How I do an ADHD evaluation. What is an adequate ADHD evaluation? — ADHD Tip O the Day 733

You need a competent ADHD evaluation.

Jeff just had a horrible experience with an evaluation.  I felt very sorry for Jeff and very embarrassed for the psychiatric profession.  And personally embarrassed, because I keep recommending evaluations and then this happens.

Key Points:

1.You do need an evaluation. You can self-diagnose on the net, and that’s a good start, but you need confirmation. There are other things that can mimic ADHD. You don’t want to start medication from a doctor who doesn’t understand ADHD. There are conditions that contraindicate trying medicines.  So you need an evaluation.

2. You need an evaluation from someone who understands ADHD. This may be a psychiatrist, a psychologist, or an ADHD coach. I personally recommend the psychiatrist. Do research before you make an appointment.

Unfortunately, there are many physicians who don’t understand ADHD and don’t understand that they don’t understand. I used to be one.  Hope I’m not now.

An Evaluation:

I’ve been asked what I do for an evaluation:

1. Screen on telephone.
2. Send a general medical/psychiatric questionnaire to bring to appointment.
3. Get a history and get releases signed.
4. Do any indicated physical and neurological exams.
5. Go over questionnaire.                                                                                                                     

 6. If I suspect ADHD:
7. Review criteria together.
8. Some education about ADHD.
9. Some discussion of options.
10. Find out who else I can talk to – mother, spouse, etc.
11. Give Brown attention scale test to take home; explain the test.
12. Try to answer any questions.                                                                                                       13. Schedule next appointment.

13. Write up evaluation, 1-3 pages.
14.Whew!

I can usually do this in an hour, sometimes in an hour and a half. I do charge a little more for any initial evaluation appointment.

doug

Notes:

  1. Jeff put his experience into our comments. Thank you, Jeff. I will put some of his ordeal into an upcoming post.

2. I rarely see any indication for psychological testing. Extremely rarely.

3.  This is past tense. I retired from private practice in 2013.

 

Links:

Getting an ADHD diagnosis

Diagnosis by an ADHD coach

Diagnosis and What then?

A good ADHD evaluation.

 

@addstrategies  #adhd  #add  @dougmkpdp
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About doug with ADHD

I am a psychiatric physician. I learned I have ADHD at age 64, and then wrote two ADHD books for adults, focusing on strategies for making your life better. Your Life Can Be Better; strategies for adults with ADD/ADHD available at amazon.com, or smashwords.com (for e books) Living Daily With Adult ADD or ADHD: 365 Tips O the Day ( e-book). This is one tip at a time, one page at a time, at your own pace. It's meant to last a year. As a child, I was a bully. Then there was a transformation. Now I am committed to helping people instead abusing them. The Bully was published in January, 2016. It's in print or e book, on Amazon.
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4 Responses to How I do an ADHD evaluation. What is an adequate ADHD evaluation? — ADHD Tip O the Day 733

  1. coachag says:

    Hi Doug,
    I am a 62 yr old woman diagnosed with ADHD when I was about 48. My family doctor (who i love and respect) prescribed for me the non-stimulant medicine Stratterra. For six years I was not rid of my ADHD symptoms and I didn’t know it because I didn’t know what it felt like to be rid of the symptoms. I had no idea how a neurotypical person felt in their head.
    Although I worked hard, along with my pediatric psychiatrist to determine the right combination and type of medication for my ADHD, I know I will never be like someone without ADHD and that is fine with me. I want to be me with at my best, ADD and all.
    Do you think the patients and doctors use that as the criteria for medicating or do you think either one are reaching for goals they cannot obtain?
    Agnes

    Like

    • coach – i’m not sure i understand your question exactly. I believe the meds can help us focus better, which i think is the key to everything. they can also increase motivation drive and energy. i dont think they can make us non ADHD.
      sounds like you are on the right meds now? good.
      thank you for commenting
      doug

      Liked by 1 person

    • holdthatthought says:

      Hey coachag, I think that’s a really good question. I think of it this way: it evens the playing field.
      In adhd treatment, it’s understood that the medication itself is not enough. What is effective in treating it is medication + skills.
      Those skills (like the many, many tips and strategies that Doug has provided) are what essentially “level” the playing field among those who have adhd with those who do not. Those skills can be developed in many different ways. The most common and effective way I think is through therapy–something like CBT and BA where you’re taught the skills and behaviors necessary to manage adhd. (CBT & BA are just different types of therapy a psychologist can provide. Think of them as just different ways to skin a cat).

      For some people, knowing or having those skills is simply not enough.
      For example, we all know we should be eating healthy. We all know what vegetables look like and that we probably shouldn’t be having that third serving of chocolate cake. But for many people, it’s not really that easy right? There’s something else at play here.

      This is where the medication comes in. The medication makes applying the skills and tips more likely. It generally makes like easier. It helps us with motivation, control our emotions, we get less cranky, etc.

      Just taking the medication is not enough, either. Without the skills, life doesn’t really get much better, does it? Just because you can focus a little better doesn’t mean that you’re focusing on the right thing.

      So, to summarize: meds + skills = playing field leveled (at least compared to the general population that doesn’t have adhd).
      Just having the skills is often not enough. People with adhd are often essentially missing an ability to apply those skills. This is where the medication helps: it makes it easier and more likely in applying those skills and strategies.

      And I guess to directly answer your question about the Doctor’s goals with their patients: I guess they do both. I think the goal is to get you to ultimately be the best possible version of “you” that you can be.
      You might be surprised. Often, that version of you is not only attainable but maybe surpasses the general population (aka the ‘normies’).

      I hope I helped answer your question–or at least think about it in a different way.

      d

      Liked by 2 people

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