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ADHD Marriage and Professional Help Part 1 - ADHD Assessment


In a previous blog post, "Overcoming ADHD Marriage Challenges," I briefly touched on the importance of finding the right therapist for my husband. Today, I want to start with an earlier step – the ADHD assessment. Over the next 3 days, I will share a 3-part story on our journey and my learnings on getting professional help, from ADHD Assessment, finding the right therapist and finally staying on treatment plan. I hope that through this blog, provide you some insights as to what you should expect so you have an easier path on getting help that your ADHD spouse need. So, let's get started


As a non-ADHD spouse, my husband has undergone three separate assessments by three different doctors. The cost of these multiple diagnoses was a financial ($1500+) and emotional burden for both of us. While it wasn't our intention to get multiple assessments, our circumstances forced us down this path. However, these experiences have taught me valuable lessons that I want to share with you to help your ADHD spouse avoid the need for multiple assessments as it is costly both from a financial and mental health perspective.


But before we delve into these lessons, let's cover the basics:


1. What Does a Typical Assessment Involve?

An ADHD assessment typically includes:

  • Clinical Interview: A licensed mental health professional, such as a psychiatrist or psychologist, will conduct a comprehensive interview to gather information about symptoms, medical history, and daily functioning.

  • Behavioral Observation: Observations of behavior in various settings may be conducted to assess symptoms in real-life situations.

  • Self-Report Questionnaires: You or your spouse may be asked to complete self-report questionnaires that provide valuable insights into ADHD symptoms.

  • Medical Examination: While this is more common for children, a medical evaluation can help rule out other conditions that may mimic ADHD symptoms.

2. Is There a Standard Test for ADHD Assessment?

No, there is no single standard test for ADHD assessment. However, in the US, most physicians follow the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) to perform ADHD assessments.


3. Where Can You Find Professionals Who Offer ADHD Assessment?

CHADD, ADDA, and various ADHD experts all provide a directory of professionals who offer ADHD assessments and treatments. I provided a few links I have used in the past for you to start your search.


4. How much does an ADHD Assessment Cost?

In the US, the cost without health insurance can range from a few hundred to a few thousand dollars, depending on where you live, and who is performing the assessment (i.e. psychiatrist and a psychologist). If you have health insurance, you might pay a fraction of the full cost. However, in our case, our out-of-pocket cost for the 3 sessions ranged from $130 to $1100 as some of the providers are out of network.


Our ADHD Assessment Journey

As I have mentioned, my husband was tested 3 separate times. Here is a quick walk-through of each assessment as it will demonstrate the variety and range of information we got from each diagnosis.


1st assessment: We had a referral to a child psychiatrist, who performed the assessment. The assessment consisted of three sessions, 2-3 hours per session. It was the most comprehensive test he has taken, which included a clinical interview, behavioral observation, patient history interviews, and an IQ test. We then had a full 90-minute session where the doctor when through his diagnosis with both of us. His diagnosis did include comorbidities. A letter confirming his ADHD diagnosis was sent to our marriage counselor; we didn't get a copy of that letter.


Cost: $1100, all out-of-pocket as insurance at that point stated they do not cover ADHD assessment


2nd assessment: We found an ADHD assessment center through a list provided by ADHD expert's website. It consisted of two online questionnaires that my husband (30 min) and I (15 min) took separately, a 1-hour virtual behavior and patient history interview, a 1-hour diagnosis review session and 1 detail test report and 1 letter confirming his ADHD diagnosis. I was not invited to the diagnosis session. This diagnosis did NOT include comorbidities. I had my husband follow up with the assessor on comorbidities assessment for his diagnosis and the assessor referred my husband to another doctor. We had reported this back to the ADHD expert who had since taken this ADHD assessment center off the list due to the fact they fell short of providing a comprehensive assessment.


Cost: $475, all out-of-pocket as they are an are an out-of-network provider


3rd assessment: My husband performed an internet search himself and found a psychiatric nurse practitioner, who practices at an ADHD clinic. This nurse is in state but in a different city. It consisted of two, one-hour sessions. He shared the 2nd assessment's diagnostic letter before their first meeting. Hence, the cost is less because it is treating it as a normal therapy session verses a full assessment. The nurse practitioner added comorbidity to his ADHD diagnosis.


Cost: $130, in-network provider


Overall, we spent over $1500 out of pocket on multiple ADHD diagnosis and after the first two assessments, my husband felt into a depression that lasted for over a month each time. That is very taxing on both your mental health. For him, it was yet another time of re-living his traumatic childhood, where he was put down often for being slow, stupid, hopeless, etc. For me, it was another vicious cycle of deep depression where I had to take over almost all the responsibilities of our lives. Here are the lessons I learnt from our journey on ADHD assessment and hope that it could save you pain financially and mentally.


Lesson 1: Research and Understand ADHD

ADHD is a developmental disorder associated with an ongoing pattern of inattention, hyperactivity, and/or impulsivity. As individuals grow into different phases of life, different behaviors may manifest. By understanding ADHD and what to expect based on the age group your spouse is being diagnosed in, you can ensure a more comprehensive assessment and avoid the need for a second opinion.


Lesson 2: Interview the Evaluator for a Comprehensive Evaluation

ADHD assessments can vary significantly in cost, which can be a financial and emotional strain on your ADHD spouse. Additionally, approximately 80 percent of individuals with ADHD are diagnosed with at least one other psychiatric disorder during their lifetime. Therefore, it's crucial to ensure that the evaluator can provide a comprehensive diagnostic assessment, including an evaluation for comorbidities. When interviewing the assessor, consider asking the following questions:

  • What method do you use to assess ADHD?

  • How long will the assessment take?

  • Do you include comorbidity as part of the assessment?

  • What is the common age group you perform ADHD assessments for?


Lesson 3: Keep Records of Diagnosis

One significant mistake we made during our original evaluation was misplacing the diagnosis that the doctor provided us. This error led to the need for a second assessment because we couldn't produce the original diagnosis. To prevent this from happening to you, I highly recommend keeping a record of all diagnosis-related documents in a safe and easily accessible place.


Conclusion:

I hope that you can learn from our missteps in our ADHD assessment journey to save you time, money, and emotional stress. Remember, as a non-ADHD spouse, your support and guidance are invaluable in helping your partner with ADHD thrive. By sharing these insights, I hope to assist you in your journey of connecting the dots in your ADHD marriage and providing the necessary focus resources. Together, we can create a more supportive and empathetic environment for our loved ones with ADHD. Come back and check part 2 of my blog, where I share my experience and key lessons on ADHD treatment.

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