Hello,

I recently decided to see someone about my ADHD symptoms. I just wanted to make sure I went the right route for an accurate diagnosis.

First I went to a normal psychiatrist for problems with depression and anxiety. I was already on Lexapro (prescribed by my family doctor) for anxiety and depression problems and they decided to up my dosage from 10mg to 20mg which helped with that. I have near zero anxiety and no depression what so every anymore.

After seeing the psychiatrist I got to thinking about what kind of problems I was still having before seeing psychologist for therapy. The Lexapro is working great, except for problems with concentration, procrastination, etc that I've had since childhood. The psychologist I talked to there pretty much blew me off about my ADHD symptoms and attributed all of them to my problems with anxiety and depression (which have cleared up!!). They wanted me to continue one on one therapy there for those problems and charge me $4000 for the "total package" of treatment. I didn't really like that idea, especially since they didn't want to listen to me.

I decided to leave that clinic and find one that specializes in ADHD and learning disorders. At the first appointment I met with a psychologist who specializes in ADHD and we talked for an hour telling her my problems and symptoms since childhood. She agreed that I could possibly have ADHD and sent me home with a self test and one for my girlfriend to fill out. It was a tan colored test with brown writing, anyone know which one it is?? After filling them out, she scored them based on people my age. On my test I scored extremely high indicating a very high probability of inattention, hyperactivity, and impulsiveness. The test my girlfriend filled out on me scored high for inattention and above normal for hyperactivity and impulsiveness.

She agreed that there is a very good chance that I do have ADHD and we talked about medication options. We decided upon Adderall XR. In Louisiana, psychologists with another degree in neuropharmacology (spelling?) can also prescribe medication after talking to your family doctor.

Is this an official diagnosis or how do I get an official diagnosis? Do I have to go through a battery of tests beforehand? I know this cannot 100% diagnose ADHD but is what I have done sufficient or should I see other doctors about it?

Thanks!

BTW, I'm 25 and have had symptoms since 5-7.

That does not sounds like an official diagnosis. The self-test is just part of the information gathering process. Other parts include interviewing you, and getting info from your family if possible. Records from previous doctors also prove useful. A suite of psychological tests would typically complete the evaluation process and lead to a formal diagnosis.

It all depends.... some practitioners rely on symptoms and interviewing , and other sprefer the less subjective route of testing to gather information.

In my case, I obviously had focusing difficulties, but the case for ADHD was not compelling until I was formally tested and a proper diagnosis was derived from all the available information.

Call it as you see it, but my choice was to hold off on a formal course of treatment until I had a good , solid daignosis.


Me :D

Thanks, I'll talk to her about it next time I'm there. I guess the main reason I'm asking is because she never really said I have it for sure, she just went straight to medication. I guess I'll try the Adderall and see if it helps then go from there.

It could be the Conners Adult ADHD Rating Scale (CAARS) or one of the Brown Scales.

Since I work with kids, I really don't have any of those protocols in my office.

If I end up evaluating an adult I simply borrow one from a colleague.

I've posted quite a few times on what constitutes an evidenced based assessment(s)for both children/adolescent's & adults .

So that info is around here somewhere.

Either way,that is an "official" diagnosis.:)

What the clinician always hopes for is corroborating information from as many outside sources (who know the client well) as possible.

Interestingly enough, there's research to show that adults with ADHD tend to under report their symptoms because they've gotten used to them over time.

It sounds like she did a solid job.

It's also interesting to see that pyschologists can prescribe there.

There's definately a nationwide movement and I (personally) expect it to happen in most states in the near future.

As for me, I (personally) want no part of it.

Hope things continue to go well for you.

tc
mctavish23 (Robert)

Thanks for the response! It's good to hear that you feel she did a good job. Probably starting the meds on Monday.

I hope things go well for you and that you can tell a noticable,positive difference.

Medicine/psychiatry and Psychology are far from exact sciences.

I almost always tell families when I meet them for the first time, that if they were to go to 10 different psychologists, they'd get 10 different personalities and 10 different ways of doing the same thing.

And then I sneak in ..."and at least half of them would be wierd as hell.":)

You have to learn to poke fun at yourself or you'll take yourself too seriously.

Please read the posts on Diagnosis that I've done and hopefully, that will help some more in terms of understanding an evidenced based assessment.

I will say that now you've been diagnosed, you really have to start reading and learning as much as possible; as you will need to be your own best advocate.

Good luck


mctavish23 (Robert)

My doc diagnosed with even less than that. And was most certainly correct.

I'm a bit more tolerant of uncertainty than Speedo, but I believe that adults can be diagnosed with much less information than children because the patient themselves can pretty effectively communicate their symptoms.

Every doctor is different; some are more comfortable with a list of scales and tests (I'm sure McTavish has covered this info on the "Diagnosis" page), and others are fine with a brief family history and discussion of symptoms.

Either way, from your description, the person you saw is qualified to make a diagnosis and will likely say that it's "official", even if "tentative".

Keep in mind that a diagnosis is never carved in stone.

Barb,

That was excellent feedback.

I would say that, personally, kids are easier to dx than adults.

The symptomatic behaviors are easier to observe and more closely related to the DSM-IV sample size.

There's also the ready access of the school as a source of information, as opposed to a gap of many years.

We can look directly at kids report cards and see what things are causing them trouble.

The most important thing tho, to me, is the availability of the Risk Factors (family history,etc.) and Pre & Peri-natal care.

Checklists and test scores are absolutely NOT my favorite things.

However, when used properly, you can really make the case for the diagnosis being more than just random chance.

The other thing is that many of the EF deficits are "covert" or invisible.

I use the BRIEF to explain to schools that Initiation problems aren't the same as lazy, oppositional or purposeful procrastination.

In addition, I also try to make a major point out of time managment and organizational deficits being behind ADHD kids doing their work and then forgetting to turn it in or losing it.

Everyday, already diagnosed ADHD kids,many with existing IEP's, get zero's and F's for exactly those problems.

I would say that, personally, kids are easier to dx than adults.

Really? Interesting. I suppose the information you do have is less subjective, too.

Then again, a mistake in dx is probably a little easier to deal with when the patient is an adult, right?


The symptomatic behaviors are easier to observe and more closely related to the DSM-IV sample size.



I use the BRIEF to explain to schools that Initiation problems aren't the same as lazy, oppositional or purposeful procrastination.

Okay, so now if we can just convince ourselves of this...:rolleyes:

In addition, I also try to make a major point out of time managment and organizational deficits being behind ADHD kids doing their work and then forgetting to turn it in or losing it.

Everyday, already diagnosed ADHD kids,many with existing IEP's, get zero's and F's for exactly those problems.
Now THAT's insane. Even as a college instructor, I do what I can to avoid giving poor grades based on things like this. It's not difficult to work with a student to find a way to properly assess their understanding of the material.

I bought the book "Driven to Distaction" over the weekend and started reading it. Most of the case studies I've read so far sound eerily similar to my life from childhood to adulthood. That said, I feel pretty comfortable with the diagnosis at this point and will persue treatment. If the medication does not work at all for me I'll talk to my doctor about other options or possiblly another diagnosis.

Welcome to the "club", Huh?!

You'll find us a fairly lively bunch, I think.;)

Thanks! Yeah I've noticed that and love it. Everytime I check the board there's always a new topic to read about that I can relate to. While it gives me something to do during the day when I'm bored with work (95% of my time, lol) it might also make my distractability problems worse! :) I guess I can tell my self it's OK since I'm actively seeking help for my condition by reading the boards, which will eventually make me more productive at work! (riiiight, I'll keep telling myself that haha).

Wow... just got off the phone with my mom. I finally decided to talk to her about the problems I've been having and tell her that I've been diagnosed. After talking with her and telling her the symptoms I've had since childhood, she agreed and thinks she might have it as well. My brothers and sisters all show signs too. Some of her symptoms: Chronic procrastination, trouble starting/finishing projects, trouble focusing on tasks, easily bored, fidgety. She's probably going to go see my psychologist if my treatment helps.

Looking at my family I can easily point out some symptoms. My dad changes jobs and companies frequently. My brother had a lot of behavioral problems in school as well and was expelled from high school. He was bright but "scatter brained" as my mom called him. Eventually graduated from high school. Works in construction now and changes jobs frequently. Dad and brother both have problems with authority. Oldest sister could not decide on a profession and has changed jobs more times than I can count. That I can remember, she's been a hairdresser, worked at Lowe's, been a dental assistant, sold real estate, worked as an office manager, and driven a school bus. Second oldest sister dropped out of college and has been changing jobs since. Both are married now and have settled done some.

Huh?,

Your family and my family should get together......


OR, maybe they should stay away from each other! :D

three small words.........
now!!!!!!!!!!!!!!!!!!!!!!!!!!!
Stinky needs you dude!

http://www.addforums.com/forums/showthread.php?p=254185#post254185

SB.

Huh, It sounds like you're doing the right things including further educating yourself by reading more about ADHD. You might enjoy Tom Brown's book Attention Deficit Disorder: The Unfocused Mind in Children and Adults. I believe I remember from another post that you finished college. He writes about bright ADDers who don't get "caught" as early and why. He also discusses the frequency of comorbid conditions like anxiety and depression -- those frequently are the first thing diagnosed in an adult ADDer. Glad you got some useful feedback from your mom -- it really helps to have your family's support and understanding.

Scattered

Thanks, I'll check that book out next. Sounds a lot like my story. :)

F$&%. The psychologist I saw spoke with my family doctor and he doesn't want to handle my medication, and doesn't want my psychologist to either. So I guess it's back to the last psychiatrist I saw for anxiety and depression.

The problem is I left there on kind of a bad note... I just stopped going to their inhouse psychologist (the one who wouldn't listen to me about possibly having ADD) and didn't setup anymore appointments with them. They're also do addiction treatment and see a lot of crackheads, so I'm guessing he will be reluctant to try most medications except Strattera, which takes weeks or months to work and has a bunch of bad side effects from what I've read. I just want to rip my hair out right now. :(

Huh?:
A couple options:

1) Find a different family doctor...since yours doesn't seem all that willing to help you.

2) If you do not like the old psychiatrist and the way that practice is run, why go back there? Find a different psychiatrist.

3) Ask your psychologist if they have any family doctors or psychiatrists that they might recommend experienced with those exploring ADHD diagnosis.

I wasn't super happy with my family doctor and they seemed like they weren't going to work well with me. My psychologist recommended a doctor that had worked with another patient. I went to see this doctor and actually like this one quite a bit. This doctor is not just doing what I and my psychologist want, he is offering his own opinions and advice, but is also listening to me and my psychologist, is open to trying stimulants and seems pretty up to date on some of the meds.

Also... re getting an "official" diagnosis. I've been seeing a psychologist since last April and still don't know if I would call myself "officially" diagnosed. At first I waffled - didn't want a label, but part of me kind of did to "settle" things once and for all. I'm probably "tentative" diagnosis. I understand that getting the "official" dx for some folks is important because they need it in order to start meds. Since my doctors are working with me and I'm trying meds I'm not feeling as much of a need to label myself. The meds won't work different, I am still the same complex person with or without the official label and all the reading I've done and work with psychologist has made me more self-aware and given me some tools and strategies for dealing with my ADD type problems.

I've worked with my psychologist a lot. I probably do have it... but there are so many factors and everyone presents differently, etc. One day I was complaining to my psychologist (a day I was having more of a need to figure it out and label it) that I see overlap of symptoms/behaviors on these forums and in various books, but when I read descriptions of childhood it doesn't fit because I didn't struggle with school. I was a good student and I don't think it affected my work until late high school or college. "I don't fit the pattern," I grumbled. Psychologist said actually I fit pretty closely to what they often see in their late high school/college/grad school patients. I do??? Oh. :o ;) I have an above average IQ and after reading stuff on high IQ and ADD, especially some info in Dr. Brown's book that Scattered suggested, things seemed to fit better.

:soapbox:
Also the first med/dosage you try may not be the right one. How you react to meds can be helpful in evaluating your diagnosis, but don't base your entire diagnosis on how you react to it because:
1) it might not be the right dose,
2) it might not be the right med - another might work better, and
3) a very small percentage of folks with ADD don't respond to any med

...so if there are folks with ADD for whom no med works, then one can't base a diagnosis solely on someone's response to meds (the old "it sounds kind of like you have it so let's give you a med and if it helps then you have ADD" line).

If a med doesn't help, sure, there's a chance you were all wrong and you were misdiagnosed and maybe there's something else to explain your behavior and symptoms. On the other hand I don't see how after ruling out other possible explanations and doing a history combined with checklists, self-report etc. that someone would be willing to say, "well we tried this one drug and it didn't help so we must have been wrong, I guess you don't have ADD."

I think there exists out there the dual problem of some who are too quick to say a person is ADD without a sufficient and thorough evaluation and others who are too quick to say that it is not ADD, and I think the problem is the same: various doctors (and patients?) are too impatient and unwilling to put in the necessary time and effort to diagnose the person, influenced by a quick-fix, fast-food culture.

Like McTavish said - this is not an exact science.

Sorry this post ended up a bit long.
Welcome to the forums :D , and I'm glad that you're getting some help and educating yourself, and enjoying all the threads. I found myself really sucked into the Forums when I first discovered it too... since then I've been able to exercise a little more control over how often I'm on here.

~~bythesea :)

Thanks for the advice. :)

I just got off the phone with my psychologist and had her refer me to a family doctor in town who has seen some of her patients before and will probably let her handle the medication. My psychologist is really great and has been wonderful in helping me through this.

I just did not feel comfortable with that psychiatrist. They made me feel stupid, like there was no way in hell I had ADD. Someone from there office called me to talk about the report my psychologist had sent to them. He made me feel stupid and questioned the possibility that I might have ADD because I graduated college. I also got the sense that they were in it for the money and did not make me feel very comfortable talking to them.

psychologist and had her refer me to a family doctor in town who has seen some of her patients before and will probably let her handle the medication. My psychologist is really great and has been wonderful in helping me through this.

I am glad to hear you found a good psychologist that is willing to work with you on this.


Good luck let us know how things go.

He made me feel stupid and questioned the possibility that I might have ADD because I graduated college.

Gee a short run about here on this site should reveal who is the ignorant one when it comes to ADDers finishing collage classes and getting degrees!!! I am glad you won't be having meds handled by some one who still lives in the "dark ages" of ADD!!!!

I also got the sense that they were in it for the money and did not make me feel very comfortable talking to them.

I am with you on this one ....don't walk away RUN!! People with this kind of attitude in the medical profession often do more harm than good!!!!

Woohoo. Saw the new doctor today and he was very nice and understanding. He agreed with my story and said it sounded like classic ADD. We decided on Adderall XR 20mg / day. Took my first one this morning and it is working well so far but I need to get used to it. Suprisingly for a stimulant it has a very calming effect on me so far. I'm LESS jittery than normal. I have to see him again in a month unless the dosage feels right, then I can call in my prescriptions and see him in 3 months. :)