So I had my private assessment today and I will give some feedback, which might help others.
I had a zoom appointment with someone from the ADHD Centre based in London. I won't give the name of the psychiatrist I am going to be critical of him.
He didn't smile through the whole assessment and the sound quality was poor, which was something to do with his equipment as it was effected by the direction of his head. I had to ask him to repeat a lot of the questions. I always did so apologetically and politely but he appeared to be irritated at having to do this and it never occurred to him to apologise for the fact it was his fault. He looked like he had just got out of bed as his hair was unbrushed and his shirt looked like a pyjama top although it could have been an un ironed shirt. Part way through he asked me to google the forms we were looking at so that we could go faster. This was a bit demanding as I had unexpectedly find them, open them and locate the parts he was looking at and them answer the questions at the same time as looking at him on the screen. I found this quite stressful and I would guess anybody would feel the same-especially someone with ADHD! This did not seem to occur to him and he appeared to be irritated that I found it hard to concentrate.
The assessment simply consisted of him going through the same questionnaires he had already emailed me. I had already read them, looked at the scoring system and completed and returned some of them to him so the consultation added nothing to what I had already worked out for myself by doing the forms. In fact anybody could do this for themselves at no cost and without having to wait. Of course if you need medication or coaching you will need a diagnosis, so you will have to go through this process, but I don't think I want either.
In the end he was unable to complete the assessment because of a couple of things I'd like to share with others, which are the forms you ask another adult who knows you well to complete as well as someone who knew you well in childhood.
There are lots of problems with these two forms. The wording just does not bring out the issues involved in ADHD. The childhood form talks about 'careless' mistakes. Although I constantly made slips in childhood because of poor concentration, they were never careless. I cared about them very much. Also, it asks about chores and responsibilities I had as a child and whether I forgot things I needed to take to school or avoided doing homework. We had no chores as a child, I didn't have to take anything to school, we had no homework or after school activities. It was a different world (I'm 59) and my parents were hippies with ADHD (probably) themselves and my school was extremely relaxed. I was left to get on with doing things my own way. The form assumes that everybody has the same kind of regulated childhood that people have nowadays. I did not have to avoid anything or procrastinate because I had almost nothing I was obliged to do. I also dislike the judgmental use of words like 'careless' or 'avoid' and I feel they fit much better for children (often boys) who adopt a defiant attitude towards their struggles.As a girl I felt I had to everything exactly as asked, even if it meant doing it over and over again until it was exactly right. I know if I give the form to my mum to fill in about my childhood she would have reacted to the form in the same way as me. It just doesn't capture my difficulties. So, I completed the childhood form myself saying it was from memory (I have a very clear memory of childhood). I explained to him why I had done this and that I have no school reports as an alternative. This also seemed to make him very irritated. I am not stupid (I am an academic) and I understand totally that a diagnosis HAS to establish that it was present in childhood, especially I would imagine with somebody my age, in case there has been age related cognitive decline/dementia etc. I thought I may be able to discuss this with him but he was just annoyed about it.
I also had a problem with the form that an adult who knows me now has to complete. I gave it to my husband and he said almost none of the criteria matched me. This is because I try incredibly hard to be super organised. I had a very rigid system to help me get by. This doesn't mean I am not affected though. The psychiatrist did not seem to take this point at all. His attitude was that if I was that if my husband says I am not forgetful and that I meet deadlines then I don't meet the criteria. I don't procrastinate precisely because I have had so many lapses in the past and I know from experience that I will need to start almost every task immediately to give me time to do it over and over again. The forms only take into account your behaviour, not your mental processes.
Of course psychiatrists use the same criteria all over the world, they do not design the checklists themselves. So, what I would say is that if you are a people pleasing woman and you get a psychiatrist who is not interested in drawing out exactly what is going on with you, then you are likely to be told you don't have ADHD.
To his credit he did email me two new forms after the consultation to allow me to find two other people and have another go at completing them. I can't think who I would ask, and the wording on the forms is likely to lead most people who know me to say I have no problems. I therefore don't think I will complete them and he will be unable to finish the assessment.
My goodness, I am so sorry this is so long. What I would say to anybody thinking of a private consultation is: try to self refer using NHS funding. Don't pay a fortune getting it done privately. In fact, if you think you won't want any medication then don't book a consultation at all. All of the tests are online. You can do them by yourself.
Secondly, I would not recommend this particular psychiatrist. Going through this kind of process is quite emotional and I really think a doctor needs to be friendly and show an interest in individuals however world weary and tired he may be. If you are thinking of using this clinic and would like to know who he is I can tell you by private message.
I don't know if there are any pressure groups for women suffering with ADHD. The diagnostic criteria really have to be changed to take into account sex/gender and also sociocultural differences which affect reporting of symptoms.