Medication for ADHD? Choosing a Psychiatrist
I would be remiss if I didn't start with an acknowledgment that there are many people concerned with the use of medications for ADHD, especially with children and teenagers. Everyone must make their own decisions and for me medication was the right choice. Why was it the right choice?
One thing scientists know for sure about the cause of ADHD is that they have not determined a specific cause and there are many possibilities. The possibilities include: brain development, genetics, brain injury, environmental factors, and diet. When I began my training as a counselor, the diagnostic classification for what is now ADHD was "Minimal Brain Dysfunction." It was a catchall category for behavioral difficulties thought to be caused by some vague problem in the brain. That was the label used in the 1968 version of the Diagnostic and Statistics Manuel, Version II, written by the American Psychiatric Association. Today, especially with the advent of technology that allows us to look inside of an active brain, much more is known about this diagnosis. There is a large body of evidence to indicate that the brains of individuals with ADHD are different from non-ADHD brains. Scans of an active brain with ADHD show a link between the level of glucose in areas of the brain used to inhibit impulses and maintain attention. Lower levels of glucose indicate that these parts of the brain were not as active and could not control impulses and attention as those with the regular levels. This is one of the clear links between the brain and behavior.
As a psychologist and foster parent, I referred many individuals for evaluations for ADHD. The process should include extensive history and information gathering to make the diagnosis, prescribing the medication, and then an assessment of the correct medication and dosage. In all cases, the medication resulted in an improvement in behavior and in academic achievement. Every one of the foster children I recommended for evaluation was reluctant. I took time to gain their trust and help them to understand why I thought they were ADHD and my reasons for believing medication would help. Despite their hesitation, every one of them immediately realized it was helping them focus and improved their behavior. Given this track record it seemed obvious that it was now my turn for an evaluation. The first step is finding a qualified physician. Here is what I looked for:
· There are many medical specialists, pediatricians and internists, who are qualified to diagnose ADHD, a psychiatrist was my choice. They have received specialized training in the brain and medications. All of my foster children were evaluated by a child psychiatrist, even though their pediatrician was a very good and highly qualified doctor. I wanted them seen by a specialist because ADHD can be hard to diagnose, especially the inattentive type.
· A lengthy history of the person's behavior, including at home, work, and school, should be taken. Misdiagnosing a person with anxiety or who is oppositional should be avoided.
· Unfortunately, some diagnosis are based solely on complaints from parents and teachers. This should never be the case.
· The psychiatrist should keep up with recent research in the causes of ADHD and the latest medications.
· A short term follow-up appointment is scheduled to discuss the effectiveness of the medication and the appropriateness of the dose. Each individual's body handles medication differently. Care must be taken to find the most effective medicine for each person.
· The doctor should spend time discussing the areas of improvement and where there is no effect. There should also be questions about side effects.
How do you locate a qualified psychiatrist? You can get a referral from the family doctor, school counselor, or a friend. There is a directory of medical professionals who are "Board Certified" in their specialty. This means that they have extra training and have passed a very difficult test and evaluation. You can find a board certified physician, in any specialty, by going to the American Board of Medical Specialties. Information is provided below.
I followed all of the steps that I recommended and am very happy with the services I am receiving from my psychiatrist. My life has improved a great deal. It is much easier for me to read professional material. My ability to focus and concentrate improved, even with distractions. When I have a problem to solve, it is easy to choose between many solutions. The medications are not a magic bullet. I am still easily bored, loose focus at times, get distracted, and walk fast. For information on my life with ADHD, go to my Hubpage My Life with ADHD, Predominantly Inattentive Type. For information on the strategies I developed to deal with life with ADHD before my diagnosis, see my Hubpage My Life with ADHD, Strategies for Survival.
American Board of Medical Specialties: go to their website http://www.abms.org/. A board certified doctor of any specialty can be looked up here. Finding a psychiatrist is easy. Once on the home page:
1. Click the blue square titled "Consumers."
2. To find a certified physician:
a. Look up a particular doctor by filling in the doctor's name, city and state fields.
b. To find a list of doctors in your area, complete the city, state and specialty fields. The specialty fields to use are: "Psychiatry" or "Child and Adolescent Psychiatry."
3. Press "search" and the information will be delivered.
Relevant Hubpages and Web Sites
- My Life with ADHD, Strategies for Survival
This is the second of a two part article on my life with ADHD. If you wish to read the first part, which relates my experiences with ADHD, Predominantly Inattentive Type, then go to my Hub entitled My Life with ADHD, Predominantly Inattentive Type...
- My Life with ADHD, Predominantly Inattentive Type
For my entire life I have suffered with a condition that is now called Attention-Deficit Hyperactivity Disorder, Predominantly Inattentive Type. This means that I am a person who has difficulty with attention but few symptoms of hyperactivity; a...
- Welcome to ABMS: Improving healthcare quality through board certification
The American Board of Medical Specialties (ABMS) is a not-for-profit organization that oversees 24 approved medical specialty boards in setting standards for the ongoing evaluation and certification of physician specialists.