question about diagnosis and treatment

a month ago by mika june [she|her] to c/adhd

i have a lot going on in terms of my mental health, but one thing that is really destroying my life right now seems to be executive dysfunction. i'm well into middle age now and never got assessed, but i'd like to be evaluated and treated if possible. i really don't know where to start. i don't have insurance as i'm unemployed (u.s.). what sort of professional should i see who can help me? any thoughts on what to expect along the way? any advice would be most appreciated!

quickenparalysespunk 7 points a month ago

https://www.prosperhealth.io/

they provide assessments and/or therapy fully online and the pricing is hugely discounted compared to many in-person mental health providers. for example, for my state, psychologytoday.com provider directory is about double the price on avg of those in Prosper.

if your state has health care coverage for low/no income people, the cost could potentially be reduced to almost zero out-of-pocket. as with everything, proceed cautiously, YMMV

edit: do not confuse with https://prosperhealth.ca/ (a Canadian rehab center)

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crowcore_explorer 4 points a month ago

thank you for the info and the link! i'll look it over and talk with my partner about it.

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13readie 1 point a month ago

Prosper was how I got my autism diagnosis!

Though, I was under the impression OP was wanting ADHD diagnosis and not autism diagnosis (question mark?)

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crowcore_explorer 3 points a month ago

honestly, i suspect add, but who knows? i sorta suspect my mental health issues are legion so anything is possible. glad they could help you out either way!

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13readie 2 points a month ago

Best of luck to you! It felt very validating to be able to put a name to the struggles I've been experiencing my entire life.

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crowcore_explorer 2 points a month ago

thanks so much for the kind words!

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quickenparalysespunk 1 point a month ago

so they exclusively provide autism services...

i wasn't sure

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irotsoma 5 points a month ago

I found a psychiatrist who not only had experience with ADHD but also had it. He pointed it out to me in my late 30s and before that I didn't really ever consider it.

If you want medication, you'll need a psychiatrist. But if you just want evaluation and therapy then a therapist is enough (and a little cheaper if no insurance). I will say mental health providers are generally spread pretty thin these days, so expect a waiting list to get in with a good one.

Anyway, make sure it's one who has experience with ADHD because a lot do not and tend to discount it or default to assuming people are just trying to get drugs.

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WoodScientist 4 points a month ago

I found a psychiatrist who not only had experience with ADHD but also had it.

My psych also has the same AuDHD I do. On the positive side, she really gets it and offers great advice. On the negative, my ADHD psych herself has ADHD, and getting prescriptions filled can sometimes be a challenge. Not because she thinks I'm a drug seeker and doesn't value medication, but because she can be just as squirrel-brained as I can! 🀣

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crowcore_explorer 3 points a month ago

thank you for the words of caution. that gives me a good idea of what to aim for.

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Goldmage263 2 points a month ago

Quick note. Without insurance in the US, the meds can get a bit pricey. I'd be looking at roughly $14 a day without it. $0.80 with. A general perscription discount card will probably help.

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crowcore_explorer 2 points a month ago

i'll keep that in mind. thanks for the info!

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dgdft 3 points a month ago

Formal eval is generally gonna be expensive; you should look towards figuring out what public programs you qualify for, and then work towards getting diagnosed after you have coverage.

Instead, what you can do in the short term is go to a primary care doctor, tell them exactly what you put in your post body, and ask if they would be willing to prescribe any non-stimulant medications to help manage your cognitive symptoms while you work towards getting coverage and specialist care. Very few will say no, but if they do, it’s a reflection of what they consider their wheelhouse rather than you asking anything untoward.

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crowcore_explorer 3 points a month ago

this might be the way to go for now until things get more stable. i didn't know that was an option, but i'm gonna look into it!

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AddLemmus 1 point a month ago

In parts of Europe, Modafinil has a decent ratio of "easy to get" / "helpful with executive dysfunction". It's schedule IV in the USA; not sure if a GP can and will prescribe it, especially when intended for off-label use. Safety is also not great compared to real ADHD meds, but it helps pretty well.

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Rhynoplaz 2 points a month ago

Apply for state benefits ASAP. The application is a lot of paperwork, but they should cover what you need.

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HubertManne 2 points a month ago

I feel your pain. Im in a similar situation but what I really want to find out is if I have this variation on dyslexia someone mentioned here. Its initial thing was about hitting things when you pass them by which I do pretty regularly and have done my whole life. Along with tripping, and I am sorta clumsy with tying and buttoning and such (I have so often had a scenario when im doing it in someones prescense and they get annoyed and do it for me). I do this thing when parking where I am adjusting again and again. My dad used to do it to. knocking things over or literally not setting them on a surface but on the surface edge. Always bad at sports. Had othopedic shoes because of my gait but now I wonder. Can't draw to save my life. Things that are hard to explain with breathing and posture. But then there are other things. I distinctly remember when I learned how to read because I was having trouble and was put in the dummy group. My older sister was forced to help me at home which made her angry at me. When I learned to read it was all of a sudden and I became an avid reader. It was like all of a sudden it just made sense. I talk to others and they remember a gradual process of learning to read. I don't think anything can really be done about it but man it would make so much sense to know.

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kindnesskills 2 points a month ago

Dyspraxia. I remember it because it sounds like dyslexia but for practical things, with a fancy doctor spin on it.

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crowcore_explorer 2 points a month ago

that sounds really rough to grow up with and live with for so long. i think I have some sort of mental processing issues. my partner will try to explain something she wants help with and will often have to draw me a picture or take me to the space she's talking about so i can understand what she's talking about.

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01189998819991197253 2 points 19 days ago

For medication, once you're prescribed, use a discount program. There are several in your country, but I've found (at least based on their advertised prices) SingleCare to be generally less expensive.

For comparison:
Generic adderall looks to be around $35 US.
Generic vyvanse looks to be around $120 US.

I also found GoodRX. Generic adderall looks to be about the same as SingleCare.
Vyvanse looks to be less expensive.

Looks like a hit/miss, but nothing says you must use only one.

Good luck!!!

Edit. It is funny to me. SingleCare was less expensive on other drugs I compared, but definitely not so on the two I know are common for ADHD, making my first statement and my last contradictory lol

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Triumph 2 points a month ago

See if you qualify for Medicaid. That's what it's there for.

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HubertManne 2 points a month ago

although soon it will require 20 hours a week of work and if you can't find it well then sucks to suck.

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