Adult ADHD Assessment - Confused!

[ShoobyDoos]

I'll try to keep it short - I'm late 30s and think I've got ADHD (lots of executive dysfunction and honestly, it all just fits. Big a-ha moment when I connected the dots.). Anyway, I finally had a formal assessment today, and the result came back that I do NOT qualify, as there is not enough evidence to suggest it manifested before the age of 12! (I was very chatty, daydreamy, and impulsive, but I also did well academically.) I also suffered a lot of trauma between the ages of 12 - 25, which I think the psychiatrist leaned into as alternative potential reasons for my 'symptoms'. I'm not sure what to do from here! I just have this gut feeling that this is an incorrect conclusion. Has anyone else had similar? what did you do next? Is it worth fighting for medication? It's so isolating and confusing.

Hmm, I didn't have any childhood input because i was NC with my parents at the time of assessment. It was only what I could remember of primary school, which wasn't very much. And I was still diagnosed.

Also had trauma in childhood.

What form did the evidence take? Is it the answers you gave to questions about your experiences when you were <12?

Seems unfair if yes.

The assessment usually has a questionnaire for someone who knew the person in childhood.

obviously that is not always possible to do.

trauma can give symptoms similar to adhd and the differential diagnosis is apparently complicated.

As I understand it having trauma can often cause traits akin to neurodivergence.

As ADHD is something you are born with, there needs to be evidence from childhood (I used school reports that my parents had kept as part of my evidence) so if you only have evidence from the time or after trauma, then I can see why you haven’t been diagnosed.

Just remember that they won’t have said that you don’t have ADHD, just that you didn’t have evidence or present in the assessment strongly enough to meet the threshold. I was told the threshold is 5/9 but if you reach 5, they still sometimes might not diagnose you if they feel something else (eg trauma or autism) could actually be behind the score.

Do you have any friends from very early childhood who remember you? Or any contact with teachers from back then as a child with undiagnosed ADHD might have stood out enough for them to remember?

Same

Much-wanted label? Going through life the way I've felt for most of it has definitely not been 'much-wanted'. I want a diagnosis because I'm interested in support, management and possible medication that might help me have a more fulfilling life experience.

Hi- the diagnostic criteria are clear that there has to be evidence of concerns before the age of 12, but different practitioners vary in how they interpret that and the evidence they will accept. It can be very hard to identify in adults, particularly women as it’s so often an internalised inattentive rather than hyperactive presentation of ADHD. If you or your parents happen to have any old school reports from primary school (unlikely I know!) or other evidence pointing towards inattention/distractibility in primary school you can present that to the assessing psychiatrist and ask if they might reconsider the assessment information. Or you can ask for a second opinion from another clinician but unfortunately no guarantee they will give a different conclusion. Good luck with it and I hope you get the support you need.

Me too

So much ignorance here. Just for future knowledge, whether you go privately or via the NHS it is still the same NICE guidelines used for the assessment and diagnosis. There is lots of evidence of people not being diagnosed after completing an assessment.

I had to answer 18 questions. Honestly, I don't even remember the questions, really, as I completed the form about 5 months ago, and today was an online talk with a psychiatrist to talk further and discuss the form. And he did ask about primary school but he didnt believe it qualified as I generally did well.

Performing well academically does not mean you don’t have ADHD. You can obviously be bright and know how to pass exams…

This is why I’m reluctant to pursue a diagnosis though. Despite it being glaringly obvious to me. Plus I have a DS with a diagnosis and it’s highly genetic. DH definitely does not have ADHD.

I wasn’t that long ago they thought girls couldn’t have ADHD…

What exactly was the full process?

Video call
Face to face?
How many sessions ?

(Sorry, i have no idea how to reply or quotes shorter parts of texts!)

Hmmm, thank you for this. I didn't realise trauma and ADHD could present quite so similarly. He also raised autism screening (which I dismissed), but I do think the trauma part needs exploring further.....

When I was assessed, evidence from an early age was an essential requirement. Fortunately all my school reports had been kept so there was a tangible record going back to the age of 5. Also consistent secondary school reports and workplace appraisal records to show how my behaviour never changed. Also, after a few sessions he said could tell by observation e.g. the way I spoke (I was a shy quiet child, not chatty like you. That's not really a symptom.)

I guess what I am saying is that an experienced psychiatrist would have found other ways to diagnose you without that evidence if they otherwise felt certain you had ADHD. The fact that they haven't given you the diagnosis sounds like they are basing it on more than just you ticking the right boxes, but on a holistic assessment. I would explore the effect your trauma has had on you a bit further first, rather than rejecting outright the findings of a qualified expert.

Why did you dismiss autism? I feel that there is an awful lot between ADHD and autism that overlaps but it seems autism still has a bit of a stigma to it. I’m not saying you were wrong to dismiss it but perhaps look at it again (from a female perspective) with fresh eyes and see whether there could be more to it than you realised.

ADHD often hides a lot of autistic traits (if you have both of the conditions) so it’s possible some of the things you are putting down to trauma are really autism.

Thank you!

It's hard as there isnt a clinical test for it. Did you go private or nhs, my son ahd had both private and nhs assessment and they are vastly different. Private is so much more thorough over several sessions, and tests.
That said, there are many many other reasons why you may have adhd type symptoms and trauma is in fact one of those.
What do you want out of the diagnosis?
I have adhd but have never pursued a diagnosis, I have no plans to ever medicate and so there isnt really anything a diagnosis will change. Everything you can do to support yourself without medication is readily available on the internet to try.
If medication is what you wanted then you definitely don't want to start taking medication for something you don't have.

1 form of 18 questions filled out by me, 1 form sent to my mum (which tbh, wasn't the best idea but I didn't know who else to ask), followed by today's 1 hour online session with the psychiatrist.

I don't think that is nearly enough

Should be more robust

Can you ask for a review ?

I wonder if that was all it was because it was apparent there wasn’t any point in continuing as it was clear the threshold wouldn’t be met.

For contrast my sons private diagnosis was with a top clinical pschychologist.
It was over 6 weeks, several obaervation sessions, several play and talk sessions, several cognative and skills based tests, benchmarking, surveys over time, deep analysis of everything in his life since birth, interciews with teachers and his parents. All combined into a 30 page report. It cost us 5 grand.
I really find it outrageous that the level of testing is allowed to be so quick and shor, he also had an nhs assessment and it was two meetings and a couple of forms. I am so glad we did the full test privately. I also think people are being diagnosed with adhd incorrectly as I have seen the nhs test and a proper full test and I can not beleive that the nhs test is sufficient to diagnose a lifelong neurological condition like adhd

I think before you seek another opinion re ADHD, it's worth exploring trauma as a potential factor, because it also opens up potential avenues of treatment (eg trauma focused CBT or EMDR) and support.

I think that since so much of my experience seems to align with ADHD, I just honestly believe and feel that it makes sense.

But you're right too - I haven't done nearly as much research into possible autism, so I can't truly know for sure that that isn't a possible alternative. I do need to look into it further.

Physchiatrists are not Clinical Physchologists. Another reason I think these test are bullshit.