Like, if its nots public health system its obviusly price-gated for obvious reasons (it can be a commodity or boutique diagnosis for the rich and connected to get their sweet-sweet pharma speed)
I take arguably the sweetest or 2nd sweetest of that sweet-sweet pharma speed on prescription so lets not get into the the whole speed semantics for those of us otherwise inclinced
Edit: some advice- skip your first appointment on accident. It seems counterintutitive but its actually completely intuitive and expected for an actual ADHD person. If I was a psychiatrist I woupd almpst expect or come to expect people who end up diagnosed to do that haha
Maybe my experience is out of the norm, but I did some searching online for recommendations of psychologists that do ADHD evaluations. I called the most recommended and was told they had no open appointments but recommended three others that often have availability. I checked those out, chose one, and made an appointment online. They specifically have adult ADHD evaluation as a service they provide with a defined set of appointments and processes. I did an online appointment first, followed by a ton of surveys and questionnaires (it was I think 5 different forms with 30-50 questions each). My wife also did one. I had an in person appointment with some testing over the course of an hour or so, then a follow up to discuss my diagnosis. Of note, it was a few hundred dollars, paid out of our HSA and covered by insurance as mental health services. I didn’t need to “game” anything. I was on time for appointments, honest, and upfront about everything. I discussed why I was looking into this at 30+ years old (I was noticing it interfering with my work and home life more, and through talking to friends and seeing videos online I started to suspect ADHD was a likely explanation for struggles and experiences I’ve had my whole life). Medication never came up during the evaluation, and afterward it only came up in terms of an option for treatment but advised as part of a larger regime of therapy. Psychologists can’t prescribe anything anyways. I do take medication now though it isn’t a stimulant (what OP refers to as pharma speed which is a gross mischaracterization of stimulant medications for ADHD, but it seems they are aware of that and don’t care about continuing to stigmatize ADHD treatments) and both my wife and I have seen a huge difference in my ability to generally function in ways that are healthy, productive, and much more pleasant. I still need to find a therapist though, been meaning to get on that for the last year or so…
For those in the US looking into this, check out psychologists, they are fully equipped and qualified to evaluate and diagnose various types of neurodivergence in people and are easier to get appointments with than most psychiatrists (if you are diagnosed and want to try medication as a treatment option you’ll still need to find a psychiatrist, but that can be easier with a diagnosis in hand). They are generally cheaper since they aren’t medical doctors, and many insurance plans still cover their services. Don’t skip or miss appointments, especially on purpose. It isn’t going to help in a diagnosis and is likely to just make it harder to get help you need and are trying to get. Lock in on that hyper focus and be that person that’s there 20 minutes early (because with an appointment in the afternoon can you really do anything else that day anyways?). Call around, or email, most offices want to help and seem willing to point you to other providers if they can’t help you. Be prepared for a wait though, it’s common to get an appointment 3-6 months out in many areas (more reason not to miss appointments on purpose!).
Many variables at play.
Price shop some independent psychologists in your area, but never mention ADHD.
Go see one and have a laundry list of things you’re struggling with (classic ADHD symptoms), let them do the troubleshooting. Be open to behaviour changes/mitigation strategies.
Part of the challenge is patients have to demonstrate willingness to work on things, and the doc has to document your start point and difficulty improving.
They have to be able o diagnose tho, and often thats only psychiatrists.
Theres an entire different use case for psychologists for when you sctually want to improve your habits/behaviors but the first order of business for most undiagnosed is to gdt that D…X!. I have all that done so I’m not the usual audience
Psychologists diagnose, psychiatrists prescribe meds. Rarely you can go to just a psychiatrist, but it’s not the standard pattern, and you risk being perceived as a drug seeker.
Start with a psychologist - let them do their job. When you have them on your side it’s a whole lot easier for a psychiatrist to justify medication.
Im from a public system and you absolutely go to a psychiatrist firsf, lots of psychologists make bank when they cant prescribe anything and to some degree its not a sure thing their dx is a bigboy dx thats enables access to meds
Psychiatrists definitely prescribediagnose . Access to psychologists is far more “boutique” and discretionary. Its like me saying i have (can afford) weekly freudian psycoanalysis sessions or whatever, I doubt a psychiatrist is going to care unless they’ve personally evaluated you
Theres a huge risk if you go ymthat route you’re gonna get gypped
experiences i’m aware of mainly consist of “doctors that don’t believe you and do nothing to assuage your own concerns about your brain so you have to keep making more appointments and spending more money, or maybe try seeing another doctor who most likely also won’t believe you and do fucking nothing about it but demand more money”
