ADHD

I was diagnosed about a year ago. I’m mid-60s. I was given a preliminary inventory to complete and then met with a psychiatrist for further evaluation. She asked me questions and we dug into some topics more than others. Most were about challenges I’ve had in life. At the end she prescribed a medication. I followed up monthly, had a med adjustment and now follow up every 3 months.

As far as other symptoms, I’ve dealt with low thyroid, low testosterone as well as depression. When my child was noted in school to have dysgraphia (poor or illegible handwriting) it brought into focus that I had the same learning disability. This was previous to my adhd diagnosis so I can’t comment on that issue. I work in IT so I’m not bothered by disgraphia as I type everything anyway.

From what I've read in various online sources, it seems to vary a LOT between different providers, patients, locations, etc. Even those who live in the same general location seem to have had dramatically different experiences. But, here is what I remember my process being like:

• Made an appointment with a psychiatrist (THIS WAS THE HARDEST PART BY FAR AND I HATED IT - It took me almost an entire year from start to finish to find psychiatrists that were in-network with my insurance, had open availability that wasn't months and months out, I could get ahold of, specialized in my general areas of need (ADHD + other conditions), etc. Part of the problem was I kept giving up when I'd hit these barriers, to be fair)
• Had a consultation appointment with the psychiatrist where she asked me a lot of introductory questions, going over my general upbringing, career, daily life, concerns, symptoms, things that have helped or hurt, etc.
• Completed a few different questionnaires, some for ADHD and some for other things, like anxiety, and also had to share a questionnaire with my partner for him to fill out from his perspective on me
• Had a follow-up appointment with the psychiatrist plus another more senior psych, where we went through all of my results together and discussed my diagnoses, potential treatment options, etc.
• Had to visit a lab to get general bloodwork done, and also an electrocardiogram, to make sure there weren't any health concerns to be aware of (or that could explain my symptoms) before trying stimulant medications for the first time
• Got cleared with all of that, had an appointment where we settled on a first medication to try, and then continued to meet with the psych every 2 weeks while we titrated my dosage and medication type.
• Nowadays, I only have an appointment every ~3 months with a psych to check-in and continue my prescriptions and/or update things, etc.

I hope that is helpful! I know it is scary starting the process, but I can't stress enough how helpful it has been in the end for me. I'm really glad I pushed through and finally got help.

If it helps as well to hear what appointments were like, I found that the psychiatrists I have had (changed psychs occasionally due to moves) tended to be less interested in detailed discussions about feelings, emotions, or symptoms than my therapists have been. Not to say they aren't interested, they are and they specifically ask things about them. But, they have seemed more interested in a "do you experience this", "is it the same as before or improved/worsened", etc, and less interested when I would go on detailed explanations of exactly what I was thinking during a particular event or experience, if that makes any sense. For example, it seemed like they preferred "Most days, I feel like my symptoms are significantly improved during midday, but I tend to consistently get spacey and sluggish around 5 pm every day. Increasing water and protein intake hasn't seemed to fix it." rather than, "Well, it's different everyday, but I usually take my first dose around 9 or 10 AM or so. About an hour after that, I feel less "stuck" and am able to actually get up out of bed and do 'normal' things, like brush my teeth or get dressed. Sometimes I don't get anything done after that, but I still feel more 'normal', you know? I tried changing my lunch to include more protein, and......" I realize reading this back that this seems like generic advice to not be long-winded and overly explain things, not just for psychiatrist appointments, but I hope what I'm trying to explain sort of got across lol.

I now realize I've written a significantly longer (and long-winded, hah) comment than I intended to, but I hope it is helpful in some way to you or someone else!

I was diagnosed about 7-8 years ago, and I was in my early/mid 30s at the time. I was referred to a specialist by my pcp, and they started out by asking me some questions about my symptoms and whatnot. The final thing I had to do was take this computerized test thing that involved looking at a screen while doing some simple stuff. There were cameras that tracked my eye movement to determine how long I was appearing to focus on what I was supposed to be looking at (versus anywhere else on the screen or in the room). Afterwards, we talked about what meds/dosage to start out with. For the first 6 months or so I was going in almost monthly to adjust my dosage and/or switch meds entirely. Once we found something that worked, I started going in every 2-3 months to check in. Overall, not an unpleasant experience.

I've was in my late 30's on active duty in the military. As someone who has been in more than a decade, I still couldn't remember all my uniform pieces on workout days.

When I spoke to my doctor, he referred me of base for testing. There testing was fairly straight forward. There was some testing for learning disabilities and IQ. Mostly written work, but half was doing a rather long computer questionnaire. When I took the test for the ADHD it was a particularly bad day. Apparently the psychiatrist had seen 3rd graders with worse scores. I think she thought I threw the test. When the testing concluded I got the results and went back to base for the rest of the treatment.

I don't know your circumstances, but I would advise simply asking your doctor for a referral. They did check for other disabilities, and also other contributing conditions, like depression. Getting treatment started with a few different drugs in very small doses. My biochemistry muddy be off because I had significant reactions to those small doses, but just communicating was able to solve it all. There was even one that made me not want sleep anymore. On day 2, I called and they made me stop immediately (given that is pushing deadly if it continued). So definitely don't think it's all smooth sailing.

On the far side of that wall now it's amazing though. I can read again and play video games again for longer than a simple phone game. Once you figure out the right balance for your body chemistry, you'll be amazed you managed without it.

I got the questionnaire and an interview and the psychiatrists said, yeah that's probably ADHD.

The real epiphany I had when I went into a group therapy setting and suddenly I was somewhere where everyone fucking understood me! That's how I came to actually believe, yeah, it's probably ADHD.

However the diagnosis turned out to be somewhat irrelevant, what's relevant is to change yourself so that you can live with yourself.

“There’s no way you have ADHD since you didn’t have symptoms as a kid” … instead I have bipolar. I believe it’s ADHD, can’t get anyone to listen. I’m not hunting for god damn stimulants. Im 36 with 3 kids.. I just want help.

Before going to a doctor I would look up local/regional ADHD support and advocacy sites to see what they lost for late diagnosis options. A lot of folks will otherwise waste your time or tell you that since you made it this far a DX won't help.

I did this when seeking my ASD+ADHD diagnosis a few years ago as a 35yr old adult and my process was way less time consuming and frustrating because of that help.

It depends on the medical professional involved in the process. No matter what test they may or may not use, at the end of the day diagnosis is always up to the subjective opinion of the provider.

This was my process that started at age 28 while I was in graduate school. (I'm 30 now)

It started with a friend getting diagnosed. Talking to her about her symptoms, I kinda just thought all that was just normal existence. It then lead me to suspect that maybe my struggles weren't exactly "normal". So I dug into it and starting learning about ADHD through various online resources. Eventually became entirely convinced and self-diagnosed. I so cleanly fit the pattern ever since early childhood and while I had developed some decent coping strategies, things were always on the verge or in the process of falling apart.

I started with Cerebral which has the well-earned reputation of being a pill-mill company. I didn't even finish explaining my symtomology and background before the prescribing NP said "sounds like ADHD, here's an Adderall prescription". It took like 30 minutes.

Adderall was life-changing and helped a ton, but after a while I started getting some weird emails from people not associated with the "treatment team" at Cerebral asking me to make an appointment with a doctor to get drug tested. This was because they were getting heat from the DEA. I saw the writing on the wall and decided that the best move would be to find a new provider that was local to me.

So I got an appointment with a local place that mentioned Adult-ADHD. The process with them was supposed to consist of 2 separate 2 hour screenings. In the first meeting with them, I answered questions and explained my personal and family history, symptomology, and what medication treatment had been doing for me. That meeting ended up only lasting an hour, the Doctor thought my analysis of things was legit and she offered to continue treatment without needing the other 2 hour followup. I've been seeing that provider ever since and she's been great, eventually switched to vyvanse.

So yeah, I basically self-diagnosed, got treatment through a pill-mill. Jumped ship when it seemed like the company was going down, switched to a legit provider and used the effectiveness of previous treatment as a solid piece of evidence for why it should continue. No weird test needed.

This answer is for the USA.

A health care professional is going to ask you questions from the DSM (Diagnostic and Statistical Manual of Mental Disorders). There are 9 symptoms for each kind of ADHD. If you have five of one or the other, you have ADHD. The difficult part is, everyone does these things sometimes. The question is, do you do them often, and does it have a negative impact on your life. A mental health provider is going to have more training on evaluating you than a general practitioner. When it comes down to it though, anybody can ask the questions, you have to give the answers.

I scheduled a physical with my GP and figured I'd get to take care of everything at once. Unfortunately that's not how the helthcare system works. The doctors don't like to combine multiple ailments into a single visit, because they can't bill them that way. So I left with a referral to psych. I haven't gone yet and still don't have a diagnosis. If you're going to go the GP route, make a specific appointment for an ADHD diagnosis. Make sure to ask beforehand if your GP feels comfortable giving the diagnosis and, if you're interested, prescribing meds. If you don't ask, your GP is likely to wait til after you've paid your copay to tell you that you'll need to see a psych specialist.

Young adult (mid-20’s) ADHD diagnosis here.

I went to my general practitioner, who had prescribed me flu medications and stuff like that before and was covered by my insurance. I basically wanted them to refer me to a therapist or a psychiatrist, because I was grappling with huge depression and anxiety at the time from being on my own as an adult away at school for the first time.

As a side note, since it’s true, I want to mention I actually unbeknownst to myself was going through a bit of a major mental breakdown at this time which motivated my actions, because long story short, on top of the undiagnosed ADHD, I had been trying to hold myself to a standard of my peers, who all were older and more experienced and worldly than I was. And that was very difficult for me in an advanced program like I was taking, and this difficulty I had, I saw as flying in the face of the idea I was even equipped to be admitted to that program, in an “imposter syndrome” type way… despite being, again, literally younger than everyone else in the program, and being literally admitted to the program in the first place. Lol.

I was being very hard on myself with sleep and nutrition and stress about money, in a way I never had to be before, because again I had never been an adult before. I was up all hours and would sleep until late afternoon and was truant to classes—classes in my supposed field of career interest, no less—and didn’t desire to do any of the things I used to enjoy. And, when I went to classes to avoid failing outright, I was propped up on caffeine pills and coffee cans from the school vending machines—which was basically my ONLY coping mechanism aside from bad food.

It all got to the point where one time I left class while someone was presenting to vomit from stress in the school restroom, and then returned to class pretending nothing was wrong, lying to myself that I could take it and that I was normal and fine and so what big deal, class is over in two hours anyway.

I hated, HATED myself. I didn’t understand what what happening with me or why I didn’t want to do things I loved, or anything, anymore. All I knew was—and I don’t remember how exactly this became crystal clear to me, but it did, I had a wake-up call—that something was wrong, and I was not healthy and was actually suffering, in a way I never had before.

So, I went to my doctor, who I had seen before for like bacterial infections and viruses and stuff like that. In the hopes they could refer me to a psych specialist for, I don’t know, drastic hypnosis shock therapy or something, that they could tell me what to do, anything to make me feel like less of an abject failure of consciousness. And I started trying to explain myself a handful of times to my doctor, who listened and watched me talk to her, asking questions sometimes, trying to understand—but ultimately all I had to point to was my depression and anxiety and, like, hypersomnia, and difficulty at school, so it was hard for me to define the problem. I was actually embarrassed I was even sitting in the doctor’s office trying to communicate what was wrong without understanding myself.

Until she went “Okay, I see… so, I have a questionnaire I want you to fill out. And just looking at you and listening to you I have a feeling you’re going to score highly on it.”

And, wouldn’t you know it—I did score highly on it! Turns out, a doctor’s job is to identify what is wrong with a patient for them, so there’s literally no reason to be embarrassed about seeking a diagnosis at all!

Suddenly all my baggage… didn’t matter. The imposter syndrome, the pressure, the feelings of failure, all the nonsense about my mental issues at college that you had to slog through to get to this point in my comment, which clouded my ability to explain what was wrong to anybody including myself? It didn’t matter. All that mattered was my symptoms, which were validated by my doctor as real and serious, and the available treatments and coping mechanisms I could use to take back control of my life.

Edit to add: Presently, my outcome is pretty positive, as well. I hold down a full-time job and drive to work and have a dog and everything.

I’m in a place now owing to my diagnosis where I am looking into therapy to start to address and unpack what I understand to be underlying traumas from going through primary school/early life in general without a diagnosis, and the mental impacts of that on my brain in development. I have no doubt if I didn’t have my diagnosis, I would be ill-equipped for that kind of shadow work, let alone particularly interested in undertaking it.

I had to answer a questionnaire (did you know that NT people can quiet their brains?? Like, thinking about absolutely nothing, and have a purely silent mind. I had no idea!) and answer on a scale of 1-5. While this was happening, the doctor would randomly start conversations with me. While there, I thought she was just being annoying, but I think it was part of it to see how my focus gets derailed (it derailed and destroyed every town nearby). Then, I had to wait for a board review (about a week or two). Then, I had to sign a thing saying that I won't abuse any meds and that I consent to urine tests and pill counts if the doctor thinks I'm abusing the meds. I don't want to take meds in the first place, and absolutely hate the side effects, but man! That brain quiet was amazing! Good luck! May your right treatment be prescribed to you the first time.

Not op bit just wanted to thank you all for your responses. I have a Dr appointment in a couple weeks and want to ask them about an assessment. Likely just going to ask for a referral but want to be prepared. Kinda stressing but reading your experiences has helped a bit. So once again thank you. Been putting this off for way too long.

Late 30s here. I was diagnosed as a kid, on meds for a couple months before my parents didn't like the emotion nullifying effects it had on me. Proceed to forget entirely about it until Covid hit.

So, mine (as an adult) was virtual and I was (am) incredibly stressed so my symptoms were through the roof. In a single hour session I had my diagnosis and a prescription. It was mostly the doc asking me questions. No formal test or anything like that, but this guy's specializes in it - so I think my experience might be a bit different than the norm.

Diagnosed at 43-44. Went to psychologist, talked about why I wanted an assessment, did a questionnaire. Had a second appointment, asked questions based on first questionnaire, did another one while also assessing for other co-morbidities. Wound up doing at least two more questionnaires, plus my spouse and wife did one each. Received ~10 page report that several aspects of the ADHD “spectrum”, as well as other common co-diagnoses such as anxiety, depression, autism. We discussed to ensure I was ok with it and understood it, she suggested other resources and tools, and I took that to my PCP to start trialling medications.

Late 30s for me as well. I'd been struggling to get things done at work and around the house and reached out to a counselor/therapist to talk it over. He immediately identified ADHD symptoms and helped me 1) connect with a psychiatrist 2) lay out and practice the language I'd need to accurately communicate it to the provider and, maybe most importantly, once I started medication...3) help me identify, practice, and reflect on systems in my life to make the most of my new brain chemistry like productivity tools, meditation, etc.

Highly recommend adding some sort of therapy visits to your care if that's feasible.

I was diagnosed approx a year ago. Late 40's. I saw my GP for a referral to a specialist. The wait was about 9 months. GP and specialist asked why I thought I might have adhd. They asked about how school went, work habits, etc. I filled out a long questionnaire that really helped me to see how obvious it was that I have adhd. I did a zoom call with the specialist and his partner. It was pretty cut and dry which really floored me. He faxed an Rx to my pharmacy, but said to start at a low dose, but move up quickly as I likely need a higher dose. Parts of it were embarrassing. I'd tried to hide it for so long and I guess I thought I had? But nope. My life is clear evidence of adhd. I started vyvanse and I still have adhd, but getting work done isn't impossible for me. I should probably be on a higher dose, but it's a fine balance. If i was diagnosed and treated as a kid, im positive my entire life would be different. Anyhoo. Thanks for reading.

P.S. I have dysgraphia, which was diagnosed when I was a child. To my knowledge, no professional ever diagnosed me with ADHD. I've tried to ask my mom about this, but she's being cagey. She says, "we all knew you had ADHD." I was never given medication for ADHD. The only help I got was for the dysgraphia. All this is to say, if you want to get help for another disability you will absolutely need to be proactive.

I was diagnosed 10 years ago via a neuro-psych assessment. It wasn’t cheap but I wanted to assess for other areas of needs, such as short term memory retention. The assessment included an interview followed by several hours of structured testing.

These days, I believe there are quicker ways to test specifically for ADHD via a limited set of questions. A psychiatrist can certainly do this but most primary care physicians should also be able to as well. Depending on where you live, access to psychiatry might be limited and your primary care physician may be the one to manage your meds (if warranted) in any event. A psychologist may be able to diagnose ADHD but can’t offer medication options.

Re: learning disability/dyslexia, the neuro-psych testing can identify these issues. There may be simpler, more cost effective methods to identify these or other deficits. If you potentially need accommodations in the workplace, they may require some proof of assessment.

Hope that helps.