Which Doctor Should You See for ADHD? A Guide for Turkey

Someone is finally curious about the name of a struggle that has lasted for years, and their first question is: where do I go?

This question looks simple, but finding the answer is not as easy as one would think. Because ADHD is a condition to do with the brain, neurology comes to mind first. Because it is an attention problem, some people go to a psychologist. When it is seen in a child, they apply to pediatrics.

All three are the wrong door. Let me write the right one and why.

Who does the assessment

An ADHD diagnosis is made by a psychiatrist.

This is split into two separate specialties by age. For eighteen and over, adult psychiatry; for those under eighteen, the child and adolescent mental health and diseases clinic.

The transition period at the end of adolescence sometimes causes confusion. A seventeen-year-old goes to the child and adolescent clinic; after turning eighteen, follow-up is handed over to the adult side. If you are a patient under follow-up, talking about this handover beforehand prevents a gap from opening in between.

Why not neurology

This question comes from a fair place. ADHD is classified as a neurodevelopmental condition, that is, it has to do with the developmental course of the brain. Logically it seems like neurology.

But in medicine, specialties are divided not by which organ a disease concerns but by the method with which it is assessed. Neurology deals with structural and functional diseases of the nervous system: conditions seen through imaging, electrophysiology and the neurological examination.

The diagnosis of ADHD, though, is not made with imaging or a blood test. It is made through history, observation and functioning, and that method is the field of psychiatry.

There are situations in which neurology enters the process. If the symptoms point to another neurological condition, for example a suspicion of epilepsy or a change that began at a particular time, the doctor can refer to neurology. That is a differential diagnosis step; the ADHD diagnosis itself is still made in psychiatry.

What a psychologist does and does not do

This distinction is one of the most confused places in Turkey, and when it is confused people lose months.

Psychologists carry out an important part of the assessment: they administer scales, do neuropsychological tests, collect data on attention and executive functions. This is information that strengthens the file going to the doctor.

Psychologists also conduct therapy, and in ADHD psychological support is one of the main components of treatment. In the article on medication or therapy I explained that the two work on different problems.

What they do not do is make the diagnosis and prescribe medication. A psychiatric diagnosis is a physician's decision; ADHD medications in Turkey are prescribed with a red prescription (the controlled-substance prescription) and only by psychiatry specialists. I covered this in detail in the prescription article.

The practical result is this: the process can be started by going to a psychologist, and this can be a useful first step. But at some point that process has to connect to a psychiatrist.

Getting an appointment is also work

This is the most realistic part of this article.

Psychiatry clinics are busy, and appointments most of the time fall weeks away. The job of getting an appointment itself asks for something from exactly the area you struggle in: opening a system, finding a suitable date, confirming and not forgetting that date.

The obstacle I described in the article on why phoning is so hard shows up here too. Getting stuck at the appointment step is one of the most common reasons the process is delayed for months.

A few things help. Squeezing the job of getting the appointment into a single sitting and not moving on to something else in that sitting. Writing the appointment into the calendar the moment you get it and setting a reminder for the day before. If the appointment is on a distant date, planning at the same time the preparation to be done until that date.

What to bring to the interview

This part is what speeds up the diagnostic process the most, and most people go unprepared.

There are three kinds of information the doctor needs.

Childhood history. The most critical condition of the diagnosis is that symptoms began before the age of twelve. What you remember yourself is valuable but may not be enough on its own. School reports, teacher comments, old health records and the observations of someone who knew you as a child fill this gap.

Functioning today. The presence of symptoms alone does not give a diagnosis; they have to be really disrupting life. That is why, instead of the sentence "my attention is scattered," concrete examples telling what the scatter costs help more.

At least two settings. Symptoms appearing in only one place do not support the diagnosis. You need to think separately about how they look at work and at home, at school and among friends.

I covered these three headings step by step in the diagnosis process article.

Going with an internet test

Many people come with a screening test result in hand, and this is not a bad thing.

These tests do not diagnose and cannot. I wrote in detail why in the article on online tests: they were designed as screening tools, and they also give positive results in other conditions such as anxiety, depression and insomnia.

But they do one useful thing: they create a reason to go to the appointment. The right thing is to take the result not as an answer but as a starting point for the conversation.

State, university, private

Which is better is a frequently asked question, and the answer is this: because the diagnostic criteria are the same, the type of institution does not change the diagnosis.

Two things are decisive.

The first is the time given to the interview. An adult ADHD assessment requires a detailed history, and this history does not fit into a short interview. In a busy clinic the doctor tries to do the same job, but the conditions are different.

The second is the preparation you bring. This is the only variable in your hands whichever institution you go to, and its effect is larger than assumed.

On the reimbursement side there is a difference: the medication report and SGK (the Social Security Institution) processes run in public institutions. I dealt with this topic separately in the medication report article.

If no diagnosis comes out

This possibility needs to be written too, because when it happens people are caught unprepared.

At the end of the assessment an ADHD diagnosis may not be made. This means one of three things: the criteria are not met, the symptoms are better explained by another condition, or a decision cannot be made because the history was insufficient.

The third is the most common and something that can be solved. If what is missing is childhood information, it is possible to collect that information and go again.

In the second case there is also something to do: treatment of whatever picture emerges comes onto the agenda. I dealt with the comparisons of anxiety, depression and trauma in separate articles.

What I take from it

The strangest side of this system is that the route to applying is written nowhere clearly. Which clinic to go to, why it is not neurology, and what a psychologist can and cannot do; all three are things people learn by trial and error.

The cost of trial and error here is months. An appointment taken at the wrong specialty means a waiting period spent for nothing.

The second oddity is that the system asks for the most organized application from the person who struggles the most. Getting an appointment, collecting documents, remembering the date and telling a tidy history; all four ask for something from exactly the area that is to be assessed.

Even so, it is worth going. Because without this door being opened, no other door opens.

The information here is a general framework. Decisions on diagnosis and treatment are made with your doctor.