ADHD - Adults

[sparkyhx]

Sslink said:

I recently had an "assessment" with a private psychiatrist (via work/Bupa) he's certain that I have ADHD (Inattentive & Hyperactive) however, he still wants me to have a "full assessment for ADHD" with a Mental Health Nurse. Is this typical?

Additionally, whilst it seems BUPA will cover up to diagnosis, they won't cover any treatment/medication post diagnosis and I definitely can't afford to stay private (especially knowing how much the initial assessment cost!).

Am I right in thinking that once I have a formal diagnosis I can continue my journey via the NHS? Titrations, counselling, etc?

Depends! - usually you have to pay privately for the meds and the consultations during the titration period then the Psychiatrist will push for shared care with your GP and that is then under NHS with periodic assessments by the private Psychiatrist.

In my CCG area they are pushing back on shared care. Also insisting you are re-assessed by the ADHD provider - cue waiting 2 years again for another assessment then the meds. Its an absolute sh*tshow

Other areas are happy to take shared care and also get into the system without another assessment - go figure

Good luck

[Sslink]

sparkyhx said:

Depends! - usually you have to pay privately for the meds and the consultations during the titration period then the Psychiatrist will push for shared care with your GP and that is then under NHS with periodic assessments by the private Psychiatrist.

In my CCG area they are pushing back on shared care. Also insisting you are re-assessed by the ADHD provider - cue waiting 2 years again for another assessment then the meds. Its an absolute sh*tshow

Other areas are happy to take shared care and also get into the system without another assessment - go figure

Good luck

I might be SOL then as a definitely don't have the cash to stay private, got a baby due in October and with childcare costs as they are, VERY reluctant to spend on anything non-essential (to life).
Hopefully, my local GP will accept my diagnosis and I can titrate with them instead, even if it takes another few months.

Thanks.

[Animal]

Sslink said:

sparkyhx said:

Depends! - usually you have to pay privately for the meds and the consultations during the titration period then the Psychiatrist will push for shared care with your GP and that is then under NHS with periodic assessments by the private Psychiatrist.

In my CCG area they are pushing back on shared care. Also insisting you are re-assessed by the ADHD provider - cue waiting 2 years again for another assessment then the meds. Its an absolute sh*tshow

Other areas are happy to take shared care and also get into the system without another assessment - go figure

Good luck

I might be SOL then as a definitely don't have the cash to stay private, got a baby due in October and with childcare costs as they are, VERY reluctant to spend on anything non-essential (to life).
Hopefully, my local GP will accept my diagnosis and I can titrate with them instead, even if it takes another few months.

Thanks.

I hadn't even thought about this! I've got my (private) assessment on Tuesday morning and I'd just assumed that (on the assumption that I am diagnosed with ADHD and recomended medication) I could just make an appt with my GP, shown him the assessment and be given a prescription?

[Bloxxcreative]

Animal said:

Sslink said:

sparkyhx said:

Depends! - usually you have to pay privately for the meds and the consultations during the titration period then the Psychiatrist will push for shared care with your GP and that is then under NHS with periodic assessments by the private Psychiatrist.

In my CCG area they are pushing back on shared care. Also insisting you are re-assessed by the ADHD provider - cue waiting 2 years again for another assessment then the meds. Its an absolute sh*tshow

Other areas are happy to take shared care and also get into the system without another assessment - go figure

Good luck

I might be SOL then as a definitely don't have the cash to stay private, got a baby due in October and with childcare costs as they are, VERY reluctant to spend on anything non-essential (to life).
Hopefully, my local GP will accept my diagnosis and I can titrate with them instead, even if it takes another few months.

Thanks.

I hadn't even thought about this! I've got my (private) assessment on Tuesday morning and I'd just assumed that (on the assumption that I am diagnosed with ADHD and recomended medication) I could just make an appt with my GP, shown him the assessment and be given a prescription?

I tried this approach and got told to go through the private provider. A friend who has adhd told me the Dr's aren't keen on prescribing stimulant medication so most knock back to private.

[Teddy Lop]

Sslink said:

sparkyhx said:

Depends! - usually you have to pay privately for the meds and the consultations during the titration period then the Psychiatrist will push for shared care with your GP and that is then under NHS with periodic assessments by the private Psychiatrist.

In my CCG area they are pushing back on shared care. Also insisting you are re-assessed by the ADHD provider - cue waiting 2 years again for another assessment then the meds. Its an absolute sh*tshow

Other areas are happy to take shared care and also get into the system without another assessment - go figure

Good luck

I might be SOL then as a definitely don't have the cash to stay private, got a baby due in October and with childcare costs as they are, VERY reluctant to spend on anything non-essential (to life).
Hopefully, my local GP will accept my diagnosis and I can titrate with them instead, even if it takes another few months.

Thanks.

Titration has to be with specialist, NHS will only accept shared care once specialist advises dose.

It's b0ll0cks basically as all the specialist does is write scrips and ask how you feel and if you want to try more or less or something different. It's you who basically decides.

I've heard there are GPs who've trial prescribed before proper diagnosis but it's rare. The whole show is ridiculously guarded over what are some pretty mild drugs, far less harmful than a lot of stuff they will happily throw at you.

[Bloxxcreative]

Sslink said:

I might be SOL then as a definitely don't have the cash to stay private, got a baby due in October and with childcare costs as they are, VERY reluctant to spend on anything non-essential (to life).
Hopefully, my local GP will accept my diagnosis and I can titrate with them instead, even if it takes another few months.

Thanks.

Congratulations on the new arrival. Just to add, you may find that depending on sleep patterns and you're involvement it makes your adhd symptoms worse. After my first I was fine as I could still get alot of me time after the initial adjustment. After 3 I really struggled from the old dopamine production side!

[sparkyhx]

Sslink said:

sparkyhx said:

Depends! - usually you have to pay privately for the meds and the consultations during the titration period then the Psychiatrist will push for shared care with your GP and that is then under NHS with periodic assessments by the private Psychiatrist.

In my CCG area they are pushing back on shared care. Also insisting you are re-assessed by the ADHD provider - cue waiting 2 years again for another assessment then the meds. Its an absolute sh*tshow

Other areas are happy to take shared care and also get into the system without another assessment - go figure

Good luck

I might be SOL then as a definitely don't have the cash to stay private, got a baby due in October and with childcare costs as they are, VERY reluctant to spend on anything non-essential (to life).
Hopefully, my local GP will accept my diagnosis and I can titrate with them instead, even if it takes another few months.

Thanks.

I've never heard of a GP titrating. ONLY the psychiatrist. These are controlled drugs and need to be prescribed and monitored by a specialist. That monitoring irrespective of shared care is ongoing and will need paying for every 6/12 months, maybe £150-200 a time.

The only other route is to get into an NHS Psychiatrist - that's where the issues start around waiting times and possible need to re-do the diagnosis which appears to be dependent on your local area.

[bigweb]

sparkyhx said:

bigweb said:

I haven't had a formal diagnosis but I have friends who have and also have doctors who are friends and a psychologist who are in firm agreement that I have ADHD. (I don't want or need a piece of paper telling me what I am or am not)

but I have found that if I know I have a day where I am going to be fixed on 1 thing I take Modafinil which helps me concentrate

Bit confused here,

Pretty much the only reason to get a diagnosis is access to medication (its illegally without prescription), otherwise you may as well self identify as you have done.
.................but you take medication (albeit not a common one, but still illegal without prescription) - in the same way my daughter uses her ADHD meds on an as needs basis.

Just curious, how do you get hold of Modafinil - do you have narcolepsy?, in which case do you not take that all the time?

Edited by sparkyhx on Friday 28th April 10:01

I take Modafnil a couple of times a month, for the focus it gives me, I don't need to take medication regularly as I see more positives than negatives with ADHD for me but it has a specific use case.

No I don't have narcolepsy, if I did I could see how Modafnil would work as I've had trouble sleeping when I've taken it after 7am sometimes.

It's not difficult to get hold of though. It's pretty widely available.
I'm also not worried about my house getting raided for a few Modafnil 👍

[Woodrow Wilson]

Motoring12345 said:

People who have taken the meds, have you noticed a personality change?

Like a change in your humour or typical ADHD ticks?

I'd be interested to know whether people have improved their work or career prospects as a result.

[pherlopolus]

Woodrow Wilson said:

I'd be interested to know whether people have improved their work or career prospects as a result.

As said above I am happy where I am, but I know I would have had a more stable career if medicated earlier. I know for a fact that 9 months is roughly my limit before getting board in a role (normal job, not current position)

[Bloxxcreative]

Woodrow Wilson said:

Motoring12345 said:

People who have taken the meds, have you noticed a personality change?

Like a change in your humour or typical ADHD ticks?

I'd be interested to know whether people have improved their work or career prospects as a result.

I'm not medicated but I can say with some certainty it would have helped stay in roles prior to taking on contract work and small clients. I would love to try it. Just cba having a follow up call to get meds now I know at least ways to help manage it better.

[timeism0ney]

Emma Watson has ADHD and is believed to have benefited from appropriate medication during filming of Harry Potter. I think it’s easier to see the effect in others than in yourself. Also maybe easier to see it in younger people because they have so many exams, milestones and generally need to achieve almost non-stop to establish themselves in life so an improvement in productivity never goes unnoticed. My teenage daughter thinks her ADHD friend is far more productive when medicated. I had a colleague who I found impossible to work with (argumentative, abrasive, unsupportive) and it all changed when she went on meds, she was awesome and considerate and planned things well, a pleasure to work with. I have no personal experience of meds myself and on the waiting list for ADHD diagnosis so watching with interest. At the moment I’m guessing that you will need honest feedback from friends and family about the effects of meds to fully appreciate if they’re working or not.

[Motoring12345]

So I have a gp appointment in 2 weeks to persuade my GP why I believe I have ADHD. My issue is that in 2016 I already went through an assessment on the NHS with the "top" ADHD specialist. I didn't have a good experience and I was told "maybe education wasn't for me" and I should "pursue an other route". Overall the consultant lacked empathy and was quite rude towards me but he diagnosed me with mild OCD. I did end up getting my degree with top marks at the end but I had a lot of push from my therapist sister.

Since then I've had multiple people tell me I have ADHD. My NHS therapist sister, my teacher gf (deals with diagnosed ADHD kids all the time) and through private therapy, where I was told OCD and ADHD go hand in hand and I likely have both.

So I have no clue how I'm going to navigate this right now as my current situation doesn't allow me to go private sadly.

[timeism0ney]

Like you, I had a bad experience in 2019 which completely put me off. At that time I didn’t even know what was wrong and I thought it might be autism. I was told that waiting lists are many years and I needed much more prominent symptoms for a referral to be made but as I had a job and was married, I was considered to be doing just fine.

Now that my daughter was diagnosed with autism and ADHD I can see more clearly that I have both, too. I went to GP again recently and my experience was nothing like last time. I think the situation has vastly improved in the recent years due to the introduction of Right to Choose program which is a partnership with private providers (but NHS pays for it) and so GPs can actually offer some help that’s not years of waiting away.

Try again, you’ve got nothing to lose.

[GiantCardboardPlato]

Motoring12345 said:

So I have a gp appointment in 2 weeks to persuade my GP why I believe I have ADHD. My issue is that in 2016 I already went through an assessment on the NHS with the "top" ADHD specialist. I didn't have a good experience and I was told "maybe education wasn't for me" and I should "pursue an other route". Overall the consultant lacked empathy and was quite rude towards me but he diagnosed me with mild OCD. I did end up getting my degree with top marks at the end but I had a lot of push from my therapist sister.

Since then I've had multiple people tell me I have ADHD. My NHS therapist sister, my teacher gf (deals with diagnosed ADHD kids all the time) and through private therapy, where I was told OCD and ADHD go hand in hand and I likely have both.

So I have no clue how I'm going to navigate this right now as my current situation doesn't allow me to go private sadly.

Firstly, it’s quite possible to have strong traits/aspects of ADHD but to not have ADHD - unless the characteristics are harmfully affecting your life in two areas, it’s not considered ADHD. It could be that was the conclusion of whoever diagnosed you before. They could be wrong, of course - I am not questing your self diagnosis here. At the same time, I’m not sure I’d rely on others. The symptoms of ADHD can be caused by many, many other things, like anxiety or depression or even physical or physiological disorders, all of which need to be ruled out, which is diagnosis is quite thorough and lengthy.

Here’s what I’d suggest:

I would say have a look at the clinical assessment process for your NHS area - there will be extensive notes for GPs on what they have to do when a patient presents with possible/suspected ADHD. In mine, there were two short forms/assessments the GPs are asked to give to patients to assess likelihood of ADHD - if those come up positive they refer to someone who can diagnose ADHD. From there, you need to look at the Royal College of Psychatrists to see what their diagnostic criteria are for the fuller process. This should also be useful: https://www.rcpsych.ac.uk/mental-health/problems-d...

None of this is so that you can fabricate or imitate symptoms or impairments. People who have ADHD tend to know it, I think, once they have read a description of it. That’s true even if they have some uncertainty or self doubt (‘what if I’m just lazy’). But being able to map what you experience and feel day to day onto the language and framework that the medics are using is helpful. Focus throughout on being able to talk about your symptoms and experiences and practice communicating them. Don’t exaggerate, but don’t underplay the effect or distress or impact they are having on your life. In a sense, and this is quite depressing to do… think about yourself on a bad day, not a good one.

Complicating all this is that IF you do have ADHD, you tend to overestimate your abilities and underestimate your deficiencies, you get a false picture often of how good you are at something. A silly/small example, but when I was diagnosed I said that I rarely lose or misplace stuff, but my partner would tell me it happens every day or at least very
very often…

So yeah - find out how the professionals talk about it, and learn to talk about it like them.

Post a bit long, bit rambly, havent got time to edit, sorry.

[pherlopolus]

Doing a caars test should give you more of an indication, I got Mrs P to score how she perceived me and the score was higher.

Anyhow, been prescribed 30mg Elvanse with 5mg of something that lasts 4 hours for afternoon/evening if required. Onwards!

[Motoring12345]

GiantCardboardPlato said:

Motoring12345 said:

So I have a gp appointment in 2 weeks to persuade my GP why I believe I have ADHD. My issue is that in 2016 I already went through an assessment on the NHS with the "top" ADHD specialist. I didn't have a good experience and I was told "maybe education wasn't for me" and I should "pursue an other route". Overall the consultant lacked empathy and was quite rude towards me but he diagnosed me with mild OCD. I did end up getting my degree with top marks at the end but I had a lot of push from my therapist sister.

Since then I've had multiple people tell me I have ADHD. My NHS therapist sister, my teacher gf (deals with diagnosed ADHD kids all the time) and through private therapy, where I was told OCD and ADHD go hand in hand and I likely have both.

So I have no clue how I'm going to navigate this right now as my current situation doesn't allow me to go private sadly.

Firstly, it’s quite possible to have strong traits/aspects of ADHD but to not have ADHD - unless the characteristics are harmfully affecting your life in two areas, it’s not considered ADHD. It could be that was the conclusion of whoever diagnosed you before. They could be wrong, of course - I am not questing your self diagnosis here. At the same time, I’m not sure I’d rely on others. The symptoms of ADHD can be caused by many, many other things, like anxiety or depression or even physical or physiological disorders, all of which need to be ruled out, which is diagnosis is quite thorough and lengthy.

Here’s what I’d suggest:

I would say have a look at the clinical assessment process for your NHS area - there will be extensive notes for GPs on what they have to do when a patient presents with possible/suspected ADHD. In mine, there were two short forms/assessments the GPs are asked to give to patients to assess likelihood of ADHD - if those come up positive they refer to someone who can diagnose ADHD. From there, you need to look at the Royal College of Psychatrists to see what their diagnostic criteria are for the fuller process. This should also be useful: https://www.rcpsych.ac.uk/mental-health/problems-d...

None of this is so that you can fabricate or imitate symptoms or impairments. People who have ADHD tend to know it, I think, once they have read a description of it. That’s true even if they have some uncertainty or self doubt (‘what if I’m just lazy’). But being able to map what you experience and feel day to day onto the language and framework that the medics are using is helpful. Focus throughout on being able to talk about your symptoms and experiences and practice communicating them. Don’t exaggerate, but don’t underplay the effect or distress or impact they are having on your life. In a sense, and this is quite depressing to do… think about yourself on a bad day, not a good one.

Complicating all this is that IF you do have ADHD, you tend to overestimate your abilities and underestimate your deficiencies, you get a false picture often of how good you are at something. A silly/small example, but when I was diagnosed I said that I rarely lose or misplace stuff, but my partner would tell me it happens every day or at least very
very often…

So yeah - find out how the professionals talk about it, and learn to talk about it like them.

Post a bit long, bit rambly, havent got time to edit, sorry.

Thanks for this, this and the other posts have been good help.

When I went for my initial assessment in 2016 I mostly talked about my career and academic struggles and barely mentioned my social and personal traits. At the time I had never been in a relationship. Since then I've had 2 long relationships and from my partners I've realised just how much of the traits I didn't believe I have I actually have. Exactly like you mentioned with overestimating your ability.

[MikeGTi]

GiantCardboardPlato said:

Complicating all this is that IF you do have ADHD, you tend to overestimate your abilities and underestimate your deficiencies, you get a false picture often of how good you are at something. A silly/small example, but when I was diagnosed I said that I rarely lose or misplace stuff, but my partner would tell me it happens every day or at least very very often…

This part is very, very, true. Since I got the diagnosis, and I've actually paid a bit more attention to little things, like forgetting words, misplacing things, or walking into a room and not knowing why, I've realised that it happens far more frequently than I realised when I believed it was normal.

It was probably most obvious in the first few days on medication, when I started to notice their frequency increase as the medication started to wear off.

[Woodrow Wilson]

Motoring12345 said:

So I have a gp appointment in 2 weeks to persuade my GP why I believe I have ADHD. My issue is that in 2016 I already went through an assessment on the NHS with the "top" ADHD specialist. I didn't have a good experience and I was told "maybe education wasn't for me" and I should "pursue an other route". Overall the consultant lacked empathy and was quite rude towards me but he diagnosed me with mild OCD.

I had a bad experience with an NHS psychiatrist too. I suppose they see many people in a dreadful state, rather than articulate people who can pretend to be "normal".

A few years later I went back to my (sceptical "everybody does/I do that") GP about it, and it took two more years for an appointment with ADHD 360.

Motoring12345 said:

I did end up getting my degree with top marks at the end but I had a lot of push from my therapist sister.

That was certainly never going to happen for me. My inability to focus on it, despite turning up to all lectures and wanting to be able to, and my dreadful results set me back for years, in various aspects of my life, and I've only really begun getting over it in my mid 40s.

[Animal]

Animal said:

I hadn't even thought about this! I've got my (private) assessment on Tuesday morning and I'd just assumed that (on the assumption that I am diagnosed with ADHD and recomended medication) I could just make an appt with my GP, shown him the assessment and be given a prescription?

Right, had my assessment and I apparently have mild ADD (Inattentive) so prescribed 30mg Elvanse initially, although it's a private prescription and I haven't got it yet. Also offered an ADHD coaching course, but at £300 an hour I think I'll skip it!