Where to Get an ADHD Diagnosis as an Adult

After deciding I needed to make an appointment, I did nothing for weeks. The reason was not indecision; I did not know whom to go to.

When I searched online, neurology came up, and psychologists, and places advertised as an "ADHD center." Each looked like a different door, and I was afraid of knocking on the wrong one. That fear genuinely delayed me.

The answer is actually plain.

I covered the choice of specialty and the steps for making an appointment separately in the article which doctor to see.

Whom to go to

The adult ADHD assessment and diagnosis are carried out by a psychiatrist. The department to ask for when making an appointment is adult psychiatry.

A few distinctions help:

• A psychiatrist is a physician; they make the diagnosis and can prescribe medication.
• A psychologist conducts psychotherapy and administers some tests; they do not make the diagnosis and do not prescribe medication.
• A neurologist is not the usual address for an ADHD diagnosis; they come into play if another neurological condition is being considered.

Whether you go to a state hospital, a university hospital or a private one varies with access and waiting time. At university hospitals you can sometimes find teams with a particular interest in adult ADHD.

There is also this, and it is worth saying: not every psychiatrist is equally interested in adult ADHD. Saying "I am coming for an adult ADHD assessment" when you make the appointment makes things easier for both you and the other side.

What happens in the interview

The assessment described by the European consensus statement (Kooij et al., 2019) consists of several parts:

Current symptoms. Which symptoms there are, how often, and for how long.

Childhood history. This step is mandatory. Because ADHD is a developmental condition, the symptoms are required to have been present in childhood too. The diagnosis does not need to have been made in childhood; the symptoms need to have existed in that period. In the glossary this is called the developmental history.

The two-setting rule. The symptoms need to appear not in a single area but in at least two. Struggling only at work is not considered enough.

Functioning. The symptoms must affect life in a measurable way. Here a concrete example is asked for: missed deadlines, ended relationships, interrupted education.

Differential diagnosis. Whether there is another condition that explains the picture better. The review by Katzman and colleagues (2017) stresses that in adult ADHD the presence of another co-occurring condition is the rule; that is why anxiety, depression, sleep and substance use are asked about too. It is under differential diagnosis in the glossary.

Rating scales. You may be asked to fill in one or several scales. They support the assessment and do not make the diagnosis on their own; I covered what they can and cannot do in the article are online ADHD tests reliable.

A scale does not make the diagnosis. What makes the diagnosis is the whole of the history.

What to bring

This is the part of the process that can be sped up the most. Preparing in advance, rather than trying to remember during the interview, helps a great deal.

Documents from childhood. Report cards, teacher comments, notes in the style of "capable but inattentive." These count as strong data in the assessment.

A family observation. Someone who knew you as a child. The NICE guideline (NG87) recommends obtaining information from another source whenever possible. If they cannot come with you, written answers to a few questions you ask them also help.

A list of concrete examples. Telling lived events rather than naming symptoms gives much better results. Instead of "my attention is scattered," "in the past year I forgot to pay three bills and missed two appointments."

Your own timeline. In which period what went wrong: school, job changes, things left unfinished.

Your medication and diagnosis history. The medications you use, past diagnoses, diagnoses known in the family.

Fit it on one page. Write all of this on one page and put it on the table the moment you walk into the interview. Getting scattered while telling it is very common in this picture; the paper both gathers you and gives the physician orderly data. If I had not written it down, I would have left without saying half of what I had prepared.

Making the appointment is a task too

I do not want to skip this, because most articles say "go to a psychiatrist" and move on, and that is where people actually get stuck.

Making an appointment is a task with several steps: logging into the system, choosing a department, finding a date, writing that date in the calendar, going on that day. When any link in this chain breaks, it sets things back six months, and this is a very familiar kind of break.

A few things that help:

• Making the appointment the moment you decide, without postponing.
• Writing it in the calendar as soon as you make it, and setting a reminder for the day before.
• If possible, telling someone; making a promise keeps the chain standing.
• Starting the preparation page weeks before the appointment and filling it in piece by piece.

I wrote about postponing health matters in general in the article health appointments in ADHD.

A few frequently asked things

Is it necessary for my family to come? It is not necessary but it helps. If they cannot come, asking a few concrete questions about your childhood in writing and bringing the answers also works.

Is medication prescribed without a diagnosis? No. The decision on medication is made after the diagnosis and by the physician's assessment; there is no dose or medication recommendation in this article, and there cannot be.

I was not diagnosed as a child, am I too late? No. The diagnosis is not required to have been made in childhood; the symptoms are required to have existed in that period. Most adults diagnosed late are in this situation anyway.

What if I cry in the interview? It happens. Telling these things to someone for the first time goes this way for many people, and it is not something that spoils the assessment.

Will I get a report? If the physician considers it necessary, an assessment letter or a report is issued. If you are going to request accommodations at work or at school, you need to say so in the interview, because asking afterward means a separate application.

How long it takes

It may not finish in a single interview. It is normal for it to be spread over two or three sessions; an additional assessment may be requested for differential diagnosis.

A long process is not a bad sign. On the contrary, a diagnosis made in a single short interview, looking at only one scale, deserves a second opinion. I described how the process works step by step in the article how adult ADHD is diagnosed.

Is neuropsychological testing necessary

No. These tests give information about attention and executive functions but do not make the diagnosis: a person with ADHD can get normal results on the tests, and a person without it can get low ones.

The physician requests them if they consider it necessary. If they did not, that is not a shortcoming.

If no diagnosis comes out

That can happen too, and it is not a process gone to waste. During the assessment something else that explains the picture may be found: a sleep disorder, anxiety, depression, thyroid or iron deficiency. All of these can be treated.

If your struggle is real, it deserves to be addressed regardless of what it is called.

Afterward

The address is adult psychiatry. The process is carried out not with a single test but with a detailed interview that also covers childhood, and the preparation that helps most is to go with lived examples rather than symptom names.

The feeling that comes after the diagnosis does not turn out as most people expect; I expected relief, and something else came first. I described that in the article grief after diagnosis. Whom to tell what is a separate decision, too; I weighed it in the article disclosing your diagnosis.