You keep losing your keys, feel you can never finish anything at work, or maybe have had a family member say “you might have ADHD.” Whatever the reason, getting a specialist assessment is the first step towards resolving this suspicion.
Finding a qualified mental health professionaL
Finding a clinician that is especially familiar with ADHD is key to a good diagnosis. In NZ this means seeing a psychiatrist. Referral from your doctor, suggestions from support group members, or contacting ADHD NZ are all ways to start your search.
Unfortunately, assessments for Adult ADHD are not given a high priority in the public health system as people with this condition often pose minimal risk (due to resource constraints people who pose overt risks are often given a higher priority over those that pose no risk). As a result, they may state that their referral criteria have not been met.
A psychiatric history will include a comprehensive face to face interview of at least an hour looking at all aspects of the presentation. The early part of the assessment will include what led you to thinking you may have Adult ADHD as well as identifying any problems that you are experiencing as a consequence of this.
Then the clinician will compare the symptoms you describe against diagnostic criteria and attempt to see if these symptoms could be explained by any other condition. At a minimum this will include questions regarding depression and anxiety (two relatively common conditions that have difficulties in attention and concentration as core symptoms) as well as looking at stressors that maybe influencing the description of your symptoms (for example medical conditions such as hyperthyroidism or social conditions such as poor housing).
Interview of a loved one
If you have someone accompanying you to the interview, a collateral history may be obtained as your friend will be able to provide an objective viewpoint of your symptoms and any problems arising subsequent to them.
A unique part of the assessment for Adult ADHD is a discussion about the presence of possible childhood symptoms as this is the kind of condition that arises in childhood and keeps on going. Part of this discussion will be about schooling and whether or not there were any difficulties at school. If you are looking for an assessment for Adult ADHD, a useful thing to do is to discuss with your parents how you were as a child but also see if you can find any school reports as these are often invaluable objective reports as to how you compared to other children.
Screening for co-existing conditionS
If a patient is treated for ADHD but the symptoms are not caused by ADHD, the treatment is not going to be successful. Doctors will also look to see if any co-existing conditions exist. Often if the co-existing condition is not treated then the treatment for ADHD will not be as effective.
Many people find that having a diagnosis of ADHD helps them make sense of their life and past decisions. You will want to discuss treatment options with the psychiatrist. Treatment can include lifestyle changes, medication, and therapy, and often includes more than one component.
An essential part of any management plan (especially if you discuss the role of medication) will be a letter to your GP. If medication is discussed, you should expect dosing regimes and side effects to be part of this discussion.
Follow up appointments can then be agreed (as to whether it is with the psychiatrist or the GP and when follow up appointments should occur)