The Adult Diagnosis Pathway Jane McFadden **This is a guide written by someone who is not a medical professional or Psychiatrist - please seek your own medical advice** Welcome to "ADHD Mum's," a space where authenticity meets the complex world of ADHD. I'm Jane, your guide on this journey, and in this e-guide, we delve into the realities of ADHD, particularly in the Australian context. This guide aims to share personal experiences and practical advice, helping you navigate the path to ADHD diagnosis and management for yourself and your children. The Search for Answers My journey to an ADHD diagnosis was not straightforward. Like many, I scoured resources, seeking something that resonated with me. This path is often littered with more questions than answers, and I hope to help you out. Two Paths to Realization There are often two groups in the quest for an ADHD diagnosis. 1: Those uncertain, nding similarities but not sure if it's ADHD, ASD, or something else. 2: Then there are those who feel a deep conviction about their ADHD, seeing their life's story mirrored in the symptoms. Both paths are valid, and both deserve attention and understanding however the paths are di erent. Chapter 1: The Path to Diagnosis Understanding ADHD: A Personal Journey and Practical Advice The road to diagnosis often leads to psychologist assessments, which can range from $1,500 to $3,000. These assessments, whether in-person or online, are detailed explorations of one's mental landscape. However, they're not always accessible to everyone due to cost and availability constraints. These can be done in person or via Telehealth, I'd recommend nding a Psychologist with lived experience of ADHD or ASD. Clinical Psychologist reports can be used for NDIS accessibility. Remember that currently 75% of people with ADHD also have ASD which can get you on the NDIS pathway. **Note here that this Psychologist pathway does not have access to medication, this is an incredible resource for understanding yourself but you would need to see a Psychiatrist to receive medication and Psychiatrists often want to do their own assessment** I would recommend this pathway particularly if you are uncertain if you have ADHD/ASD or something else or you want to understand yourself more deeply. Personal Experience with Diagnosis My own diagnosis came in an unexpected way - during therapy for burnout - the Clinical Psychologist put me through an ADHD assessment which was shocking, yet it brought immense clarity. This personal path has highlighted to me the importance of understanding oneself, a journey that is unique for each individual. I then went to a Telehealth Psychiatrist for medication but have now circled back to a Clinical Psychologist for a full assessment to fully understand myself. For example, a lot of Mum's struggle with navigating sensory processing, especially after receiving medication, this can sometimes heighten sensory processing challenges like loud noises for example this can unveil ASD or a variety of other symptoms Chapter 2: The Psychologist Assessment Pathway Chapter 3: The Psychiatrist's Path Psychiatrists: A Faster Route to Diagnosis and Medication For those eager to expedite their journey and gain access to medication, consulting a psychiatrist can be a quicker path. This is particularly relevant for individuals con dent in their ADHD diagnosis or those who have been previously assessed by a psychologist. Financial and Practical Considerations The process of seeing a psychiatrist, especially for in-person consultations, can be both costly and time- consuming. It's important to be prepared for potential out-of-pocket expenses and to consider the logistics of follow-up appointments. You do need to prepared to attend more than one appointment. The Importance of Personal Advocacy Navigating psychiatrist appointments may require a level of self-advocacy. Be prepared to articulate your experience clearly, as psychiatrists may conduct their own assessments independently of previous reports. Think through your symptoms, write them down and be prepared to demonstrate how this impacts on your daily function. Telehealth psychiatrists will ask you your symptoms in childhood. Often women 'mask' or 'camou age' their ADHD - for example, using multiple reminders in their phone, anxiety fuelled calendar coordination. Psychiatrists generally will not help you 'unpack' your symptoms they will just write down what you report. Please consider listening to 38. Denied a Diagnosis (Part 2) and 32. Preparing for a Diagnosis Appointment on my podcast with Jasmine Meek. Chapter 4: Telehealth Psychiatry for ADHD Diagnosis The Telehealth Option Telehealth psychiatry o ers a more accessible and often quicker alternative to in-person consultations. This can be particularly advantageous for those con dent in their ADHD diagnosis and looking to initiate medication. A Tele-psychiatry appointment can have a two week wait time compared to a 12 month wait time for an in person Psychiatrist. Understanding the Telehealth Process Telehealth consultations involve pre-appointment questionnaires and potentially involve family members in the assessment. It's a process that requires some navigation but can result in a more expedient diagnosis and treatment plan. Consider checking my downloadable guide on ADHD Mum friendly Practitioners. This list are provided from recommendations I've received from fellow ADHD Mum's for Psychiatrist who understand how ADHD presents in women. Be aware that not all psychiatrists are aware of masking, camou aging ADHD in women and it is a good idea to do some research on who you are seeing so you are not disappointed by the assessment process. The cost of Telehealth psychiatry can vary, and it's essential to be aware of the changing fee structures. While it can be more a ordable than in-person consultations, repeated visits for medication adjustments can add up nancially. You need a referral from a GP to access Medicare funding. Cost Considerations Chapter 5: Navigating ADHD Medication The Journey Through ADHD Medications The process of nding the right ADHD medication can be complex and highly individual. Exploring di erent options, such as Ritalin and Dexamphetamine, and understanding their e ects, including potential side e ects is a crucial part of managing ADHD. Remember often Psychiatrists must prescribe Ritalin rst - so don't think that is the ONLY type of medication Personal Experiences with Medication Personal anecdotes highlight the trial and error involved in medication management. From initial experiences with Ritalin to exploring longer-acting options like Concerta, the journey is often marked by adjustments and reassessments. The tele-psychiatrists often will then hand over care to your GP after the dosage is right so you don't need to return to them - and you might be put on a yearly review. Chapter 6: The Challenges of Dosage Management Understanding Dosage and its Impacts Managing medication dosage can be a challenge, especially when starting new medication. Experiences like overstimulation or under-dosing are not uncommon, emphasizing the importance of clear communication with healthcare providers and personal vigilance. The Role of Short-Acting vs. Long-Acting Medications The choice between short-acting and long-acting medications is a signi cant decision. Personal preferences and lifestyle considerations play a key role in this choice, with each type of medication o ering di erent bene ts and drawbacks. The stereotypical stimulant medication are 'Ritalin' - short acting - you need one tablet every 4 hours and 'Concerta' which is the same type of medication but long acting so you might take one tablet in the morning that lasts all day. OR I nd that most ADHD Mum's use 'Dexamphetamine' - short acting - you need one tablet every 4 hours and 'Vvyance' which is the same type of medication but long acting so you might take one tablet in the morning that lasts all day. Sometimes I take one Vvyance in the morning and 'top up' with a Dexamphetamine if I need too. Personally I don't take 'medication breaks' because as a busy Mum, my weekends are just as busy as my weekdays. If I had a hearing issue, I would wear a hearing aid, I deem my brain function as exactly the same. Some ADHD Mum's report that they use a stimulant with an anti anxiety medication. Rarely have I heard of a ADHD Mum who went to one appointment and didn't return because the medication was right the rst time. Please be persevere - the results may be life changing. Chapter 7: The Impact of Medication on Daily Life Improving Daily Functioning ADHD medication can signi cantly impact daily functioning, from enhancing focus and reducing anxiety to improving the ability to complete tasks and engage in family life. These improvements can be transformative, o ering a glimpse into a more manageable life with ADHD. The rst time I took Dexamphetamine I couldn't believe the huge di erence it had. I felt more calm and focused than I ever have in my life within 15mins. I was able to have lunch with my husband without feeling panicked on all the things I should be doing instead. I was able to sit down and play UNO with my kids without feeling impatient and agitated. Balancing Act: Medication, Side E ects, and Lifestyle Balancing the bene ts of medication with potential side e ects and lifestyle considerations is a continuous process. Understanding how medication a ects sleep patterns, appetite, and daily routines is crucial for e ective management. Chapter 8: Understanding Dopamine and ADHD The Role of Dopamine in ADHD Dopamine plays a critical role in ADHD, particularly in how it a ects motivation and the brain's reward system. For individuals with ADHD, a dopamine de ciency can lead to challenges in feeling motivated and completing tasks that don't inherently interest them. Seeking Dopamine: The ADHD Brain's Quest The ADHD brain often seeks activities that provide a quick dopamine hit, leading to behaviors like video gaming, risk-taking, or even shopping. Understanding this biological drive can help in managing ADHD more e ectively and compassionately. Chapter 9: Stimulant Medication and its E ects The Mechanism Behind Stimulant Medications Stimulant medications increase dopamine levels, helping the ADHD brain to function more like a neurotypical one. This can lead to improved impulse control and a reduction in behaviors associated with dopamine-seeking, such as excessive online shopping or other impulsive actions such as binge eating. Personal Experiences with Stimulant Medications Personal anecdotes reveal the trial and error involved in nding the right stimulant medication. The journey underscores the importance of monitoring e ects, adjusting dosages, and understanding the unique impacts of each medication. Please listen to my episode on Medication and Psychiatrist on my podcast (number 20) for further information. Chapter 10: Real-Life Impacts of Medication on ADHD Enhancing Daily Functioning with Medication Medication can signi cantly improve daily functioning for those with ADHD, aiding in task completion, reducing anxiety, and improving focus. These improvements can be life-changing, o ering a more manageable and ful lling life experience. Finding Balance with Medication Balancing the bene ts of medication with potential side e ects is crucial. For instance, the choice between short-acting and long-acting medications depends on individual lifestyle needs and preferences, highlighting the importance of personalized treatment plans. I found I lost my short acting medication constantly - so I went with the long acting. Chapter 11: Exploring the NDIS and ADHD Navigating the NDIS with ADHD While ADHD isn't a primary diagnosis for NDIS eligibility, it can be added to support those who have it alongside other conditions. This inclusion allows access to ADHD-speci c therapies and tools, like ADHD coaching and aids for sensory overload. Understanding how to navigate the NDIS with an ADHD diagnosis can open doors to much-needed support. I'd recommend reading my NDIS ebook if you'd like to know more about that. Conclusion: Embracing the ADHD Journey with Knowledge and Support The Power of Knowledge and Understanding Understanding the role of dopamine in ADHD and how it in uences behavior is crucial. It not only demysti es many aspects of ADHD but also provides a foundation for empathy and compassion – both for those living with ADHD and for their families and friends. Knowledge is power, and in the case of ADHD, it's a tool for empowerment and positive change. The Importance of Personalized Approaches Each individual's experience with ADHD is unique. This guide underscores the importance of personalized approaches in diagnosis, treatment, and daily management. Whether it's choosing the right medication, understanding one's own or a child's behavior, or nding strategies to cope with daily challenges, a tailored approach is key. A Community of Support No one should navigate ADHD alone. This guide aims not just to inform but also to connect – to create a sense of community and shared understanding. Whether it's through podcasts, support groups, or online forums, nding a community can provide invaluable support, advice, and encouragement. Looking Forward with Hope and Con dence Armed with knowledge, understanding, and support, those a ected by ADHD can look forward to a future lled with more clarity, control, and con dence. This journey is ongoing, and while it may have its ups and downs, it is rich with opportunities for learning, growth, and ful llment. Final Thoughts Remember, whether you're just beginning to understand ADHD or are well along in your journey, you're not alone. Continue to seek knowledge, embrace support, and above all, be kind to yourself and others on this path. Together, we can navigate the complexities of ADHD with strength and optimism. Thank you for joining us on this journey. May this guide serve as a stepping stone towards a more informed, compassionate, and empowered approach to ADHD.