Starting ADHD evaluation for the second time next week. I am really stressed out because this is basically my last shot. I am pretty confident that I have ADHD, but since I also have bipolar, they are just assuming that whatever symptom I am experiencing must be that.
I’ve been through public healthcare where they discharged me after the intake conversation, because they regard me as too high functioning (did good in school and have a job) and they don’t have the capacity. So no help there unless I run my life into the ground. Got declined by my health insurance because they have a clause in fine print saying they don’t cover ADHD. So now I am paying out of pocket, blasting most of my savings. The price tag is around $2700. If they discharge me because they think I don’t have it, it will “only” be $1900 though.
So now I am stressed out, worried I am just throwing my money out the window. And that I am just wrong. If this doesn’t pan out, I don’t know what I’ll do.
Not really looking for any advice (but they are welcome), just wanted to vent a little.
Hey there, sorry to hear about what you are going through. I was diagnosed with ADHD at a young age, it has gone untreated but that’s another story. In my adult life I’ve dealt with anxiety and depression. I’ve recently been diagnosed with bipolar.
My daughter (20ish) had a very similar outlook as you. She was confident she had ADHD and wanted a diagnosis. But similar to you her psychiatrist wanted to focus on anxiety and depression. She pushed back against this and didn’t make progress.
But recently she went through a severe depressive phase and sought help. Instead of seeking help to get a specific diagnosis she went in simply asking for help.
You could try going to a psychologist and saying I’m feeling x, y, and z and they are impacting my life in a, b, and c ways. Then let the expert guide you through what you need.
I’m not saying this is you, but my daughter was convinced she needed to be treated for ADHD. But she really needed to be treated for her depression first.
Separate from all that a word of caution from someone who is prescribed a controlled substance. If you come in strong asking for an ADHD diagnosis you might be flagged for drug seeking behavior. It’s better to present what you are feeling and let the docs try and figure out what works.
Best of luck to you, life isn’t fun when it feels like your brain is out of control.
Interesting insight! I travelled the same road in the other direction. As someone who loves science, I always saw my role as a patient to just report symptoms and let the doctors do their thing. And I’m sure this would be the ideal approach if everybody had the House M.D. team on their case.
But after decades of this failing, I realised that this method does not work with a real-world medical system where doctors have more bias than they should, work with methods from their studying days that assumed they had more time and resources per case, and wrong monetary incentives.
So Method 1: I say I have X, and make it clear that I’ll be a PITA if their test doesn’t confirm it. If there were no bias, there would be no harm to this, but if there is, it’s working to my advantage now.
Method 2: Just think of them as the idiot who is clueless but gatekeeper of the much wanted prescription.
Nobody wants to hear this, but a layman’s web research, LLM and 1000 hours of thinking often beats 10 years of medical training if the doctor interrupts the patient after 20 seconds and only thinks about the case for 5 minutes. (With 30 minutes, my money would be back on the trained professional, but nobody has 30 minutes.) A patient can also fixate on a premature assumption just like a doctor can, but my very subjective experience is that doctors are more prone to that.
Thanks! I am glad to hear your daughter has been getting help!
You provide a nice perspective, but I don’t think it applies in my situation. I feel I am coming from the opposite way. I have been getting a lot of help for my bipolar illness, and I also went to a therapist for two years for general help with life. And it is through this process I have become healthy enough to see that there is something else going on here, which was previously masked by bipolar and shitty life situation
Hey, that is a good vent, when you do a good vent people see it and say “damn I have been through/am going through/will go through that” and there is an inherent kindness to making that not a solitary feeling experience for everyone else so thank you!
If you are worried about your ADHD evaluation I get it, people around me all the time try to get me to really trust the healthcare system around me and I just can’t, at every point of contact with the US healthcare system it is demonstrated that not only does the US healthcare system not understand WHY ADHD destroys my quality of life, it is actually quite violently uninterested in it to the point that the only people I am ever allowed to talk to are people without any power (on purpose) to change the things that are hurting me about the healthcare they are offering.
I would recommend focusing on how hard ADHD has made your life, but not in terms of where you have gotten. Every time you notice the doctor start to look at your credentials and go in their head “well they seem really distraught but that is a good college and not an easy job so they must be exaggerating to me” smack them back to reality with a description of how much brutal stress and anxiety ADHD brings to your daily life that you can’t just sweep under the rug or meditate out of because it has to do with necessary basic life tasks.
I have to tell you as I have to tell myself every day people really DO NOT FUCKING GET how unbelievably hard you have to try to do things you can’t get yourself to do. People will not only NEVER understand you for that, they may become so intimidated by your strength and power from realizing you are constantly doing that in the background seemingly “effortlessly” that they will want to destroy and crush you out of pure fear instinct. An equally large group of healthcare providers will simply never be able to grapple with how much their ignorance has hurt ADHD people they have spent far too much time extracting pride out of believing they were helping and it is easier now for their story to destroy you than start a new chapter that grapples with all of the already written chapters.
The stupidness and inanity of being invisible with ADHD because healthcare providers listen to the words you say and then look back down at their instructions after nodding and letting the words pass through their mind like wrapped gift presents not to be overly examined or memorized… will drive you up a wall and also it may eventually kill you when healthcare providers begin to identify a more simple narrative that fits their worldview about why you won’t do the thing you are supposed to.
Yeah, this is war, act accordingly…
Thanks for the reply, really appreciate it!
Even though the healthcare system (especially for mental health) is a bit fucked here, I do imagine this to be a true nightmare in the US. I’m feeling for you!
Yeah thanks. I have written four pages in my diary, focusing on stuff not related to bipolar and how these symptoms are fucking with my day to day life. And how this is not sustainable over time. Amongst other things. So I hope I am able to get that through to the therapist.
Just if it starts to feel weird because you feel like you are trying to exaggerate a story that may or may not be there in the data, trust yourself :) you aren’t!
$2700??
Cant you just find a psychologist and schedule an appointment for a lot less than $2700? Like $250?
2700 is for all the hours required in total. Basically a “package deal”.
The private clinics here either charges per the hour, but the total is higher. Or you get these packages which are higher upfront, but cheaper total. I didn’t go for the cheapest place I could find, but not the most expensive either. They got a good reputation. The total prices here for a full ADHD evaluation and medication is around $1500-4000
It’s so dystopian in the states. When I needed Ritalin I spoke to my GP, they referred me to a psych. Did three sessions and then the psych called my doc and asked him to write a script.
This might be cost prohibitive but it also could be helpful to miss your first appointment so it takes a few months to rebook and there’s an established data point that helps you in terms of setting expectations.
I see where you are coming from, but the private clinics charge in advance. No-show means that the money is gone. I don’t have that kind of cash to squander. In the public sector, if you don’t show up, you will just get discharged.
Telling you out of my personal experience: It’s not worth seeking professional help. I started helping myself. I did the opposite of what physicians, psychologists and psychiatrists told me, and I’m feeling much better now. I started understanding how I function. I started working on myself and I readjusted my priorities. I learned to stop caring about all unnecessary responsibilities. And now I accept myself the way I always have been - not how people tell me to do.
People always judge me. It’s this ubiquitous fear and my true weakness. I learned to let go. Be the weird guy. But it’s all fine to me now.
Next step I’m working on: stop forcing myself to burnout at work. I don’t need to accomplish all my goals for the day. I have more time for them than I would expect. It’s better in the long run.
I don’t need the stimulants which the doctor wants to prescribe me. I’ve been highly functioning because of my fears, but I decided to stop relying on them constantly. The time for a more relaxed life has started now.
Depends on the help I guess. Not to discredit your experience. The help I got for bipolar had been immensely helpful for me. Maybe even life-saving. But when I was asking for help I had hit rock bottom. So it was easier getting help from the system, as I was prioritized.
I have no problem being weird or accepting who I am. I do have struggles that impact very practical things in my life. Making life quite hard
A mom I met said Omega supplements worked for her son. I believe you can get prescription versions that are more potent than random supplement. There are some studies that Omega can be lacking in ADHD brain.
Also some newer studies finding electrically quiet areas in ADHD brain, and when stimulated with an electrode pacemaker device gave ADHD suffered the focus they struggled with, so maybe hope is coming.
As a aide note Ritalin helped a friend and a family member with ADHD.
I thought the omega thing was a myth that has been debunked, though? Pretty sure Dr. Russell Barkley has said several times that there are no supplements that has any real effect on ADHD.
There is a science paper on it. Not everyone had results but some did, and the mom I met said it had a huge effect. I will see I can find it and add it here.
Overall summary of studies https://pmc.ncbi.nlm.nih.gov/articles/PMC4968854/
Nice, I’ll think I will try out omega supplements actually. Nice tip. I have friends with ADHD and from the outside, they are light and day on/off meds
