Getting an actual diagnosis - CHADD's Adult ADH...

CHADD's Adult ADHD Support

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Getting an actual diagnosis

18 Replies

How does one even go about getting an actual diagnosis? It seems everyone I speak to doesn’t “do that here”. My recent psychiatrist thinks I have ADHD, but they also don’t go into ADHD diagnosis at this specific place.

I have so many issues that could probably be lessened with treatment of this (suspected this for a long time, never taken care of as a kid) but no one seems to help. I don’t get it.

Maybe it’s just my area, idk. Maybe it’s harder for adults. I don’t get it.

Did anyone else have a hard time? What did you do to go about a diagnosis as an adult?

18 Replies

Ok, there is a lot of confusion here about "diagnosis."

The long and the short, there is no such thing. I mean yes, there are groups that will do extensive and expensive testing. But ... the next provider you go to may not take that "diagnosis" seriously at all. Diagnosis outside school is not like school. There is no official paper you carry around. A diagnosis is just one clinician's judgment. The next clinician is not bound by it at all.

Now, the way I read your note, you DID get diagnosed. The psychiatrist said they thought you had ADHD. That's a diagnosis to me. So why isn't he treating you?

in reply toGettingittogether

Odd, since it does interfere with your life, and there are meds you can take to help with it. I always heard, and read, that it is diagnosable.

The Psychiatrist said they don’t really treat it at the place I’m at. I’m going to assume they don’t prescribe controlled substances or stimulants.

Gettingittogether profile image
Gettingittogether in reply to

Yes, but in the real world, it's pretty much diagnosed the same way depression is diagnosed or anxiety is diagnosed ... through conversation with a provider. Some psychiatrists might give a questionnaire to fill out. I filled out a ten-item or so questionnaire that took 5 minutes ..

Now I did have a therapist who gave me a questionnaire that took probably 20 minutes to complete ...

So focus on treatment. Yes, you need to convince a provider you have ADHD. But there is no widely accepted test ... you can go online and see tests ... but again, no provider is required to accept those tests ....

So look for someone who treats ADHD and schedule an appointment. If the provider is willing to treat you then you have been diagnosed.

addacademic profile image
addacademic in reply to

A quick follow up to my larger post now that I see this comment of my yours.

It's VERY possible you are seeing a psychiatrist who is nervous about controlled substances. This is very annoying for many of us who have ADHD. I have to remind myself to try to understand that they are under a lot of pressure to treat addiction not cause it. But ... It's becoming a real problem for the MANY people who have difficulties accessing adequate mental healthcare and need stimulant medications to function.

Aak him/her straight out ... "If you think I have ADHD but you don't treat that here, is there any reason you are not referring me to a clinic/doctor who can diagnose and treat ADHD?" If they have a reason to think it's not ADHD, they should then explain themselves. If they think IS, the referral is absolutely the right next step.

All MDs have training that encourages them to refer patients to specialists. If they are even moderately good at their job, they'll respond accordingly.

addacademic profile image
addacademic in reply toGettingittogether

Well, let's not mislead scarlett too much about flimsy diagnoses ... There's no "official paper that you carry around" for any medical diagnosis. Breast cancer or the measles doesn't come with an official stamp. Psychiatrists du, however, (if they are doing their job adequately despite pressure from insurance companies to shorten their appointments), take histories which include previous diagnoses and neuropsych testing. If a patient has previous diagnoses of ADHD from other doctors, that's taken seriously because it's considered a developmental disorder -a lasting condition unlike mental illnesses such as depression or anxiety disorders which tend to come and go.

The only difference between psychiatry and other medical specialties is that doing differential diagnoses can be tricky. This leads to a greater amount of second-guessing previous diagnoses, even their own - something that doesn't happen in branches of medicine where you can run bloodwork, di a sonogram or a radiograph, or cut someone open and have a look.

Gettingittogether profile image
Gettingittogether in reply toaddacademic

I don't think psychiatrist's diagnoses are flimsy at all. An experienced psychiatrist is a great listener and has a knowledge bank of human experiences and possible conditions and all of that in their heads as they practice.

And some do perform long evaluations ... Well, several of the top psychiatrists in my area require initial sessions of an hour or an hour and a half. They may give the patient questionnaires and they listen ... listen closely ... listen for certain symptoms ... even listen to screen out would-be drug addicts.

I was directing the OP to schedule a session with a treating psychiatrist and to go from there ... getting them away from the idea that there is some official certification "diagnosis" out there that all providers automatically accept.

addacademic profile image
addacademic in reply toGettingittogether

Fair enough. Sorry if I misread the subtext of your original comment. Mea culpa!

smendrick profile image
smendrick

I understand the difficulty. I am much older than you (I'm 75). I read as much as possible about ADHD and then reflected on my behaviors as compared to the readings. I realized that starting at 3 years old my ADHD patterns interfered with much of my daily life, and that persists today. I also recognized that I was able to compensate by adopting certain routines and though processes to control some of my lack of executive functioning. I was able to have a decent career as a result. Drugs probably would have helped in my earlier years yet I never got diagnosed. When I was young I was told "to try harder." In my older years, recognizing my ADHD, I decided not to use drugs.

The best places where you might find help are CHADD (sponsor of this site) and ADDitude . ADDitude has several great webinars about adults and part of the information is where to find help. additudemag.com/adhd-expert.... I found the webinars and readings by William Dodson, David Goodman, and Benjamin Yerys to be most helpful.

Best to you and you are alone so please keep reaching out.

Totoro101 profile image
Totoro101

Contact Dr Dodini. He will help even if you don’t live in Virginia. dodini.com/

addacademic profile image
addacademic

Every psychiatrist is qualified to give an ADHD diagnosis. Psychiatrists are also trained to be very careful with any psychiatric diagnosis, which might be why yours is still saying you "probably" have ADHD. The issue for them is that most mental health diagnoses have overlapping symptoms with other possible diagnoses and psychiatry still doesn't have the objective lab or medical imaging tests that other branches of medicine have. So ... They say things like "probably" fairly often.

But none of that helps you understand how to move forward, right? It's frustrating. Most of us diagnosed as adults have been in your shoes.

There are a couple of things you can do.

1. Accept that psychiatry is messy. What matters is if you are getting help towards functioning better and feeling better. This can be way harder than it sounds. But it's important.

2. Have they prescribed you something? Is it helping, hurting or a bit of both? If nothing is prescribed, ask your psychiatrist to explain their thought process. They could be trying to eliminate another possible diagnosis first - perhaps one that would respond very badly to ADHD meds.

3. Are they trying psychotherapy? Is it helping or not yet helping? If you aren't in psychotherapy, maybe start and ask your psychiatrist to coordinate care for better diagnosis and treatment outcomes. That's important.

4. Ask for a referral to a neuropsychologist for ADHD screening and testing. But be ready for 3+ hours of tests. (Mine took six hours but i was a complicated case.). This is the closest thing modern psychiatry has to lab tests. It's not perfect but if your psychiatrist has already covered the ground of tracing the history of your symptoms back through childhood enough to say that you "probably" have ADHD, this could be the next step.

If you are in the USA, there could be other motivations for delays in any of this having to do with making sure your medical insurance will cover each of these steps being taken in a particular order. In other nations, there could be rules governing when patients are referred to neuropsych. (It's expensive.)

in reply toaddacademic

Thank you. I definitely understand that psychiatry isn’t always on point and can be messy. I’ve seen multiple ones throughout my life. Some didn’t seem to know what they were doing, and threw multiple drugs for me to try. I mean, I understand why they did. The brain is a complicated organ.

I’m doing a treatment program right now, which is basically an outpatient thing. The psychiatrist there said she suspects ADHD, but they don’t treat it at that specific place. I didn’t ask why, as this is more focused on my OCD. I do believe rhe ADHD is related to my OCD.

She did put me on a medication, but it’s just a generic anti depressant.

I might look into a neuropsychologist.

addacademic profile image
addacademic in reply to

i find it disappointing that any psychiatrist wpuld tell a patient that they do not treat ADHD. It is their own area of expertise. As if it isn't difficult enough to get adéquate mental healthcare!

OCD is a real bitch to deal with. I don't want to speculate too much about what he/she might be trying to do but maybe they think your OCD symptoms are interfering with your functioning more. I have also heard that many psychiatrists want to clear anxiety and mood disorder symptoms first before confirming a suspected ADHD diagnosis. In fact, I think my first psychiatrist was doing this for me. He tried me on bupropion for depression. But that drug acts in norepinephrine and dopamine which are also "low" in ADHD. I suspect he already suspected ADHD all those years ago.

I really hope you get the answers and solutions you need - and ask for them directly if necessary. You deserve adequate care.

in reply toaddacademic

Thanks, I hope so too

stevedomer123 profile image
stevedomer123

its weird that your psychiatrist only thinks you should be able to get a proper diagnosis off him

Choco-Joy profile image
Choco-Joy

I am new to this site as of today. My Primary Care doctor gave me the assessment in ADHD 2.0 after I had a bad UTI day after colonoscopy that required pelvic PT (yes, it happens), so with no more coffee (sensitive to acid), my focus was noticeably a struggle and I could not blame anxiety or depression because I felt ok otherwise. I was already being prescribed Buspar for anxiety and that was stable. She diagnosed mild to moderate ADHD and put me on Atomoxetine and I have experienced some positive effects (regulation of focus, self-awareness, able to get rid of old useless papers, not over eating to deal with stress). Work is getting really difficult, so I am realizing I must do more than medication and why I joined group to learn. I think she prescribed Atomoxetine/Strattera because as this is not a stimulant (controlled substance), she did not need to refer. Plus maybe she thought a stimulant would aggravate my anxiety or bladder, not sure. She also knows me well now as I have seen her for over 20 years. And she is about my age, 52, so has had recent training at prime of her career. Have you tried reaching out to your primary care doctor for help and possible referrals? Not sure the Atomoxetine would help you, but it might be worth a try. I hope you get the help you need soon.

Toofers profile image
Toofers in reply toChoco-Joy

Those positive effects from Atomoxetine sound great. Do you find it affects your sleep at all? I know you said it isn't a stimulant.. Thanks.

Toofers profile image
Toofers

Diagnosis is so frustrating, I'm in the same boat. I've been on a waiting list for a year to get a complete neuropsych assessment at the only place I can find covered by my insurance to get 'an official diagnosis'.

Outside of that, I've considered using ADHDonline.com for $150 bucks for 'the piece of paper'. A psychiatrist referred me there in order for them to be able to just give me pills.

Living one's best life with ADHD, or any neuro/psych divergence, seems to come down to management. With meds being a part of that management. So I'm gunning for the thorough neuropsych assessment to learn better the ins and outs of how my brains works, while continuing to read and learn from others all I can about their experiences and how ADHD works. I just read and highly recommend the book Scattered by Gabor Mate for this, by the way.

Best of luck! To us all..

60plusNY profile image
60plusNY

Yes, Im having trouble as well. Reources are slim to none in my area. I know you can go online and be tested for ADHD but only if you will commit to taking medication with limited access to follow up and no counseling to go with it. Or you can look for a psych doc, like you said, who will give you the battery of expensive tests . I have high blood pressure, so the usual medication is not an option. CHADD has add group listings, but again, nothing in my area. The only "support" Im finding is online instagragm acounts, but theyre mainly informational, or coaching based, again for mucho deniro.

What I keep coming back to is to choose a local therapist who specializes in adhd for for counseling support to at least help with the mental health issues that go along with adhd. I havent found any online that do that, and the online therapy sites want a payment commitment of at least $260-$300 a month.

I really would like to have a free local support groupwhere you could drop in, share your experiences, listen to others, and feel heard, understood and supported.

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