Who diagnoses add anyways?
August 26, 2012 6:18 PM   Subscribe

I don't have a primary care doctor, who should I see about referrals for ADD/ADHD evaluation?

I'm not sure it's something I'd like to pursue, but I'd like to at least figure out how much evaluation would cost to me. I don't really have a primary care doc (I go to college, I hate going to the doctor so I haven't gone to one regularly and the last few I went to are all at home across the country).

There are nurse practitioners available for free appointments at school, as well as short-term counseling services, neither of which seem exactly right.

I saw a psychologist all summer (~3 months) for related issues, we talked about strategies for work but never about diagnoses. He, too, is across the country. I feel like he is the right person to talk to, but he's less accessible if I can't make an appointment (and I don't want to pay for his time if I don't know exactly what I want to ask him).

When I've talked to the behavioral department for my insurance before, they've actually been pretty nice - would it be crazy to call them?

I've heard past accounts on metafilter, but if you have any experience with this process I'd be happy to hear it. I'm terrified that I'll seem like a drug seeker, especially at a school with very high study drug abuse rates, but I'm not really looking for medication explicitly (unless a doc familiar with my situation thinks it would help me, then yeah I'd like to do whatever they recommend). I've had really acute issues with difficulty doing my work, but I'm only slightly less scared of doctors than I am of facing another year like the last few.

Keeping costs low is a concern, but I'm $100 away from my deductible right now (thx therapy) so if it's likely to be covered by my generally okay insurance than that's fine.

Anon email: mefiquestionadd@gmail.com
posted by anonymous to Health & Fitness (8 answers total)
I would start with a NP or counselor at school. They'll be unlikely to just throw drugs at you because adderall abuse is a problem on college campuses, but that's fine since you want to get properly screened anyway. I would actually avoid bringing ADHD up first - lead with your symptoms as the problem you are trying to solve.

Hopefully they will refer you to someone - if not, then you can go with a plan b. good luck!
posted by lunasol at 6:28 PM on August 26, 2012

Certainly call the mental/behavioral health line for your insurance to find out whether you even need to get a referral. My insurance does not require it for mental health, although I do have to stick to their in-network providers if I want to get full benefits.
posted by drlith at 6:30 PM on August 26, 2012

Also, medical professionals who work with college students should be well-versed in ADHD. If you have a problem or are treated like a drug-seeker, I would consider going to a dean or ombudsman. Yo have the right to be taken seriously, especially on something that impacts your ability to learn.
posted by lunasol at 6:31 PM on August 26, 2012

I would also go to the college health center, with the understanding that they might or might not be able to help you. My goal would be to get a referral from them, and if it's going to be private and cost you, I'd specifically ask them to find you somebody who takes your insurance. The person you're referred to should be a psychologist or psychiatrist.

Or -- can you e-mail the psychologist you saw with your concerns?

Keep in mind that diagnoses for ADHD are made on the basis of interviews. It's not really "hard science" or a specific "entity." (in my opinion)

What are you looking to get out of a diagnosis of ADHD? Have you done some reading about it? I would highly suggest you start with "Driven To Distraction" by Hallowell. His "Delivered From Distraction" is also an excellent book.

Maybe after looking through these books you'd have a greater sense of where you are and what kind of help you'd like to pursue.
posted by DMelanogaster at 6:50 PM on August 26, 2012

unless you are willing to bare your soul, your life is falling apart, and you have a good story to tell them, i think they'll be very skeptical. i'm sorry, that's the experience i had anyway.

it's the start of the school year, i'm sure your school councilors/psychologists are or soon will be flooded with people who think they have ADD/ADHD.

especially if you're only $100 away from your deductible, i say go all out and find a psychologist/psychologist with the most experience that your insurance will cover. there are still 4 months left in the year, take advantage of your over-deductable-ness.
posted by cupcake1337 at 8:48 PM on August 26, 2012

If you're that near the deductible mark, might I suggest going to a psychiatrist who specializes in ADHD? They will be more likely to know if this is your diagnosis, as they've the most experience with it. And if they believe that you need meds, they will be comfortable with prescribing them, which generalists sometimes aren't. (Got taken off my meds by a psychiatrist who wasn't a specialist because he didn't feel comfortable with prescribing them because I wasn't diagnosed as a child. I was told to seek a specialist.)
posted by Meep! Eek! at 9:07 PM on August 26, 2012

There are nurse practitioners available for free appointments at school, as well as short-term counseling services, neither of which seem exactly right.

Perhaps not for the referral but they are free, accessible and infinitely more likely than Random Internet to have a clue as to how to pursue this in your particular venue. Your possible situation is commonplace in the university setting: what's more depending on where you are legitimate learning disabilities are likely a protected condition that the school is obligated to help with. Your school may have a disability services coordinator. If so this person would probably be happy to point you in good directions.

Never avoid the obvious particularly when it's free.

If I might humbly suggest given your aversion to the doctors you are maybe unnecessarily complicating this because doing internet "research" is less intimidating than actually doing something about it? I only say because I, ahem, resemble that accusation. But for real, working on getting over your doctor avoidance in general would be a really great goal for your ongoing self-care. You're more likely to get away with it when you're young but it is a terrible and irrational policy to go through life with.
posted by nanojath at 8:21 AM on August 27, 2012

I actually just did this, 6 weeks ago. It cost $149.60, through the behavioral health clinic of my local hospital. (I have terrible insurance, and it doesn't cover mental health, so they gave me a discount.) The whole experience was pleasant and fascinating. The guy I saw actually specializes in psychological assessment. His website hasn't been updated in a couple years, but if you run into trouble finding a similarly qualified specialist in your area, his sidebar links should help.

No one treated me like a drug-seeker, but then I already had a prescription for ADD meds, from my primary care doc. One thing the specialist told me that you might find useful: the meds only help with one or two components of executive function -- for the rest, you need skills, i.e. practice and workbooks and stuff, in order to train your mind and thereby change your brain. So I'd suggest you make it clear that you're looking for treatment that's been clinically shown to help with all your problem components.
posted by feral_goldfish at 8:26 AM on August 27, 2012

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