First time poster here, sorry if my question has already been answered. I've tried to use the search tools and look at the stickys but I must have missed this specific question.

Here is my situation. I have had many curious symptoms all my life finally decided to do something about it. After researching online and considering many different possibilities, I am very certain that I have adult ADHD.

I talked to a friend who explained before he could receive treatment for this he had to take a long, drawn out test that cost him $1500 (and insurance does not cover it). Is this what everyone has to do to be diagnosed with ADHD and receive treatment? Currently, I am without insurance. I think I could afford the medicine but the test seems kind of pricey. How does one typically receive treatment for this? Is the $1500 test mandatory?

Thanks<o:p></o:p>

No. This usually happens when people go to a psychiatrist/or a general MD and say "Give me Adderall!". Doctors do NOT generally give out controlled substances without some proof of an illness - and will make you go through tests, etc. Adderall is a form of amphetamine (aka 'speed') and nowadays people abuse it so Doctor's don't just give out drugs like candy.

What you COULD do - the most logical thing - is to go to your doctor and tell them that you think you have Adult ADHD/ADD and ask for a sample of Strattera - it's not habbit forming, not controlled and it is the only drug that is designated specifically for Adult ADHD - and they can probably give you a sample pack of it right at the doctors office. If it WORKS - then they may discuss trying out a stimulant like Adderall, Dexedrine, Vyvanse or a stimulant like Ritalin/Concerta/Daytrana/etc.

But I find a lot of doctors nowadays like to give out Strattera to 'test the waters' before they start writing RX for controlled substances. If you do that and they give you Strattera - make SURE you get the right dosage (which is 25mg the first week or two, then 40 mg, then 60+mg.) A lot of doctors have really messed up titrating it since it's a BRAND NEW drug in the USA (the only NRI in the United States so far) - they give out 40mg the first week, 60mg the second week or something like that and that is absolute HELL on most people's body. The side effects scare a lot of people away - but they are mainly there because people get an over-dosage of Strattera and the body has to take time to acclimate and get 'level'. It usually takes a couple of weeks to go into 'full, optimal effect' and a lot of people don't have the patience needed and they just quit and say "Strattera is horrible, it doesn't work, etc." And to be fair - for some people it does not work - but for most people, they're expecting something like a stimulant and Strattera is completely different in the way it works.

Doctors do NOT generally give out controlled substances without some proof of an illness - and will make you go through tests, etc. Ben, Thanks for the response. I will look into requesting Strat. My point is I do not mind undergoing testing. However, I do mind paying $1500 for such a test. Do you know of having to pay something like this for the testing you are referring to?

Thanks

Ben, Thanks for the response. I will look into requesting Strat. My point is I do not mind undergoing testing. However, I do mind paying $1500 for such a test. Do you know of having to pay something like this for the testing you are referring to?

ThanksNo. ADHD testing is usually just asking you a series of questions about your symptoms.

I remember (I have Adult Inattentive-type ADHD) that my doctor was really keen to make sure that I had ADD and NOT depression. Because the two share a lot of symptoms (and some medications are even used to treat both diseases - Strattera for instance is a mild anti-depressant or 'mood stabilizer').

I am currently in my 4th week of testing, and I have taken buku tests and answered tons of self assessments, but I only paid $160 getting it done at my university here locally, it was the student price... but they said they do it for people who are not students, and for cheaper. like on a sliding scale of sorts... i dunno the exact price but def at least for a third of what you were quoted... check your nearest universities psychology department for their clinic and if they specialize in adult adhd testing.... theres a bunch of schools near chapel hill... p.s. it was very important for me to get this done cheap too as I do not have insurance.

It'll depend on the doctor. For most you can just say you think you have it, describe the symptoms and within 10 minutes or so they'll say okay and hand you a prescription for whatever. If you have a physician that already knows you and you have an established relationship with, this is even more likely to happen. And in that case you could probably even get away with outright asking for certain medications like Ritalin or Adderall as long as you don't have a history of substance abuse. Placing you through a battery of tests is rare, at least for the getting diagnosed and getting medications process. If the doctor you go to insists on it, you can much more easily just shop around and go to a different doctor that doesn't. Actually, just ask the person you talk to about the diagnostic process *before* you go and they'll tell you what's involved. I was in the same lack of insurance boat as you a year ago (still am actually) and that's exactly what I did, since I knew what I had and didn't want to waste any time/money on tests. And from what I gather, insurance companies are very hesitant to pay for such things anyway. Which is probably why it's rare for a person to be advised to take them since everything in healthcare is pretty much dictated by what insurance companies will actually pay out for. The only situations where I've heard of ADHD testing being required are situations where accommodations will be required on account of you having it. Like at my university, if you have ADHD you can get accommodations made where on any exam you take, you have unlimited testing time. But of course in order for that to happen, the university wants some empirical proof that you actually have ADHD, as no reasonable person is going to pretend that some doctor is an infallible seer who can listen to some 10-15 subjective self-report by you and render a diagnosis verdict that's 100% reflective of the true reality.

I partially agree with dynam... I believe that if you are seeking a script... it can be found through a "dr. feel good", though I dont see a regular doc. nor can I afford to jump from doctor to doctor to put this theory on trial. I would have rather gone through the battery of testing that I did to be certain. Also to rule out other types of disorders, and to KNOW for me. Secondly and more importantly to me, I'd really like to have on going treatment.. and work with experienced specialists with adult adhd so im not 100% dependant on meds, and to have an official diagnosis that I could use in school if need be. To each his own.

I partially agree with dynam... I believe that if you are seeking a script... it can be found through a "dr. feel good", though I dont see a regular doc.

You don't need to find a "dr. feel good." This just happens to be precisely the way most doctors operate. I'm not promoting anything shady here. Agree or disagree with it... personally I do think it's rather lousy, but I was just describing the way it is in most instances when you go in to get psychiatrically dxed for something.

nor can I afford to jump from doctor to doctor to put this theory on trial.

I should have added in my above post to make sure one sees a psychiatric doctor. If you go to a general practice doctor, there is a likelihood that all he/she will do is just give you a referral to psychiatric M.D. anyway. This is bad news for the uninsured who would just like to get their problems solved while keeping spending to a minimum, so one in this case is best served by short-cutting this step.

I would have rather gone through the battery of testing that I did to be certain. Also to rule out other types of disorders, and to KNOW for me.

Sure, I would have liked that too. But I have to work with what I'm able to afford, you know? If you feel like you really need testing to be sure, then by all means, do go for it. In my instance, I didn't feel it necessary. I knew enough about ADHD and psychology and trusted my own intelligence enough to recognize that I do in fact have it. A psychiatrist wasn't going to be able to tell me anything I didn't already know about this. But the way the system works, you have to have their OK on things before you can get treated, which is all I was after.

Secondly and more importantly to me, I'd really like to have on going treatment.. and work with experienced specialists with adult adhd so im not 100% dependant on meds,

You can get continuous treatment from any doctor. They're not going to throw some pills at you, take your money, and tell you never to come back. You'll have follow-up appointments and what not. If you choose not to go back, that's at your discretion. However, for most of them, their approach in treating you is going to pretty much be exclusively with medication. If you're looking to learn coping strategies and other alternative means of dealing with ADHD, they're not going to have much to tell you. You'd be better off reading some books about living with ADHD.

So yes, you are wise in wanting to see people who actually specialize in ADHD. But it will cost you a lot. And even with insurance, you might find yourself having to pay out of pocket, because a lot of insurance providers get real miserly when it comes to paying for speciality things like this. Nevertheless, if you *can* afford it, I certainly recommend it. A little over a week ago, I finally did see a psychiatrist who specializes in ADHD at a place called The Attention Center. Check it out here. (http://www.attentioncenter.com/) I wish every person with ADHD had access to a place like this, see if there is anything like that where you live. Going there and speaking with the doctor was a rather therapeutic experience for me.

and to have an official diagnosis that I could use in school if need be.

If any M.D. signs off on a diagnosis that you have ADHD, then it is official. However, to use it in school... the school usually has it's own independent stipulations that have to be fulfilled before that can happen, like the tests you are doing now. Beware though, because unless there is an M.D. involved saying "you have ADHD"... then it means nothing to the rest of the world and you won't be able to get any kind of medication for it or anything else that might rely on a real diagnosis. It's stupid, but that's how the world is currently set up. The most reliable, scientifically validated test designed and confirmed by the most brilliant psychologists and neuroscientists in the world could say you have ADHD... and it still wouldn't be official until an M.D. came along and said so.

$1500 is quite a bit of money. I would imagine that they would want to do an extensive battery on you (IQ testing, personality testing, LD testing, etc.) An examination that includes a set of questionnaires about your symptoms, even if it includes many different common mental disorders, should not cost even close to $1500 (maybe more like $300+).

Not all doctors would have you do a $1500 test. While it's the norm to be tested in some way, the extensiveness of the testing varies widely from doctor to doctor. Not that testing is not a good thing (I almost wish mine would have done some more just out of my own personal curiosity), as it's important to get the correct diagnosis in order to receive the correct treatment.

I'm sure the odyssey of getting diagnosed is different for everyone, but I'll share a little of my process (which isn't finished yet) with all of you here. . .

I got on an inspired spree to return to school and finish the 39 credits seperating me and my undergrad degree. However, the 85 credits I do have thus far were done at 4 different universities and with numerous dropouts, medical withdrawals for psychiatric reasons, etc. A few days after my spree began, I realized that I would never finish unless I got help. As hopped up and motivated as I was, I knew that inevitably the fervor would wane and I would not reach my goal. I called my insurance plan (I have an HMO through Medicaid), and asked to see a psychiatrist specializing in ADHD. This time, I decided that that might be the problem, I was told I was "hyperactive" as a child, but never put on medication and I had never talked to a psychiatrist about it. On my previous visits to the psychiatrist (the dean of the college would often personally escort me there), had been a mess. Anti-depressants make me severely hyper and manic. They put me on mood stabilizers once and that was great, but I took afternoon naps, so I quit taking them and lived unmedicated for many years.

I found a psychiatrist and at my first appointment, I recounted this story, and rambled on many other tangents, etc. He kept making me stop, so trying to direct me back to the original question/topic. I didn't ask for any specific medication and had nothing in mind. Before I went to see him, I had rehearsed what I was going to discuss with him in my mind, and had visualized every detail of the appointment at great length. I always do this, yet, invariably, when I get there, I forget everything and just ramble. I see a therapist weekly; however, she does not specialize in ADHD. Our appointments usually consist of me rambling for an hour without taking a breath. Sorry, I have trouble not becoming long-winded in speech and in my writing. . . . .

Anyway, after an hour, he gave me a prescription to Adderall, yet wouldn't say if he thought I had ADHD or not. He told me that I have to go for neuropsychological testing and that I need to be screened for "personality issues." That one phrase is still driving me nuts and I can't figure out what he means.

Fast forward. . . I am now on 20 mg. of Adderall IR, 2X day, and have just now found a neuropsychologist to do the testing who will take my insurance. My psychiatrist will not say if I have ADHD or not, but still gives me a prescription. When I told him that the neuropsychologist is doing an extensive test (4-5 hours total) and can fill out the requisite paperwork to classify it as a disability at the university I attended. He just smiled and said, "If that's the problem." This whole thing is driving me nuts and I just don't understand why he won't say if I have ADHD, but gives me prescriptions to ADHD meds.

I discussed this at length with my therapist (she has a phD in neurobiology, and one in psychology), she explained to me that a small amount of Adderall will help even people without attentional difficulties focus; however, if that were not my problem, then there would be no way in hell that I could take 40 mg. a day and be zen, calm, focused, and fall asleep at a normal hour every night. She's known me for 8 years, and I gave her the psychiatrist's number. She is going to call him and ask what he might be thinking as far as a diagnosis is concerned, and then tell me, as he won't tell me anything.

Insofar as the neuropsychological testing, I had my first appointment for 1 hr, on Friday. I had to go for a consultation initially, so that the neuropsychologist could determine what tests she wanted to do. After that, she got the tests certified through my insurance. She initially told me that I would have to pay $2100 as insurance doesn't generally cover it. I also went to someone else who quoted me $3500. I had a huge meltdown in front of her about it. I was ready to call my insurance and yell at them; however, they told me that they would cover everything. The neuropsychologist was surprised, but she called them and they approved the entire battery of tests. Thank goodness for Medicaid!!

I'm not sure what the tests I've taken were for, but I had to draw a geometric picture. She then read me a list of words and I had to recite back the ones I remembered. I also did a test where I had to press the space bar after every letter that flashed on the screen, except for X. That one was a mess-- I was trying so hard, but kept pressing the space bar when I saw the X, and saying the F-word every time I screwed up. Then I got so bored, that I started rambling about who knows what. After that, I had to draw the picture from memory and recite any words from the lists I remembered. She also read me a list of words and I had to tell her whether or not each one was on the list she'd read me previously. The last thing that I did was look at a series of geometric shapes and tell her whether or not they were elements of the original picture that I had to reproduce.

She told me that I would have to do an IQ test, she would screen me for learning disabilities, psychiatric problems, and I forget the rest. At the end of the appointment, she also gave me some rating scales to fill out with a parent and also a friend.

I have my next appointment, this coming Friday, so if anyone is interested, I will report back upon the tests. I suppose at some point after that, she will tell me whether or not I have ADHD or some other psychiatric problem. I feel like it's pretty obvious that my difficulties stem from that, but I suppose they want to do all the official testing so that they can justify to the insurance company why they're prescribing me a controlled substance.