Steps to get Assessed for ADHD

[livinginchaos]

This is a question that is asked a lot on this forum, so I hope this guide is helpful

1. Get a referral from your general physician, if necessary, to see a psychiatrist
at the same time, work with your General Physician to out rule other disorders/issues/concerns/conditions (ie: 50 conditions that mimic ADHD)

2. Find a psychiatrist who specializes in ADHD (it's usually best to get a referral; meadd823 wrote up a post on it here)
- you want to see a psychiatrist because they are typically more knowledgeable about ADHD and are able to prescribe medications
- General physicians can diagnose and prescribe, but they might not be familiar with the diagnosing process, nor up-to-date with current research, treatment, etc.
- psychologists can diagnose but not prescribe
- neurologists can diagnose and rule out other neurological abnormalities, but will be very expensive and likely require more testing than necessary
- other professionals may be able to assess and diagnose (not prescribe), but it depends on their training (Licensed Professional Counselor, Clinical Social Workers)

3. Prior to your appointment, write down:
a. any questions you want to ask the doc
b. reasons why you came in for the assessment
c. symptoms

4. At the appointment, if your doctor uses language that is not up-to-date (doc should use: ADHD, ADHD-combined, ADHD-inattentive, ADHD-hyperactive)
I highly recommend you get a second opinion. It's likely that the doctor isn't up-to-date with the most current DSM (Diagnostic and Statistical Manual of Mental Disorders), which says to me that the doc isn't likely up-to-date about anything regarding ADHD (assessments, treatment. . etc).
- the doctor should use the DSM IV to evaluate ADHD
- if the doctor uses a different method, the question the doctor as to why he's using other tests
- an IQ test does not diagnose ADHD
- more often than not, the doc will ask you to get a family member, teacher and other people in your life to fill out a questionnaire (this is appropriate)
- assessments may take more than 1 appointment
- if a doc diagnoses (or says absolutely not ADHD) you within 10 minutes or so, then look for another doctor. 1 session is pretty normal.

5. While at the appointment, make sure you have a pen/pencil and paper to write down what the doc says and any questions and answers

6. If you are diagnosed, ask about treatment and what the doctor recommends
a. when your doc gives a recommendation, remember to ask "why" the doc recommends that specific treatment
b. if your doc recommends medications, then that doc should also inform you of the possible benefits and risks (side effects)
- if your doc tells you to learn about the med on your own, then go see a different doc
c. ask your doc about other ways to manage your ADHD (coping skills, ADHD coach, behavior modification, using positive reinforcement. . )
d. ask about possible medication interactions if you are on any other medications

7. Work with your doctor as a team to work with your ADHD

[StoicNate]

Great post.
Though sometimes a doctor will take blood tests to rule out thyroid problems and ECG to make sure your heart is healthy enough to take medications.

[sPacie~Gracie]

O gosh went through all in that list for about 20 years finally I did get a profesional phychiatrist new it ADD much better.......

[Myth]

Oh dear! I would assume that going to the free clinic is not a good way to be dxd. They are only third year residence MD. They pretty much just push people through one door and out the other. Rarely if ever see the same doctor twice.

No way would they be able to help me. I am nearly 50 years old and never dx'd. If I am going to be dx'd I want it done right. The last thing I want is to get a med. for anxiety and sent away. I waited this long I can wait until my husband insurance starts which could be up to a year or never where he's at because they are growing company.
I am so discouraged.

[tipoo]

- the doctor should use the DSM IV to evaluate ADHD
- if the doctor uses a different method, the question the doctor as to why he's using other tests
- an IQ test does not diagnose ADHD
- more often than not, the doc will ask you to get a family member, teacher and other people in your life to fill out a questionnaire (this is appropriate)
- assessments may take more than 1 appointment
- if a doc diagnoses (or says absolutely not ADHD) you within 10 minutes or so, then look for another doctor. 1 session is pretty normal.

Seems like my doctor did all the wrong things

He didn't use the DSM, but maybe thats not in Canada? He didn't have me fill out any questionnaires, and during the first session he said he didn't think I have ADHD since I'm quiet and don't get into much trouble. Big warning flags right there. He did have me take a blood test, everything came back good. But I did just find out my university has an on-site learning disabilities center which has speciallists who can diagnose ADHD, I might go there.

[jamcracker]

Originally Posted by tipoo

Seems like my doctor did all the wrong things

He didn't use the DSM, but maybe thats not in Canada?

we definitely DO have the DSM IV in canada. I had an assessment done about 3 months ago. go into your schools student support centre and sit down to speak with somebody. They'll refer you to the right people and if you're OSAP eligible the entire evaluation might be covered through OSAP because OHIP does not cover the assessment.

If you're not OSAP eligible then you might be entitled to a price break based on a sliding scale income.

best of luck!

[Fokus1]

I'd been seeing a counselor for about 3 years and, during that time, had mentioned to her the possibility that I might have ADHD. You see, the thought was first brought to me by a professor of mine when I told him about some of my struggles. Well, my counselor didn't think it was ADHD, but that I was depressed about my current job situation (which I don't deny). Anyway, the talk therapy has been very helpful, but the overall struggles persisted. You know... procrastination, difficulty focusing and getting things done, poor time management, etc.

Finally, about a month ago, she referred me to a psychiatrist who, after the typical medical history form and a 10 minute conversation, decided to prescribe Vyvanse. I've been taking Vyvanse for about 2 1/2 weeks and have also been doing more research about ADHD. What I've found out is that the assessment process should have been much more thorough. Did this psychiatrist just assume that, since I'd already been going through talk therapy, that ADHD was a forgone conclusion?

I've already gotten a list of other doctors that my insurance covers and am strongly considering a second opinion. The Vyvanse has made a big difference in how I feel. I feel more alert when I'm taking it, more motivated to get things done. After the current psych offered to prescribe the meds, I asked her about cognitive testing and evaluation, and she said if I wanted to do testing I should do it before taking meds, but she didn't offer to do the testing herself or even refer me. I thought about it for a week and decided that, if the Vyvanse worked as she thought it might, I'd go ahead and give it a shot. I could always stop if it didn't work. Now, I'm not sure what to do. Any thoughts?

[BR549]

If you're concerned that your diagnosis is incorrect, by all means, find a doctor that specializes in ADHD and get tested. It would stink to be on the wrong medication or any medication for years only to find there was another reason for your symptoms. Other conditions can mimic ADHD

Also, people who don't have ADHD can sometimes see a positive difference in themselves when they take these stimulants. So, while taking a stimulant and having a positive effect can lead someone to find out if they really have ADHD, it doesn't automatically mean a person has ADHD. College kids take it unprescribed to help them focus and study for exams.

Another reason it's good to find an ADHD specialist (whether it's a pdoc or a gp who specializes in it) is that they understand how to treat ADHD. How the meds work and how to properly dose. That's really important, considering everyone reacts and responds to these meds differently. Any doc can prescribe meds. And many who don't understand how to convert dosages from one med to another end up under-medicating or over-their patients. I've heard people say that when they went from Concerta to Ritalin (both methylphenidate) it was terrible. They were on 18 mg of Concerta and the doc said, well 20 mg of Ritalin is the closest. Well, they were completely on the wrong dose. Concerta 18 mg is roughly the equivalent of 4 mg methylphenidate 3 times a day, since not all of the medication fully releases. And going from an extended release to an IR isn't going to help when it's given once a day.

That's just one example of why it's a good idea to find an ADHD specialist. It's also good because they understand your symptoms and should you discover you have another condition (ADHD and comorbidity with other conditions is common), they can work closely with you to find the right combo of meds and other treatment options.

There are some psychiatrists and some gp's who don't believe ADHD exists.

Please don't think I'm telling you that your doc is wrong or to go get another diagnosis. I'm definitely not! But if you feel uncertain about your diagnosis, go get a second opinion. It's always good to go into these things with some info so you know what and/or who to look for and questions to ask!!!

[LeedsMan123]

Hi,

I am at the very begining of trying to determine exactly what might be causing me to be so disorganised, distant , hyper focussed , proscrastinating for days over certain tasks etc. as I've been having increasing difficulty with such things since I was in school. I'm now 31 and having some serious work problems now I'm a manager with children.

What worries/reassures me about my list of symptoms is that my full list really does fit most of those associated with forms of adult ADD. I am also accutely aware that there are many other causes of my symptoms.

Really, I have two questions
1) How best to approach my UK doctor about this? and

2) A lot of people on the forum seem convinced they ADD dispite mis/wrong diagnosis in the past. In such a situation, how are they so sure they do have ADD?

I mean no disrespect by the second question at all I am simply worried that I might be over thinking my issues

Thanks for any replies

[eats_mice]

Ok so I don't really know how to get a referral, and I don't want to get my parents involved unless its necessary (i'm 20). Should I just call the doctor's office or what?

[eats_mice]

nevermind. i emailed some people. maybe they can help.

[Psychmjr13]

I did all of those steps, and my pych is assuming it is depression and anxiety that is causing my inability to concentrate. I constantly procrastinate and cannot finish a task to save my life. I have been over active since a child, and have struggled to keep my grades above water since adolescence.
My older brother and sister are now diagnosed with AD/HD, although only my sister takes the medication.
I have seen him three times and I took a Conners test, he told me I scored high on my scores, showing signs of high impulsivity as well: and when I asked him what a high score meant he wouldn't answer my question. And told me that in a few weeks after I start the medication he would like to me to retake the test.
I do not show many signs of depression, but my anxiety levels are at all times high. I am a psych major so I have done extensive research on the symptoms of depression, anxiety and AD/HD.
My question to you is can the Conners test show false negatives? How is it scored? and because of my age (22), I believe that he may not be diagnosing me properly because of fear that I may be trying to abuse a stimulus.
Thank you for your time-
-psychmjr13

[TheaPie]

"the doctor should use the DSM IV to evaluate ADHD"

The first psychiatrist I saw, did this and prescribed Ritalin, which i found extremely helpful. She, however, left the state and my follow-up was with another doctor who took me off the Ritalin and wants me to have a neuropsychiatric test to evaluate whether or not I actually have ADHD. He says the reason for this, is that I am also being treated for depression. and the last thing they want to do is give stimulants to a depressed person.

I am frustrated! I am sure the testing will eat up a lot of my insurance benefits and I don't understand his reasoning at all. Maybe this is what I get for going to residents instead of established psychiatrists...

[pechemignonne]

I just got told that the low-cost evaluation by a psychiatrist at the hospital is going to cost me 700$.

That is much better than the private evaluation, which was 2000$, but it might as well be a million dollars because I can't afford that.

It's either that or go on a two-year waiting list.

My symptoms are bad enough that I am about to lose my job (again). I can barely pay rent as it is.

To those people who get mad at others for mot having a thorough diagnosis before going on meds: sometimes it's the only option.

I don't know what I'm going to do.

[ADHD0905]

I'm currently being evaluated for ADHD, my doctor is having me do a test called NeuroTrax. There's a lot of explanation online but there isn't too much that says how reliable the results are. Has anyone ever done Neutrax testing? I think its also called Mindstreams. Thanks for any help!!