Okay, I'm really losing confidence in my psychiatrist. She's been fine in addressing my anxiety and OCD but not with my ADD. My hubby also has noticed that she doesn't seem to be well versed in ADD/ADHD. I've located a neurologist nearby that specializes in Adult ADD. She says neurologists aren't as versed in ADD as psychiatrists, but yet she doesn't seem to be either! I'm leaning towards going to see this neurologist because he would be more receptive to Amen's different types of ADD and prescribing meds based on what type of ADD I have.

Any thoughts?

I'd think a neurologist would be more interested in technical evidence to support any ADD claim such as EEG scans. I dont see them being much different than psychs though, ie they're just going to prescribe meds.

Thats what all shrinks i've talked to have done anyway. People tend to think of them doing similar things as psychologists do but in reality they're mostly just a talking prescription pad.

From what I understand, psychiatrists deal with the intersection of brain and behavior, and are usually the ones to diagnose ADHD because the primary diagnostic criteria are behavioral. Furthermore, they are more likely to look at the effects that a condition has on life issues, such as personal and romantic relationships, employment, academics, etc. Neurologists are more concerned with the physical conditions within the brain itself. While a psychiatrist deals with neurological issues (as many psychiatric conditions are known to have a neurological component), he deals with them as part of the larger context of the person's life. The neurologist is primarily concerned with correcting the neurological condition itself. This does not mean that a neurologist doesn't care about or deal with how that condition affects your life, but their primary concern is with the neurological issues.

The other difference is that neurologists generally treat conditions which can be diagnosed using neurological testing. While Dr. Amen claims to have established valid neurological tests for ADHD, his tests are not widely considered valid. Unfortunately, neurological imaging simply isn't at that level of accuracy, both because of the limitations of our equipment and the limitations of knowledge. There is quite a bit of evidence, of course, of the neurological origin of ADHD and its likely etiology (thanks to Alan Zametkin), but there is no widely accepted level of neurological functions where a line could be drawn between ADHD and non-ADHD.

Now, this doesn't mean that neurological imaging might not help an individual, where one can find that an individual may have a certain set of problems, and imaging results might show a lack of activity in certain areas, but there isn't the kind of obvious test that could be applied to a large population of people, and thus no way of testing whether that testing method is statistically valid.

If you believe that your psychiatrist is not helping you, while a neurologist seems to be more familiar with the condition, then it might not be a bad idea. Or in your situation, where the neurologist may be more willing to accept the neurological aspect of ADHD, where the psychiatrist isn't treating the neurological aspects of it, then the neurologist might be a good person to talk to.

Dr. Amen might not be the one whose research to bring in, though. You should see if you can find some of Alan Zametkin's stuff, he was one of the first researchers to show fairly conclusively that there were definite differences in brain scans of ADHD patients compared to normal control subjects. He also demonstrated that these differences occurred in regions of the brain known to be involved in attention, planning, prioritization, etc.

However, it would be best if you are also diagnosed using the DSM IV psychiatric criteria, which are behavioral symptoms. Whether you have your psychiatrist or neurologist do this is up to you. If your psychiatrist has already diagnosed you in this manner, then it's not as big of a deal, but it is important to first seek a diagnosis in a valid manner, and then consider who might approach the treatment from the best angle.

One other option might be to see if you can find a psychiatrist who specialized in ADHD. Different psychiatrists often specialize in treating different conditions or different types of patients. In my former city, I saw a psychiatrist who did general work, but who saw a number of ADHD patients. It wasn't so much that he specialized in it as it was a small town, and he had the most experience with ADHD of the available options. On the other hand, I recently moved to a larger city several months ago to take a new job, and managed to find a psychiatrist who specialized in the disorder (his office offered not only standard individual treatment, but also specialized couples counseling for couples where one or both partners had ADHD, and counseling for families where multiple members had the disorder). I found that he was more familiar with some of the odder issues that I might face. It was interesting, he asked me questions that came at it from odder angles, looking at things other than the standard academic or work or organization stuff, looking at how it affected my entire life, and I found that his recommendations for treatment, while a little more unorthodox, were very effective. Actually, I shouldn't say that his treatment was unorthodox, it made perfect sense, it was just that it was more fitted to my specific schedule and to the specific issues that I was dealing with and the specific effects that the medication had on me, rather than being a standard "treat x condition with y dose of drug z, 2 times per day."

I know that chadd.org has a list of psychiatrists, psychologists, and other therapists who claim to specialize in ADHD and have requested that their names be included, but it would obviously not include everyone, and they disclaim that they do not necessarily recommend those individuals, only that they have requested to be listed. Another option might be to ask around, or get a phone book and call various psychiatrists or therapy practices asking if they specialize in ADHD. "Family therapy" or childrens therapy practices may be more likely to have people who specialize in the disorder.

If you don't mind...will you private message the Nurologist you found that has experience with Adult ADD.

I'd be very intersted in meeting that Doctor.

Thanks :D

First, any professional who specializes in adult ADD/ADHD should be better than one who doesn’t. With that said, from what I’ve learned and experienced, a Psychiatrist is simply a Psychologist with a MD tacked on. In fact, a Psychologist could be more knowledgeable about psychological problems and issues, because that’s his only field. A Psychologist will spend more time with your assessment, diagnosis and personalized treatment, than a Psychiatrist will and you should be glad, since a Psychiatrist cost more per hour. Many times the Psychologist will make all the recommendations to the Psychiatrist, then he merely agrees and writes the prescriptions. Treatment progress is also better understood by the Psychologist and again he relays this info to the Psychiatrist so he can make adjustments in your meds if necessary. It is imperative that they both communicate. Of course, if the world was perfect, the Psychiatrist would do both jobs with the same diligence and excellence. Then, you’d only have to pay one. But I don’t know of any such animal. If you do, keep it to yourself, because you’d never be able to schedule another appointment. The line would be too long.

PS: Sorry, I don't know much about Neurologist.

Limbo

I see a nerologist, not a psy

we do not speak about my problems in depth..., he really just observes my mental signs and how my body is taking my medication.

I have a psych and, like bekahboo, find her rather useless. She doesn't seem knowledgable about ADD at ALL. She's asked me every time I've been in there about whether I might be bipolar instead. Um, no. I don't fit any of those symptoms and have a thorough testing analysis saying I have ADD.

She hasn't 'found the time' to read it. She says she'll check on things with other psychs in the practice (it's a big university). She doesn't.

Everything I've learned about ADD I've learned on my own.

I'm looking for a new doc, but can't find one that takes my insurance. I agree that any doc that knows something about Adult ADD is better than one that doesn't. If you're thinking of switching, call up the Neuro and ask her some questions about her treatment philosophy.

I trust my nero completely.. never have i seen a doctor so bang on