I have been seeing my psychiatrist for over a year now.

While he always seemed to think ADHD was more common in children then adults... he was open to the idea that I may have it as an adult.

He was willing to try me on some medication. First Ritalin, then DEX, then Adderall XR.

I have always been up and down about ADHD, one minute I think I have it.. the next minute I'm not totally sure..... looking at my family I'd say yep, them too ADD.

I have never been offically tested, have always wanted to get offically tested and diagnosed, but, at the same time I am afraid of the results.

What if I am ADD, seems so final..yet, would provide relief, as well as, proof on paper that I am not just a failure... but then, what if results come back negative...?

The idea that I may be this way for no "justified" reason.... is scary and I am afraid to find out that I am so bad at everything because of ME, and, not because of ADD.


:confused:

I have had that problem with other things (the afraid to get tested deal) and it passes eventually.

The only percs for getting tested is that you can then get the meds that I probably do need, but cant afford now. So there is no reason to get tested till I can afford it. I am taking something to help though, im still waiting for some positave effect though.

i know what you mean Veighen, i also think if im tested and its not ADDs as i suspect, then i would feel lost somehow. This forum is so helpful, informative and respectful. I totally feel comfortable with these guys and if i was proven non ADD i'd feel hopeless.

What is the "test"? My pdoc used the interview method, which in your case would already have happened. He did a few memory checks, and the questionnaire, but no official test.

I know there are some brain scans done sometimes, but do most pdocs do this?

I guess it is up to you to decide how many months or years you want to run in circles with your PDOC.

Most miss ADD. (If you were a seriously impulsive/hyperactive Adult ADDer (the easiest to diagnose by eyeball alone), you'd likely be incarcerated. That's where they are.

The DSM "interview method" (structured Interview), IMNSHO, misses ADD in adults and children.

Interviews are a form of "self report", which is inherently flawed. (e.g. why things like the MMPI have "lie scales". People unintentionally deceive, even doing it unknowingly.)

2. There are no RCT proven "brain scans" for ADD/ADHD yet. [RCTs are the highest level of clinical trial.]

Even if there were, remember: brains are as individual as faces. Sharing commonalities in scan anatomy doesn't mean a correlation with symptoms always. (and vice versa -- one can have symptoms w/ no lesions or defects or morphology issues like hypovolume/maldevelopment).

Are you in Post Secondar,y Veighen?

Interviews are a form of "self report", which is inherently flawed.
...There are no RCT proven "brain scans" for ADD/ADHD yet.So what is the "official testing" that everyone seems to refer to then?

Queens U : I was in college.. twice in fact. Did poorly, and, dropped out...again.

I never really got to see if switching to Adderall XR made a difference with my studies, dropped out just as I was starting it.

Last time I saw my psychiatrist, he said something along the lines of.... "well Adderall must not be helping then since you didnt stick with school....."

I think it has worked better then Ritalin and DEX....but never got to test with school....anyways off topic.....now I dont have any medical coverage, and, no more Adderall.

Guess I am just worried my psychiatrist might think that meds weren't helping since I dropped out and maybe stop prescribing them.

Yeah, it is true, there is no official test to worry about taking. My suggestion would to read ADHD books (you may find it amazing the way they describe your life exactly) such as Driven to Distraction and Delivered from Distraction (there are many other good ADHD books), and talk to those who know you best especially regarding the ADHD symptom checklists you find in these books. Also, think about your past school history and family life in terms of what you have now learned about ADHD.

Most of all, don't be afraid of the psychiatrist and worry about what they may or may not be thinking. Drive your own life, research the subject, tell him/her why you feel certain you have ADHD and ask him/her for help.

Conversely, if you do good research and still aren't sure about your diagnosis, talk to you psychiatrist about what seems to fit and what may not, and ask for help. Just please, don't show up to your psychiatrist unprepared and ready to passively accept whatever diagnosis pops into his/her head.

Most miss ADD. (If you were a seriously impulsive/hyperactive Adult ADDer (the easiest to diagnose by eyeball alone), you'd likely be incarcerated. That's where they are.

There's a lot of truth to that one...

So what is the "official testing" that everyone seems to refer to then?I can only speak to what I'm going through right now, but what my psychologist is using for evaluation is a bunch of questionaire forms... There's a developmental history, current symtoms self report, childhood symptoms self report and a work performance self report that I have to do, and then I have a current symptom report form that my husband has to fill out, a childhood school performance scale that a chilldhood teacher (or parent in leiu of not having access to a childhood teacher), and a childhood symptom scale that someone else who knew you in childhood has to fill out.

I don't think there's any such "official test" per se, but some professionals will use tools like forms and such to make a diagnosis.

I know the diagnosis process that I'm going through is horribly nervewracking... I started going to my psychologist with complaints of not being able to focus and complete anything and anxiety because of it. At this point, she's already diagnosed me with Generalized Anxiety Disorder and Social Anxiety Disorder... but the question now being, is the fact that I have issues focusing because of GAD or is the GAD being made worse because of undiagnosed ADHD?

I think the trouble with diagnosing mental illness is that on the one hand, you want to be educated about what sort of things you might be diagnosed with but at the same time, you don't want to be so fixiated on one sort of diagnosis that you discount any other possibility....

Sure, I feel I fit the criteria mostly for ADHD. I know I would feel extremely at peace with recieving that diagnosis. (I am not at peace at ALL with my GAD/SAD diagnosis alone.... I feel that there *IS* something more to all of this). But at the same time, the big scary is that maybe my evaluation forms won't come back showing that I meet the criteria.

I think bottom line, for me anyway, I want an explaination more than anything, and I'm afraid that I may not get one.

there is alot of cross over for symptoms...so, even if you don't get a "concrete" diagnosis, you can start working on behavioural modifications and such for the specific issues that you are having.

for example: disorganization. this can have many causes. anxiety, depression, bipolar, adhd, and on and on.

so, what do you do? yes, there are drugs that will help, but they are an aide. if you really want to get a handle on the disorganization (or whatever your specific things are), there are quite a few changes that you can, and should be, making in your everyday life. drugs aren't a cure, nor is a diagnosis. they help, sure, but in the end, you and your psychologist should be working on how to set up good support systems of all kinds to help you for the rest of your life. you don't want to have to lean on the drug, you want to lean on yourself, and build up the confidence in yourself so that if you can't get to your drugs, you know that it'll be tough, but you'll get through it.

don't be afraid to get tested. you may not agree with the diagnosis, but you will have a place to start. testing will help you narrow down the areas that you are really struggling with, the things that affect your daily functioning. and that is a good thing!


of course, i understand that this is hard, and maybe even impossible for some folks. i don't wanna sound preachy, and i'm not a doc. for me, when i was on the verge of losing yet another job, i got frustrated. and i tend to do the black and white thing, i have alot of impatience. i wanted to get tested right away because i was just done with trying to deal with all this crap on my own, and i wanted answers. i wanted to know how i could take control. i wanted to know what things i needed to work on, so i could get started and fix this stuff already! i didn't know about about adult adhd before i got tested though, just had a list of all the things that have continuously been going on throughout my life.

let go of the fear! you've gone too long suffering, and you deserve to get started on the road to a better life!

There is no test for ADHD. It's a clinical diagnosis. ALl of these crazy neuropsych tests may provide some evidence for it to exist, but a lack of these findings does not exclude the possibility of ADHD. In my opinion, these tests should only be used when a "comorbid" problem is suspected, such as a learning disability.

Hence the inherent problem with ADHD, it's basically just a group of symptoms. Attention-Deficit Hyperactivity Syndrome would have been a better classification I think, at least until a definitive, empirical laboratory finding is found to be highly correlated with ADHD. I think we're heading in that direction with the research on neurotransmitters. I would not be at all surprised if, in the future, the diagnosis is confirmed or at least greatly supported by norepi and dopamine metabolite levels on urinalysis, or perhaps combinations of SPECT/PET scans, UA, blood work, etc., just like any other disorder.

By the way, and this is really important to know, ALL medical problems are diagnosed by patient interview and history. When a patient presents with a complaint, the physician asks questions to narrow down the possibilities and comes up with a tentative list of causes, known as the differential diagnosis.

The physician then conducts a physical examination to narrow his differential even more. Sometimes he may find things to add or remove items from the differential. The physician then orders lab tests or imaging to CONFIRM HIS DIAGNOSIS, and only those tests with a high sensitivity and specificity for that condition are used. Lab tests 99% of the time are not used to make a diagnosis, they are used to confirm it. Why are they not used?

Common sense would tell you that lab values should be used to diagnosis problems, but you'd be wrong. Why? Two reasons. One, it's really expensive to just order a bunch of everything to find out what's wrong. Two, values vary individually and the "normal" ranges for lab values are based on averages. Thus, a person with a normal sTSH may actually have a thyroid problem because their "individual normal baseline" is higher or lower than the established normal. So, basically, normal may not be normal. This is why neuropsych tests are not used to confirm ADHD, because the results may still be normal. If you're a smartypants, you may still do well without much trouble. If the task is interesting, you may not be distracted. If you're under pressure to perform, you may hyperfocus and not be distracted. If you're convinced you have ADHD but really do not, you may fubar the test to skew the results in your favor. Get the idea?

Surprising results may cause the doc to go back to his list and change it, and perhaps do another interview or PE.

Since a psychiatrist can't crack open your skull and examine your brain, he's left with the interview and patient history. I'm not familiar with any lab tests used to confirm a psychiatric diagnosis. My guess would be because nobody really knows what a "normal" level of certain transmitters are. Some neuropsych problems will present with PE findings, and some will not.

There is a reason why this question has come up on every single clinical skills exam. By the second exam it was a give me question, but it highlights its importance. "The single most important aspect in diagnosis is A) Reivew of Systems B) Physical Exam C) Chief Complaint D) History".

ADHD is often misdiagnosed largely because of an incomplete history. If a patient presents with poor concentratoin, memory problems, fatigue, etc. since childhood, this history fits with ADHD (of course there are more DSM criteria). Now what if I said, "Oh yeah, the patient also stops breathing several times a minute during sleep"? This one piece of information completely changes the diagnosis and, as a result, the treatment. Putting someone with uncontrolled or poorly controlled OSA/CSA on CNS stimulants is only going to mask the problem; the patient will go untreated for OSA and probably end up with cardiac problems in the future.