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What goes on during one of these? I took meds for ADD for 6 years and was able to function, then I moved to a city with different prescribing laws and couldn't get meds and I was completely non functional and not working for a year. My case is pretty extreme, and I'm going to be eligible in my area to be treated again but I have to do a very expensive assessment first. What goes on during an assessment? I'm very worried about wasting $500 and them just telling me it doesn't sound like ADD and then not being able to work for even longer. :( I...acquired some low dose Concerta and I've felt like my old self again work wise and was able to do enough to save up for the assessment and I'm so scared about this feeling of normalcy ending.

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I did neuropsychiatric testing five years ago. I don't remember a lot of particulars about the specific tests, but it took a few hours and was administered by a clinical psychologist, who subsequently wrote up a report and sent it to my psychiatrist. The psychologist concluded that I seemed to have some deficits in performance, but   attributed it to my anxiety instead of ADHD, partly because I had not had an ADHD diagnosis as a child, I assume. But I debated this point with my psychiatrist, who finally prescribed me a stimulant on his own and seems confident saying that I have ADHD. Not sure what the laws are where you are, but my experience (in the US) suggests that there may be more than one path to diagnosis. You don't mention what your current diagnosis is, but it's also not uncommon to get a stimulant prescribed for treatment resistant depression, so it's not clear what you mean when you say that the stimulant made you "able to function."

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On 6/12/2019 at 5:07 PM, looking for answers said:

Ive never had to have an ADD assessment. I would assume a psychiatrist of pcp would be able to diagnose you. Are you in the states? If you dont mind me asking how are the laws different?

In Texas now, I don't think it's law but it's happening everywhere that doctors are trying to CYA so now even if you've had a diagnosis and you move, you HAVE to have an assessment done by a psychologist first and then they refer you to a psychiatrist now who may or may not prescribe for you.

Also, the assesment is about $500 out of pocket that my insurance that I pay a $300+ premium on monthly doesn't pay and it doesn't go toward my deductible. For the chance to maybe get a prescription but probably not -- here they try really hard now to just give you Wellbutrin or Straterra. It's a nightmare because of the 'opiod crisis.'

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On 6/12/2019 at 5:17 PM, Unstrung Harp said:

I did neuropsychiatric testing five years ago. I don't remember a lot of particulars about the specific tests, but it took a few hours and was administered by a clinical psychologist, who subsequently wrote up a report and sent it to my psychiatrist. The psychologist concluded that I seemed to have some deficits in performance, but   attributed it to my anxiety instead of ADHD, partly because I had not had an ADHD diagnosis as a child, I assume. But I debated this point with my psychiatrist, who finally prescribed me a stimulant on his own and seems confident saying that I have ADHD. Not sure what the laws are where you are, but my experience (in the US) suggests that there may be more than one path to diagnosis. You don't mention what your current diagnosis is, but it's also not uncommon to get a stimulant prescribed for treatment resistant depression, so it's not clear what you mean when you say that the stimulant made you "able to function."


Ugh I'm worried about not being able to get the diagnosis now because I was diagnosed as an adult and not as a child, I've had a psychiatrist here say that that means I don't really have it but I grew up in a poor neighborhood in the 80s and literally nobody was diagnosed.

I've had a long battle and I had to take last year off completely because I moved and couldn't get my meds refilled so I had to go cold turkey off Adderall and Clonazapam.

Now that I'm out of withdrawal and my thyroid condition is being treated better, I have almost no issues with depression anymore (been good for about 8 months now off antidepressants/anxiety meds) and so all that's wrong now is my inability to focus.

It's debilitating, and I've gone the route of working with my endo about it because thyroid issues CAN cause brain fog, but this goes beyond that.

I'm unable to focus and I have zero motivation, despite otherwise feeling great. I'm a self employed graphic designer and I really can't work -- I open the software I've used for 15 years and that I've been certified in and I don't know where to begin. Even really simple tasks...I'm  so easily confused and can't stay on track and I have no motivation.

I've made lists upon lists but I forget how/where to access the lists or that I even made them. I feel like I've maxed out all the dietary and natural things to fix it and it's not working -- I started biking 30 miles/week a few months ago, I eat a super healthy gluten free diet high in Omega 3s, I supplement whatever I can and get plenty of sleep and water...I'm in great health I just can't work for shit.

Straterra makes me puke and Wellbutrin just makes me irritable. 

Right before I moved I was named among the Most Influential and Inspirationl Entreprenuers in Silicon Prairie by a prestigious magazine and now I can barely get through a 15 minute convo with a potential client without bluescreening at least once. It's bad and nobody here is taking me seriously and I'm soo frustrated because I need to work to pay for my health insurance in the first place.

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2 hours ago, yellowlovesgray said:

I'm unable to focus and I have zero motivation, despite otherwise feeling great. I'm a self employed graphic designer and I really can't work -- I open the software I've used for 15 years and that I've been certified in and I don't know where to begin. Even really simple tasks...I'm  so easily confused and can't stay on track and I have no motivation.

 

I hear you. Having similar problems myself with intensely poor focus and motivation, even with Adderall, which helped for a good while when I started taking it, but has been a diminishing returns situation over time. I see you have GAD as well. I'm approaching things right now by trying to control the anxiety, in hopes that a level of anxiety I'm not completely conscious of could be getting in the way of my focus. Certainly, not being able to work and flatlining every time you try is anxiety provoking, so that's certainly part of the picture with me. Maybe also with you? Also doing some behavioral stuff to try to focus on work in small chunks of time, and recently started supplementing with B vitamins and NAC, which maybe be helping. Hard to say, but I've gotten a little done this week. But maybe you'll get your ADHD diagnosis, and if not, it's also not impossible that you'll find a doctor who will prescribe a stimulant even without an ADHD diagnosis just based on treatment resistant depression. It's certainly frustrating.

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I had an adult diagnosis based on who knows what, surely no formal testing. When I switched pdoc the new one didn’t pull me off concerta or test me but said he was sure I didn’t have adhd. More recently he changed his mind based on experience with treating me over time. Go figure. But if I moved or changed pdoc again, who knows. I hate these trends in stopping meds we see lately. I totally have had brain fog. I hope you test accurately whatever that may be, so you can get what you need. (As an aside, hormonal stuff gave me brain fog too, but that doesn’t sound relevant in your case at all). 

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On 6/12/2019 at 5:22 PM, yellowlovesgray said:

What goes on during one of these? I took meds for ADD for 6 years and was able to function, then I moved to a city with different prescribing laws and couldn't get meds and I was completely non functional and not working for a year. My case is pretty extreme, and I'm going to be eligible in my area to be treated again but I have to do a very expensive assessment first. What goes on during an assessment? I'm very worried about wasting $500 and them just telling me it doesn't sound like ADD and then not being able to work for even longer. :( I...acquired some low dose Concerta and I've felt like my old self again work wise and was able to do enough to save up for the assessment and I'm so scared about this feeling of normalcy ending.

I have the same fear - it's always a pain in the ass when you switch pdocs to try and get stimulants. I was initially prescribed one for treatment-resistant depression. I also grew up before they started diagnosing kids with ADHD...I have had my pdocs write an official letter stating how long I was on it, and how the treatment greatly helped my functioning...but I still worry if I change doctors this tactic won't be sufficient and I'll be required to do this expensive assessment also. i hope all goes well. Just describe your related symptoms like you did here, and say how it has greatly helped your ability to function/work.

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I went today, and we had an hour long talk and a one-sheet long list of questions with yes or no answers, and then when the therapist asked me if I had any questions, I inquried about what was next and she said that they'd contact my insurance to get some guidance about what they'd pay for, and then they'd let me know if I needed extended testing in a week or so.

...why do I just know that their diagnosis is going to be based on what my insurance will pay for? 

Also, I mentioend that I really need to return to work and they asked me if I had anxiety about it, and I said that I speak to a therapist already and we both think it's a substantiated fear that I haven't been able to work in over 6 months, and they suggested that I had simply an anxiety issue that needed to be medicated.

I think not being able to work and therefore not being able to pay for your health insurance is a completely valid substantiated fear....

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18 minutes ago, yellowlovesgray said:

I went today, and we had an hour long talk and a one-sheet long list of questions with yes or no answers, and then when the therapist asked me if I had any questions, I inquried about what was next and she said that they'd contact my insurance to get some guidance about what they'd pay for, and then they'd let me know if I needed extended testing in a week or so.

...why do I just know that their diagnosis is going to be based on what my insurance will pay for? 

Also, I mentioend that I really need to return to work and they asked me if I had anxiety about it, and I said that I speak to a therapist already and we both think it's a substantiated fear that I haven't been able to work in over 6 months, and they suggested that I had simply an anxiety issue that needed to be medicated.

I think not being able to work and therefore not being able to pay for your health insurance is a completely valid substantiated fear....

Ugh. I hope they don't make the assumption that your problems are all anxiety-related without actually evaluating you. I found that completely infuriating that the psychologist who evaluated me just decided without really any evidence that my deficits that he identified were based in anxiety rather than ADHD. I mean, you can have both. They're not mutually exclusive.

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3 hours ago, Unstrung Harp said:

Ugh. I hope they don't make the assumption that your problems are all anxiety-related without actually evaluating you. I found that completely infuriating that the psychologist who evaluated me just decided without really any evidence that my deficits that he identified were based in anxiety rather than ADHD. I mean, you can have both. They're not mutually exclusive.

I'm pretty sure that's where they're going with this, the therapist really fixated on it even AFTER I told her that I've been speaking to a therapist on Teledoc since it's free with my insurance since January. My therapist on Teledoc literally doesn't have anyhthing more useful to tell me about ADD so we just talk about how frustrated and jaded I am about this not being fixed in our system and how upset I am about it and how to deal with it.

I have ZERO other stressors in my life besides this -- I'm in REALLY good demand professionally I just can't take the work. And I work in a very cool industry, I have a job that a lot of people would love to do for free and I have a ton of critical acclaim.

...why would I be making this up?? I don't udnerstand why they won't just treat it, especially since I had a diagnosis for a decade in another city with records that I already faxed and dozens of pill bottles to show.

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11 hours ago, Unstrung Harp said:

Ugh. I hope they don't make the assumption that your problems are all anxiety-related without actually evaluating you. I found that completely infuriating that the psychologist who evaluated me just decided without really any evidence that my deficits that he identified were based in anxiety rather than ADHD. I mean, you can have both. They're not mutually exclusive.

I had the same thing happen to me! Went in for a formal ADHD assessment, I filled out a stupid checklist type questionnaire and then had a short interview with someone. Despite me having most all inattentive ADD symptoms (going back as a child, from outside accounts/parents) they said deficits were all depression-related. (like people can't have co-morbid diagnosis? bah..) Mind you, this was in europe where they don't really believe in ADHD, I'd assume it is totally different in the US because stimulants seem to be handed out like candy a lot of places. Maybe things are changing.

This was AFTER my pdoc at the time had first trialed me on a stimulant and its been the main med that has helped BOTH my depression and focus issues....I had already been under his care and on the med for nearly a year....Now the real PITA bit, everytime I switch pdocs, I will be forced to go through this BS assessment hoops riggamaroll again, then denied. They charge A LOT of money to be specifically assessed by a specialist for ADD (usually around $500). I feel like I'll have to exaggerate the ADD and not mention my depression at all. Stupid!!!!!

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4 hours ago, Blahblah said:

I had the same thing happen to me! Went in for a formal ADHD assessment, I filled out a stupid checklist type questionnaire and then had a short interview with someone. Despite me having most all inattentive ADD symptoms (going back as a child, from outside accounts/parents) they said deficits were all depression-related. (like people can't have co-morbid diagnosis? bah..) Mind you, this was in europe where they don't really believe in ADHD, I'd assume it is totally different in the US because stimulants seem to be handed out like candy a lot of places. Maybe things are changing.

This was AFTER my pdoc at the time had first trialed me on a stimulant and its been the main med that has helped BOTH my depression and focus issues....I had already been under his care and on the med for nearly a year....Now the real PITA bit, everytime I switch pdocs, I will be forced to go through this BS assessment hoops riggamaroll again, then denied. They charge A LOT of money to be specifically assessed by a specialist for ADD (usually around $500). I feel like I'll have to exaggerate the ADD and not mention my depression at all. Stupid!!!!!

Yeah, that's really frustrating. I'm lucky I have a Pdoc who really listens to me and views our relationship as a collaboration. We got the assessment report, I told him why I thought the psychologist's conclusions were bullshit, and he tried me on Adderall, which was really helpful for a long while (less so now). 

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Although we did not have the diagnosis of ADHD yet when I was a child (I'm 56 now) my pediatrician was a head of his time and tried it on me (They thought I had a learning disability and I do). It really helped me start to function better in school. Since then as an adult I have had no problems getting amphetamine for my ADHD, I have seen 3 psychiatrists in my adult life and it was clear to all I had ADHD. No one ever asked to see old records or do testing. It seems taking a stimulant as a child is a key sign.

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1 minute ago, notloki said:

Although we did not have the diagnosis of ADHD yet when I was a child (I'm 56 now) my pediatrician was a head of his time and tried it on me (They thought I had a learning disability and I do). It really helped me start to function better in school. Since then as an adult I have had no problems getting amphetamine for my ADHD, I have seen 3 psychiatrists in my adult life and it was clear to all I had ADHD. No one ever asked to see old records or do testing. It seems taking a stimulant as a child is a key sign.

Which is problematic, because girls in particular are less likely to be identified as children, because we tend to act out less and not get referred for assessment for behavioral reasons. And it's a real thing to be able to handle the structure of childhood reasonably well, particularly if you are academically strong at baseline, and to then come up against the expectations of being a teenager and and adult and having to structure your own time and juggle multiple priorities, and to hit a wall of your own limitations. So the idea of not getting a diagnosis because you were never diagnosed is really bizarre. I'm not shooting the messenger here, because I think you're right, that is the key. But it really shouldn't be. 

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3 hours ago, Unstrung Harp said:

Which is problematic, because girls in particular are less likely to be identified as children, because we tend to act out less and not get referred for assessment for behavioral reasons. And it's a real thing to be able to handle the structure of childhood reasonably well, particularly if you are academically strong at baseline, and to then come up against the expectations of being a teenager and and adult and having to structure your own time and juggle multiple priorities, and to hit a wall of your own limitations. So the idea of not getting a diagnosis because you were never diagnosed is really bizarre. I'm not shooting the messenger here, because I think you're right, that is the key. But it really shouldn't be. 

Agreed. I had a friend who struggled with this and it took some time to get to a provider who would treat ADHD in women.

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1 hour ago, notloki said:

Agreed. I had a friend who struggled with this and it took some time to get to a provider who would treat ADHD in women.

Which is especially unfortunate, because women tend to find themselves in life situations involving more rather than fewer expectations relative to men, and it can be a real challenge to try to manage all of those expectations if you have ADHD. 

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On 6/20/2019 at 12:37 PM, Unstrung Harp said:

And it's a real thing to be able to handle the structure of childhood reasonably well, particularly if you are academically strong at baseline, and to then come up against the expectations of being a teenager and and adult and having to structure your own time and juggle multiple priorities, and to hit a wall of your own limitations. So the idea of not getting a diagnosis because you were never diagnosed is really bizarre.

 

On 6/20/2019 at 7:13 AM, Blahblah said:

Despite me having most all inattentive ADD symptoms (going back as a child, from outside accounts/parents) they said deficits were all depression-related. (like people can't have co-morbid diagnosis? bah..)

I worry about this. I will hopefully be getting an assessment done in the next month or so and I worry about getting a false negative. I want to believe that the tests are accurate and sophisticated enough enough to give a correct result, but depression and decades of coping mechanisms muddy the waters, not to mention the stereotypes about ADHD.

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