The Official AD(H)D Diagnosis
With insurance coverage to boot
One of the most consistent takeaways from my initial ADHD deep-dive was that it’s one of the most treatable disorders out there — in fact, success rates of medication can reach up to 80% according to the adorably named and well-respected ADDITUDE Magazine. One just has to be officially diagnosed to start the medication experiment (and yes, “just” is loaded).
The therapist who kicked off my whole ADHD adventure isn’t able to diagnose or prescribe medication, but encouraged me to take these next steps and helped me do so. Though initially hesitant toward the concept of a daily pill (the alteration of routine, potential side effects, potential expense, the diehard habit of trying to force my brain to work differently), my hope was piqued by the research — along with personal stories from kind and open friends who shared how revolutionary treatment was for them. I got on board.
Enthusiastic about the option of treatment, less so at the expense of non-insurance-taking psychiatrists for months of medication trials and maybe even neurological testing, my therapist then shared something that felt like a bit of a hack.
Nurse Practitioners + Insurance, Ahoy
She informed that nurse practitioners are able to diagnose and prescribe medication and many of them accept insurance. Wha?! She shared search results from Headway, which you can filter by your insurance carrier as well as by practitioner specialty, aka, ADHD. Some medi pros out there don’t believe it’s real (which is something I struggle with..) yet it was a relief, and surely time-saving, to be able to search for providers who touted their ADHD expertise right there.
I was relatively thrilled by the search results and eager to get this train rolling. Which I did about two months later. This was partly because I was heading out of town for a month (in a month) and had other ducks to get in a row. I was also hesitant to start new medication while traveling to new places and generally being away from my homebase. And, because it seemed like a lot to get into, and important too. Also, fear. There was fear of change, fear that I might “fail” the diagnosis, that the revelations and new relating to my brain and the emotional journey I’d gone on since this first entered my awareness was all a fraud, also fear that I might be seen as a fiend seeking stimulants. So my (ADHD?!) brain scooted the whole thing under the rug to be peeked at again later.
When I finally got to browsing the practitioners (I was looking specifically at Psychiatric Nurse Practitioners; why not) it took a couple tries to find someone who I thought I’d resonate with, had good reviews, and who accepted my insurance. Before long all the elements aligned and I had a virtual appointment set up.
Testing, Poking, Prodding, Defending
In the week or so before the appointment I got my personal story organized, meaning I clarified the main struggles I wanted to share — I was indeed afraid of “failing” the ADHD diagnosis but eventually realized that if that happened, it’s OK. I recognized that my actual primary goal was to see if there was treatment that could help me with my struggles, whatever shape that took.
When it came time to meet my shiny new psychiatric-mental health nurse practitioner (PMHNP), it was a relief to frame the session as a desire to seek help rather than a desperate hope to be diagnosed. I shared things I’d learned with my initial therapist about my mental conflicts, the persistent battles that keep me from achieving what I want, and within minutes the NP was pretty much like, “Let me stop you there.” Or, more closely said, “This sounds like classic ADD.”
I had anticipated needing to proffer notes and lists, charts and Venn diagrams of my research and my habits.
In a way, the simplicity of the diagnosis made me question — was it really so straightforward? Were these decades of painful idling, impulsiveness, escapism, forgotten phones and credit cards and purses and projects so quickly and summarily attributed to these three little letters? In a way I wanted to have to fight, to prove, harder. Like, maybe my brain is “normal,” maybe I just hadn’t tried hard enough, maybe the struggles I’ve gotten so used to being part of my identity and life… still will be.
A bit hazily I answered a series of questions about my family, my history in school, and substance use; all seemed to verify her initial world-rocking yet also somehow obvious statement. (She also shared that I don’t have the hyperactive part of ADHD but am more purely ADD. The different kinds are pretty interesting if you want to take a look.)
She also mentioned, unsurprisingly, that thanks to the influx of ADHD/ADD/neurodivergency almost as a trend on social media, people have come to see her to be like, “I can’t get my laundry done,” etc, and that that’s not it. Although I also often don’t get my laundry done, but suppose that’s just a smaller piece of a bigger pie.
ADD Medication For Adults
Before I knew it we were discussing potential medical treatments and I had some real hope for a less frustrating mental future. My initial therapist and I had both agreed that stimulants probably weren’t a good fit for me, which I (bravely!) mentioned to the NP. So we landed on Wellbutrin or Strattera. Wellbutrin is an antidepressant with common off-label usage for ADD treatment, though she mentioned it can cause insomnia which I’ve struggled with in the past. So I went with the latter, a strictly ADD treatment that takes 4–6 weeks to really take affect. I had heard great success stories from friends and friends-of-friends — understanding that no two experiences are the same — and am in my first couple weeks of taking it.
I gotta say a generic month’s supply was pretty ridiculously expensive even with insurance (though I do have a high deductible plan). I met with the NP two weeks after the initial session to ensure nothing wacky was happening with the meds, and I will need to meet with her every month or so following, to the tune of $150 per 30-min session. Medication, and indeed mental health treatment, is not cheap though thankfully at this juncture feels like one of the worthier expenditures. I have high hopes for the regimen and, despite feeling some physical side effects, will keep it up. More to come as the Strattera/norepinephrine adventure unfolds.
