Reply To: How to get mental health professionals to listen past “Bipolar”

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Dr. Eric

ADHD is a diagnosis of exclusion.
You don’t test “positive”.
You have to meet the profile of someone who meets the criteria.
Then, all alternative explanations need to be systematically ruled out.
Once the assessor has conclusively ruled out every other explanation, then the ADHD diagnosis stands.

Part of the criteria explicitly states, “the symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.”

It is extremely difficult to separate bipolar symptoms (and the medication side-effects, potentially), from ADHD symptoms. It is generally only done when the individual has their bipolar well-controlled and/or there is a lot of time of no depression and no manic/hypomanic episodes between cycles.

Also, you are dealing with a disorder for which a very large percentage of patients are in denial of the need for meds or of the impact of the disorder until it is too late. In fact, the more aggressive the denial, the more likely the therapist is going to brace for a manic/hypomanic episode.

Remember that online self-tests do not do differentiated diagnosis or rule-outs, there are plenty of non-ADD’ers who will score high on these tests if they have anxiety, bipolar, depression, diabetes, sleep apnea, or autism.

Your best bet is a person who is willing to look at your history longitudinally and gets to know you over time.
If I were in your position I would ask for a referral from the neurologist and sign a waiver for them to consult.