Why is it so hard to get an ADHD diagnosis? How do you find a good psychologist?
(warning and TL;DR : long and kinda ranty - I do want advice but this also ended up being me venting about my frustrations with two separate medical professionals)
I've suspected most of my adult life that I have some form of ADHD; some mornings I face debilitating initiation paralysis that causes me to be up to 2 hours late for work; I forget conversations happened and my mind is in a constant jumble of starting 5 tasks and finishing neither; sometimes I hyperfocus and sometimes I lack any focus - seemingly at random - and other tiny tidbits that upon a cursory glance through medical material, scream ADHD to me.
I've learned to cope with most of it, and thankfully I have a pretty chill job that lets me be flexible with my schedule without issues, but when you look at everything in context, it's pretty clear that my quality of life could be so much better if I sought professional guidance and medical attention.
So I did just that; went to my clinic, scheduled an appointment with a psychologist, and I dragged myself there.
I did my best to be objective and factual about my behavior, I made notes of stuff I did and symptoms I experienced over the course of a week, and answered every question as openly as possible, and yet everything felt wrong.
The psychologist didn't see ADHD in me, and instead chose to pursue my childhood and familial history, narrowing down on signs of anxiety. That felt viscerally incorrect to me, as it didn't reflect how I perceive my behavior. The way I understand anxiety doesn't align with how I think and behave. I don't worry about things when I am stuck in bed - I am pleading with my body to let me move so I can do the things I enjoy. I don't dread going to work - I want to go to work, and my brain says no. That is not anxiety, no matter how you frame it; at best, any signs of anxiety I may have are a byproduct of my struggles with executive dysfunction.
At the end of the session she recommended I return for a few more sessions so we can build a proper profile of my background and identify what we need to work through. But before that, she mentioned I could also see a psychiatrist, and ask them to refer me to her so the sessions could be paid for by national healthcare (I'm Romanian, for context).
So I did that, booked an appointment with a psychiatrist that seemed alright, and I basically hit the same brick wall I did before. My issues aren't neurological, they're behavioural - and I just need some counseling and discipline. And my inability to make my body move in the mornings could be just a sleep hygiene issue.
You've all heard or read about women having debilitating period pain and just being told to drink water or eat healthier or maybe go for walks more often, right? This felt like that; I'm facing a clear disconnect between my brain and my body, I have my daily life disrupted by things that are 100% out of my control, but apparently I just need discipline and better sleep. I don't buy it, as much as I want to.
I got so frustrated during the session that I started involuntarily masking and going along with the motions just to have it over. Internally I was on the verge of tears but I put a pretty smile on and left the room upbeat. That is not normal. I need help.
But they just don't seem inclined to want to offer it. I am a firm believer of Occam's razor but the psychiatrist's conclusion didn't feel like the simplest one - it felt like a massive oversimplification.
I did get a recommendation to take the DIVA-5 test (because neither of them were qualified to do it) so now I'm searching for a psychologist that is certified (which are rare, and pricey, from what I can see).
But until then, I just feel disappointed, misunderstood, and honestly quite angry. I asked for help and was given what amounts to scraps. My lived experiences were invalidated in front of me, in the places that were supposed to validate them and guide me towards finding an understanding of my behaviors and my mental health, twice in a row.
Those of you who got diagnosed, how many tries did it take? Is this the norm, just hopping from clinician to clinician until you find one that clicks and feels right? Or did I get massively unlucky?
Also, has anyone else taken the DIVA-5? How did it go for you?
Hack: If you're in the US (and may work elsewhere?) just tell your doctor you were diagnosed as a child ("around six or seven"), but your parents didn't want you to take anything that would affect your brain. Current requirements place a heavy importance on 'proof of childhood existence', as most literature is under the belief that adults can't have ADHD without a childhood prognosis, even if modern research (and lack of testing in prior generations) prove this otherwise.
That's all they need to hear to legally give you a prescription as they were all paper records and were easily lost. If the first doctor doesn't work out, try with another. In everyone I've told this to all of them get it by the second doctor. Otherwise, it's nearly impossible to get a prescription as an adult.
You can also tell them that you've tried a specific medication during college/high school and that "it really worked, and they will be more likely to let you try it.
They likely will prescribe you Straterra (atomoxetine) for a month, it likely won't work, it
neverrarely does on its own, but they will prescribe it (research says it increases efficacy of ADHD meds, so some doctors believe it will work without the ADHD meds, and it often doesn't). When you go back, tell them it doesn't work (or not as well as you expect, which is likely) and they will likely get you set up with a proper medication.Edit: updated from never to rarely, the research on it very much skews towards a very small population having any effect after the placebo phase with a higher side effect rate.
Edit 2: Added some additional information on why this 'hack' works.
They aren't in the US, and that will only get them medication without any support structure. Given they specifically talk about feeling misunderstood and wanting help I am not sure this is the best advice to give.
I know mental healthcare in various countries can be in such a disastrous shape that people are resorting to methods like this. But, I also don't think it should be the first thing recommended either.
I mostly posted this as a hack to anyone who is and might be curious as to read it for additional tips or input, but I did miss that they were Romanian, but I have read reports that this works similar in other countries. long shot, but it might help.
As for first recommendations (in the context of medication), I am one of those weird ones who believe that medication being over-prescribed as a first-effort is better than going through a litmus test to determine care (therapy, psychologists, etc), or even as an entrance requirement that by requirement removes the people who are the most in desperate need of care. If there is medication that can help fulfill the mental needs to get to a point where therapy, support, etc becomes more realistic, then we should have it a first case option.
To reiterate, I believe in immediate care first with long-lasting support after, especially for things that are this detrimental (ADHD/Depression/Anxiety/etc) to every day life, where medical attention and speed at initial resolution is far more important. A lot of people disagree with me on that, but results first, routine later, seems to more effective for more people and reducing harm. I believe in an informed consent model for practically all forms of medical care, and if it requires hacks like this, then so be it.
I really want to push back on your dismissal of atomoxetine. I've been on it for around 3 years now. It absolutely can work. I'm sure it doesn't work for everyone, but it does work for a lot of people. Atomoxetine works much differently than the other ADHD medications. You have to take it continuously for 2-3 months before you see significant changes, so trying it for just one month isn't really trying it. And the nocebo effect is very real. If you expect a medication to not work, even if it does work, it can be less effective. So give it a chance, and don't expect it to be the same type of "I can focus for 8 hours" pill like the stimulant medications.
I think the main issue is prescribers (especially in Europe, from what I've heard, although luckily this was not my experience) defaulting to non-stimulant medications like atomoxetine when there aren't any contraindications for stimulants, despite the fact that stimulant medications are the most effective option for such a large proportion of people with ADHD. The fact that it takes several months for non-stimulant medications to "kick-in" only adds to the unnecessary delays added by forcing people with ADHD to try non-stimulant options first due to an undue fear of prescribing stimulants. That said, it is a very good thing that we have non-stimulant options for people who cannot take the stimulant options or for whom the stimulants are effective for whatever reason.
Yeah the controlled substance aspect - and I suspect like other such drugs, the US federal pressures on and requirements for such prescriptions - makes some doctors wary. It can work great for some but the side effects of Strattera were so bad for me my compliance was awful and I never got out of the weird Technicolor dreams phase.
Luckily for me, my psychiatrist started me with methylphenidate, so I didn't have to spend several months seeing if one of the non-stimulant options works.
My pediatrician (I was in college but hadn't transitioned) switched me to Adderall shortly after and here we are today... In a nationwide Adderall shortage. ಠ︵ಠ
I don't think it's an undue fear, it's likely 1. A real concern over drug seeking behavior and malingering, given how quickly commenters here suggested lying and or gaming the system in order to get a dx/stimulants, and 2. Stimulants are addictive and dangerous if abused. I'm happy you don't know anyone who has abused stimulants, but people can and will develop actually destructive addiction to stimulants, even ones legally prescribed for legitimate diagnosis.
I think a large problem that I've personally seen, is that attention and motivation are not really context independent. I was screened for ADHD as an adolescent, I just needed to be moved into harder courses. Even now I struggle to focus at work..... Because my work is very boring. I can focus in the right contexts.
This isn't to say that I don't think that OP would benefit or should avoid stims, I know many people with ADHD who take stimulants as directed with little downsides, but it's a bit too blase about it to say it's a non-fear, right?
Firstly, don't make fucking assumptions, because I do know someone who's abused stimulants.
Secondly, studies have shown that when patients take stimulants orally in the amounts prescribed by a doctor, the risk of addiction is extremely low. People who become addicted to prescription stimulants are overwhelmingly taking stimulants at higher doses than they've been prescribed (if they themselves have been prescribed them at all) and/or are snorting them. These are things that the fact sheets that came with my prescribed stimulant medication explicitly include as instructions. Moreover, refusing to prescribe prescription stimulants is not a no-risk anti-addiction decision, as people with ADHD have much higher risk of addiction than average when unmedicated and prescribed stimulant medication has been shown to lower that risk significantly.
I'm not gonna deny that there's abuse potential, because of course there is, but there are already plenty of hoops to jump through to get prescribed ADHD medication. After having been diagnosed by a professional and reaching someone who is qualified to prescribe and titrate your medication, being forced to spend months trying something that is less likely to help you and has its own side effects solely because providers are overly cautious about prescribing one of the most effective psychiatric treatments that exists regardless of the lack other risk factors for addiction is, in fact, bad.
I'm glad that the psychiatrist I saw when I began medication, who was very experienced with patients with ADHD, didn't waste my time like that, as due to the fact that stimulant medication doesn't take months to kick in, it was much quicker to find the right dose and medication that way. Since I was self-paying for sessions with them at the time, it would also have been significantly more expensive if I'd had to wait for a non-stimulant medication like that.
As for the rest, congrats on not having ADHD, but stop implying that others are faking because it's normal to get bored by things that are boring. Even the symptoms OP listed in this post exceed that, and spouting misconceptions from an uninformed place isn't helping anyone here.
Second that. Atomoxetine literally made me able to finally relax on a couch, without worrying all the time that I forgot to do something important for sure
Objectively untrue. It ended up being the first medication that worked for me, though I tried stimulants first. Particularly for people with ADHD and comorbid anxiety, it can actually be the best option. It's an amazing drug with the benefit that it lasts all day and night, I can forget to take it for a day or two with and still have the effect, and I don't have to deal with federal government narcotic bullshit, or people stealing it to get high.
Looking back, I may have shot myself in the foot by not being able to recall much from my childhood.
I should ask my mom about it. Additionally, during the DIVA-5 the interviewer can ask me to reach out to a trusted person that knew me as a kid, so preparing her for that isn't a bad idea.
That said, I certainly don't want just medication, I'd also like to find a medic/therapist that gets me and is willing to work with me besides just giving me prescriptions.
A good portion of diagnosis criteria requires evidence in childhood, so preparing her for that would likely be very beneficial.
I wrote it in another response, but I have found that medication first, routine later, seems to be effective in immediate and longterm benefits. Even then, it will likely be easier to find a therapist who can deal with ADHD without them having to worry about diagnosing it as a first action. More therapists are trained in ADHD treatment, then there are for those willing to diagnose it, or have the legal ability to do so.
I'll try it the next time I see a psychiatrist (god, I have to search for that too, besides the test, and a local psychologist to see for therapy. Baby steps, though.)
Thank you!
I'm not a psychiatrist and cannot judge whether you have ADHD, anxiety, or neither. I'm also not Romanian and have no idea what social stigmas there might be that could influence your doctors. I do want to note, though, that feeling like you want to do something and being unable to can 100% be a symptom of anxiety. Anxiety is not always a state of worry at the front of your mind. It can manifest in other ways too (avoidance, paralysis, etc.)
It sounds like you had a really frustrating experience and I sympathize. I think it's worth at least considering whether anxiety might be involved here, though.
I'm considering that too, but taking all my other patterns into account, I find it hard to think it's anxiety.
That said, they are co-morbid, so who knows at this point. Could be one, could be both.
Yes - so I got an ADHD diagnosis as an adult in my early 20s here in the US.
I started with a psychologist who did the evaluation work and then went to a psychiatrist. The psychologist and I had a lot of conversations on why I think I had ADHD and also asked for a lot of outside viewpoint on how I acted - especially because I had been very successful in school and career despite it. So I gave feedback from my colleagues and my parents and also discussed my brother who is diagnosed and his story. The outside feedback here was really important. All of that that took about 7 or 8 sessions. He then referred me to a psychiatrist who he liked.
The psychiatrist and I didn't click and he really struggled to medicate me in a way that didn't have weird side effects, so I decided to stop.
About 10 years later, I did an MBA at a pretty serious school and I had multiple exams where the professor circled my math mistakes and wrote "WTF?" in big red letters after I subtracted 13 - 7 and got 4 despite having well reasoned arguments otherwise. So I went through an online psychiatry service to start medicating with a small dose of adderall xr and that really helped. They mostly did some online type of assessment. These online services usually get criticized as being pill mills, but I wouldn't have been able to restart going through the above process again.
There are a couple things that make ADHD diagnoses tough. One is that there is a lot of social media/Tiktok stuff that are explaining every issue as ADHD and so providers are being flooded with people seeking ADHD treatment. Some are legit, and some have something else going on. Second, is that at least in the US, most ADHD meds are schedule II and have very strict prescribing oversight by the FDA and others. Third, adult diagnoses are a bit tougher since a lot of the early studies and treatment viewed ADHD as something that is identified in childhood in the classroom. So if you didn't receive a diagnosis while you were a child, the psychologists are usually trying to understand why that didn't occur.
All of that leads to a system where treatment for ADHD is a pain in the butt with a lot of built in barriers unintentionally setup in a way that makes getting treatment for people with ADHD really hard.
All the best to you and good luck.
I felt this viscerally. I had an extremely kind physics professor who understood that I cant do consecutive steps of simple maths, who would walk through a problem with me and if I could explain it without using numbers he'd give me the marks.
I feel like, as an immigrant millennial, it's harder to have been properly diagnosed as a child. My parents would be horrified, and would not have put more thought into it beside taking the teachers' "not applying themselves" evaluation as fact. Medication would never have been an option even if magically diagnosed.
Not sure this is helpful at all, but my wife also struggled with getting an ADHD diagnosis in Canada.
I'm no expert, but I have been with my wife for over 10 years and I never noticed anything that would make me think she has ADHD. A couple years ago she watched videos on TikTok that convinced her she has ADHD, which led to her embracing obsessive tenancies. Seeing this, I encouraged her to speak to a professional in hopes that it would validate her assumption or help her move on from the changes in behaviour I had noticed.
Apparently the doctor said there weren't very good ways to test it and if my wife doesn't feel like it impacts her life negatively and doesn't want to take medication, then there isn't much benefit in pursuing a diagnosis. But it is extremely rare to develop ADHD later in life and is often misdiagnosed. We kind of just left it there, as I don't have the ability or knowledge to pretend to diagnose my wife but she seems to embrace it.
I don't know if that helps since you actually have negative experiences related to your potential ADHD, but it sounds like it is also hard to get ADHD diagnosed in Canada.
Diagnostically speaking, I don’t think it’s possible for anyone to develop it later in life. You can cope until you can’t, but that’s not the same as turning ADHD as an adult. You’d still have, for example, report cards that say “good student but fails to complete assignments” because it’s a neurodevelopmental disorder.
TBI’s not included, but yeah. You’re right.
In my case it was "good student but annoying know it all" I completed all my assignments in class before going home until high school where I couldn't always keep up like that, but at which point no one documents it.
Not being a boy meant that it didn't even flag, especially in the era of it being Hyperactive forward.
Yeah, I was told that for folks with higher ability to cope, folks who test well, folks who can just brute cognitive cycle through deficiencies, it'll look like they're doing okay (mask) until they hit a wall with a new job or change in family dynamics or different field.
A lot of us were told "not applying themselves" or "carelessness" or "attitude requires adjustment to excel" etc
I've heard all of those through high school. Nowadays, every manager tells me I have "potential" and that word is now so tainted I physically recoil when, without fail, a new manager tells me that. It's probably a little self fulfilling at this point, but hearing that is usually the beginning of the end, as I'm never going to live up to the ideal they have in their mind of what I could be.
The occasional "good day" that allows me to apply myself to the fullest extent is rare.
Cpt, did medication not work for you ? From your other comment it sounds like you were at a clinic that was happy to try and find something
Same, Potential is a four letter word, defining the chasm between other's expectations vs where I exist.
Eh... The efficacy has been varying. It helps me in the moment, but I'm unable to break through the bad habits and easy distractions. Work can be such a slog.
Combining it with CBT probably helped me the most, but it's been years of slow decline at this point. Probably something I need to start picking up again but you know how most of those plans end.
It also made my shortcomings feel more apparent when they rear their head and the medication isn't helping as much.
What did get better through medication is my executive function. It's muuuuch easier to start the task I need to do without feeling I need to scale a mental mountain. Another improvement is being able to filter incoming signals. This doesn't impact me often or much at all but on days I'm tired and in a busy place it can help create some quiet around me.
I'm also, years in, still navigating dosage. Some days I'm aces with the smallest 5mg dose. Other days I just get suppressed hunger and incessant sweating unless I up the dose to 20mg+.
At the time it felt like lisdexamphetamine (the slow release one) fit me the most. But situations and your physiology change over time and I'm now more inclined to the short release version.
There's probably an argument to be made about trying to go and keep to a therapeutic baseline too.
Long story short: I'm happier with my medication than without. But for me it hasn't been the magic bullet that some others experience. Every thing I mentioned in this post swings back and forth, some days I'm focused, able to start tasks, feel sharp, etc.
Other days I'm none of those things, medication or not.
We can probably make a metal sign over a little bell, and just ring it every day or as often as this comes up. You're definitely not alone
It is one of the diagnostic requirements that symptoms of ADHD must have begun at a young age (I think the DSM says before age 12), so definitionally ADHD cannot be developed later in life. People who are being diagnosed as adults aren't people who develop the disorder later in life, but rather people whose ADHD was not diagnosed when they were children for any number of reasons. Merely being a girl was often enough reason to have one's ADHD overlooked, so a lack of a childhood diagnosis does not entail that there were not ADHD symptoms in childhood. The teachers' comments on my elementary school report cards (which luckily my mom saved) were helpful during the process of getting my ADHD diagnosis, because they made some of my symptoms during childhood much more evident deapite the fact that I generally got good grades and was a "smart kid" (another thing that commonly prevents ADHD from being noticed and diagnosed in children).
But if it isn't impacting your wife's life negatively and she doesn't want to take medication, there genuinely doesn't seem to be much reason for her to get a diagnosis. The main utility of a diagnosis is access to medication and the ability to address your symptoms in therapy through an ADHD-informed lens. If you don't want either of those things, there's not much point in a diagnosis. You don't need a doctor to relate to TikToks, and one can't stop you from doing so by denying you a diagnosis either.
There are definitely people with ADHD whose lives aren't severely negatively impacted, but that tends to be due to their having robust support networks that make up for the negative impacts of ADHD symptoms. For instance, picture the (now somewhat old-fashioned) idea of a man with a wife to handle his affairs at home and a secretary at work -- most of the stuff adults with ADHD struggle with would be handled by these other people and he could focus on the aspects of his career and home life that are more spontaneous and require less of the executive function that people with ADHD have deficits in. I'm not sure if this is the case for your wife, but it is something that happens.
I'm a little confused by what you say about your wife embracing obsessive tendencies, but it's also possible she's neurodivergent in some other way and relates to ADHD-related content due to similarities between her experiences and those of someone with ADHD. But figuring that out would also be the job of a professional, and it might be difficult to investigate if she's wed to the idea that she has ADHD specifically.
Yup, same here. Also as I said in my other comment they also did interview my parents. There were several other things like that which basically made the psychologist remark that with the current knowledge of ADHD I would have likely been diagnosed as a child already.
Because one of the reasons a lot of adults were not diagnosed as a child is because back in the late 80s early 90s (in my case) ADHD was simply not that well known. Even more so the various types.
Yeah, mine couldn't interview my parents since I lived in a different country at the time, but I did ask my mom for some relevant info to pass along as part of the process. When I was in school ADHD was just the "hyper young boy" disease, whereas public perception has luckily been changing since then. The number of comments I got on my work that were essentially "really smart, but needs to pay more attention to details" though... it was practically textbook.
She basically decided that she had ADHD and that expressed through things like playing the same video game over and over or just listening to the same band. I hadn't noticed that behaviour before and wanted her to do what you suggest, speak to a professional to see if it is really ADHD or something else. I'm not a big fan of self diagnosis or TikTok diagnosis so I was hoping she would speak to a professional instead of deciding she had a condition. It didn't really go anywhere, but if she does really have ADHD she has coped with it 40+ years and it's not negatively impacting her day to day that I can see.
Hey, first I just want to validate your experience by sharing that ADHD in women is critically underdiagnosed.
My wife discovered she had symptoms in adulthood - it took about 2 years of us just talking to one another, and importantly, her talking 1-on-1 to other women with diagnosed ADHD before she accepted that she should speak to a professional. I grew up with a dad with some very intense ADHD symptoms and so I recognized a lot of them in my wife. Unfortunately, like you, she found this process of getting a diagnosis very challenging.
My wife's GP said it sounded like she had ADHD and referred her to a Pysch. The pysch was an old man who basically didn't believe that women could have ADHD. Here's where it gets crazy and frustrating. The pysch insisted on speaking with me, her husband. We had a 15 minute conversation in which I explained growing up with a father with ADHD and drawing parallel after parallel between his behavior and my wife's.
It was only after speaking to me in this capacity, that the pysch finally diagnosed her with ADHD 🤦. The good news, is that since then, and after receiving treatment, my wife is thriving and has been able to reclaim so much of her life.
The process for diagnose can be so frustrating for women. I hope it gets better for you. I'd leave you with 2 pieces of advice: first, advocate for yourself fiercely. I recommend bringing printed out literature like the study I shared and asking them to read it.
The second is to be open to alternative diagnoses. I don't know you personally of course. There's this weird dichotomy where on one hand we have to advocate for our own diagnoses but on the other hand, we're not medical professionals. Many neurodivergences have overlap and similarities. My wife for example has some trait overlap with ASD and OCD but her and her doctor definitely agree she does not have those disorders. Neurodivergences and psychiatric conditions are tricky stuff!
I hope you can eventually find a doctor you trust and you can rely on their diagnosis. It can be a frustrating road but it changed my wife's life in so many meaningful and positive ways!
Your wife's story makes me feel angry and I hope doctors who don't listen to women all leave practice sooner rather than later.
Interviewing family for history is valuable part of diagnosis, sure, but that doesn't sound like what was happening
I identify as male - sorry for the confusion, the anecdote was based on a friend's frustrating experience, and I can now somewhat relate to it.
The fact that doctors dismiss women's health so easily is outrageous and finally being subjected to the same treatment feels awful.
Also, I now realize I may have masked my way through both interactions by being much more outgoing and carefree than I usually am, in my attempt to be an open book. Has that clouded their judgment? I'll bring that up for the DIVA-5, seems like a good idea.
Ah my bad, sorry for misgendering!
But yeah I think part if the difficulty with living with a neurodivergence is it's hard to describe how impactful it is until you've experienced life without it!
I hope you find success in your health journey!
No worries about that, and thanks for the support!
I would recommend looking for a second opinion and finding a psychologist who specifically has experience with ADHD (and thus presumably deems themselves qualified to administer the DIVA-5, though iirc it was literally designed to be easy for providers to use even if they aren't very familiar with it 😒). Therapists will often list information like this on their websites -- but when I was diagnosed, I was self-paying for therapy due to how bad the German public health system is when it comes to insurance, so I don't know how much the public health system of your country will influence things there.
The first therapist I saw in Germany told me I couldn't have ADHD because I was able to sit down and write an essay (despite the fact that I described the fact that I couldn't ever write something like that in a gradual, planned way, only in one big burst). Then she went on maternity leave and her replacement suggested ADHD without my prompting during our first session (so presumably it was pretty obvious). We then did what I think was the DIVA-5 (or something quite similar) over the course of the next couple sessions and afterwards she wrote up my official diagnosis. Then I had to start the process of searching for a psychiatrist, which was its own struggle. So my experience probably isn't super replicable, but it's a good illustration of how much even therapists who are presumably otherwise aligned can differ on ADHD depending on their experience with it.
I think I may have seemed too outgoing and carefree in both sessions, and maybe the way I described my symptoms made them sound less serious than they are? I dunno.
Masking is something I do quite a lot, unfortunately.
This is timely for me, I have a psychiatrist appointment tomorrow to discuss my own possible undiagnosed ADHD. I was rebuffed by a psychiatrist in the past when I sought help for anxiety I was experiencing brought on by an unhealthy work environment and brought up potential ADHD but was dismissed, and at the time I suppose it made sense. I’ve since left my previous job and the anxiety has essentially disappeared but executive dysfunction has remained. Thus I decided to pursue treatment, but have concerns I’ll have a similar experience tomorrow. From my experience talking with peers, it seems to be a bit of a grab bag and depends highly on your psychiatrist. I don’t necessarily expect a stimulant prescription right off the bat, but when the efficacy is that strong it’s hard to look past it as the solution to my problems.
I’m amazed though at how they often seem to default to stimulants for children right off the bat but give undiagnosed adults a harder time. I’ll be sure to report back.
Undiagnosed adults are exponentially more likely to abuse the fuck out of stimulants than a 6yr old.
Of course, and perhaps I’m thinking about it with the wrong perspective, but considering that said 6 year old will become an adult eventually, does the abuse risk increase as they get older? And if stimulant medication is the treatment with the strongest efficacy, it seems a disservice to an adult who should have been diagnosed earlier to deny otherwise successful treatment. Not a psychiatrist privy to the numbers obviously, but it definitely seems like a tough balance and can understand why they might be more apprehensive.
Sending good wishes with you for your appointment
Thank you!
Hope it goes well for you! Feel free to reach out if you want to talk about it later.
Thank you!
I was already diagnosed with ADHD and autism as a child in 2006, and frustratingly I got a referral from my doctor who can't perscribe me stumulants without a Psychiatrist, so I got one over a phone appointment ignored me saying I have anxiety and depressive disorder and sent my Doctor prescription for anti psychotics and anti depression SSRIS. I said not interested at all in taking those, I need stimulants as I already self medicate with Pseudoephedrine which is very helpful. So he's now sent a referral to another Psychiatrist which will be another appointment which involves will be more successful as I'm sending my original diagnsoes first.
I went to my GP, got a referral to a mental health institution/clinic (they have a specific name but that doesn't translate all that well), had to fill in surveys about myself, then had a bunch of talks with a psychologist where they also invited my partner and parents (with my permission) to both look at my youth and how my partner sees me doing things. After that they made a report, which was discussed with them internally and evaluated by a psychiatrist who then got me the formal diagnosis.
It was not a short process, but it wasn't difficult either. Other than remembering to fill in everything in time and all that.
This is in the Netherlands. From what I understand it differs hugely per country how the process is and how well the mental health care in that country is developed. Purely anecdotal I do get the impression that in former eastern bloc countries the process is often more difficult because of a overal lack of knowledge about ADHD and such.
I know there are online services in the EU where you do your sessions through video calls. But I have no clue how reputable they are and actually helpful. A diagnosis in itself isn't really going to help you. Medication might help, but what also did help me where sessions with a physiologist giving me structure to things and approach things from different angles. A relevant comment I wrote about it a few years ago. I don't know if these online services provide this.
I also don't know if they will be covered by health insurance.
I also got referred from my therapist to a center that only does such assessments.
They even did brain wave readings, which was very creepy and kind of disgusting.
You have to put a sort of gel in your ear to ensure proper contact.
I think I got lucky that in my childhood it was suspected, and also, most likely, my dad has ADHD as well. I think I just dealt with it fine since as a child I had a very rigid structure. No spare time, essentially.
I've also tried meds, but none have worked so far. I can take Ritalin now through my main doctor. I have tested it like 2 or 3 times so far, but I am very much still undecided if I like it or not.
Now I'm also doing the same thing but for an autism assessment. They have now stopped taking applications, and it's really tedious and a long process. I had to wait from when my therapist signed me up and when I got the first appointment for over a year.
I hope everyone who needs meds or support or even a diagnosis gets it. I wish all of you the best of luck!
I'm in Switzerland, btw
This is really similar to the process I just went through in Norway, except I went private due to the long queue with public.
Lots of forms and questionnaires, spoke to my partner, my parents and me quite a lot about my current behaviour and how I acted as a child.
The psychiatrist I spoke to also had a session with me where they went though Non-ADHD diagnosis which I found extremely helpful.
Now I'm waiting to speak to the psychiatrist about medication.
I will have to explore the GP route as well; I have avoided that until now because I first need to move my file to a local GP (as it's still in the town I grew up in) which takes some time.
Also my employer pays for private health coverage so I opted for that in hopes of getting better expertise - as you can see that turned out wonderfully.
ADHD Centraal?
They did my diagnosis. They came under a bit of fire for possibly over diagnosing (the perverse incentives are there unfortunately) but I had a really good experience with them.
Their guidance during medication use was great as they would quickly adapt or even outright change if I said it didn't work or gave me an unintended side effect. When methylphenidate flattened my emotional responses they immediately changed my script to dexamphetamines.
Especially the talks with the psychologist and the CBT were of genuine help. It's something I wish I could've kept going. The fact the psychologist was knowledgeable about ADHD specifically made it easy to discuss the ins and outs. It also helped we had a pretty good friendly connection so talking came easy.
After my experience with them and openly talking to my friends about it, two of them followed after coming to the realisation they may need help too. One of them was unschooled before and is just finishing up his masters now.
No, a local GGZ practice. Relatively small practice ran by two psychiatrists I think combined with a staff of psychologists. It was recommended by my GP at the time I was looking into it and basically was similar in experience as to what you described. At some point they were also upfront about where I stood and said that I could come back for yearly checkups. But considering costs they'd also be happy to transfer me back to my GP for the medication.
Huh. When they're not even qualified to do the DIVA-5.
I had a short journey and a long journey: my family doctor who has been seeing our family for decades, gave me one of the diagnostic questionnaires, and then we tried different meds that don't work.
Last year, I decided to seek out a private self paid psychologist for a full neurological assessment: ADHD, intelligence (X2), depression anxiety bipolar autism you name it we went through it all. It was crazy expensive (Canadians aren't used to paying out of pocket for health care, except for those who are) but at the end of the day I have a fancy list of yes and nos that other doctors and specialists now respect that they didn't before.
Moral: pay. Ideally a specialist who themselves is neurodivergent and not from a country where they believe it's moral or behavioural in nature.
Yeah, I have found someone qualified to do the test, for 125 euro, in Bucharest. It's a 2 hour train ride but it just might be worth it.
Best wishes for the trip. And if it turns out you don't have ADHD, it's okay there are probably executive functioning books you can read to set up your life in a way that make a bit more sense to you. If you do end up with the diagnosis, we can go on the meds search together
To be honest, the quality of mental health services seem to vary a lot depending on the country, at least based on my experience seeking counseling years ago in the US versus another western country (the US being worse). At the same time, it's a dangerous thing, as a patient/non-expert, to be shopping around for opinions beyond simply getting a second opinion, since you'll eventually be able to find someone who will affirm your potentially incorrect theory of what's going on. There's also something to be said about mental health treatment being both a science and an art. How do we define when something is truly pathological or normal person-to-person variation? One definition might say something is a mental health disorder when it gets in the way of work, relationships, and/or your physical health. But, there are a million things that limit our ability to be perfect worker bees or perfect friends and it would be strange to want to medicalize all that. In Romania, I would expect them to have a different set of paradigms in mental health treatment which, completely separate from the question of how good or bad the care actually is, have their own set of justifiable trade offs. I don't have an answer for your situation but those are just some things to chew on.
The average Romanian mentality towards mental health is "uh, just be normal like everyone else?" unfortunately.
So I'm definitely fighting against the current just by pursuing the DIVA-5 so insistently.
I had a very different experience in the US. I got a referral from my GP to see a psychiatrist for a diagnosis. They asked me like 5 questions and then started doling out prescriptions, it was like a 5-10 minute appointment. I was hoping to have a more comprehensive assessment but at least I got to try out the drugs. I haven't been a fan of anything they have prescribed so far though, but it has been as easy as emailing them, saying this one doesn't work and describing the issues for them to pick another. The drugs themselves have been expensive as fuck though and that coupled with not finding success with the ones they prescribed led me to stop and go back to my old coping mechanisms.
It took me two tries to get referred for a DX. The first request was denied because my therapist thought I was just anxious. When I brought it up a year later with my psychiatrist, she immediately referred me. My test was just me in a room with a computer with a program that frustrated me to no end. Two days later, I had my diagnosis. I think I got really lucky, because my psychiatrist had to deal with me being late to appointents a few times as well as forgetting before and she knew I was ADHD before my request.
I've heard that ADHD tests are frustrating on purpose, to observe how you deal with that - seemingly the DIVA-5 repeats questions a lot just to give the interviewer time to observe you, your mannerisms, and your attention span.
I'm really curious how it'll go, I just hope I don't end up masking, or worse, lying, to get through it more easily.
:) pretty sure if you lose interest and stare out at middle distance in your internal happy place, that's probably one of the criteria as well
My siblings had a time getting diagnosed, and struggle with getting Adderall reups every time that rolls around. My experience was seeing a psychiatrist when I was coming out of school and Adderall making me sleepy, and revisiting it recently where a psych talked about how he could run an ADHD diagnosis or just help with better coping mechanisms, and I dipped because it didn't feel helpful to me for the rate I was going through my deductible. My bias is that I'm adverse to the idea of long term medication, especially given the environment, but it certainly wasn't something I was pushed towards in my recent go around.