Everything you wanted to know about adult ADHD....
December 9, 2017 12:28 AM   Subscribe

....but were afraid to ask. I'm pretty sure - in large part because of what I've learned here! - that I am an adult with ADHD (who was once a very unhappy kid with ADHD). But my PCP visits have never left a space for this and I am anxious about being labeled a drug seeker. Those of you who have this diagnosis and who have been helped by making it official - how, exactly, did you go about it?
posted by anonymous to Health & Fitness (9 answers total) 14 users marked this as a favorite
I ended up talking to my mental health prescriber about the symptoms I was having during an appointment for something else. For me that was mostly really severe inattention, lack of focus, and difficulty getting work done. She went through a checklist with me and I had every single symptom. She let me know she thought I had ADHD and because of how much it was affecting my work, she suggested I try Adderall, which quite literally changed my life.
posted by fairlynearlyready at 1:01 AM on December 9, 2017 [4 favorites]

I ran across some articles talking about inattentive ADHD and they resonated with me so, so much. I tried to go straight to a psychiatrist but my insurance required me to go to my PCP, which was a complete waste of time on both our parts as he he just listened to me talk about why I though that I had it and said "oh I don't know anything about this, here go see a psych." So that took another few weeks but the psych PA completely agreed with my assessment and prescribed adderall. Like fairlynearlyready, it was life-changing for me.

I printed out some of the articles and highlighted symptoms that matched. The PA then asked me a battery of questions, some about childhood, some about current behaviors and tendencies. Based on my answers, she agreed.

My suggestion would be to find some articles or online screening tools and print out the results to bring to an appointment. (If you can go straight to a psychiatrist, I would, otherwise you'll have to waste time explaining to a PCP, or maybe you will be lucky and they can help you directly.) According to my therapist, if you have ADHD, you will notice a difference immediately, and if you don't it won't work so the provider might try something else.

Good luck!
posted by emkelley at 1:14 AM on December 9, 2017 [2 favorites]

Make an appointment with a psychiatrist.
posted by DMelanogaster at 6:40 AM on December 9, 2017 [1 favorite]

Here's my standard advice for this type of thing:

1. Do your research (sounds like you already have). Optional: Take an online quiz that looks fairly reputable (here's one, here's another, and print the results for your doc.

2. Make a list of your symptoms that make you think you may have ADD/ADHD, including additional detail on those that have a severe negative impact on your life. If you were the kid who couldn't stay still in school, or who was daydreaming all the time (inattentive-type ADD); if you've had trouble at work because of your difficulty maintaining focus, if you find yourself paying a lot of late fees because you lose track and forget to pay bills on time - those things should go on your list.

3. Keep an open mind. You may or may not have ADHD. You *do* seem to have a problem of some type - other conditions can be misdiagnosed as ADD/ADHD (and ADD/ADHD can be misdiagnosed as other conditions). You don't want a misdiagnosis - you want the truth.

4. Here's how I'd approach my doc on something like this: "I have symptoms x, y and z. They affect my life like this (your list from point 2 above). I've read about ADD/ADHD and a lot of this is true for me - here are my quiz results. I'd like a referral to be evaluated for ADHD. Of course, whatever the issue is, I need to figure it out resolve my symptoms so that I can do better at home, work, school, etc."

Your doc might talk through your symptoms a bit. Assuming your symptoms are anything like mine, and cause issues with your quality of life, you should get a referral.

You don't need to mention medication at that point. Based on my experience, it's very unlikely that you would get a diagnosis of ADHD and not be offered medication in the U.S., though you should look into all the other things that can help with managing ADHD symptoms - with or without meds - including exercise and therapy/coaching. In my experience my docs have been quick to medicate me but have not always been helpful in helping me manage the medication by eating at the right times, etc.

5. Assuming you get a diagnosis and are offered medication - there are several different meds for ADD/ADHD and sometimes it takes a while to find the right one and the right dosage. Some meds can make you forget to eat, and you may need to set reminders to hydrate and eat, and make sure you have decent snacks on hand, including protein. I have to watch my caffeine intake especially when I am adjusting to a dosage increase.

Additude is a helpful resource.

Good luck!
posted by bunderful at 6:44 AM on December 9, 2017 [3 favorites]

My daughter was diagnosed by her pediatrician. In researching it, I found research that it could be inherited, and a list of symptoms and related behaviors that matched me. The next time I went to my PCP/GP, I explained all this, he put me on ritalin. Really no big deal.
posted by rudd135 at 6:45 AM on December 9, 2017 [3 favorites]

Primary care provider here! We often have trouble with adult adhd diagnosis because there are no commonly used diagnostic tools (like the Vanderbilt for kids) and because some people DO work the system for drugs and make us nervous. I would ask for a referral to a psychiatrist with experience in adult adhd, if that’s not financially possible for you, bring any documentation that you have of your diagnosis and treatment as a kid-that really helps us feel that people are legit.
Finally be open to non-stimulant meds, at least to start. When people only want the amphetamines and nothing else we worry
posted by genmonster at 8:41 AM on December 9, 2017 [1 favorite]

I just went through this.

Two weeks ago I went to my PCP about this. When I told him why I thought I had ADD, he agreed but referred me to a neurologist (I don't know why that instead of a psychiatrist) for an official diagnosis.

I went saw the neurologist yesterday and was diagnosed and prescribed medication, which I took the first dose of yesterday. It was annoying to have to take the extra step, but I shouldn't have to keep seeing the neuro, since my PCP said he'd be willing to prescribe once I had the official diagnosis.

If you don't have an especially good relationship with your PCP, I second (or third, or whatever) the advice to go straight to someone who can give you a diagnosis, if the situation allows.
posted by Tabitha Someday at 10:41 AM on December 9, 2017

Here’s what I wish I had done when I first realized ADHD might be my problem:
  • Made an exhaustive list of all the things in my life that I kept getting in trouble for — at work, domestically, financially, etc. — and when it had dawned on me that those problems were not “just what everybody copes with only they cope better because they aren’t lazy and selfish and evil
  • Investigated how my insurance was set up to support a Dx — in my case, going to my GP was a mistake (she assumed I was depressed and threw a bunch of Wellbutrin at me instead), but going to counseling and obtaining a psych referral was more useful
  • Recognizing sooner that my first psych referral wasn’t a good fit for me (though she acknowledged the ADHD she spent most of our appointments lecturing me on the differences between men and women). Asking for a re-referral as soon as the word “homeopathy” came out of her mouth.
  • Been more honest about how I’d already tried to cope without an Rx (or by self-medicating with caffeine) for decades, and while I was nervous about going on speed for life, it was already time for last resorts.
The fear of being seen as a drug-seeker is all too common among folks with real ADHD — especially adults who have already been criticized and blamed all our lives, and are now being accused of making excuses and just being (again) evil/selfish/lazy. Your best defense against this is going to a specialist with copious notes in hand (ADHD tends to rob you of your planned talking points at Dx time) and acknowledging out loud that you wouldn’t even be asking about meds if any normal-people solutions had worked for you.

It’s not easy, but it’s within your grasp to get answers and support, and it’s soooo worth it when you do. Good luck!
posted by armeowda at 7:13 PM on December 9, 2017 [3 favorites]

I did this!

Finding a doctor: I googled doctors in my area that specialized in adult ADHD, read their bios to find what sounded like the best fit, then emailed their office and asked for an appointment. (as a bonus, I found that many doctors who specialize in treating adult ADHD also themselves have adult ADHD, which made me feel a lot better about being taken seriously.) Admittedly this might not be an option for you if you're not in a major city, and these docs often also have a month-long waiting list at least.

They emailed me a checklist to fill out beforehand. I did that.

The intake appointment itself was just the doctor asking questions -- most of which I expected from the forms and suchlike, but also a few regarding symptoms that I didn't think were ADHD related, but turned out to be (for example, having a bad sense of direction). After about an hour, I left with a prescription for stimulant medication, plus a titration plan, and a follow-up appointment in about a month to see how that worked out. I reported back a month later basically saying "this changed my life" and am now at quarterly follow-ups to monitor how I'm doing.
posted by Xany at 3:53 PM on December 10, 2017 [1 favorite]

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