April 18, 2018 at 1:43 pm #82151frinkwhaabParticipant
After struggling with attention and focus, and consequently having very few productive hours at work for many many years (I’m 35yr), I realized I may have ADHD and sought help from my healthcare provider. They had me schedule an appointment with a a psychiatric nurse practitioner. I brought with me my ADHD self-report scale (ASRS-v1.1) which strongly suggested my symptoms are consistent with ADHD. She asked me a bunch of questions with qualitative answers that were hard to answer, and then she said she said although I have some symptoms consistent with ADHD, there’s not enough for a diagnosis. And therefore she was unwilling to prescribe a stimulant. She attempted to state back to me a description of my challenges, to which I thought and said “that doesn’t at all sound like me.” I felt she just didn’t get me or my challenges at all. For reasons I didn’t fully understand, upon me pressing that I need some help as the focus problems are affecting my work and my family, she stated she’d like me to try an anti-depressant (bupropion) which also may help with ADHD. I don’t consider myself depressed other than the lousy feelings relating to being unable to focus on things and get stuff done. I’ve been on a very low dose of buproprion and have perhaps seen mild improvement in my focus.
I then looked for a psychiatrist specializing in ADHD for a second opinion. I had a difficult time finding a doctor accepting new patients in my insurance network, so I decided to pay out of pocket to see specialist who could see me relatively quickly (my in-network provider had a 3 or 4 month wait). We talked for about an hour, and I felt he understood me really well. He articulated my challenges precisely, and diagnosed me with ADD. He said he would not have prescribed bupropion, but he agreed in some ADD cases (he said 20-25%), it has been shown to help. He is willing to prescribe a stimulant if I decide I want to try that.
My challenge is that he is out-of-network, and my insurance won’t cover the appointments (medicine TBD). I’m hesitant to go hunting for even more doctors who might take months to get appointments and who may or may not agree on the ADHD diagnosis. I’m also worried about being labeled as someone who doesn’t actually have ADHD seeking out stimulants. I know these drugs are abused by some.
So I’m looking for any suggestions. My goal is to find a doctor who can help me find the right medicine and dosage, who is in-network. Can I try bringing the diagnosis from my out-of-network psychiatrist to my GP and ask him to prescribe? Can I go back to the psychiatric nurse practitioner, and try again to get her to accept the diagnosis given the 2nd opinion? I can afford the out-of-network psychiatrist in the short term but I don’t want to have to pay out of pocket forever.
Or should I just try the bupropion longer perhaps at a larger dose since my dose is very small?
Any thoughts are appreciated. This is my first post, and I’ve never tried any meds before other than the buproprion I recently started. I’ve never previously seen any mental health professionals. So this is all very new to me and I’m struggling to map out a good path forward.
April 19, 2018 at 12:04 pm #82248Penny WilliamsKeymaster
It’s tough to balance adequate care with insurance restrictions, especially in mental health.
You could certainly start medication with this psych and then continue to look for someone to switch your care to that is covered by your insurance.
There are other clinicians who treat ADHD as well:
ADDitude Community Moderator, Author & Trainer on Parenting ADHD, Mom to teen w/ ADHD, LDs, and autism
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