How to get diagnosed with ADHD
What is ADHD, anyway?
ADHD (attention deficit/hyperactivity disorder) is a neurodevelopmental condition (and a form of neurodiversity) in which the brain develops in a different way to what is considered neurotypical.
These differences are thought to be related to the levels of a neurotransmitter called dopamine in the brain, and result in hyperactivity, difficulties with attention or both.
Let’s talk about how to be diagnosed with ADHD and the costs associated with it.
Do you need to be hyperactive to have ADHD?
No, but there’s a bit of confusion around this. ADHD used to refer to what is now known as the hyperactive presentation of ADHD, while ADD (attention deficit disorder) was used for what is now known as the inattentive presentation of ADHD.
The term ADD is no longer in use. These days, if someone has enough symptoms to meet criteria for both presentations, it’s known as the combined presentation of ADHD rather than ADHD + ADD.
The inattentive presentation of ADHD is more common in females, and is harder to spot in childhood (they are the kids quietly doodling in their books instead of taking notes, not the kids distracting everyone around them). As a result, it’s not uncommon to reach adulthood without it ever being diagnosed.
But no one believes I have ADHD
Because you can’t “see” ADHD, it’s hard for someone without extensive training to determine whether or not you have it. And there are other factors that make it difficult for people in your life to understand what you’re going through.
For example, ADHD has a genetic component, so parents and siblings may experience life in the same way as you and therefore believe it to be “normal”.
Teachers or bosses may not know the extent of your struggles due to how well you manage assignments or projects (often with a great deal of effort and the use of compensatory strategies).
And neurotypical people who don’t know you may just accuse you of being lazy or disorganised, because they can’t see how hard you’re working to stay on top of things.
I didn’t get my own ADHD diagnosis until I was studying psychology and was discussing the list of symptoms with the class. “But everyone has these,” I pointed out in confusion. The concerned faces and shaking heads from the rest of the room were my first indication that I had ADHD – and I was in my thirties!
How to be diagnosed with ADHD
In Australia, ADHD can be diagnosed by a psychologist, a psychiatrist or (if the client is a child) a paediatrician.
Psychologists often administer a battery of psychometric tests to aid in their diagnosis. This can be valuable as a “deep dive”, looking at all the angles and exploring alternative explanations for symptoms.
Psychiatrists, on the other hand, often diagnose ADHD without such thorough testing because of the high costs of their appointments and the heavy demands on their time.
How ADHD is treated
Evidence suggests that the best treatment outcomes are achieved with a combination of medication and therapy.
A psychologist can help you with the emotional aspects of ADHD, as well as working on organisation and productivity skills, and changing maladaptive habits.
Another option is seeing an ADHD coach. ADHD coaches generally focus more on skills and less on emotional aspects, however, there is a degree of overlap between psychologists and ADHD coaches.
How do I get ADHD medication?
In Australia, only psychiatrists or paediatricians can prescribe medication for ADHD.
You will need a referral from your GP to see a psychiatrist, and it can take months to get an initial appointment with a psychiatrist. Your GP or psychologist (if you are seeing one) may know of a psychiatrist in your area who has availability sooner, but you may need to be patient.
How much does it cost to get diagnosed with ADHD?
A common concern for my clients who are wondering if they have ADHD is the cost of being diagnosed and prescribed medication.
If you are on a tight budget and want to try medication, I suggest skipping the thorough psychometric testing process with myself or another psychologist. Instead, my standard procedure when finances are a concern is to start with some basic screening questions regarding symptoms.
If, based on the answers, ADHD appears likely, I will then ask you to do the Conners’ Adult ADHD Rating Scales (or the Conners’ Comprehensive Behavioural Rating Scales for children). This is a questionnaire that asks about things like behaviour, work or schoolwork, and social life.
As well as a self-report, it is ideal to get a few people that know you well to complete observer reports.
Though the Conners’ scales are charged at $20 (adult) or $12 (child), they are worth doing, as if the results do not show enough evidence of ADHD, it’s probably not worth spending any more money pursuing a diagnosis.
If the results do show evidence of ADHD, taking the reports to your psychiatrist/paediatrician appointment can speed up their diagnosis process, saving you money.
If you are already seeing a psychologist, you could ask them if they have access to the Conners’ scales, or a similar well-validated ADHD questionnaire to complete ahead of your psychiatrist/paediatrician appointment. I also recommend bringing old school reports (if available) into the appointment, with any evidence of hyperactivity or inattention highlighted.
How much does ADHD medication cost?
Once you have a diagnosis, and if you choose to take ADHD medication, there are ongoing costs involved in keeping the prescription filled. Prescriptions expire after six months, requiring additional psychiatrist appointments to get them reissued. This is the major cost, as most types of ADHD medication aren’t expensive.
GPs generally can’t prescribe ADHD medications, but your psychiatrist may be able to transfer the authority to prescribe over to your GP once they have established the type and dosage that works best for you. This can be a good way to minimise costs, as psychiatrist fees can be very high.
ADHD online test
If you’re looking for support for an existing ADHD diagnosis, you can make an appointment with me here. Or get in touch to find out more about how I can help.