Hey All,
I am a 24 year old male who recently flunked out of college. After skimming a magazine and reading an article about ADHD, I light bulb went off in my head. I am not looking for excuses, but when I learned about ADHD, I realized that alot of the problems in my life (not living up to potential, always late, hyper, hard to relax and concentrate, time blindness) were probably due to ADHD. I researched the disorder (read Driven To Distraction, alot of Russel Barkley lectures, this forum and alot of CHADD articles) and decided to go to a professional for a diagnosis.

I met with a psychiatrist who said he screens many adults a month for ADHD. He took a family history and went through a fairly long list of basic ADHD symptoms and other symptoms of every other disorder know to man. He asked very few questions that related to my life, such as "tell me about how your always late?" , or "why did you flunk out of school?" He just went down the checklist and after about 30 minutes said I qualified for further testing.

He gave me surveys to have my parents fill out and one of my close friends. I dont mind doing this, but the surveys were the basic DSM criteria used to screen children like "Does the person have problems sitting still?" I found the Questions posted in Driven To Distraction much more relevant to Adult Behavior and I don't feel comfortable giving my loved ones a questionare used to screen children.

Lastly, the further testing is a 4 to 6 hour battery of tests that costs $1500. I have no health insurance, so all the fees are out of pocket. I don't mind spending money for an accurate diagnosis, but everything I read said that psychological tests are not that accurate in diagnosing adults for ADHD. I would much rather pay the money for some more 1 on 1 interview time, since that is where I think the diagnosis is made for adults, in hearing about your life and giving them examples in how you deal with situations compared to my brother and sister or friends.

Any advice will be GREATLY appreciated!!

I am sure that is not the only person out there that can diagnose ADD. for 1500 they probably want brain scans or something..

I went to an educational specialist in Charlotte, NC and got my ADD confirmed. She did the surveys for family members, asked me a LOT of questions and went through my old report cards from school. I think it cost like 80 bucks per visit and she confirmed that I was ADD on the second visit.

Maybe you can tell that person that you dont have insurance and cant afford those extra tests. I would think that he/she would have enough info with those other things.

Call the psychiatric departments at the universities in your area. Chances are they do it on a sliding scale (you don't have to be a student at the university to get the deal).

I was just recently tested. With out the sliding scale it would have been $1500 but with it, it ended up only being $150. The only down fall is that there may be a waiting list. It took me 5 or 6 months until I actually saw someone. Good luck.

Well, I went for the 5-6 hours of psychological testing by a neuropsychologist to get diagnosed, and I have to say I thought it was pretty thorough. Fortunately, I had insurance, though. I do not know how much it would have cost me without. The main advantage of psychological testing is that it can rule a lot of things out and identify conditions other than ADD. My testing identified a learning disability, for example.

The psychology/psychiatry department at the local university/med school sounds like a good option to me. I definitely would get the testing done.

Interesting. I dont think most insurances pay for psyc testing anyway. My doc doesnt use it unless meds arnt working and there is a real handicap. No test is absolute, evenh brain scans. Id put finding a real add expert as #1. IMO this is the real quality way to get your diagnosis. Pscy testing sounds real fancy, but for ADD alone its really not vital.

That's just about what my dx cost....my insurance picked up about 60% leaving me with the remainder.
I did go through almost 2 monthes of testing.

Thanks for the replies, but I see that some people received a diagnosis in about 2 sessions for $200 and some took 2 months and $1500 worth of testing.

I know every case is different, but which scenario is more common for everybody reading this?

I don't want to spend $1500 if I don't have too. I will if thats the only option, but if some of you share your experiences with cheaper diagnosis optionts that would help me greatly.

I bought my add medication illegally for 6 years. The websites where I bought the ritalin closed down eventually. I guess there are people who abuse it. It pains me to think of all the money I spent. I finally went to a PCP and told her my symptoms and that I had been taking 20 mg. of ritalin for 6 years. I'm 40 years old and should have been diagnosed as a child. Your PCP should be able to help you while your in the midst of getting a diagnosis. - that is if you need medication to help in school. I went back to college and graduated with honors at the age of 35. I would never have been able to do it without the medication.

Psychological testing does not provide a diagnosis for ADHD. They are used to show where your strentgths and weaknesses are and can provide helpful information but are not necessary.

My doctor had me read "Driven to Distraction" and give examples of each of the criteria. I wrote a short narrative as well and gave him 5 type written pages. My doctor is a general practitioner, not a psychiatrist but he happens to be very knowledgeable regarding ADHD and other biological disorders. My doctor visit was $100 (only because he's not on my insurance plan) and an extra $50 for the EEG test (to make sure there are no problems with your heart--not necessary but was recommended more recently, at least for children).

I think too many doctors take advantage of their patients with what they are charging. Of course, it is not always easy to find a doctor who can or will diagnose ADHD in adults.

ADDMAgnet

Is there any chance you can get insurance? Any chance you could work at Starbucks? They offer insurance to part-time workers. Not sure about the benefits for mental health though.

There is no way I would pay $1500.00. You already know you have it. Don't you. Do you feel you need more validation or what?
If I were in your shoes I would simply go to my regular family doctor and tell them that you have already used medication and tell them how effective it was. My bet is that they will prescribe you your Ritalin unless they believe another medication would work even better for you. I get my medcine from my regular doctor, no problem.

I agree with Maurice.

I called a ADHD clinic a few days ago and they told me anywhere from $400 to $1100, depending on testing.

I called another psychiatry office and they wanted me to see a psychologist numerous times before finally being able to see the psychiatrist. The heck with all of that, I'm going to try my normal doctor first.

If I spent $1500 on a psychiatrist they'd probably diagnose me with anger issues because I'd be one p*ssed mofo after spending that much money.

Psychological testing can diagnose ADHD, it is different in adults, but a competent psychologist knows the right questions to ask adults and will be able to differentiate symptoms of ADHD with anxiety, bipolar or trauma... a lot of times anxiety symptoms can cause ADHD like symptoms but for different reasons, same with bipolar, and people often are not aware of their symptoms of anxiety or bipolar. unfortuanately the drugs for adhd can actually make the symptoms of bipolar and anxiety worse, so it is good to have an accurate diagnosis before starting medications. Ideally, psychological testing provides good informaiton, including information about how you learn the best and what symptoms are most impairing, and they should be able to link this to treatment options or strategies including ideas beyond medications. 1500 is probably the going norm for psych evals, it is outrageous, but it does take a fair amount of time to sum up all of the results and integrate it - if it is done right that is... Other options might be going to a university clinic that has a psych department - they likely have a sliding scale, or a flat charge of about 150$ or so depending on where you are at, or research docs in your area and see if there are any who work with adults with ADHD. I live in a small town, but I currently work with a doctor and a nurse practitioner who are wonderful for diagnosing and treating adults and they just charge for a regular doc visit, which is expensive but less than the alternative. One note, if you have adhd and you think you will want to take meds, you may just want to get insurance first anyway (regardless of whether it pays for the eval, which I think it will if you find a doctor who does evals who will put up with insurance companies) because if you get diagnosed before you get insurance, it becomes a preexisting condition and will not be covered by your new insurance policy. good luck

Testing is not the route to take in my opinion. A competent psychologist/psychiatrist/physician should be able to determine your diagnosis with in a visit or two. Shop around for a doctor. It took me almost 4 long, discouraging months until I found a psychiatrist who was competent and talked to me like a human being, instead of reading from the DSM everything I might "qualify" for. Another way to find some competent help is to search for any studies in your area, either medication trials or university studies on ADHD. If you call a few doctors in the phone book, ask them if they have experience in diagnosing and treating adults with ADHD. Remember, you are the consumer and many doctors today are not much different then a big box retail store competing for sales quotas and insurance kickbacks. If you don't think your current doctor is taking you seriously, treating your condition correctly or even competent then move on to the next. Good luck!

It took me almost 4 long, discouraging months until I found a psychiatrist who was competent and talked to me like a human being, instead of reading from the DSM everything I might "qualify" for.

That reminds of about 5 years ago when I went to the a psychiatrist about my anxiety/panic attacks. I took this loooong test and after all of that he ended up telling me that he thought I was a hypochondriac.

I felt like telling him "No sh*t? Isn't that part of anxiety?" :rolleyes:

That guy was totally useless.

That is a cheaper cost assessment.

Do the math of the years of suffering that the average Adult ADDer has.

I was not diagnosed until age 33, and look at all the misery of lost education (low executive function of ADD causing low marks despite high intelligence), lost wages, lost relationships (low self monitoring of ADD).

Maybe you can save up your TAX REFUNDS for several years and pay for it.

I think these assessment things ('know thyself') are worth every penny.

CBUS: usually the disability office at your college/univ will pay for assessment if you are low income/on student aid.

As a FAILING/underacheiving college student, you really need investigation because you need to know the root of your problem. This is why testing is important.

Dizfriz+ has posted quite a bit on this and I'd encourage all of you to please check those

out.

The best synopsis on how to assess for ADHD is on pages 8 & 9 of :

http://www.greatschools.net/pdfs/2200_7-barktran.pdf?

Look under "Appropriate Assessment "

tc

mctavish23

(Robert)

My doctor was treating me for depression because that's what I thought I had. I finally saw a therapist and he detected the ADD almost immediatly because I described what was going on...just said I was tired of never being able to get anything done. He asked questions from some test and (not being a psych) wanted me to ask my physician for adderall. Got straterra instead but had to stop taking it.

The point is there are numerous tests on line and a regular doctor or licensed counsellor should be able to recognize the symptoms and ask the right questions.
I saw an ARNP recommended by my doctor today and she also asked the right questions and prescribed dexetrine. Took one pill today and have been alert ever since.
You don't have to go to a full fledged psychiatrist to be diagnosed.

Similar situation for me - I'm in my 6th year of undergrad, and finally went to go get tested. So initially I asked a GP at the health centre at my uni, who referred me to the disability support services there. Then two appointments with the psychologist, then a $1000 assessment (75% of which would have been covered if I had had a student loan). Then back to the health centre with my report discussing the assessment results, then a referral to a psychiatrist. The only thing I had to pay for was the assessment (but I live in Canada, so it's probably a bit different).

The testing I underwent was the full Wechsler IQ testing, a bunch of tests to assess coordination and visual acuity, a memory and attention scale (which I did miserably on), a subset of a personality inventory test, and a few ADD-related tests. It took around 4 hours but I was told I might be there for 7.

Although testing is not perfect for ADD (and I actually took the Driven to Distraction book with me open to the adult ADD checklist with notes on how I fit the criteria, just in case), I found the tests I went through really helpful. The man administering the tests (it was 1:1) was trained to observe patients through the testing too, so he picked up on a lot of ADD symptoms not necessarily from the test results, but from watching me. There are also some IQ discrepancies that are characteristic of ADD - like a greater than 10 point difference between verbal performance and something else, I forget.

I also ended up with a report that identified my strengths and weaknesses. For example, my verbal recall is really good, but my visual recall, not so much. So that's definitely an area where I can adjust what I do for school preparation.

For me personally, it was worth it to pay for the assessment. I was wary at first, but now it's nice to have a diagnosis after so long, and to have something 'official' to show teachers, instead of trying to make up excuses why I forgot to complete an assignment or need more time.

I wish that were true.

Unfortunately,tests of any kind are inappropriate for the sole purpose of diagnosing

ADHD.

I do agree that Licensed Counselors "should" be able to recognize and diagnose ADHD.

However, the reality is that most clinicians, while well meaning & ethical, don't read and

keep up with the research on ADHD.

I can't comment on physicians, but I have my own reservations about "quick & dirty (

non-standardized) questionnaires,whether they be online or in an office setting.

tc

mctavish23

(Robert)

Thank you for posting this again. I saw it somewhere last week and read a bit and found it informative and then lost track of where I viewed it.

i remember 40 pages.

Infinity~


Dizfriz+ has posted quite a bit on this and I'd encourage all of you to please check those

out.

The best synopsis on how to assess for ADHD is on pages 8 & 9 of :

http://www.greatschools.net/pdfs/2200_7-barktran.pdf?

Look under "Appropriate Assessment "

tc

mctavish23

(Robert)

Psychologists's DO NOT get "kick backs" from any source.

I also don't know of any Psychiatrist's I've worked with in the past,including my late

father, or work with now, getting "kick backs" from anyone.

Psychiatrists are among the lowest paid of the medical specialities.

tc

mctavish23

(Robert)

Robert

I found this paragraph sorta plunked down like an after thought in Barkleys lecture on page18 :)


Okay, we’ve already talked about the psychiatric disorders that AD/HD predisposes to. I just want to show you that as they grow up there are several others that begin to enter the picture because they’re adult disorders. Those are the personality disorders—Antisocial Personality, Passive-Aggressive, Histrionic, and Borderline—and then, of course, substance use disorders, which is what SUD stands for. But the rest of these we’ve already dealt with.


And some of those disorders were , depression, angziety, OPD , Bi polar ( which cannot be co morbid with ADHD ,

What I'm wondering is . since it has not been common to diagnosis females with ADHD ( in childhood)

does it not make sense that these women who may have had ADHD as children ended up with the above diagnosises later in life. ( And women tend to be diagnosised with personality disorders more so then men from what I have heard)

wouldn't it make sence . That theses disorders would not get any better UNTILL the ADHD is discovered and treated. and even possibly some of the personality dissorders stand in as a misdiagnosis for ADHD.

Infinity~

And some of those disorders were , depression, angziety, OPD , Bi polar ( which cannot be co morbid with ADHD ,




justhere to correct the OPD .. which should be ODD. And I see where Bi polar can be comorbid with ADHD. just that the stimulants do not fair well with the mania .


well just did some googling on women ADHD and personality disorders . and adhd and bi polar .

Found soem intresting articals.


funny , I wonder though how they missed the comorbid WSD diagnosis or sometimes refered to as WHD


"Wounded Soul Disorder" or "Wounded Heart Disorder."....

Next!




my appologies if I'm off topic....

Infinity~

Robert

I found this paragraph sorta plunked down like an after thought in Barkleys lecture on page18 :)



And some of those disorders were , depression, angziety, OPD , Bi polar ( which cannot be co morbid with ADHD ,

What I'm wondering is . since it has not been common to diagnosis females with ADHD ( in childhood)

does it not make sense that these women who may have had ADHD as children ended up with the above diagnosises later in life. ( And women tend to be diagnosised with personality disorders more so then men from what I have heard)

wouldn't it make sence . That theses disorders would not get any better UNTILL the ADHD is discovered and treated. and even possibly some of the personality dissorders stand in as a misdiagnosis for ADHD.

Infinity~


A lot depends on the personality disorder you are talking about and who is doing the diagnosing. And unfortunately, they took the Passive-Aggressive Personality Disorder out of the last DSM--so it's no longer a PD.

More men are diagnosed with Anit-Social Personality Disorder and more women are diagnosed with Borderline Personality Disorder and Histrionic PD. There may be more men with Narcisstic Personality Disorder but not really sure. Studies have shown that men are more likely to be diagnosed ASPD and females with BPD even when they have the same symptoms!

The latest study on adults with ADHD found a significant portion had a comorbid personality disorder.

My husband was diagnosed with BPD and when the subject came up in talking to a therapist last year, she remarked that she didn't think men got BPD. I could introduce her to quite a few!

Studies have shown that men are more likely to be diagnosed ASPD and females with BPD even when they have the same symptoms!

The latest study on adults with ADHD found a significant portion had a comorbid personality disorder.



since ADHD is diagnoised in childhood it makes sence its not looked for in Adults who finally drag themselves in for help . so they are diagnoised with a personality disorder . so a personality disorder can be the ADHD child undiagnosised all grown up. but limited in social skills, depending on a few other factors like

being ingnored or a problem by peers, and other physical traumas or abuse .
so i supose if one was considerd to have a peronality disorder and later it was ruled out but they are still having problems that are characteristic of ADHD. like distracted , can't focus to name a few, Then maybe it just might be ADHD

Okay .. I think i may have an answer...

it's looking to me that its very possible a child could have ADHD and it just graduates into a pd if not caught/treated in childhood.

just shows how complex testing evaluations may need to be for the Adult. And I'm wondering how phychiatrists can make a diagnosis in 50 min.

(smooth how i tied this into the topic:cool:)

i think it would be difficult for an Adult with ADHD to be able to focus enough and stay on track well enough to even get to the needed questions of childhood patterns and especially if they have difficulty bringing back those days of long ago. takes some digging.



Thanks for letting me share from a consumer / patients point of veiw.

Infinity~

I am not that familiar with the cause of personality disorders, do they tend to be caused by neuro/chemical problems or are they more of an effect of trauma/stress/ or some other cognitive problem or external stimuli? Or maybe both?

When you say an ADHD kid might graduate into having PDs, do you see this as a reaction to so much negativity they get or as a new expression of other neurological problems?

Let me pose this question to you: Do you know what you're getting for $1500? You're not gaining anything by simply getting a diagnosis of 'ADHD'.

Personally, you'd be better off spending $1500 on a therapist that can help you identify your tendencies and work with you to help cope and control your symptoms. That's about 10-11 hours of therapy, and that's more likely to be covered by insurance than some "test". When I took a personality "test" while under therapy, I didn't get charged for it (but all of it wasn't for ADHD)...

I think psychologists are far more adept at psychotherapy than a psychiatrist, but that's my opinion...

I have no insurance either.

I went to my family doctor ( he's been our doctor for a couple of years but mostly has seen my kids) back in august. I had done a ton of research, found questionares online and answered them, had my husband ( who was also certian afer reading all of the stuff I'd found) fill them out as well. I even printed out a post that I made on this very site and took with me. My husband went with me and it cost me $55.

we were only there for couple of hours and he asked us both lots of questions , he read the post i made and said that he felt like I was right--that it was ADD and that I'd probably had it even as a child ( but Im 40 and we didnt even have a name for it back then).He said that he wouldn't diagnose me with ot of he didnt feel sure that this was wwhat was going on with me.

I went back today for my follow up app, another $55. ( I didnt go back sooner because I only taken the meds when I have to( tests, homework, or a tough class that I find impossible to follow), otherwise I dont take it so the pills lasted me for almost 2 months.

I had some problems with side effects from the generic ritalin so he changed my perscripion to generic adderall. he said call if there are any side effects that are bothering me. that he was gioing to start me really low on the dosage and gradually we'd raise it until its right.

he said that he knows I dont have insurence so he doesnt want to make me come in all the time but he wants to see me once a month until we find the right med and dosage, after that he wouldnt make me come for an office visit everytime i need a refill -just to call him when my perscription runs almost out--but that I have to call him if I have any concerns at all and if I need to see him I could of course make an app.

So there are some doctors who can help you for less than $1500. I read in several places that those fancy tests can't show any more that a questionarre asked to the ppl that know you the best can .

Testing may or may not be the right avenue...have to weigh many factors. I am a 37-year old male, with life-long anxiety and nagging thoughts that I've never had a particularly good memory. In spite of it all, I was a good student and successfully completed college, graduate school and a post-grad program. However, my study habits, particularly in undergrad, were **** poor. I would attempt to cram as much information into my lii' nugget the night before the exam and then exorcise all information, with minimal retention.

I recently took a thorough neuropsych battery of tests and truly wish I had explored something similar in college. The test was 7-hours long...ugh...and tested, among others: working memory, spatial acuity, IQ, quantitative/reading/reasoning abilities, etc. Anyhow, I'm really interested in improving my memory, so I think the neuropsych evaluation was important. I get the test results this Wednesday.

I think under the right conditions and with the right practitioner, the cost/benefit analysis is a no brainer...

Please take the time to look at any of the posts on Diagnosis by Dizfriz.

There a number of excellent evidence based posts;several of which are contained in

this thread.

As someone with ADHD who deos this very thing for a living, please check out what

actually works.

tc

mctavish23

(Robert)

he said that he knows I dont have insurence so he doesnt want to make me come in all the time but he wants to see me once a month until we find the right med and dosage, after that he wouldnt make me come for an office visit everytime i need a refill -just to call him when my perscription runs almost out--but that I have to call him if I have any concerns at all and if I need to see him I could of course make an app.

So there are some doctors who can help you for less than $1500. I read in several places that those fancy tests can't show any more that a questionarre asked to the ppl that know you the best can .


actually, that's the typical schedule even if you do have insurance. once a month visits, and call over the phone for prescription refills.

$60 is also average for a regular family physician prescribing the meds. A psychiatrist would charge anywhere from $90-$160 per 15 minute-to-hour session, and pretty much end up doing the same thing.

and that's what is so concerning about doctors and medications nowadays.
i work with kids, and wouldn't prescribe ANYTHING, even a diet change or more homework, without monitoring the person and the environment at least every three days.

which comes out to about twice a week.

unfortunately, the only time i ever saw a psychiatrist who wanted me to come in that often was when i was attending a really expensive private school (on scholarship). each student could have four free visits to the clinic a semester, but they made an exception for some students, who went in regularly.

because the psychologists and psychiatrist were getting paid oodles regardless of how many people they saw or how often, they were very good.

and they definitely wouldn't settle for prescribing mind-altering drugs and supervising only once a month.

i recommend educating yourself as much about ADHD, diet, exercise, and alternative careers/lifestyles as possible. and if you are the type of person for whom information gathering-processing is tedious and difficult, enlist someone who loves you to be the resource specialist!

actually, that's the typical schedule even if you do have insurance. once a month visits, and call over the phone for prescription refills.

$60 is also average for a regular family physician prescribing the meds. A psychiatrist would charge anywhere from $90-$160 per 15 minute-to-hour session, and pretty much end up doing the same thing.

and that's what is so concerning about doctors and medications nowadays.
i work with kids, and wouldn't prescribe ANYTHING, even a diet change or more homework, without monitoring the person and the environment at least every three days.

which comes out to about twice a week.

unfortunately, the only time i ever saw a psychiatrist who wanted me to come in that often was when i was attending a really expensive private school (on scholarship). each student could have four free visits to the clinic a semester, but they made an exception for some students, who went in regularly.

because the psychologists and psychiatrist were getting paid oodles regardless of how many people they saw or how often, they were very good.

and they definitely wouldn't settle for prescribing mind-altering drugs and supervising only once a month.

i recommend educating yourself as much about ADHD, diet, exercise, and alternative careers/lifestyles as possible. and if you are the type of person for whom information gathering-processing is tedious and difficult, enlist someone who loves you to be the resource specialist!

Stims are not a 'phone in' prescription. It is not unusual to see a psychiatrist once a month when seeing a psychologist weekly. They fulfill different functions. Many GPs refuse to prescribe ADHD meds, others have no issue doing so. There is no general rule there, it is case by case.

Second tier treatment- diet, exercise, others- will vary depending on the person overseeing those treatments. There are no hard and fast rules.

Being "very good" and being "paid oodles" are not necessarily synonymous.

tc

mctavish23

(Robert)