagnose ADHD, so this is not like school. There is no test that definitely has credibility with all providers. There is massive disagreement in the field. The test is the psychiatrist asking you questions about your life. That's the way the condition is diagnosed. Not all that different from the way a psychiatrist would diagnose anxiety or depression--by talking to you and hearing your symptoms.
Ok I understand now I was trying to rush when I cant.
I have called a psychiatrist in my town and they require a referral for new patients. I also called my counselor to see what she suggest and theres a Dr. who treats ADHD but is not seeing new patients currently. The other place I called doesnt answer the phone(called 2 times) so I left a voice message.
I'm already pretty frustrated with the barriers to get started. I'm considering the next town thats an hour away. Do I need to go directly to a pshychiatrist or could I go through my primary dr?
Your counselor should be able to advise you on this, as well, a primary care physician. Did you finish school? Can you talk more about how you feel impaired? Inattention can be a symptom of other disorders and problems. Do you also feel impaired in your relationships, and at work? Was it like this when you where a kid, going through kindergarten through 12th grade? If it's pervasive and in other areas of your life other than school than you have some level of impairment.. An accurate and thorough diagnosis is important because there are many quick professionals out there who will give you an adhd diagnosis when you may not have the level of impairment required for it to be considered a disorder.
A diagnosis would give you a direction of treatment based on empirical, qualified methods. But you can start working on your symptoms right now! I recommend researching the work of Russel Barkley and Ned Hallowell - just google them and start researching adhd and how to fix, manage it, live with it.
And be super gentle with yourself.
So many people think there is something wrong with themselves which is a problem in of itself.. So go slow and be gentle with yourself.
And right now, in America at least, primary care physicians are the key to either referrals and or diagnoses.
Ok I will get with my counselor and go from there based on what she advises.
Yes I finished school with a 3.4 GPA which was pretty awesome compared to first college degree I got where it was closer to 2. At work it definately affects me in the way of motivation if its something boring vs something I love doing. I tend to procrastinate on things and it gives me extra push to finish because of the stress. It also affects relationships as I have trouble listening at times, interupting others(I really hate this but I get so excited and dont want to forget what i'm thinking) and other things too. I am not hyperactive but I will say theres anxiety along with it.
You mentioned the exact reasons I want a thourough diagnosis, I think there was some misunderstanding in my initial post because I dont want a Dr to just have me fill out a very basic test prescribe me something and thats it. Meds help greatly but the type that works depends on what type you have.
I have researched a ton and found Dr Barkleys work. I started taking Vitamin D3, fish oil, and magnesium and they do help some but I feel like I need to try something more.
You weren't rambling at all I'm thankful for all your great info
A couple of years before my diagnosis, I finally got into a habit of taking vitamins. It was because my younger son developed stomach pains, which turned out to be due to a vitamin D deficiency (other symptoms included low energy levels (lethargy), pale complexion, and dark circles under his eyes. Looking around the family, I and all three of my biological children had all those symptoms, except only the one son had stomach pains.
So, we all started on multivitamins, with extra vitamin D.
By a year later, I also started taking Omega-3, ginseng and ginkgo. All those supplements together helped my attention and working memory to improve, only a little bit, but it was noticeable.
Then, I went to a mental health counselor, and was diagnosed with ADHD and anxiety. My doctor confirmed both diagnoses, started me on meds for the anxiety, and then on Adderall XR.
The Adderall did much more for me than my vitamins and supplements (about 5 times the effect), but it still wasn't enough. A higher dose of Adderall was no more beneficial, and started the side effect of tachycardia.
I then started on atomoxetine, and it's twice as effective as Adderall was, ten times as effective as the vitamin and supplement combo. (I've since eliminated the ginseng and ginkgo, but got turned down from a blood drive because of low iron, so I added an iron supplement.)
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I was only able to form a vitamin habit because I had to take care of my kids' needs.
It was then easy to form a medicine habit because I had formed the vitamin habit. (Ironically, I was taking my meds regularly, but was forgetting to take my vitamins, until I got a weekly medicine dispenser last week. Now, it's easy to remember everything I need to take.)
Yeah Im kinda where i've tried the alternatives and they do help some but it just seems like I need something that helps more. I'm currently trying to find a psychiatrist and thats proving to be difficult, the only one i've actually gotten in touch with needs a referral.
The way you get really specific treatment is to understand that treatment is a process. You're worried about generic, off-the-shelf treatment, it seems. That takes time. Time for you to understand your experience and time to find the language and time to trial and error the meds.
You're missing something. So you take a quick test and start with medication X. Well your job is to observe and report on how your life goes on medication X. And then you report that to the provider at one of the next visits. The provider will take in that information and consider adjustments. The normal process is to change meds and change doses multiple times in order to get an optimal medication regimen for you.
So you're jumping way ahead and missing the key point. The updating of your symptoms, the reporting of your symptoms, the adjustments by the provider--that IS the treatment. This is not a condition where you take one medication and just stay on it. So you will get granular over time.
But you have to start somewhere. And starting almost anywhere, even with a quick diagnosis, gets you going. THEN you refine. I'm in physical therapy for my knee right now. My PT gives me certain exercises and an exercise routine. I try it out and report back. She takes in what I say and updates the routine. Sometimes the update is just doing more of what I was doing (if my strength has gotten better). Or just tweak certain exercises.
Right now, the tests don't neatly map onto the right medication. The science isn't that advanced. And you need to be able to find the language for your own symptoms. You could take 20 different in-depth tests and you still will have to go through the trial-and-error of specific medications.
In general will I have to get a referral to see any pschiatrist or does that vary on them? It would be great if I could just call and make an appointment directly with them but is that a thing?
Depends on your health plan. Some health insurance programs require you to get a referral to specialists of all kinds, including cardiologists, orthopedic doctors and so on. These are POS (Point of Service) plans. Is that the kind of plan you have? On the other hand PPO plans allow you to just schedule with specialists directly.
Check your health insurance card ... you should see POS or PPO. What kind do you have? You can always pay out of your own pocket to a specialist.
Now, here's the cold truth: in my area and many areas, it's really hard to find a psychiatrist who takes a $25 copay, who takes insurance payments. A few years ago, I could only who took my insurance, who was taking new patients. Most psychiatrists in my area require you to pay up front and you then get reimbursed (at a very low rate) for your payments. In other words, they "don't take insurance."
So I called around and finally got ahold of someone who directed me to a clinic that test for adhd along with other things. I called them and made an appointment next week for an initial visit and interview. After the first visit the counselor will order a test based and then we will go over that test during the next appointment. All appointments can be through video which is convenient being that the office is an hour away. The counselor then gets with the psychologist to diagnose and can prescribe medication if needed.
I plan to use the tele appointments since to drive there would basically require a day off of work.
So I was diagnosed with Inattentive ADHD a few days ago and just got done with the consultation to try medicine. I will be starting out on generic Concerta 18mg and see and if needed take 2.
I'm relieved to finally have a diagnosis but frustrated that none of my teachers ever suggested I get tested. I wish i'd gone years ago. What do you guys suggest in this first trial?
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