Adult ADHD Diagnosis and Treatment: Why Things Can Go Wrong

While there are many good, educated doctors and mental health professionals practicing today, there are also many who haven't read a journal in their field or gone to a professional conference in years. Then you have others who have only a cursory knowledge of adult ADHD (or name your psychological disorder), but pretend like they are experts. In truth, some doctors and mental health professionals know just enough to be dangerous.

"When my doctor entered the exam room he asked me 'How are you doing?' I reviewed my experience with him for a minute or two. He then began to tell me how important it is to balance the side effects with the clinical effects of the drug. I sort of watched him speaking, wondering what he was getting at. Then he explained how I will need to take 'drug holidays', and that I 'can't be on this forever'. So then I began to wonder if he thought Strattera was a stimulant medication. I have close to zero faith in my family doctor's knowledge about ADHD.

"I told him that I had read 'drug holidays' are no longer recommended to patients who take stimulant medications. And I said either way, it didn't apply to me as Strattera is a non-stimulant medication. I didn't even bring up his 'forever' comment - I was thinking instead about what my new doctor will be like, the one I intend to switch to from this idiot." ~From Mungo's Adult ADHD blog

As a patient, it's difficult enough to get an accurate adult ADHD diagnosis from a competent mental health professional, so imagine what happens when you go to someone who isn't. Not only can you get an incorrect diagnosis, but now you're turning to this person for treatment of adult ADHD!

Poor Adult ADHD Treatment Outcomes

Veteran journalist, Gina Pera, is the author of the award-winning book Is It You, Me, or Adult A.D.D.?, a comprehensive guide to understanding Adult ADHD, especially evidence-based treatment strategies. A long-time advocate and expert in the area of Adult ADHD, Pera claims many doctors aren't using evidenced-based treatment practices to the detriment of adult ADHD patients who depend on them.

What is Evidenced-Based Treatment for ADHD?

It's a phrase that's starting to make the rounds in psychological circles, especially among consumer mental health advocates. Evidence-based treatment is just that, treatment based on outcomes from scientific studies that shows a certain treatment works best for a specific group of people.

In the mental health field, especially, there are doctors and mental health professionals who diagnose and treat patients based on their own personal experiences with a psychological disorder or from anecdotal evidence. In other words "it worked for me, so it will work for you." Or, "I heard other doctors are doing this, I'll do this too." That's a lot different than following established clinical practice guidelines. For instance, here are the Guidelines For Diagnosing ADHD in Children and ADHD Treatment Guidelines established by the American Academy of Pediatrics.

In our interview with Ms. Pera, we delve into this further and discuss how you find a competent professional to diagnose and treat adult ADHD.

Gina Pera: How and Why I Got Involved with ADHD

My foray into the field of Attention-Deficit/Hyperactivity Disorder (ADHD) began by chance. In 1999, my eclectic reading habits led me to pick up an interesting-looking library book about the brain. What I read radically changed my life, my husband’s life, and, eventually, thousands of other lives through my advocacy efforts and then my own pioneering book.

In that library book, I read about a fascinating syndrome called Adult ADHD, and sensed I'd suddenly stumbled upon a clue why, as much as we loved each other, my then-fiancee and I were driving each other nuts! I showed the book to my husband, a neurogeneticist who fortunately had the deep knowledge base by which to vouch for the authenticity of the material. “Doesn’t this sound like you as a kid?” I asked him. "And, well, doesn’t it sound like you now?” He agreed. And off we went to navigate our mental healthcare maze. Who knew it would be so hard for a highly trained scientist and a well-read journalist to do this successfully?

It’s not enough to say that I was stunned at the widespread ignorance about ADHD, including among mental health professionals. Frankly, I was outraged. There is quite enough suffering in the world that cannot be prevented. The suffering that comes from unrecognized ADHD is not one of them. We have a strong knowledge base about ADHD. We have good ADHD treatment strategies. All we lack is more people willing to step into the 21st Century. And that includes physicians, who far too often do not give ADHD treatment the respect it deserves as a highly complex condition.

Deciding to put to use my background as a print journalist, I became a very persevering advocate for better awareness and evidence-based treatment standards—by lecturing, blogging, writing articles, and leading discussion groups in Silicon Valley and online.

After a few years, the need became clear for a comprehensive nuts-and-bolts guide to Adult ADHD, especially as it affects relationships. A guide not only to understanding Adult ADHD symptoms but also the “emotional baggage” that comes with late-diagnosis — baggage carried by both partners in the relationship because for so many years they had no explanation for their challenges.

I also strove to provide readers with a consumers guide to Adult ADHD treatment strategies — the particulars that all the other books on Adult ADHD lacked, such as the therapy to seek (and avoid), the medication protocol that so few prescribing physicians seemed to know about (and perhaps that’s why so many people had unnecessary side effects), and, that big deal breaker: how to get through a loved one’s “denial.”

That’s why I wrote Is It You, Me, or Adult A.D.D? And that's why I conduct workshops and speak at conferences internationally. Especially in hard economic times, people with ADHD and their families need solid strategies to keep them afloat.

Soon, I will be completing The ADHD Roller Coaster Guide to Sleep, because this is one of the top health and cognitive challenges among people with Adult ADHD.

Adult ADHD Videos

The interview with is no longer available. Here is a playlist of adult ADHD videos that may interest you.