View Full Version : Was I cheated out of a proper diagnosis?


Chris21820
08-04-17, 11:25 AM
Back in 2014 I noticed my lack of attention and focus was actually becoming an issue. Upon doing some research it led me to looking up ADHD and basically it all seemed to fit how I am and how I was growing up. Minus the hyperactive part of it.
So I talked to my mom about it and she had me see a neurologist who literally within under a minute of meeting him asked if I had ever been told I might have an attention deficit disorder, and when I told him no, he said 'Okay, you don't have ADD." and moved on to asking me about the headaches I was getting (my mom told me to ask about that while I was there and then he latched onto that and said I couldn't focus because I had chronic migraines).

The headaches eventually went away, and 3 years later at 26 I was still having the same issues and was relating to most of the things I was reading about adhd and peoples experiences having it, so I scheduled an appointment with a psychiatrist a few months ago (apparently he's a busy man lol) and was finally able to go see him this week in hopes of a diagnosis.

He didn't ask me anything about why I might think I have adhd, or anything about my history in school or anything like that. He just handed me a piece of paper with about 9 questions on either side (one side was general stuff i guess and the other side was about hyperactivity). Each question was like a category with a few examples and you had to circle 0- none, 1 mild, 2 moderate, and 3 severe.
Most my answers on the one side were 2's and 3's and then they second side had a few that were in the 2's or 3's for like fidgeting and some restlessness.

So he looked at it and then told me he was going to prescribe me adderall and then to come back in a month to go over how I was with it I guess. But it just seemed really quick? Like most the time online people would say when they were diagnosed they took tests and stuff? I mean I'm not opposed to not having to take tests haha but has anyone been diagnosed that easily?

I asked him if it was possible it could be anything other than adhd (because I was curious if it could be anything else cause he seemed to come to the adhd conclusion pretty quickly) and he looked at me like I asked him the most absurd question he's ever heard and said that I answered mostly 2's and 3's so as long as I was being honest (I was) then there's no reason why it wouldn't be that. And that I didn't look depressed or seemed like I have anxiety (which I have neither of those) so it had to be that.

Basically, I wasn't disagreeing that I could have adhd. The pieces all fit in my opinion, I just didn't want to be a hypochondriac and diagnose myself from reading stuff on the internet. But I guess I just expected a more thorough questioning/testing kind of thing.

PoppnNSailinMan
08-04-17, 11:03 PM
Back in 2014 I noticed my lack of attention and focus was actually becoming an issue. Upon doing some research it led me to looking up ADHD and basically it all seemed to fit how I am and how I was growing up. Minus the hyperactive part of it.
So I talked to my mom about it and she had me see a neurologist who literally within under a minute of meeting him asked if I had ever been told I might have an attention deficit disorder, and when I told him no, he said 'Okay, you don't have ADD." and moved on to asking me about the headaches I was getting (my mom told me to ask about that while I was there and then he latched onto that and said I couldn't focus because I had chronic migraines).

The headaches eventually went away, and 3 years later at 26 I was still having the same issues and was relating to most of the things I was reading about adhd and peoples experiences having it, so I scheduled an appointment with a psychiatrist a few months ago (apparently he's a busy man lol) and was finally able to go see him this week in hopes of a diagnosis.

He didn't ask me anything about why I might think I have adhd, or anything about my history in school or anything like that. He just handed me a piece of paper with about 9 questions on either side (one side was general stuff i guess and the other side was about hyperactivity). Each question was like a category with a few examples and you had to circle 0- none, 1 mild, 2 moderate, and 3 severe.
Most my answers on the one side were 2's and 3's and then they second side had a few that were in the 2's or 3's for like fidgeting and some restlessness.

So he looked at it and then told me he was going to prescribe me adderall and then to come back in a month to go over how I was with it I guess. But it just seemed really quick? Like most the time online people would say when they were diagnosed they took tests and stuff? I mean I'm not opposed to not having to take tests haha but has anyone been diagnosed that easily?

I asked him if it was possible it could be anything other than adhd (because I was curious if it could be anything else cause he seemed to come to the adhd conclusion pretty quickly) and he looked at me like I asked him the most absurd question he's ever heard and said that I answered mostly 2's and 3's so as long as I was being honest (I was) then there's no reason why it wouldn't be that. And that I didn't look depressed or seemed like I have anxiety (which I have neither of those) so it had to be that.

Basically, I wasn't disagreeing that I could have adhd. The pieces all fit in my opinion, I just didn't want to be a hypochondriac and diagnose myself from reading stuff on the internet. But I guess I just expected a more thorough questioning/testing kind of thing.

As I posted recently in another thread, the majority of medical and mental health professionals, including psychiatrists, don't have all that much training in treating and diagnosing ADHD. Thomas Brown, one of the top ADHD specialists in the country, brings this up in his recent book, Outside the Box: Rethinking ADD/ADHD in Children and Adults - A Practical Guide(Arlington, VA: American Psychiatric Association Publishing, 2017) and he says on page xx:

Assumption #14: Most medical and mental health professionals are trained to diagnose and treat ADHD effectively. Facts: Most medical and mental health professionals, including psychologists, psychiatrists, and other physicians, have had very little or no professional training in assessment or treatment of ADHD, especially in adolescents and adults. Some have developed proficiency by getting extra training for ADHD, but currently, this is the exception, not the rule.

In their recent book, The ADHD Explosion: Myths, Medication, Money, and Today's Push for Performance (Oxford: Oxford University Press, 2014), two UC Berkeley professors, Stephen Hinshaw and Richard Scheffler, both talk about how inadequate many diagnoses for ADHD are (p. 40). Although they are speaking about diagnosing children, many of their observations about slipshod evaluations apply to the diagnosis of adults as well:

Enforcement of professional guidelines is not really possible and many older clinicians have little or no training in current assessment strategies. Moreover, insurance plans rarely cover intensive evaluations: thorough developmental histories, testing, school observations, and parent-child interactions. Rating scales aren't often used. The bottom line is that far too many youth are being diagnosed with ADHD on the basis of extremely cursory evaluations. A large percentage of children receiving stimulant medication do not, in fact, even have a viable diagnosis of ADHD. In sum, many people who deserve a diagnosis never get one because of inadequate evaluations; and too many others receive this label without justification. Improved professional training, team-based practice, and reimbursement of viable assessment strategies could prevent both overdiagnosis and underdiagnosis.

sarahsweets
08-05-17, 07:16 AM
Facts: Most medical and mental health professionals, including psychologists, psychiatrists, and other physicians, have had very little or no professional training in assessment or treatment of ADHD, especially in adolescents and adults. Some have developed proficiency by getting extra training for ADHD, but currently, this is the exception, not the rule.ervations about slipshod evaluations apply to the diagnosis of adults as well:

Enforcement of professional guidelines is not really possible and many older clinicians have little or no training in current assessment strategies. Moreover, insurance plans rarely cover intensive evaluations: thorough developmental histories, testing, school observations, and parent-child interactions. Rating scales aren't often used. The bottom line is that far too many youth are being diagnosed with ADHD on the basis of extremely cursory evaluations. A large percentage of children receiving stimulant medication do not, in fact, even have a viable diagnosis of ADHD. In sum, many people who deserve a diagnosis never get one because of inadequate evaluations; and too many others receive this label without justification. Improved professional training, team-based practice, and reimbursement of viable assessment strategies could prevent both overdiagnosis and underdiagnosis.



How are these considered facts? Most psychiatrists I know actually are required to attend a certain amount of lectures or conferences a year as part of some continuing education requirement, and they want to make sure they know all about new additions to the dsm. The ones I know that work with children especially are interested in the new science.

I think the author has some big b**ls for making these claims. Overdiagnosis seems to be the soup du jour lately when it comes to talking about overprescribing or criticizing "bad" parents that supposedly want to medicate their kids into zombies for convienence.
Underdiagnosis, especially in girls needs to be studied more than worrying about who "shouldnt" have access to meds.

sarahsweets
08-05-17, 07:21 AM
Back in 2014 I noticed my lack of attention and focus was actually becoming an issue. Upon doing some research it led me to looking up ADHD and basically it all seemed to fit how I am and how I was growing up. Minus the hyperactive part of it.
So I talked to my mom about it and she had me see a neurologist who literally within under a minute of meeting him asked if I had ever been told I might have an attention deficit disorder, and when I told him no, he said 'Okay, you don't have ADD." and moved on to asking me about the headaches I was getting (my mom told me to ask about that while I was there and then he latched onto that and said I couldn't focus because I had chronic migraines).

The headaches eventually went away, and 3 years later at 26 I was still having the same issues and was relating to most of the things I was reading about adhd and peoples experiences having it, so I scheduled an appointment with a psychiatrist a few months ago (apparently he's a busy man lol) and was finally able to go see him this week in hopes of a diagnosis.

He didn't ask me anything about why I might think I have adhd, or anything about my history in school or anything like that. He just handed me a piece of paper with about 9 questions on either side (one side was general stuff i guess and the other side was about hyperactivity). Each question was like a category with a few examples and you had to circle 0- none, 1 mild, 2 moderate, and 3 severe.
Most my answers on the one side were 2's and 3's and then they second side had a few that were in the 2's or 3's for like fidgeting and some restlessness.

So he looked at it and then told me he was going to prescribe me adderall and then to come back in a month to go over how I was with it I guess. But it just seemed really quick? Like most the time online people would say when they were diagnosed they took tests and stuff? I mean I'm not opposed to not having to take tests haha but has anyone been diagnosed that easily?

I asked him if it was possible it could be anything other than adhd (because I was curious if it could be anything else cause he seemed to come to the adhd conclusion pretty quickly) and he looked at me like I asked him the most absurd question he's ever heard and said that I answered mostly 2's and 3's so as long as I was being honest (I was) then there's no reason why it wouldn't be that. And that I didn't look depressed or seemed like I have anxiety (which I have neither of those) so it had to be that.

Basically, I wasn't disagreeing that I could have adhd. The pieces all fit in my opinion, I just didn't want to be a hypochondriac and diagnose myself from reading stuff on the internet. But I guess I just expected a more thorough questioning/testing kind of thing.

Ideally, any tests you are talking about should be used to rule out other suspected disorders or conditions. In children especially they are a good thing to consider because kids cant advocate or verbalize themselves well.
Tests for adhd do not exist. This is not to say that extensive testing is bad, only that if its used to diagnose adhd, they arent much help. There arent any bottom line standards to diagnosing adhd. Ill admit, yours was quick and if you were a child I would question it. If you never suspected adhd or didnt already identify with it and it was like "new news" to you, I'd say get a second opinion. A thorough history and sometimes input from family by using conner's scales or surveys is very helpful but NOT doing those things doesnt automatically make your diagnosis invalid.
Dont believe the overdiagnosis hype.

PoppnNSailinMan
08-05-17, 10:31 AM
How are these considered facts? Most psychiatrists I know actually are required to attend a certain amount of lectures or conferences a year as part of some continuing education requirement, and they want to make sure they know all about new additions to the dsm. The ones I know that work with children especially are interested in the new science.

Most of the mental health professionals I've seen myself so far didn't seem to know all that much about ADHD, especially in adults. The psychiatrist I saw five years ago didn't seem to know who Russell Barkley is. When I went in to one of my appointment, I brought the big 770 page book by Barkley, Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis & Treatment (3rd edition) because I wanted to ask him about something I had read in it and he asked me to write the title down on a piece of paper for him. I don't know how someone could be treating people for ADHD and not know who Barkley is. The young psychiatric Nurse Practitioner I saw recently also seemed based on some of his comments not to know all that much about ADHD and had an obvious bias against using stimulants.

I think the author has some big b**ls for making these claims. Overdiagnosis seems to be the soup du jour lately when it comes to talking about overprescribing or criticizing "bad" parents that supposedly want to medicate their kids into zombies for convienence.
Underdiagnosis, especially in girls needs to be studied more than worrying about who "shouldnt" have access to meds.

The book by Hinshaw and Scheffler is not an anti-ADHD book. They think that ADHD is a serious problem and is vastly underdiagnosed especially in adults. But they are concerned that "ADHD be diagnosed carefully by professionals who know their business" and this concern is also echoed by the quote from Thomas Brown.

Fjrebqll
08-05-17, 10:36 AM
Both times I got diagnosed with adhd I did several tests for attention etc. First time was with parents involved and without computer. 17 years old. Second time with no parents and more computer tests. 28 years old.

PoppnNSailinMan
08-05-17, 10:41 AM
A thorough history and sometimes input from family by using conner's scales or surveys is very helpful but NOT doing those things doesnt automatically make your diagnosis invalid.
Dont believe the overdiagnosis hype.

If there is no thorough history, how can the person making the diagnosis even know whether the symptoms have existed since childhood? According to Chris21820, the psychiatrist who diagnosed him didn't even ask him "anything about my history in school or anything like that." If I had had a diagnosis process like that, I'd wonder, too, if I had been properly diagnosed.

Chris21820
08-05-17, 07:05 PM
Ideally, any tests you are talking about should be used to rule out other suspected disorders or conditions. In children especially they are a good thing to consider because kids cant advocate or verbalize themselves well.
Tests for adhd do not exist. This is not to say that extensive testing is bad, only that if its used to diagnose adhd, they arent much help. There arent any bottom line standards to diagnosing adhd. Ill admit, yours was quick and if you were a child I would question it. If you never suspected adhd or didnt already identify with it and it was like "new news" to you, I'd say get a second opinion. A thorough history and sometimes input from family by using conner's scales or surveys is very helpful but NOT doing those things doesnt automatically make your diagnosis invalid.
Dont believe the overdiagnosis hype.


I'm turning 27 in about two months so definitely not a child lol. And okay, that's a more reassuring thought then, that extensive tests aren't that necessary. Also not new news, I've always had the issues I have but didn't really thinking anything about them or trying to figure it out til a few years ago. I went in thinking it was adult adhd but I didn't want to just assume- that's why I was hoping for more of a thorough diagnosing process, which is also hard to figure out because I'm getting all my information from people on the internet and they all have different experiences.
Thanks for responding!

Chris21820
08-05-17, 07:09 PM
If there is no thorough history, how can the person making the diagnosis even know whether the symptoms have existed since childhood? According to Chris21820, the psychiatrist who diagnosed him didn't even ask him "anything about my history in school or anything like that." If I had had a diagnosis process like that, I'd wonder, too, if I had been properly diagnosed.


Her. I'm a girl haha but yeah basically exactly why I'm asking about it. Doctors don't ever seem to like to give me actual answers apparently. The only reason I'm not in total doubt is because of everything I've read on adult adhd, it seems to fit everything I go through. It was just a little disconcerting because I feel like I mainly diagnosed myself and the guy just went with it. Besides the questionnaire thing, but still.
Thanks for your responses!

Amberg330
08-05-17, 08:26 PM
I have been having problems since I was about 8 years old a counselor told my mom she thought I had ADHD but my mom never took me to a doctor because she didn't wanna "medicate" her child. She still to this day is furious about me taking adderall. So, i have to say from my experience some doctors will test you and others won't. I have had both experiences. I went to a psychiatrist who talked to me for about 45 min and said I was ADHD for sure just by talking to me but put me on a non stimulant and said she wanted me to take the TOVA test before giving me a stimulant. The first visit that week was 300.00 , she told me to come back in a week and said it would only be 125. Ok fine but then I found out she wanted to charge me 75 for a drug test and 150 for the actual test that's when I felt I was being robbed and said no way. (So that dr wanted to test me extensively) , when I tried looking for another doctor I decided to go the primary doctor route... he said it would only be 80.00 for a visit (yes I was so mad at myself for paying 300.00 at this point) I went in there, I wasn't in there talking to him for ten min and he put me on adderoll. I was very happy with this, because it saved me money. I also feel like putting someone thru a computer test that has ADHD is like throwing a spider on someone who is deathly afraid of spiders. But that's my experience, I guess it can go both ways . :)

PoppnNSailinMan
08-06-17, 07:36 AM
The only reason I'm not in total doubt is because of everything I've read on adult adhd, it seems to fit everything I go through. It was just a little disconcerting because I feel like I mainly diagnosed myself and the guy just went with it.

That's what my experience was like and it always felt like I was the one driving the diagnosis process rather than the therapist or the psychiatrist who were suposed to be evaluating me.

sarahsweets
08-06-17, 07:46 AM
Most of the mental health professionals I've seen myself so far didn't seem to know all that much about ADHD, especially in adults. The psychiatrist I saw five years ago didn't seem to know who Russell Barkley is. When I went in to one of my appointment, I brought the big 770 page book by Barkley, Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis & Treatment (3rd edition) because I wanted to ask him about something I had read in it and he asked me to write the title down on a piece of paper for him. I don't know how someone could be treating people for ADHD and not know who Barkley is. The young psychiatric Nurse Practitioner I saw recently also seemed based on some of his comments not to know all that much about ADHD and had an obvious bias against using stimulants.

From the American board of Psychiatry:
Continuing Medical Education (CME)

Diplomates are required to complete an average of 30 specialty and/or subspecialty CME credits per year, averaged over three years.
CME can be ANY Category 1 credits relevant to one’s field of practice.
Diplomates choose their own CME activities. CME activities do not need to be ABPN approved.
At least eight CME per year, averaged over three years, must involve ABPN-approved Self-Assessment activities.
CME activities completed for one specialty/subspecialty will satisfy the requirement for another specialty/subspecialty.
Acceptable CME credits are Category 1 CME accredited by the Accreditation Council for Continuing Medical Education (ACCME), Category 1A CME accredited by the American Osteopathic Association (AOA), or Category 1 CME accredited by the Royal College of Physicians and Surgeons of Canada.
[/quote]
That was based on one search I can look into it more later.

The book by Hinshaw and Scheffler is not an anti-ADHD book. They think that ADHD is a serious problem and is vastly underdiagnosed especially in adults. But they are concerned that "ADHD be diagnosed carefully by professionals who know their business" and this concern is also echoed by the quote from Thomas Brown.

Ill have a look at the other info now.

sarahsweets
08-06-17, 07:51 AM
I never once said the books were anti-adhd.

PoppnNSailinMan
08-06-17, 01:15 PM
I never once said the books were anti-adhd.

I know, but there are a lot of anti-ADHD books that emphasize either that ADHD doesn't really exist or that it's overdiagnosed. I was just trying to make clear that the book by Hinshaw and Scheffler especially, despite its rather sensational title (The ADHD Explosion), is not an ADHD bashing book. I thought it was a fairly good book that made some good observations but wish the authors had given it a better title. One of their main points was that the evaluation of ADHD needs to be better than what it now is for many patients so that people who ought to get a diagnosis for ADHD end up getting one and so that some people who don't have ADHD don't needlessly end up getting an ADHD diagnosis because of a very cursory evaluation process by clinicians inexperienced in diagnosing and treating ADHD.