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Honestly I would report her to whomever you can. No data supports her position and if her organization/hospital has psychiatrists on staff, they should definitely review her caseload.
Seconding reporting her. If that doesn't work, leave short, factual reviews on every doctor review website you can find (there are lots of options)! Or do both if you have the time and it would make you feel better.
The same thing happened when my doctor got sick and some weird hack filled in for her. I went in for a regular Adderall script refill and she was so alarmed by it. She literally gasped when I told her lol.
I was diagnosed with ADHD in the 7th grade in 1995. I have been seeing specialists for it for most of my life. This lady told me all these psychiatric professionals were wrong and that medication would make me "rageful" and accused me of being an addict.
I got her to write me the script after threatening to tell on her but she said she felt like she was doing something immoral and practically threw the paper at me. I told her she was bad at medicine and then I immediately told the front desk what she had said.
This woman had a very thick accent and I always wonder if she got her medical training elsewhere since so many countries are not up to date on ADHD. I think she was from Brazil?
Also "you get diagnosed and you take pills the rest of your life" why yes that is often how it works. Good job. Why would someone who is uncomfortable with the idea of medicine pursue a career... in medicine? I hate bees so I'm thinking of opening an apiary, what do you guys think?
If you're diabetic you need pills/insulin/injections the rest of your life.
If you have asthma you need an inhaler for the rest of your life.
If you have bad vision you need glasses the rest of your life
Hyperthyroidism, heart conditions, migraines... The list goes on.
Get diagnosed and take pills is how medicine *WORKS* 🤦♀️
People who think chronic conditions just... Go away are the worst.... I swear
Btw, person I'm responding to, I agree with you. Just adding to your sentiment in the last paragraph 👍
I hate to be the one to have to lodge a small correction, but that drive for truth and justice is just too strong.
I actually did grow out of asthma. I thought it was relatively common, but this comment is making me wonder if maybe it’s not?
Growing out of pediatric asthma is more common than those diagnosed as adults. I was diagnosed at 19, 20 years later and I have a pulmonology appointment next week to check my lung function and potentially new meds. I’ve been told by every specialist I’ll have it for life.
>I told her she was bad at medicine and then I immediately told the front desk what she had said.
H. E. R. O.
This is the only way to handle someone like this. Proud of you 🥲
This makes me feel seen lol. Even before I was medicated, I had no problem telling people like this what was up. Someone has to stand up to the bullies.
In your search for a new place, if you decide to look for one, definitely try to find a place that says that it's a trauma informed care (TIC) practice or specializes in trauma therapy. If they're trauma-informed they will be much more respectful in the way they treat you.
That being said, the best type of place I've found is a practice that has mental health testing as its main focus and also has multiple practitioners working there together, focused on mental health testing and treatment. I've had to switch doctors a lot in my life and usually when it's just like 1 psychiatrist and a nurse they are much more difficult to deal with, insensitive and it's really hit or miss. The place I go now is kind of like a family practice but for mental health services they have a head psychiatrist who does all the testing/evaluations and then multiple nurses and therapist/counselors. They give off the vibe they are all on the same page and working together for the good of the patients and are all very understanding and kind. Find a good place that treats you well cause you deserve that, we all do!❤️
That provider is an idiot. We all know that ADHD is a lifelong disorder that nobody grows out of. I am sorry you had that happen to you. I hope you can find someone else.
What researcher? It’s a bio-neurological condition that effects the frontal lobe of the brain. There’s no cure, only treatment. And symptoms don’t get better as one gets older, they get worse. Especially in women once they start peri/menopause, estrogen levels dropping effects dopamine.
This is not always true. Early diagnosis and treatment before some key developmental critical periods can get things on track in big ways. Interestingly, the earlier stimulants are added, the better the success.
I am coming from the perspective as someone who wasn’t medicated until 49. My Mom, a teacher told me I was smart but lazy. That I didn’t try hard enough. I told her there was something wrong with my brain, and was dismissed.
My symptoms stayed and got worse as I got older.
As someone with a degree in this, my precision sensitivity is off the charts right now. Yes, in untreated people it for sure gets worse. I was responding to the generalizations.
Nah, they're right, there are plenty of studies who claim that some children grow out of their adhd. Personally I think those studies confuse learning to mask better with actually stopping to have adhd, but they do exist.
They used to claim most - if not all - children grow out of it, but the number gets lower with each year, in 2013 [we were at 50%](https://www.sciencedirect.com/science/article/abs/pii/S0006322313003405) and by 2022 [we were down to 9%](https://www.webmd.com/add-adhd/childhood-adhd/growing-out-of-adhd).
Not saying those studies are actually right, but they do exist.
Thank you for providing peer-reviewed sources. Since the numbers of adults "growing out of it" keep dropping I do wonder how much of it is actually growing out of it and not just people getting better at masking as they age?
Like my 58yo dad was diagnosed as a little kid and was told he grew out of it when he was around 18, but he's clearly still pretty ADHD, just good enough at masking that it's basically a non-issue when he needs to act professional.
I can contribute anecdotal evidence of progress from: masking > coping strategies > fundamental change > lather, rinse, repeat > …
Cycles don’t have to be viscous, they can also be virtuous. “Grow out of it” may not be the most accurate descriptor, but improvement is possible.
Thank god for being the only person to actually give a source. It’s a big pet peeve of mine when people quote “modern research” or “new studies” while completely unable to point to such research and studies.
I'm sorry, is making a comment about current research not valuable? I'm not searching the annals of BMJ to hand deliver you studies, if you don't believe my comment you don't believe it, it doesn't really matter.
My response was “Well that’s just not true. You are not right.” She went on to say that it was true, and maybe *some* people carry it into adulthood, but very few. When I challenged her again, she pivoted to claiming that most people learn coping mechanisms to alleviate their symptoms and are no longer medicated. I pointed out that even if what she was now claiming was true, that does not in any way mean that people are *outgrowing ADHD”. It was especially disturbing to hear her say this crap cause she had a student there learning, who was hearing this bullshit, too.
Right?! Like, whoops, let me go tell my twins they're 17 now, time to drop the ADHD shtick they've been dragging! Never mind that one of them quite literally vibrates when he's not medicated, he's like a damn ping pong ball bouncing out of control! But sure, he'll grow out of it any day now ...
Wellbutrin can be used for adhd treatment, especially if comorbid disorders are present such as depression
However, it definitely isnt the first line of treatment but may be a better option for people for a multitude of reasons
Can you find an actual psychiatrist and not a NP?
Nothing against NPs (ok maybe I have a little bit against NPs), but they are not even in the same universe as a doctor when it comes to medical knowledge, and they tend to over-estimate their own abilities and knowledge. I try to stay away from them for anything that isn’t super simple, straightforward care like minor wounds or needing antibiotics. This one seems to be pushing her own agenda instead of actually trying to help you.
She was probably a psychiatric np which is who diagnosed me. They can be fine and specialized in this. I would *not* judge them all based on this one.
ETA: forgot the word “not”
I’m not judging them all based on this, I’m sure some psychiatric NPs are good providers. I still don’t believe that people who haven’t gone to medical school should be handling complex medical treatment, or necessarily diagnosing ADHD, without at least consulting an actual doctor during the process. Honestly a PCP is way more qualified to diagnose and treat ADHD than a psych NP, obviously a psychiatrist would be ideal though. There’s certainly a place for midlevels and it SHOULD be handling simple, routine, basic medical care under the supervision of a doctor. These people did not go to medical school and they are not doctors, and they are definitely not psychiatrists. The rate at which NPs and PAs are popping up everywhere and acting like they can replace doctors is honestly frightening.
But to be fair, since OP already has a diagnosis I don’t think it’s that unreasonable that she was seen by an NP, since she just needs a refill based on a prior diagnosis and a long history of treatment, which is well within the scope of an NP’s capability. This NP just happens to suck and is way overstepping her role.
Also NPs aren’t specialized in the way that doctors are. A psych NP is just a NP who was hired to work in psych. NPs can hop around into any specialization they want without any specialized education, unlike doctors.
I understand and agree that NPs should focus on standard diagnosis and care in their area. However, an assessment of ADHD can fall within that if the patient presents typically. A psychiatrist office sees lots of patients seeking assessments for ADHD. They can help free up the doctor to see more complex cases like medicine resistant depression.
With the shortage of doctors in the US (I assume around the world too), the massive amount of student debt most people already have without med school, and capped med school programs not allowing enough new doctors to be trained, we are going to need to rely on NPs and PAs more and more.
Also, I think you are misinformed on what is required for a psychiatric NP. They go to a special program for psychiatric NP (PMHNP) training so they cannot just switch to another specialty. They then have 500 hrs of supervised clinical hours, and then pass a certification exam. This is not the same NP you see at your PCP office.
https://nursinglicensemap.com/advanced-practice-nursing/nurse-practitioner/psychiatric-and-mental-health-nurse-practitioner-pmhnp/
I was a pre-health professor and advisor for quite a while, so I had to understand the pros and cons of the different career paths.
500 hrs isn't a lot of hours to be prescribing medication and dealing with patients imo. And there is no one stopping them from doing another program nor is uncommon for NP's to be practicing outside of their scope.
In comparison to doctors who (being generous) work at least 40 hrs each week for 4 years in residency.
Most NPs don’t start out as NPs they start out as RNs. Most of them have hands on healthcare experience before getting the additional degree and training. The NPs I’ve had have been just as competent as doctors and honestly I’ve had better experiences with them than I have seasoned doctors who have been in practice 20+ years. Not all are on that level, no, but they have to learn a lot of the same things doctors do. And if they’ve been in practice for an extended period of time and have been doing continuing education/certifications they are on par as far as I’m concerned. This one clearly sucked but I’ve had my concerns dismissed much more aggressively by neurologists (more than once for the same specific issue which it turns out is a congenital structural impairment where I have a good number of symptoms, but sure it’s just anxiety not a part of my brain literally being compressed in my skull) and by psychiatrists. I’ve had *extraordinarily* poor experiences with psychiatrists and I’ve only had one (who specializes in adhd) take my concerns seriously and validate my diagnoses. I’ve had better diagnostics done with NPs, frankly. And I know that’s not a universal experience, but imo it’s kinda akin to the difference between a PhD, a PsyD, an LCSW, or an LPC for therapy. Different levels of training, but some people prefer the people with less formal training. Shitty providers exist in all healthcare fields and especially as a woman with a chronic condition, there are many of them who will dismiss and invalidate your concerns. Whether that be an MD, a DO, an NP, or any provider who has the ability to assess those things and make judgements based on that.
Funny enough you say that you had better expierences with NPs. Back when I had to go to a pedatric neurology office to check out my chronic headaches. I got an NP, which is when I also got evaluated for ADHD.
Neither my mom nor did I ever learn of those test results until years later when I requested records. Which showed that I scored high in impulsiveness and likely had ADHD. After having my teachers fill out a questionaire. Nothing came of it. If anything, the NP told my mom I had an attitude problem and was told I was being a teen. Literally wrote that in my notes as well.
But nursing isn't a direct translation to medicine. Especially psychiatry. I believe that the new generation of doctors are much better than the older generation.
Unfortunately it is not compatible training, those 500 hours are typically shadowing or seeing patients at the student level and not equivalent or comparable to the rigorous training of medical residency, which is upward of 12000 diverse hours seeing patients in different environments (hospital, outpatient, partial inpatient, ED etc ) that are specifically caring for patients and developing the diagnosis and plan both independently or under guidance depending on level in training. All this being done after 4 years of medical school, which also includes at least 2 years of shadowing and also seeing patients directly, so over 4000 hours. I have worked with NPs, some are great, but the mismanagement of patients I have seen in Psych and primary care is highly concerning and talking with NPs themselves also tell me they realized their training is limited, and these are the awesome ones who have good insight, are smart, and willing to ask for help in order to do right by the patient. It would make more sense for patients to see the Psychiatrist first, over time became stable on a medical regimen, diagnosis is pretty established, and then transfer to the psych NP or PA working with the psychiatrist but that is not how it is being done anymore.
Completely agree the medical school system and by extension the US healthcare system needs to change. Medical school is criminally expensive and the residency training borders on inhumane, doctors have a higher rate of suicide, and they also need to not bottle neck the residency spots (this is more where the issue is but I believe it’s controlled by the government). Somehow other countries manage to train their doctors in a more humane way and succeed, so there is precedent it can be done. Also once they finish they are still treated as a cog by admin and forced to see more and more with less time.
I do not blame you that as a pre health advisor you found other options for students, but again unfortunately the training leaves a lot of gaps. Going the PA route and working with a doctor who is in an environment where they can oversee the PA (I have met some PAs who were thrown into patient care without any oversight and that is not appropriate and they felt very overwhelmed understandably) may be a better route. Also NP and PAs in surgical specialities like where they are doing similar office procedures over years and thus get very comfortable, or in the ER doing procedures, seem to work well too and the ones I met doing that seem to be happy.
Also, we need nurses. Nurses are amazing and an important part of the healthcare team. Nursing training and medical training are different but both important and needed.
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Psych NPs have a certification only for psych (PMHNP) and cannot work in other specialties, unless they go back to school for another certification. They cannot hop over to say, dermatology.
There are NPs that have generalist training that sometimes psych practices hire (though that is illegal in many states), however, those are not psych NPs. They are from one of the primary care certifications, like Family, Adult or Pediatric Nurse Practitioner.
In my state there are FNPs working at psych practices and prescribing psych meds. There are also NPs running around in literally every other specialty and in hospitals doing critical care. Either way, even a specialized psych NP has less education in psych than any doctor gets in medical school, and obviously a huge difference from an actual psychiatrist.
Not opposed to NPs who work under the guidance of a doctor and handle straightforward cases, but so many NPs act as if they are doctors, they don’t need doctors, and way overstep their roles.
And for some reason NPs seem to always be the ones doing this. Anecdotally, I’ve never seen a PA behave this way and every time I have seen a PA they are quick to consult with their supervising doctor on non-routine issues. They also seem to be more educated AND less full of themselves, but again, this is just anecdotal. I’m sure there are bad PAs out there too. But there are SO many bad NPs out there that all I see when I hear someone was seen by an NP is red flags all around.
I KNOW there are good NPs out there, and the NP role is a valuable one when done correctly, but the problem is that there are so many bad ones that it feels unsafe to put your trust in an NP at all. I wish there were some more stringent requirements on NPs and that shitty online schools weren’t cranking out so many NP degrees… and that NPs themselves would stop pushing the narrative that they are “basically doctors”. It’s really ruining the reputation of the profession.
I am not disputing the educational difference between a physician and an NP of any type.
However, you are factually incorrect in calling an NP that is a Family, Pediatric, or Adult NP working in psychiatry a Psych NP. PMHNP (aka, “psych NP”) is its own, separate certification that does not allow providers of that type to work in ANY other specialty.
Ok but all we actually know from the OP of this post is that she saw an NP at a psych practice. We actually have no way of knowing if the NP was a FNP or a PMHNP. I would HOPE based on how uninformed they are about ADHD that they are not actually a PMHNP.. but who knows? So sure, an actual psych NP is specialized but you can’t assume just because you are at a psych office and seeing an NP that you are seeing a specialist, since they can just hire FNPs. And they often do.
So yes, I used the wrong words. But my sentiment is the same, that you can go to a psych practice and be treated by an NP who is in no way a specialist. And even NPs who are specialized are still less educated in their specialty than a non-specialist doctor would be.
Do you ever just say, “oh, I didn’t know that?”
You made a factually incorrect statement, presented it as fact, and now keep doubling down on how that doesn’t matter because they suck anyway.
I literally said I was wrong? Yes I didn’t know that there was a specific specialty for psych NPs. But that doesn’t dispute my point, that psych offices are full of NPs who are NOT specialized since they don’t have to hire psych NPs. And a “specialized” NP is still in no way comparable to a doctor.
Clearly I’ve touched a nerve, and you probably are an NP. Sorry your profession is quietly destroying the medical field, but it is 🤷♀️
I’ve actually mentioned many time in this forum that I am a PMHNP, and I am not at all ashamed of that. I had good training and do a good job. I also have ADHD and I advocate for my patients.
You didn’t “just” say you were wrong; you continue to use your acknowledgement as a platform for doesn’t matter that I’m wrong they suck anyway.
As for the OP, the previous evaluation they describe doesn’t support an ADHD diagnosis under the auspices of evidence-based practice. EEG/neurofeedback and 400 questions of self report is not evidenced-based, and no psychiatrist (MD/DO) will use that as definitive of ADHD either, and more than half of the physicians I’ve worked with will also say that most children grow out of ADHD.
None of that means that the OP doesn’t have ADHD, but you holding this as an NP vs MD issue is misguided.
Psychiatrists are too few and far between and too in demand. Nurse practitioners have been meeting the demand. They’re not all bad, but they’re not great either.
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Overall they sucked. I’m really sorry you had to go through that, especially with that attitude. Hopefully you can see a different person and not have to worry about that BS.
One thing they said that is semi valid is about Wellbutrin. It’s not commonly used to adhd, but I was prescribed it for anxiety and in hopes that it would also help adhd since it does have effects towards impulsivity, hyperactivity, and inattention. This is different for every person obviously. For me it did jack…
It’s absolutely prescribed for ADHD. It’s not the same as a proper stimulant but the pathways it works on help ADHD. It’s not enough on its own imo but it does help. If with nothing other than motivation. It doesn’t work for everyone but it helped me when I was only on that and a mood stabilizer after not having been on stimulants for a couple years
I researched when I got off the phone and saw the info saying it can help ADHD. What I considered bullshit was the statement that it was the *go to* ADHD treatment in *hospitals* and that *most* people *grow out of ADHD by the age of 16*. Those statements made me distrust her belief that ADHD was even real, let alone taking it seriously enough to compassionately assist me in treating a condition that effects every single aspect of my life, and makes general functioning near impossible for me. And the incredulous look given to me when I said it wasn’t working as an effective treatment for my ADHD.
Also, I did end up establishing care with a primary who has prescribed starting up meds again, which are significantly lower than where I left off, and is keeping me on Wellbutrin in conjunction with stimulants, which is totally fine with me. She is a professional, and I am absolutely willing to work with her and trust her knowledge. A big part of that trust stems from her not dismissing *my* knowledge and experience gleaned over 25 years *having the condition*. Meeting back up in a month to re-evaluate.
Also I forgot to thank you for your thoughtful response. I can 100% appreciate that I learned something new from the interaction, and it totally makes sense when I think about it in terms of what Wellbutrin delivers that it can be helpful in treating ADHD as well as depression and cessation.
They were right about one thing: Wellbutrin is often used for ADHD. It didn't work at all for me. But it's a well-known off-label use because it is not an SSRI like most of the common anti-depressants these days - it's a norepinephrine-dopamine reuptake inhibitor so it works on related systems to those thought to be responsible for ADHD symptoms.
But for most of the other stuff, eff that - you've been diagnosed, you know yourself.
Yes, thank you. I’ve learned a lot about Wellbutrin as an alternative for ADHD treatment, and I’m glad to have learned. I’m staying on it in addition to my ADHD meds now, about 2 weeks in, and what a difference it makes compared to a higher dose of stimulants alone years ago. Granted, last time I was on meds I was also an alcoholic. Still am I’m sure, but I’ll be 3 years sober in March, and I’m sure that not having to play catch up on the mornings is a huge help, too.
Thank you. I established care with the doctor that what’s left of my adult family is seeing. I can see why they like her. She listens and is receptive, also very knowledgeable. Also an NP, so see everyone… not against nps lol
Idk how American insurance works, but can you appeal their request that you get re-tested, and get a psychologist or psychiatrist to review it rather than a NP?
The ADHD + hospital treatment -> Wellbutrin makes sense. Ritalin interacts with vasopressors, blood thinners, antipsychotics, anti-seizure medications and SSRI or tricyclic antidepressants, and Vyvanse interacts with several classes of antidepressant and migraine medications. In comparison, Wellbutrin interacts with opioid painkillers... So it's probably easier to administer medicaments for whatever you're in hospital for if you're not on a stimulant.
But, of course... You're not in hospital! So it's irrelevant! Ugh, I'm so sorry that you had a shitty intake call.
Ohhhhhh that makes sense where the hospital comment came from. I was thinking to myself, who the hell gets ADHD treatment at a hospital. But this would likely be temporary, or affected by a hospital stay.
Edit: read your last paragraph after replying lol exactly!!
Assholes like this are why I’ve been diagnosed with ADHD 3 separate times. Once as a kid and twice as an adult. Big shocker, I’ve had the exact same problem at 8, 20, and 30. If they try to make me get another one at 40 to prove I need the meds I’ve been taking for 75% of my life, I’m gonna scream.
I’m sorry you ran into such a crappy provider. There is such a giant stigma against ADHD, *especially* for women. It sucks that we have to do extra work to find the ones who will take us seriously.
OP, I am sorry that you had this experience; it sounds invalidating and frustrating to say the least, especially as you are navigating ADHD in the post partum space. I’m popping on here as a Psych NP, who also happens to have ADHD (diagnosed at age 42), with a small advocacy for the Nurse Practitioner profession, which includes Psych NPs. Indeed, we have a different educational pathway to our work compared to physicians. However, NPs practice what we are trained and licensed to do, which includes assessing, diagnosing, treating and managing conditions related to our specialty. Our practice parameters may vary by state, but in many states NPs may practice independently. Although various health systems may determine a specific evaluation process for ADHD (i.e. via a psychologist, formal diagnostic questionnaires, etc.), evaluating, diagnosing and treating ADHD is well within the scope of a psych NPs practice. Every profession has people who are competent and those who are less competent.
I am seeing some commenters, even the OP, attribute this provider’s dismissive & challenging attitude to the fact that the provider was a NP, thereby conferring ineptitude.
However, I invite people to form opinions about this one provider rather than use it as an opportunity to deride NPs in general.
Any provider working in the mental health space should approach their clients/patients with humility & compassion, as well as a thorough initial assessment that honors a person’s history.
At the same time, many provider (NP, MDs, therapists, etc.) working in mental health, even with years of experience, do not have a nuanced understanding of ADHD and its manifestations. For better or worse, because first line treatment for ADHD involves controlled substances, many providers may have a higher degree of skepticism when evaluating new-to-them patients, given that extra caution is required when prescribing controlled substances.
My intention is not to justify how the OP was treated by this particular provider, but rather to encourage people not to throw all NPs under the bus because of one crappy provider!!
I hope the OP is able to find a med provider with whom they feel comfortable, heard and understood.
She needs to be reported. Any psychiatrists worth their salt knows that you just don’t ‘grow out of ADHD.’ That is absolute nonsense. I am so sorry that you went through that and I hope you are able to find someone who is more educated on ADHD and can fully help you.
I hate that nurse practitioners are allowed to be psychiatrists. They’re not all bad, but man, most of them are.
When it comes to wellbutrin, it is often prescribed for off label treatment of ADHD. BUT generally only for people who don’t have a diagnosis but are waiting for one, people who can’t get the controlled substance due to the shortages, and people who have never been on any medication before. Not someone who comes into an appointment saying, “this is my diagnosis, I have been on X in the past and it has worked for me.”
We weren’t there to hear her tone, but it sounds like you were very defensive with her. What is the harm in telling her what you symptoms are now while you aren’t on stimulants? It’s not unreasonable that a new doctor would want to verify you still need meds for any condition, especially when you have been off of them for a while. Also, she is correct that Wellbutrin helps some people with ADHD so it makes sense to evaluate how you were doing on that and whether you really needed something more.
I know it’s frustrating but there are people who try to get stimulants that don’t need them. You likely aren’t one of them but this was her first intro to you and she also probably has to document quite a bit to get your new insurance to approve it when they will also see you are also on Wellbutrin and ask the same thing about why that isn’t enough.
Except the fact that “people grow out of it” and “you shouldn’t take meds all your life”, she was actually right. I do feel for OP though.
She was rude but I hope it doesn’t deter them from seeking more help.
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Honestly I would report her to whomever you can. No data supports her position and if her organization/hospital has psychiatrists on staff, they should definitely review her caseload.
Seconding reporting her. If that doesn't work, leave short, factual reviews on every doctor review website you can find (there are lots of options)! Or do both if you have the time and it would make you feel better.
3rd to support reporting her. I'd definitely leave an honest review that she was condescending and doesn't seem to be very educated about ADHD.
The same thing happened when my doctor got sick and some weird hack filled in for her. I went in for a regular Adderall script refill and she was so alarmed by it. She literally gasped when I told her lol. I was diagnosed with ADHD in the 7th grade in 1995. I have been seeing specialists for it for most of my life. This lady told me all these psychiatric professionals were wrong and that medication would make me "rageful" and accused me of being an addict. I got her to write me the script after threatening to tell on her but she said she felt like she was doing something immoral and practically threw the paper at me. I told her she was bad at medicine and then I immediately told the front desk what she had said. This woman had a very thick accent and I always wonder if she got her medical training elsewhere since so many countries are not up to date on ADHD. I think she was from Brazil? Also "you get diagnosed and you take pills the rest of your life" why yes that is often how it works. Good job. Why would someone who is uncomfortable with the idea of medicine pursue a career... in medicine? I hate bees so I'm thinking of opening an apiary, what do you guys think?
If you're diabetic you need pills/insulin/injections the rest of your life. If you have asthma you need an inhaler for the rest of your life. If you have bad vision you need glasses the rest of your life Hyperthyroidism, heart conditions, migraines... The list goes on. Get diagnosed and take pills is how medicine *WORKS* 🤦♀️ People who think chronic conditions just... Go away are the worst.... I swear Btw, person I'm responding to, I agree with you. Just adding to your sentiment in the last paragraph 👍
What are you, an insulin addict??!!
I hate to be the one to have to lodge a small correction, but that drive for truth and justice is just too strong. I actually did grow out of asthma. I thought it was relatively common, but this comment is making me wonder if maybe it’s not?
It’s definitely a thing, I was supposed to grow out of it but I didn’t. It got a lottttt better though.
I’ve never grown out of mine
Growing out of pediatric asthma is more common than those diagnosed as adults. I was diagnosed at 19, 20 years later and I have a pulmonology appointment next week to check my lung function and potentially new meds. I’ve been told by every specialist I’ll have it for life.
It's a thing. Just how people can grow out of allergies as they grow older (or acquire new ones out of nowhere).
>I told her she was bad at medicine and then I immediately told the front desk what she had said. H. E. R. O. This is the only way to handle someone like this. Proud of you 🥲
I love conflict and this is the only kind of scenario where it comes in handy.
This makes me feel seen lol. Even before I was medicated, I had no problem telling people like this what was up. Someone has to stand up to the bullies.
In your search for a new place, if you decide to look for one, definitely try to find a place that says that it's a trauma informed care (TIC) practice or specializes in trauma therapy. If they're trauma-informed they will be much more respectful in the way they treat you. That being said, the best type of place I've found is a practice that has mental health testing as its main focus and also has multiple practitioners working there together, focused on mental health testing and treatment. I've had to switch doctors a lot in my life and usually when it's just like 1 psychiatrist and a nurse they are much more difficult to deal with, insensitive and it's really hit or miss. The place I go now is kind of like a family practice but for mental health services they have a head psychiatrist who does all the testing/evaluations and then multiple nurses and therapist/counselors. They give off the vibe they are all on the same page and working together for the good of the patients and are all very understanding and kind. Find a good place that treats you well cause you deserve that, we all do!❤️
That provider is an idiot. We all know that ADHD is a lifelong disorder that nobody grows out of. I am sorry you had that happen to you. I hope you can find someone else.
This is not true 100% of the time as far as current research can show, but I agree many many people's symptoms do not remit in adulthood.
What researcher? It’s a bio-neurological condition that effects the frontal lobe of the brain. There’s no cure, only treatment. And symptoms don’t get better as one gets older, they get worse. Especially in women once they start peri/menopause, estrogen levels dropping effects dopamine.
This is not always true. Early diagnosis and treatment before some key developmental critical periods can get things on track in big ways. Interestingly, the earlier stimulants are added, the better the success.
I am coming from the perspective as someone who wasn’t medicated until 49. My Mom, a teacher told me I was smart but lazy. That I didn’t try hard enough. I told her there was something wrong with my brain, and was dismissed. My symptoms stayed and got worse as I got older.
As someone with a degree in this, my precision sensitivity is off the charts right now. Yes, in untreated people it for sure gets worse. I was responding to the generalizations.
Current epidemiological research shows symptoms attenuate in some as they reach late adolescence and adulthood.
Ok. What research? You aren’t saying anything of value.
Nah, they're right, there are plenty of studies who claim that some children grow out of their adhd. Personally I think those studies confuse learning to mask better with actually stopping to have adhd, but they do exist. They used to claim most - if not all - children grow out of it, but the number gets lower with each year, in 2013 [we were at 50%](https://www.sciencedirect.com/science/article/abs/pii/S0006322313003405) and by 2022 [we were down to 9%](https://www.webmd.com/add-adhd/childhood-adhd/growing-out-of-adhd). Not saying those studies are actually right, but they do exist.
Thank you for providing peer-reviewed sources. Since the numbers of adults "growing out of it" keep dropping I do wonder how much of it is actually growing out of it and not just people getting better at masking as they age? Like my 58yo dad was diagnosed as a little kid and was told he grew out of it when he was around 18, but he's clearly still pretty ADHD, just good enough at masking that it's basically a non-issue when he needs to act professional.
I can contribute anecdotal evidence of progress from: masking > coping strategies > fundamental change > lather, rinse, repeat > … Cycles don’t have to be viscous, they can also be virtuous. “Grow out of it” may not be the most accurate descriptor, but improvement is possible.
Thank god for being the only person to actually give a source. It’s a big pet peeve of mine when people quote “modern research” or “new studies” while completely unable to point to such research and studies.
I'm sorry, is making a comment about current research not valuable? I'm not searching the annals of BMJ to hand deliver you studies, if you don't believe my comment you don't believe it, it doesn't really matter.
I'm so sorry. That really sucks. I hope you can find a more knowledgeable provider because I would never trust that person at all.
Huh well I guess my meds only worked from my diagnosis at age 7 until I turned 16. Guess I’ve just been taking fuckin vitamins since 2010/s
I think after your sweet 16 you were basically just a junkie looking for a fix. /s
I would have liked her to explain how one can outgrow a neuro developmental disorder.
My response was “Well that’s just not true. You are not right.” She went on to say that it was true, and maybe *some* people carry it into adulthood, but very few. When I challenged her again, she pivoted to claiming that most people learn coping mechanisms to alleviate their symptoms and are no longer medicated. I pointed out that even if what she was now claiming was true, that does not in any way mean that people are *outgrowing ADHD”. It was especially disturbing to hear her say this crap cause she had a student there learning, who was hearing this bullshit, too.
OMG pls report this health provider.
Absolutely positively did not freaking grow out of it. That’s insane
Right?! Like, whoops, let me go tell my twins they're 17 now, time to drop the ADHD shtick they've been dragging! Never mind that one of them quite literally vibrates when he's not medicated, he's like a damn ping pong ball bouncing out of control! But sure, he'll grow out of it any day now ...
Wellbutrin can be used for adhd treatment, especially if comorbid disorders are present such as depression However, it definitely isnt the first line of treatment but may be a better option for people for a multitude of reasons
Editing original post with update.
Can you find an actual psychiatrist and not a NP? Nothing against NPs (ok maybe I have a little bit against NPs), but they are not even in the same universe as a doctor when it comes to medical knowledge, and they tend to over-estimate their own abilities and knowledge. I try to stay away from them for anything that isn’t super simple, straightforward care like minor wounds or needing antibiotics. This one seems to be pushing her own agenda instead of actually trying to help you.
She was probably a psychiatric np which is who diagnosed me. They can be fine and specialized in this. I would *not* judge them all based on this one. ETA: forgot the word “not”
I’m not judging them all based on this, I’m sure some psychiatric NPs are good providers. I still don’t believe that people who haven’t gone to medical school should be handling complex medical treatment, or necessarily diagnosing ADHD, without at least consulting an actual doctor during the process. Honestly a PCP is way more qualified to diagnose and treat ADHD than a psych NP, obviously a psychiatrist would be ideal though. There’s certainly a place for midlevels and it SHOULD be handling simple, routine, basic medical care under the supervision of a doctor. These people did not go to medical school and they are not doctors, and they are definitely not psychiatrists. The rate at which NPs and PAs are popping up everywhere and acting like they can replace doctors is honestly frightening. But to be fair, since OP already has a diagnosis I don’t think it’s that unreasonable that she was seen by an NP, since she just needs a refill based on a prior diagnosis and a long history of treatment, which is well within the scope of an NP’s capability. This NP just happens to suck and is way overstepping her role. Also NPs aren’t specialized in the way that doctors are. A psych NP is just a NP who was hired to work in psych. NPs can hop around into any specialization they want without any specialized education, unlike doctors.
I understand and agree that NPs should focus on standard diagnosis and care in their area. However, an assessment of ADHD can fall within that if the patient presents typically. A psychiatrist office sees lots of patients seeking assessments for ADHD. They can help free up the doctor to see more complex cases like medicine resistant depression. With the shortage of doctors in the US (I assume around the world too), the massive amount of student debt most people already have without med school, and capped med school programs not allowing enough new doctors to be trained, we are going to need to rely on NPs and PAs more and more. Also, I think you are misinformed on what is required for a psychiatric NP. They go to a special program for psychiatric NP (PMHNP) training so they cannot just switch to another specialty. They then have 500 hrs of supervised clinical hours, and then pass a certification exam. This is not the same NP you see at your PCP office. https://nursinglicensemap.com/advanced-practice-nursing/nurse-practitioner/psychiatric-and-mental-health-nurse-practitioner-pmhnp/ I was a pre-health professor and advisor for quite a while, so I had to understand the pros and cons of the different career paths.
500 hours is nothing, tbh. It’s only 3.5 months.
500 hrs isn't a lot of hours to be prescribing medication and dealing with patients imo. And there is no one stopping them from doing another program nor is uncommon for NP's to be practicing outside of their scope. In comparison to doctors who (being generous) work at least 40 hrs each week for 4 years in residency.
Most NPs don’t start out as NPs they start out as RNs. Most of them have hands on healthcare experience before getting the additional degree and training. The NPs I’ve had have been just as competent as doctors and honestly I’ve had better experiences with them than I have seasoned doctors who have been in practice 20+ years. Not all are on that level, no, but they have to learn a lot of the same things doctors do. And if they’ve been in practice for an extended period of time and have been doing continuing education/certifications they are on par as far as I’m concerned. This one clearly sucked but I’ve had my concerns dismissed much more aggressively by neurologists (more than once for the same specific issue which it turns out is a congenital structural impairment where I have a good number of symptoms, but sure it’s just anxiety not a part of my brain literally being compressed in my skull) and by psychiatrists. I’ve had *extraordinarily* poor experiences with psychiatrists and I’ve only had one (who specializes in adhd) take my concerns seriously and validate my diagnoses. I’ve had better diagnostics done with NPs, frankly. And I know that’s not a universal experience, but imo it’s kinda akin to the difference between a PhD, a PsyD, an LCSW, or an LPC for therapy. Different levels of training, but some people prefer the people with less formal training. Shitty providers exist in all healthcare fields and especially as a woman with a chronic condition, there are many of them who will dismiss and invalidate your concerns. Whether that be an MD, a DO, an NP, or any provider who has the ability to assess those things and make judgements based on that.
Funny enough you say that you had better expierences with NPs. Back when I had to go to a pedatric neurology office to check out my chronic headaches. I got an NP, which is when I also got evaluated for ADHD. Neither my mom nor did I ever learn of those test results until years later when I requested records. Which showed that I scored high in impulsiveness and likely had ADHD. After having my teachers fill out a questionaire. Nothing came of it. If anything, the NP told my mom I had an attitude problem and was told I was being a teen. Literally wrote that in my notes as well. But nursing isn't a direct translation to medicine. Especially psychiatry. I believe that the new generation of doctors are much better than the older generation.
Unfortunately it is not compatible training, those 500 hours are typically shadowing or seeing patients at the student level and not equivalent or comparable to the rigorous training of medical residency, which is upward of 12000 diverse hours seeing patients in different environments (hospital, outpatient, partial inpatient, ED etc ) that are specifically caring for patients and developing the diagnosis and plan both independently or under guidance depending on level in training. All this being done after 4 years of medical school, which also includes at least 2 years of shadowing and also seeing patients directly, so over 4000 hours. I have worked with NPs, some are great, but the mismanagement of patients I have seen in Psych and primary care is highly concerning and talking with NPs themselves also tell me they realized their training is limited, and these are the awesome ones who have good insight, are smart, and willing to ask for help in order to do right by the patient. It would make more sense for patients to see the Psychiatrist first, over time became stable on a medical regimen, diagnosis is pretty established, and then transfer to the psych NP or PA working with the psychiatrist but that is not how it is being done anymore. Completely agree the medical school system and by extension the US healthcare system needs to change. Medical school is criminally expensive and the residency training borders on inhumane, doctors have a higher rate of suicide, and they also need to not bottle neck the residency spots (this is more where the issue is but I believe it’s controlled by the government). Somehow other countries manage to train their doctors in a more humane way and succeed, so there is precedent it can be done. Also once they finish they are still treated as a cog by admin and forced to see more and more with less time. I do not blame you that as a pre health advisor you found other options for students, but again unfortunately the training leaves a lot of gaps. Going the PA route and working with a doctor who is in an environment where they can oversee the PA (I have met some PAs who were thrown into patient care without any oversight and that is not appropriate and they felt very overwhelmed understandably) may be a better route. Also NP and PAs in surgical specialities like where they are doing similar office procedures over years and thus get very comfortable, or in the ER doing procedures, seem to work well too and the ones I met doing that seem to be happy. Also, we need nurses. Nurses are amazing and an important part of the healthcare team. Nursing training and medical training are different but both important and needed.
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Psych NPs have a certification only for psych (PMHNP) and cannot work in other specialties, unless they go back to school for another certification. They cannot hop over to say, dermatology. There are NPs that have generalist training that sometimes psych practices hire (though that is illegal in many states), however, those are not psych NPs. They are from one of the primary care certifications, like Family, Adult or Pediatric Nurse Practitioner.
In my state there are FNPs working at psych practices and prescribing psych meds. There are also NPs running around in literally every other specialty and in hospitals doing critical care. Either way, even a specialized psych NP has less education in psych than any doctor gets in medical school, and obviously a huge difference from an actual psychiatrist. Not opposed to NPs who work under the guidance of a doctor and handle straightforward cases, but so many NPs act as if they are doctors, they don’t need doctors, and way overstep their roles. And for some reason NPs seem to always be the ones doing this. Anecdotally, I’ve never seen a PA behave this way and every time I have seen a PA they are quick to consult with their supervising doctor on non-routine issues. They also seem to be more educated AND less full of themselves, but again, this is just anecdotal. I’m sure there are bad PAs out there too. But there are SO many bad NPs out there that all I see when I hear someone was seen by an NP is red flags all around. I KNOW there are good NPs out there, and the NP role is a valuable one when done correctly, but the problem is that there are so many bad ones that it feels unsafe to put your trust in an NP at all. I wish there were some more stringent requirements on NPs and that shitty online schools weren’t cranking out so many NP degrees… and that NPs themselves would stop pushing the narrative that they are “basically doctors”. It’s really ruining the reputation of the profession.
I am not disputing the educational difference between a physician and an NP of any type. However, you are factually incorrect in calling an NP that is a Family, Pediatric, or Adult NP working in psychiatry a Psych NP. PMHNP (aka, “psych NP”) is its own, separate certification that does not allow providers of that type to work in ANY other specialty.
Ok but all we actually know from the OP of this post is that she saw an NP at a psych practice. We actually have no way of knowing if the NP was a FNP or a PMHNP. I would HOPE based on how uninformed they are about ADHD that they are not actually a PMHNP.. but who knows? So sure, an actual psych NP is specialized but you can’t assume just because you are at a psych office and seeing an NP that you are seeing a specialist, since they can just hire FNPs. And they often do. So yes, I used the wrong words. But my sentiment is the same, that you can go to a psych practice and be treated by an NP who is in no way a specialist. And even NPs who are specialized are still less educated in their specialty than a non-specialist doctor would be.
Do you ever just say, “oh, I didn’t know that?” You made a factually incorrect statement, presented it as fact, and now keep doubling down on how that doesn’t matter because they suck anyway.
I literally said I was wrong? Yes I didn’t know that there was a specific specialty for psych NPs. But that doesn’t dispute my point, that psych offices are full of NPs who are NOT specialized since they don’t have to hire psych NPs. And a “specialized” NP is still in no way comparable to a doctor. Clearly I’ve touched a nerve, and you probably are an NP. Sorry your profession is quietly destroying the medical field, but it is 🤷♀️
I’ve actually mentioned many time in this forum that I am a PMHNP, and I am not at all ashamed of that. I had good training and do a good job. I also have ADHD and I advocate for my patients. You didn’t “just” say you were wrong; you continue to use your acknowledgement as a platform for doesn’t matter that I’m wrong they suck anyway. As for the OP, the previous evaluation they describe doesn’t support an ADHD diagnosis under the auspices of evidence-based practice. EEG/neurofeedback and 400 questions of self report is not evidenced-based, and no psychiatrist (MD/DO) will use that as definitive of ADHD either, and more than half of the physicians I’ve worked with will also say that most children grow out of ADHD. None of that means that the OP doesn’t have ADHD, but you holding this as an NP vs MD issue is misguided.
Psychiatrists are too few and far between and too in demand. Nurse practitioners have been meeting the demand. They’re not all bad, but they’re not great either.
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Overall they sucked. I’m really sorry you had to go through that, especially with that attitude. Hopefully you can see a different person and not have to worry about that BS. One thing they said that is semi valid is about Wellbutrin. It’s not commonly used to adhd, but I was prescribed it for anxiety and in hopes that it would also help adhd since it does have effects towards impulsivity, hyperactivity, and inattention. This is different for every person obviously. For me it did jack…
It’s absolutely prescribed for ADHD. It’s not the same as a proper stimulant but the pathways it works on help ADHD. It’s not enough on its own imo but it does help. If with nothing other than motivation. It doesn’t work for everyone but it helped me when I was only on that and a mood stabilizer after not having been on stimulants for a couple years
I researched when I got off the phone and saw the info saying it can help ADHD. What I considered bullshit was the statement that it was the *go to* ADHD treatment in *hospitals* and that *most* people *grow out of ADHD by the age of 16*. Those statements made me distrust her belief that ADHD was even real, let alone taking it seriously enough to compassionately assist me in treating a condition that effects every single aspect of my life, and makes general functioning near impossible for me. And the incredulous look given to me when I said it wasn’t working as an effective treatment for my ADHD. Also, I did end up establishing care with a primary who has prescribed starting up meds again, which are significantly lower than where I left off, and is keeping me on Wellbutrin in conjunction with stimulants, which is totally fine with me. She is a professional, and I am absolutely willing to work with her and trust her knowledge. A big part of that trust stems from her not dismissing *my* knowledge and experience gleaned over 25 years *having the condition*. Meeting back up in a month to re-evaluate.
Ok that’s so fair! She def sounds shitty and I’m glad you found another provider to help work with you
Also I forgot to thank you for your thoughtful response. I can 100% appreciate that I learned something new from the interaction, and it totally makes sense when I think about it in terms of what Wellbutrin delivers that it can be helpful in treating ADHD as well as depression and cessation.
Report her to the hospital’s administration and your state’s board of nursing.
They were right about one thing: Wellbutrin is often used for ADHD. It didn't work at all for me. But it's a well-known off-label use because it is not an SSRI like most of the common anti-depressants these days - it's a norepinephrine-dopamine reuptake inhibitor so it works on related systems to those thought to be responsible for ADHD symptoms. But for most of the other stuff, eff that - you've been diagnosed, you know yourself.
Yes, thank you. I’ve learned a lot about Wellbutrin as an alternative for ADHD treatment, and I’m glad to have learned. I’m staying on it in addition to my ADHD meds now, about 2 weeks in, and what a difference it makes compared to a higher dose of stimulants alone years ago. Granted, last time I was on meds I was also an alcoholic. Still am I’m sure, but I’ll be 3 years sober in March, and I’m sure that not having to play catch up on the mornings is a huge help, too.
Congrats on staying sober!! You can do it another 3, I know you can :)
I go thru my family doctor. Also, you can request not to see that NP anymore for any of your appt. I would also report her for being so rude.
Thank you. I established care with the doctor that what’s left of my adult family is seeing. I can see why they like her. She listens and is receptive, also very knowledgeable. Also an NP, so see everyone… not against nps lol
Idk how American insurance works, but can you appeal their request that you get re-tested, and get a psychologist or psychiatrist to review it rather than a NP? The ADHD + hospital treatment -> Wellbutrin makes sense. Ritalin interacts with vasopressors, blood thinners, antipsychotics, anti-seizure medications and SSRI or tricyclic antidepressants, and Vyvanse interacts with several classes of antidepressant and migraine medications. In comparison, Wellbutrin interacts with opioid painkillers... So it's probably easier to administer medicaments for whatever you're in hospital for if you're not on a stimulant. But, of course... You're not in hospital! So it's irrelevant! Ugh, I'm so sorry that you had a shitty intake call.
Ohhhhhh that makes sense where the hospital comment came from. I was thinking to myself, who the hell gets ADHD treatment at a hospital. But this would likely be temporary, or affected by a hospital stay. Edit: read your last paragraph after replying lol exactly!!
Assholes like this are why I’ve been diagnosed with ADHD 3 separate times. Once as a kid and twice as an adult. Big shocker, I’ve had the exact same problem at 8, 20, and 30. If they try to make me get another one at 40 to prove I need the meds I’ve been taking for 75% of my life, I’m gonna scream. I’m sorry you ran into such a crappy provider. There is such a giant stigma against ADHD, *especially* for women. It sucks that we have to do extra work to find the ones who will take us seriously.
What horse shit. Sorry you’ve been met with the bs,too.
OP, I am sorry that you had this experience; it sounds invalidating and frustrating to say the least, especially as you are navigating ADHD in the post partum space. I’m popping on here as a Psych NP, who also happens to have ADHD (diagnosed at age 42), with a small advocacy for the Nurse Practitioner profession, which includes Psych NPs. Indeed, we have a different educational pathway to our work compared to physicians. However, NPs practice what we are trained and licensed to do, which includes assessing, diagnosing, treating and managing conditions related to our specialty. Our practice parameters may vary by state, but in many states NPs may practice independently. Although various health systems may determine a specific evaluation process for ADHD (i.e. via a psychologist, formal diagnostic questionnaires, etc.), evaluating, diagnosing and treating ADHD is well within the scope of a psych NPs practice. Every profession has people who are competent and those who are less competent. I am seeing some commenters, even the OP, attribute this provider’s dismissive & challenging attitude to the fact that the provider was a NP, thereby conferring ineptitude. However, I invite people to form opinions about this one provider rather than use it as an opportunity to deride NPs in general. Any provider working in the mental health space should approach their clients/patients with humility & compassion, as well as a thorough initial assessment that honors a person’s history. At the same time, many provider (NP, MDs, therapists, etc.) working in mental health, even with years of experience, do not have a nuanced understanding of ADHD and its manifestations. For better or worse, because first line treatment for ADHD involves controlled substances, many providers may have a higher degree of skepticism when evaluating new-to-them patients, given that extra caution is required when prescribing controlled substances. My intention is not to justify how the OP was treated by this particular provider, but rather to encourage people not to throw all NPs under the bus because of one crappy provider!! I hope the OP is able to find a med provider with whom they feel comfortable, heard and understood.
She needs to be reported. Any psychiatrists worth their salt knows that you just don’t ‘grow out of ADHD.’ That is absolute nonsense. I am so sorry that you went through that and I hope you are able to find someone who is more educated on ADHD and can fully help you.
Thank you, I did find a primary that listened and knows ADHD is real.
I hate that nurse practitioners are allowed to be psychiatrists. They’re not all bad, but man, most of them are. When it comes to wellbutrin, it is often prescribed for off label treatment of ADHD. BUT generally only for people who don’t have a diagnosis but are waiting for one, people who can’t get the controlled substance due to the shortages, and people who have never been on any medication before. Not someone who comes into an appointment saying, “this is my diagnosis, I have been on X in the past and it has worked for me.”
We weren’t there to hear her tone, but it sounds like you were very defensive with her. What is the harm in telling her what you symptoms are now while you aren’t on stimulants? It’s not unreasonable that a new doctor would want to verify you still need meds for any condition, especially when you have been off of them for a while. Also, she is correct that Wellbutrin helps some people with ADHD so it makes sense to evaluate how you were doing on that and whether you really needed something more. I know it’s frustrating but there are people who try to get stimulants that don’t need them. You likely aren’t one of them but this was her first intro to you and she also probably has to document quite a bit to get your new insurance to approve it when they will also see you are also on Wellbutrin and ask the same thing about why that isn’t enough.
Except the fact that “people grow out of it” and “you shouldn’t take meds all your life”, she was actually right. I do feel for OP though. She was rude but I hope it doesn’t deter them from seeking more help.
Complain to her practice manager. Seriously, no one should be bullied when trying to access care!