Took the referral from the company psychlogist recommending diagnosis for ADHD and ASD to my GP, got a referral to a psychiatrist and a name, called that one today, and surprisingly have an appointment in 1.5 weeks ... šÆ
I would suggest thinking back over your childhood, and the way you related to the world around you, stress, boredom etc. And talking to people who knew you as a child about any distinctive (or āannoyingā or ārudeābehaviours.) Take note of things you/they remember.
I was dxd ADHD in my 60s, which made questions about my childhood hard, given that my parents died years ago & my sister & a close friend are both younger than me.
Be aware that āimpulsiveā doesnāt just refer to wildly rash actions & decisions. It includes interrupting people to finish off their sentences & impatience with people who take too long to get to the point, or play their turn in a game, drivers who take forever to park their car etc.
@PossiblyAutistic@actuallyautistic There are different assessment methods even within each country, so what Iām about to share may vary in its usefulness! But I think itās very common to be asked about life events across your past where you think autism and/or ADHD traits played a part. They may ask you about specifics like major transitional periods in your life (moving schools, moving home, teenage years), or it may more likely be a case of you offering up memories of events that you think are appropriate.
A common thing they look for is whether traits are recent or thereās evidence during childhood / longer term. Donāt worry too much if you canāt remember - just tell them that you canāt remember. But anything you can remember can be very useful.
I echo the idea about notes - if only to help you remember key reasons youāre seeking these assessments. Assessors are trained to ask questions that help you to remember relevant events, but it just depends on the assessment format. My autism assessment was extremely comprehensive (3 sessions of 1-1.5 hours each), but my ADHD one felt very brief (1 hour only). Neither are better or worse, but I am glad I prepared for the brief assessment as I wouldnāt have had some key memories of my past ready in my mind otherwise. I can be rubbish at remembering things - even things I have recalled only recently and told myself to remember!!
āBeing yourselfā is certainly important, but can feel almost impossible in an assessment. They are usually very aware of āmaskingā and the anxiety most will feel during an assessment - all very natural responses to such a strange process. So being yourself might include being anxious, masking somewhat. Itās all ok, is my point. You could chat with them about the masking, though, for example.
If you have any questions you want to ask the assessor - have them ready, too. There isnāt usually any chance later on after the sessions. It can feel over and done with very quickly, and like a whirlwind. So have a think about what you might want to ask, especially considering all the possible conclusions of the assessment (whether autistic or not, ADHD or not, ātypeā of ADHD, etc). When I thought about this, one thing I requested was that I wanted to know if they thought I was āborderlineā for any of them, no matter which side of the border of assessment criteria I was on. Itās more information than just binary yes/no that might help me later on. (But this comes with the caveat that assessments and their thresholds for a diagnosis for are human-made, and far from perfect!)
Hope this helps. Very happy for you that you have so little time to wait!
@PossiblyAutistic@actuallyautistic@actuallyadhd Also - to add reassurance about what other evidence they may ask for - assessors know that a single piece of evidence is not conclusive in itself. They need to gather info about a lot of different areas to get a rounded picture.
E.g. School reports might show some useful things, but Iām in my 40s and there was no way I kept those for this long haha! So it was fine not to have them.
I asked a loved one to submit a form about me for one assessment - they gave answers in line with me NOT meeting assessment criteria (I am a heavy masker, plus I now know we both have ADHD and they think my ADHD specific quirks are just ānormalā human things!) But this was optional anyway.
I refused to include any family member in my assessments in any way - this would have been extremely problematic for me. I would have had to refuse an assessment otherwise. But this was absolutely fine.
Physical health - donāt think Iāve been asked about this except for maybe in a questionnaire for ADHD. Itās only if youāre exploring medication options anyway, which not everyone does. You should have time to submit any info after youāre assessed, too. You absolutely shouldnāt be rushed into medications immediately, anyway - it should be on your terms, after a proper chat about it. I did share with them that I have a chronic illness, though, as itās long-term and impacts my functionality, mentally and physically. I wanted to make sure they took that into account. Medications can also change physiology and mental health, so thatās useful to share.
Mental health - itās very useful to share any info you have on your current and past mental health.
Ultimately - the assessors should tell you in advance what they want you to submit, or ask you about things during the assessment. If in doubt, get in contact with them and ask for clarity upfront if you need it. But keep in mind how varied assessments are even within a single country, so advice on social media may be very varied!
@AnAutieAtUni@actuallyautistic@actuallyadhd I do have most elementary school reports. The comprehensive one at the end of grade 4 is missing, probably because my parents needed it for secondary school registration and then forgot to file it properly afterwards...
@AnAutieAtUni@actuallyautistic@actuallyadhd well, the appointment is at a general psychiatrist. Don't expect her to have a lot ADHD and probably quite misguided ASD knowledge... But for a first appointment it's still quick, I guess. University hospital would probably have a waiting list of several years. Currently their waiting list is closed.
@PossiblyAutistic@actuallyautistic They usually want to see your elementary school and kindergarten reports, so you should probably bring a copy of those, if you still have them.
You could also look up the psychiatrist and see, if there are complaints about them.
I hope that the psychiatrist has an up-to-date knowledge of the full spectrum of autism, but in case they don't, reflecting on specific situations matching these criteria might help get a more accurate diagnosis.
@PossiblyAutistic
Take medical documentation if you have some.
IDK about procedures in your country, but some things may give a head start (cardiology, neurology, liver enzymes).
@dzwiedziu@actuallyautistic I have no such things... Never really had any problems insofar. Just remember a blood test 15 years ago where one liver value was slightly above the normal range.
@Aerliss
Neurology is to exclude any other problems. Cardiology and enzymes to see if your body can handle the medications safely (at least for methylphenidate).
But see country to country dfferences. F.e. in Poland there are no such tests, but the psychology/psychiatry regulations are a farce.
@Aerliss They looked heavily into psysiological diagnostic criteria, and there aren't any obvious one (at least, using machinery availablbe in the 20th century). As far as I know, the closest potential method to purely physiological diagnosis right now involves clustering of positron-emission tomography brain maps, and even that has notorious error rates. If a clear distinction should exist, it's probably in the way ADHD synapses handle neurotransmitters, and with the current medical diagnostic tools, it's not readily observable.
On the other hand, the very concept of pursuing a diagnosis by purely physiological methods is kind of insulitng. Why should we dismiss the patient's experience?
@riley@PossiblyAutistic@dzwiedziu@actuallyautistic In my greatest and most wild dreams all tools would be used to get a dx, or at least figure out treatment for symptoms, if desired/needed. At the moment too much weight is given to observed behaviour, at least by first line practitioners. We see people every week here talking about being denied a referral, or learning they were misdiagnosed based on observed behaviour.
And it takes so looooong. Just get a pee test sorted already š
@Aerliss Making ADHD medicines OTC again, as they used to be, would solve all the complexities of diagnosis. If they alleviate the symptoms, you take them, and that's it. @PossiblyAutistic@dzwiedziu@actuallyautistic
@maggiejk So, make more of them. It's not like the process is somehow hard or complicated for Big Pharma. Let the rich weirdoes take Uncle Scrooge style dives in granulated amphetamines, for all I care; without artificial limits, it wouldn't deprive anybody else of the medicines' benefits.
@maggiejk Also, the concept of "abusing" a medicine is offensively paternalistic. If you're not the patient, who are you to second-guess as to whether they're getting benefits from it?
There's a small number of medicine with clear external costs to using them wrongly, such as antibiotics. You'll note that none of them are harshly warred upon by the Warriors On Drugs. What does it tell us?
And if it's not delayed-release, your doctor might whine every few months that they are giving you the "bad drugs" that can be "abused" citation needed, by whom? .
And promotes addiction. Not only through the lootbox effect that happens when supply is uncertain, but it's well established that untreated ADHD significantly raises addiction risk. Stimulant treatment much reduces the risk, bringing it close to the population's average.
The War On Drugs is inherently bigoted against neurodivergent people, and does the opposite of what its selling point is. It should be terminated, the system of governments boneheadedly refusing to regulate recreational chemicla markets should be reformed in favour of reasonable regulations and quality controls, and everybody convicted of belonging to one of the demographic groups that, some people once reckoned ā without the aid of modern computerised demographic research, I should point out ā might not vote for Nixon by proxy of consumption of recreational substances should be retroactively amnestied.
@PossiblyAutistic I know. I live in Germany, so I keep needing to get new triplicate yellow prescriptions.
But this has not always been the case. Before the War On Drugs, all three of the most common ADHD medicines were OTC, in both Germany and Nixonland. (One of the three has mostly fallen out of professional use, in favour of a safer molecule with one less methyl group, but is still commonly made, and sold, by unlicensed pharmaceutics hobbyists.)
@Aerliss@PossiblyAutistic@dzwiedziu@actuallyautistic when I was diagnosed for ADHD 20 years ago the way my psychiatrist tested me was he sent me home with a prescription for Adderall and a follow up appointment a week later. When I came back in the following week describing how drastically my life improved instantly after trying the Adderall he clapped his hands and said Yep you have ADHD.
Years later when I moved away and came back and I needed a new provider, my new provider made me go get an EKG before she would prescribe medication.
These are the only tests I ever had related to that diagnosis.
@PossiblyAutistic The first-line ADHD medicines are known to have such a strong calming effect on ADHD people that in some ADHD people, it causes prolongation of the QT interval, a cardiological measurement. If your QT interval happens to be long to begin with, some doctors take this as a sign that you should perhaps not be prescribed first-line medicines, because if the QT interval should get too long, some hearts have been known to stop beating entirely. And contrariwise, sometimes the doctors would like to know that your QT is sufficiently short before prescribing.
Another thing some doctors care about is blood pressure. In NT people, stimulants can drive blood pressure up, so if it's high to begin with, the theory goes, stimulants can be dangerous to you. This is nowadays less commonly considered a counterindication than it used to, unless your BP is in the extreme heights, because it turns out that untreated ADHD drives BP up, and treatment actually often (but not always) slightly reduces it. But until you know what your doctor is like, it might be handy to know about the old prejudices.
So, basically ā if your cardiologist gives you a note saying that you your heart is largely okay, your psychiatrist might want to see that note. Not for diagnostics, but for treatment options.
@PossiblyAutistic Ask your GP about it, then. Sometimes, they take ECG readings in their offices. Or, they might reckon that your heart is fine, and give you a note about it, or alternatively, refer you to a specialist cardiologist to do your ECG and maybe a sonogram.
@riley@dzwiedziu@actuallyautistic I have statutory health insurance. Maybe not as bad as the NHS, but they don't tend to do procedures just in case ...
@PossiblyAutistic If you tell your German GP that you want to know if there's concerns that might prevent you from taking stimulant medicines, they don't need to do specific tests to assess this. They have seen you before, they have some idea of what your health situation is like, and on that basis, if there's no serious concerns, they might write you a quick note saying that they believe your heart is okay.
But then again, in German you probably don't need it before your psychiarist asks for one. But listen to your ADHS support group's advice; sometimes, there can be local weirdnesses about these things.
the first few months i got dizzy spells when rising from very rested positions (i.e. couch), but they vanished with regular intake and now i am basically side-effect free.
@PossiblyAutistic Btw, fun blood pressure fact (and, perhaps, a fun rabbit hole): the rat model on which ADHD is modelled for research is spontaneously hypertensive rats. There's a strain of lab rats that was originally developed because their blood pressure tends to go high on its own; and these rats' brains turned out to behave a lot like the brains of people with ADHD, so scientists now often use these rats for testing potential new ADHD medicines or other treatments on.
@PossiblyAutistic@actuallyautistic
To follow the one piece of advice that is useless for us everywhere else. Just be yourself. Oh, and take notes, lots of notes, on all the reasons and examples for why you know you are autistic.