I finally had my appointment with a psychiatrist who specializes in adult ADD today, after trying for about five months to find someone in the area who has had any experience with this (I would have thought it would be easier in Boston!). The entire appointment took fifteen minutes. He basically asked me my basic medical history, flipped through the questionnaire he had me fill out before the appointment, and then started writing out prescriptions - for depression, anxiety, and ADD. After asking if I had any questions, I was dismissed. And he basically told me that after taking these medications for a year, I would be all better. Is that even possible?

Now I'm not sure what to do... I was extremely put off by his attitude, but I've had such a hard time finding someone, who my health insurance will accept, that the idea of starting all over again is really depressing. And I'm glad to have gotten prescriptions... but at the same time I don't particularly like going to a doctor that thinks ADD is something that needs to be cured.

Has anyone else had an experience like this, being diagnosed so quickly? How did you deal with it? I don't know if I should try to see his partner instead, and hope she'll be less abrupt or if I should just keep going to him for the monthly medication checks and get a recommendation for a therapist. I do think I need to see a therapist too, if only because of unresolved anger that no one noticed the depression and ADD for the first 29 years of my life. (actually I"m still the only one who's noticed it!)

Oh, another comment he made that bothered me was to tell me that all of what I'm going through is hereditary and it doesn't skip a generation and there's a fifty percent chance that any kids I have will get it... as if to warn me that I shouldn't have children. Maybe I'm being too sensitive, but that was the impression I got.

Anyway, sorry for the rambling post, but I needed to vent a bit and I would really appreciate any responses...

gosh that stinks
I am in Illinois
what i have expirenced at work is that inital appointmets are 30 minutes or longer and follow up never last longer than 15 (except if you request screenings )
IE TD (tarda Dyesknsia( i know i spelled that word wrong) or an annual Review
This pattern has followed into my personal life as well
Suggestions: is he in a practice? ...if you did not relate to him/her mabey your insurance will cover a second opion from someone in the same office...
good luck and hope it works out

found the perfect ADD quote last week, but now I can't remember where I found it. :( Maybe I'll come across it again someday



if this is the actual quote that is very funny

If it not the actual quote it should be it is perfect

That particular kind of visit is typical of psychiatrists. He did a diagnosis and then prescribed medicine for it. The depression and anxiety bit is a little odd, but you must have in that questionnaire demonstrated it somehow...was it a DSM-IV test he gave you to take? That would allow him to make a diagnosis that quickly, yes...

As far as "curing" ADD, it's not possible, and I'm certain he knows that. Why he would say that, I don't know, but any psychiatrist knows better than that. He may have been saying it to let you know it would be a longterm practice, or as part of his own agenda...

But it sounds as if you are not pleased with his services. He is a psychiatrist, so he is only going to write scripts; that's pretty much his best tool. If you want more counseling, you need to find a counselor or psychologist: the psychiatrist won't do that.

My shrink only took 15 min also

asked me some questions

put my answers into the computer

the computer spit back that there is a high probabillity that I have "type (I forget) ADD"

He asked me about riddlin

I told him I tried it but it wound me up too much

He gave me e script for Dexadrine which was 1 - 5mg in the morning and 1 -5 mg in the afternoon.

As he handed me the prescription, He looked me straight in the eye, and said," I can't tell you this will work for you , you have to find that out for yourself. Try it and adjust the dose according to what feels good for you. Come back and see me again if you feel you need to."

I respect him for that as I have never been back in 2 years and I know what works for me and what doesn't.

And will I be cured in 1 year

As Wayward Clam's signiture used to say

You can't fix me,

Cause I ain't broke

I don't know...I would be disappointed in that too. My first appt is in dec. and is one hour long...I have already been told this. I am relieved that it will take that long as i'm hoping for the most accurate diagnosis.

i did about 8 hours of tests over a couple of visits.. ADD hadnt crossed my parents or my mind at the time. it was good to finally have an answer tho!

Howdy. First post here; been lurking for a week or two, but just registered today.

I was diagnosed about 3 years ago, in a 15 minute session, but it was very different from yours, and I don't think I'd have liked your's any better than you did!
I was taking a medical exam to get a commercial driver's license in Texas, and when the examiner found out I took Prozac he was worried about whether I was mentally/emotionally stable enough to drive a truck (ie road rage). So, I went to a psychiatrist for a evaluation. (I knew I was OK to drive, but just wanted the proof for the doctor, but, at the same time, I was open minded enough to be aware that if I wasn't fit to drive, then I probably wouldn't know it....)
Anyway, I filled out a questionaire before the intervien, and the psych glanced through it when we met. The psych first asked me some very general questions about myself; then he asked me what I thought were some really strange questions: he asked me to to multiply some 2-digit numbers in my head and spell some fairly uncommon and difficult words; next he asked me to spell them backwards; then he asked me if I knew what the letters ADHD stood for, and I said "something like attention deficit hyperactivity disorder", thinking that question was still part of the test. :o
Then he asked if I'd ever been diagnosed with it, and when I said "no" he said he thought I had it. Knowing I took Prozac, he gave some samples of another SSRI to try and a slip for the doctor saying I was fine to drive a commercial vehicle.
I left his office with a funny little thought in the back of my mind going "Its ADHD--that's what's wrong with you". It was actually a very, very comforting thought to me. I'd always known something was wrong, and had been variously diagnosed as bi-polar disorder, anxiety or clinical depression, but none of those ever really answered my questions as to what was wrong--too many symptoms left unexplained.
I went to the local library almost immediately and got and read several books on ADHD over the next month, and concluded that it was absolutely ADHD, and any other issues I had were just minor symptoms or side effects.

So, in answer to your post. Even if the Dr. made an accurate diagnosis, that does not mean that his "treatment" is what you really need, or that that is adequate care for what can be a very debilitating condition.

I went for psychological testing to find out what was "wrong" with me. This took several hours to complete. I'm glad I did it, too, because it also identified a LD.

It seems to me that it would take longer than 15 minutes just to take a thorough history, though. My initial visit with my psychiatrist was 50 minutes, most of which was the history. He was glad I had the psychological testing done, too.

I now see him every 2 or 3 months for a 15 min med check. At first, I felt like I was being hurried along, but now that I have a therapist in addition to a psychiatrist, I don't feel that way anymore.

Thanks everyone for your replies.

"is he in a practice? ...if you did not relate to him/her mabey your insurance will cover a second opion from someone in the same office..."

He is, so I think if I don't like the next meeting any better, I will try to see his partner...

"He did a diagnosis and then prescribed medicine for it. The depression and anxiety bit is a little odd, but you must have in that questionnaire demonstrated it somehow...was it a DSM-IV test he gave you to take?"

No, I don't think it was the DSM-IV test, though I've been given that one by a therapist before and it according to that I do have ADD. But I think what is putting me off is all the things I've read that say that that, and other questionnaires out there, is just a very rough guideline and a person really needs to be evaluated by a professional who's had experience with people with ADD. By that, I thought the evaluation would involve actually asking me about my history, such as my problems in school or in work, beyond taking a very brief medical history which I would assume was just to make sure there wasn't anything that would interfere with the medications he was planning on prescribing. Especially as I think the associated diagnoses of anxiety and depression are more due to a lifetime of being told I'm lazy and knowing that I'm not going to quite get most social situations.

"he asked me to to multiply some 2-digit numbers in my head and spell some fairly uncommon and difficult words; next he asked me to spell them backwards;"

I had the first therapist I saw ask me to do this too, but I didn't know it was typical for an ADD evaluation... did your doctor tell you what it was supposed to show? Was it to rule out learning disorders?

Thanks again for the replies... I am starting on the meds today. I guess I'll see how that goes and hope when I see the doctor the next time, in a little less than a month, he'll be able to recommend a good therapist too.

I think it's possible for an AD/HD expert to conclude that somebody may have AD/HD after after oly 15 minutes but that really isn't enough to give a proper diagnosis. He should have conducted a more thorough interview though. It also would have made sense to ruled out other conditions.

That's a huge red flag if he told you that after taking the meds for a year that you would be cured. He doesn't sound like somebody who knows enough about adult AD/HD. AD/HD is best treated through a mult-modal approach. In many cases medication is the backbone of treatment but it is very rarely if ever the only treatment.

I'm also from MA. I am from the North Shore but have been living on the South Shore in the past 2 years. I have been in the same situation as you trying to find somebody who treats adult AD/HD and also understands it.

Multiplying two digit numbers is used to test short-term memory. Oftentimes, people with ADHD will have some problem holding things in short-term memory, and will need to spend a bit more time as they get the problem situated in their head. This also tests to ensure that problem-solving processes work.

Similar tests for short-term memory include asking people to spell words backwards. Doing so requires holding the regular spelling in short term memory while reversing it mentally. For normal people, doing this with 4-5 letter words isn't so hard, and 7 letter words can get rough. Anything over 9 letters, it's virtually impossible. For people with ADHD, these numbers are normally the same. However, it may take more reinforcement or repetition mentally to get the word to "stick" in the first place, especially in distracting environments.

For the most part, though, these tests are used to rule out inattentiveness due to problems with short-term memory. If your memory is seriously impaired, you may be being inattentive just because you can't remember what's going on. They can be used either way- either to confirm ADHD or deny ADHD, by the same results. It really matters about context.

ADHD Diagnosis can be done several ways. We suggest an opinion given by someone with experience with ADHD simply because they would be able to spot it more effectively and rule out other causes easier. However, because there is no set rule, method, or test for evaluating ADHD, it can be done entirely with the DSM-IV. In theory, any medical practitioner could open a copy of the DSM-IV and ask you directly each criteria in yes-no question format, and if you said "yes" to enough of them, you could be diagnosed ADHD. So the questionnaire may be more than enough to get a legitimate diagnosis.

If you're taking stimulants for ADHD, and they work, then you can trust that his diagnosis probably stands.

Again, my major concern about your story is the anxiety and depression diagnosis... you normally diagnose those through a short discussion and face to face conversation with the person, as well as an analysis of past experiences in cases of "chronic" anxiety such as Social or Generalized Anxiety Disorders. A short questionnaire is perfectly fine for an ADHD diagnosis, and it's even good for a depression diagnosis, but an anxiety diagnosis is a little odd to come from that...oh well. SSRIs can't hurt, and they would definitely help if anxiety and depression are there, so might as well.

I trust the doctor's judgment. That he even had a test, and that he could make a diagnosis that quickly, actually stands as a testament to his practice. If he was a hack, he'd probably spend a lot more time with you, if only just to get more money. If he is that confident in his testing methods, I don't see why you should doubt him.

Also, if he had access to the therapists notes, he may have used those to aid his diagnosis...

But yeah, you can diagnose ADHD relatively easily. That's _why_ it's important to go to a doctor who has experience: you don't want to be diagnosed incorrectly, or have a doctor who doesn't believe in ADHD.

See where he goes with the medication, etc. Saying you'd be cured of ADHD after a year of medication is flat-out wrong, so either he doesn't understand ADHD (less likely) or he meant something else, such as your depression and anxiety would clear up (possible), or he was just letting you know that this is a long-term program, and not an instant fix (also possible).

If you're taking stimulants for ADHD, and they work, then you can trust that his diagnosis probably stands.

The effectivness of AD/HD medication should not be used a diagnostic tool. People who don't have AD/HD also see benefit from stimulant medication. AD/HD should be diagnosed through signs and symptoms.

This is stated in the diagnostic for AD/HD guidelines which has been written by ADDA (and maybe other organizations).

The effectivness of AD/HD medication should not be used a diagnostic tool. People who don't have AD/HD also see benefit from stimulant medication. AD/HD should be diagnosed through signs and symptoms.

This is stated in the diagnostic for AD/HD guidelines which has been written by ADDA (and maybe other organizations).

I know, however an ADHD diagnosis can be made more "concrete" by efficacy of medications. Stimulants have slightly different effects in people without ADHD, for instance they tend to cause increased activity, increased nervous energy and fidgets, and so further in people without ADHD, while they decrease those effects in people with it.

I didn't mean to imply that the diagnosis should be based on the drug efficacy, because that would be, as you said, very wrong. I meant more that if the medication works to relieve symptoms of ADHD, it is more likely that they haven't been prescribed incorrectly.

KMiller, you're giving this guy more of a benefit of the doubt than I would. :D The whole "you'll be cured in a year" thing was really what got me.

Of course, you're right about the old therapist's notes. When I first saw my psychiatrist, he didn't even (need to) make a diagnosis because I already had it. It could have been the same sort of thing.

Where I have to disagree is where you say all a trained medical professional has to do to make the diagnosis is read down the DSM criteria and ask questions in a yes/no format... The important part of the DSM criteria is this: " C. the individual must not suffer from another mental disorder that could explain the symptoms." There are some very difficult differential diagnoses to be made here... think of all the people on here who have been diagnosed with bipolar disorder who aren't really bipolar. Depression/anxiety and learning disorders can also cause a lot of the ADHD symptoms listed in the DSM IV.

There's some controversy about the DSM criteria themselves, because they seem to imply that for an individual having a mental disorder that causes one of the ADHD symptoms, that symptom is always considered completely a part of the "other" mental disorder. I.e. If one is inattentive and depressed, then the inattention effectively doesn't count toward ADD. I know that's a rather literal reading of the criteria, but some professionals do interpret it that way. Look for the criteria to change in the next DSM edition.

Note that I didn't say for a medical practitioner to make a _GOOD_ diagnosis, I just said a diagnosis. What I was saying was that basically any MD, PhD, EdD, MSEd, MSW, etc. etc. can officially diagnose someone with ADHD or any other mental disorder simply by going down the checklist on the DSM-IV, making a judgment call, and putting a signature on a piece of paper. I didn't say that that was a good thing, I just said that that was a thing...

Sorry about all the confusion I apparently caused this morning with my posts... I'm apparently not being very clear LOL

"he asked me to to multiply some 2-digit numbers in my head and spell some fairly uncommon and difficult words; next he asked me to spell them backwards;"

I had the first therapist I saw ask me to do this too, but I didn't know it was typical for an ADD evaluation... did your doctor tell you what it was supposed to show? Was it to rule out learning disorders?

At the time, I thought he wanted to see my reaction to being asked to do what's generally a difficult thing for most people, and whether I would get flustered or angry or nervous. It never occured to me that he might have been looking for learning/thinking disabilities.
What's funny is that if he'd asked me to subtract two numbers with a pencil and paper, I couldn't have done it. (I'd have had to do it in my head, and then write it down!)
He did say that when I came into the room, I was acting very "alert" and "inquisitive" and "intense" or similiar adjectives, and apparently my symptoms were so obvious to him, that he just needed to do a few precusory checks to verify his initial conclusions.

Also, by this point in my life, I had spent 6 months in an inpatient substance abuse program with 1 year of follow up counseling in 1986-88, and another 2 years in a group treatment program for other problems in 1998-99, and had been on medications for about 12 years, all of which helped me greatly. So, when he was diagnosing me, I was actually in pretty good shape.
Whereas you went to get help from a professional, and felt you didn't get it, I was not going to get help--I was going to verify that I was safe to drive a semi-truck.
Although the patient needs to tell the doctor where it hurts, and the doctor needs to be able to ask the patient where it hurts, and prescribe the remedy, if the patient isn't helped by this process, then I have to say that one of the two (or both) haven't done their part.
I knew something was wrong with me by the time I was 6 or 7 years old, but never could really put my finger on just what it was. Fortunately, the psych I went to did. (Although 5 doctors who had treated me over the previous 12 years didn't)

my diagnosis only took about fifteen minutes, but it took me thirty eight years to get that diagnosis. I wouldnt care if the psych took five seconds to diagnose me and write a script...the pills worked and for the first time in my life i feel well. The psychiatrist i see hardly says much at all, and when he does i have trouble understanding his accent but the pills work so i dont mind. All my life i have sat in doctors, psychologists and psychiatrists rooms listening to their talk and taking their pills to no avail and until this fellow came along nobody and nothing helped..so what i am saying is, i think it doesnt matter how long the consultation takes, it doesnt matter what the doctor says or how it is said...what matters is you and your health. If the medications this person has prescribed for you improve your well being then just be glad you finally found the right balance, for me it has been such a blessing and has totally changed my life...fifteen minutes changed my life from suicidal and sick to extremely happy and well, its quite amazing! good luck to you, i wish you the best!

1) as for ADHD psychs in Mass...they're ALL in Mass. Wender, Murphy, Hallowell (sp.?), Ratey...and a number other big names, with the exception of Amen who isn't in the mainstream at all. Problem is, they can charge a fortune; Murphy charges $600 for an initial 1 1/2 hour consult and $300 for each subsequent $45 min. consult; naturally, no insurance plans are accepted. Anyway, I know what you're feeling about having trouble finding a psych in Mass. Only thing is, the problem isn't that they aren't there, the problem is that they aren't on anyone's insurance plan.

Have you tried Mass. General? No one famous, but lots of up-and-coming's. You could see one of the famous names, but I'm doing that and the guy isn't that great up close and in person...and if you aren't thrilled you will be sweating every $100 bill you fork over.

2) My famous name psych. did diagnose me in 15 min. He said it was obvious just looking at me and the fact that I couldn't follow what he was saying or provide straight answers to his questions (I was having a worse episode that day). And this is a man who wrote a book outlining how to properly diagnose ADHD by interviewing parents, etc...but why go through all that when it was obvious?

3) As for "you'll see the results in 1 year..." that is scary. Very scary. Because, with stimulants, you see the results in 2 days or less. Within a week you'll know definitively whether it's working. The problem is that if you take a whole bunch of meds at once, it's hard to figure out what is doing what. With ADHD meds you frequntly have to experiment.

Bottom line: if you're not comfortable with the guy, get a new psych. If you want to find another psych., you could always try reading a leading book on ADHD...the odds are good its author is practicing in New England. Pity the poor people everywhere else in the world!

I think the thing that got to me was that he didn't do any sort of in person interview - just asked me basic medical stuff like if I was allergic to any medications, have I had any major illnesses, surgery, broken limbs, etc. and *very* basic (in my opinion) psych questions like do I ever feel anxious (of course!) or depresses (again, of course, who doesn't?) or thought of/tried to committ suicide (never been nearly that bad for me). Anyway, I think I'm repeating myself. Oh, I remember what a couple of people said that I wanted to comment on - it would have made me feel better if he had had notes from my previous therapist, but he didn't. He was coming into the meeting not knowing anything else about me beyond my name, gender, age, and the fact that I thought I had ADD.

But as symbol said, right now I'm glad for getting the meds, hopefully that will at least start the ball rolling. As Tara said, I know meds aren't the solution, there needs to be therapy/coaching/whatever works too. And he did say he'd recommend a counselor, which is fine, I never expected to get therapy from him.

blueyemass1979 - thanks for the tips and you're right, although a lot of the big names are near here, there's no way I could afford them. I did try to make an appointment at MGH, but they only accept people whose primary care doctors are affiliated with them, which mine is not. Hopefully finding a therapist will be a little easier, but I'm not holding my breath.

Thanks all!

As for MGH--my therapist had a very good recommendation when I was thinking of getting a psych. there: just switch your primary care physician to there! My therapist said that that was just a tactic to get more patients for MGH. They accept most insurance plans.

Best of luck...really, you don't have to settle for the first psychiatrist you see. I ditched my first psych. and now I will almost certainly ditch this one. A therapist is probably a better person to actually talk to. I have rarely heard of a psych. who had a decent bedside manner.

A therapist is probably a better person to actually talk to. I have rarely heard of a psych. who had a decent bedside manner.

A lot of that comes from their training. Psychiatrists don't recieve nearly as much training in psychotherapy. They are trained as the M.D.s of Psychology. When a psychologist or counselor is learning about circumventing avoidant behavior in patients apprehensive to treatment, a psychiatrist is learning the chemical effect of sedatives in patients with X disease.

Psychiatrists are trained to prescribe medicines for conditions. They are trained what kinds of pharmacotherapy work for what disorders and diseases. They are not extensively trained in psychotherapy, because that's not what they do.

Say you take a depressed patient to a psychotherapist, they will try to find the underlying reasons for depression, and work therapeutically to remove the depression. Take the same patient with the same depression to a psychiatrist, and they will evaluate the depression type and tendencies of the patient, then prescribe a medicine based on their knowledge of what medicines work in other patients with the same symptoms.

Psychiatrists and Psychologists do two very, very different things, and come from two very, very different schools of Psychiatric thinking. While they often work together, and sometimes overlap in practice, this does not mean they are interchangeable.

I imagine it could take every bit of a year to adjust to the medications, and life style changes one would need to maketo an individuals self esteem and confidence. If it has been shoved back way back like most adults diagnosed with add or adhd for the first time do.*(just mho) dont judge your doctor on what he might have considered a joke.

hows that for one run on sentence tee hee

could be i dunno> add

wow, thats pretty bad... i can understand your disappointment.
but, what i think i would do in this situation is...

i would ask myself seriously and be true to myself: do i think i have ADD? do i think i have depression? do i think i have anxiety? dont just go no on any, but try to research on the internet and especially listen to yourself, then answer. then, find out if the side effects of either medication are acceptable for you... and if they are, just start taking them as advised to you by the doctor.

or, does it really matter to you that you have the CORRECT diagnosis? if not, you may go the way mentioned above - try which medication helps you, correct diagnosis or not. its what matters in the end, anyway, isnt it - that you get the medication that helps you...?

...dont know... that'd just be my approach, i guess... i'd be glad if i could just go to a doctor and say 'hey i've read this and that on the internet, i think i may have the symptoms and could benefit from drug X, give me a two weeks trial on the drug so i can see if it helps, and if it doesnt, i will come back and try another one which i think may help'. just have the doctor telling you e.g. when you cannot take a drug because of e.g. your heart condition or something, so you dont take something that could harm you... then i'd just go through everything available and see what works best.

Chicky,

First, congrats on not having to jump through hoops to get treated, but that "you'll be okay in a year" is quite strange. Usually docs want to follow up with you on a month to month basis, especially in the beginning because it often takes a lot of tweaking and sometimes medicine changes to find something that works best with your unique physiology....and if he's a "ADD Specialist", he would do that.

Second, there's something else that kind of rings a bell with your story. When my ex-wife was sick and we stumbled through doctor after doctor trying to find the right one, she became very disheartened. She felt that no one understood what she was going through and was quite depressed about it.

When we finally found a doc whose wife and daughter suffered from the same condition, it was like divine intervention. Our first visit with him was about 10 minutes total. He had all the medical records in hand before the visit and was very familiar with her situation, mainly because he lived with it through his wife and daughter, so he knew what to do and he did it right away.

However, when we got home from the visit, she was very upset because of the brevity of the initial visit. I asked her why she was upset, because we FINALLY found someone who understood.

She explained to me that she was upset that she didn't get to tell him about all the suffering and frustration, that we finally found someone who was understanding, but she didn't get a chance to "let it all out"....all that frustration that was building up for years.

Maybe you're just a little upset because you thought that this person would take a more compassionate, understanding, and sensitive approach and confirm to you that you weren't "crazy" or "abnormal", which is something many of us need to hear after all those years of questioning our abilities and self-worth?

I think getting that confirmation is extremely important, but if a Doctor deals with this day in and day out, he/she may forget the "compassion" and the "It's okay...we know what you have and together we're going to work this out" aspect, which is oh-so important in our coming to grips with the condition.

Sorry...I'm rambling.....just had to share that point of view because it just came into my head as a possibility.

Good luck!

Psychiatrists are trained to prescribe medicines for conditions. They are trained what kinds of pharmacotherapy work for what disorders and diseases. They are not extensively trained in psychotherapy, because that's not what they do.

Say you take a depressed patient to a psychotherapist, they will try to find the underlying reasons for depression, and work therapeutically to remove the depression. Take the same patient with the same depression to a psychiatrist, and they will evaluate the depression type and tendencies of the patient, then prescribe a medicine based on their knowledge of what medicines work in other patients with the same symptoms.

Psychiatrists and Psychologists do two very, very different things, and come from two very, very different schools of Psychiatric thinking. While they often work together, and sometimes overlap in practice, this does not mean they are interchangeable.

I think that what you say here is increasingly true, but its far from universal, and I think its a somewhat unfortunate trend. Judging by what I read on these forums, I've been extremely fortunate in the doctors I've seen(M.D.s and PhD.s), as I consider most of them to have been quite good. When I was a kid, I saw a psychiatrist for my medication and a psychologist for therapy, which involved a lot of activity, including role playing and computer games. This therapy was very helpful and I have trouble imagining a psychiatrist doing it.

However, for quite a while now, I've seen a psychiatrist for both therapy and medication, and I personally find the integrated approach somewhat preferable. Psychiatrists do have training in psychotherapy, and I think the extent of it depends on what fellowships they do. Some are actually psychoanalysts. I think it really depends on the doctor whether they want to focus on psychotherapy or psychopharmacology or both. It seems like more and more they are moving away from therapy though.