Who can diagnose ADHD in adults?

What type of doctor should you see for ADHD diagnosis — primary care provider? Psychologist? Psychiatrist? Is it worth waiting longer to see a specialist? How much does it cost? Get answers to common questions from Understood Explains host Dr. Roberto Olivardia: 

• Can my primary care doctor diagnose ADHD? [00:50]

• Do I need a psychiatrist or psychologist to diagnose my ADHD? [03:19]

• What other kinds of specialists can diagnose ADHD? [05:13]

• How much does it cost to get an ADHD diagnosis? [07:01]

• Is it worth waiting longer for a specialist? [08:15]

• Key takeaway, next episode, and credits [09:05]

Related resources

• How ADHD is diagnosed in adults 

• Can psychologists prescribe medication?

• Neuropsychological testing in ADHD: A special report

• About psychiatric mental health nursing

Episode transcript

Who can diagnose ADHD in adults?

You’re listening to Season 2 of Understood Explains: ADHD Diagnosis in Adults.

Today’s episode answers the question “Who can diagnose ADHD in adults?” 

My name is Dr. Roberto Olivardia, and I’m a clinical psychologist with more than 20 years of experience evaluating people for things like ADHD. I’m also one of the millions of people who have been diagnosed with ADHD as an adult. I’ll be your host.

My goal here is to answer the most common questions about ADHD diagnosis. Along the way, you’ll learn a lot about ADHD in general. 

We’re going to do this quickly — in the next 10 or so minutes. So, let’s get to it.

Can my primary care doctor diagnose ADHD? [00:50]

The short answer is yes. General practitioners or primary care providers can diagnose ADHD. But they may recommend you go to a specialist instead. 

Let’s go over some pros and cons for getting diagnosed by your primary doctor…

First, on the positive side:

• You already know your doctor. You don’t have to hunt around to find one.

• You can probably get an appointment pretty easily. 

• And your doctor can help identify or rule out medical conditions that can have ADHD-like symptoms.

So those are all good things. 

But there are some potential downsides in getting diagnosed by a general practitioner.

First, primary care doctors may not have a lot of training in diagnosing ADHD in adults.

• It’s hard to believe something that is so common isn’t fully understood even by many doctors, including mental health providers. Without the right training, ADHD can be misdiagnosed. More often, however, studies have found that ADHD is vastly underdiagnosed. This is often because people with ADHD can also have issues with anxiety, sleep, and depression. And all symptoms can get swept into those categories, and the ADHD gets overlooked. Which may be why some of you listening today have made your way to this podcast.

Also, the other point I want to make is that general practitioners may not have much training in how to treat ADHD.

• Diagnosis is only the first step. And all of your next steps will be to learn about ADHD and how to manage it. For example, if someone decides to take medication, it can take some time to find the right medication, the right dose, and manage any side effects. Sometimes it can take trying several different medications or doses before finding what works the best for you.

• It’s not as simple as “here is a prescription” and you’re on your way. Also, although medication can be very helpful as a part of the treatment regimen, it’s not enough. Remember: Pills don’t teach skills. 

• Therapy or counseling can be really important ways to help you understand how ADHD affects you and develop strategies to change those behaviors. And you’ll likely need to get that kind of advice from someone other than a general practitioner.

Bottom line: Find out how much training and experience your primary care doctor has in diagnosing ADHD. Ask them if they feel confident they can tease apart what’s causing your symptoms so they can correctly diagnose and treat your ADHD.

If they say, “Yes, I’m confident I can do this,” great! If they say no, then they can always refer you to a specialist. 

Do I need a psychiatrist or psychologist to diagnose my ADHD? [03:19]

In short, both are qualified to diagnose ADHD. But not all psychologists and psychiatrists have training and experience working with ADHD patients. So it’s important to ask first. 

So I’m a psychologist and I do a lot of diagnostic work. I also have many patients who were diagnosed by a psychiatrist and come to me for ADHD treatment. So without knowing more about you, I can’t tell you which is a better fit for you. But I can tell you how psychologists and psychiatrists are similar and how they’re different. 

Psychologists and psychiatrists who have ADHD expertise are similar in that they know how to suss out whether you might be experiencing another mental health issue that can look like ADHD or that might be happening in addition to ADHD. 

The big difference between these two kinds of specialists is what happens after they make a diagnosis. 

With psychiatrists, the big upside is they are medical doctors who can prescribe medication. 

On the downside, psychiatrists may not have the time or training to help patients work on daily life skills that can be so helpful for people with ADHD.

Psychologists are often the reverse of this. Most psychologists can’t prescribe medication, unless they live in a handful of states that require extensive training and make exceptions due to severe shortages of medical providers. Meanwhile, many psychologists do have a lot of training in cognitive behavioral therapy. This type of therapy is useful in helping people with ADHD identify problematic patterns in their daily lives and find ways to replace those behaviors.

It’s common for people with ADHD to get counseling from a psychologist and medication from a psychiatrist.

But if you’re trying to decide which one of these specialists to go to for diagnosis, it may come down to cost and availability. How soon can you get an appointment with one or the other?

What other kinds of specialists can diagnose ADHD? [05:13] 

There are three other specialists I want to discuss in this episode: neurologists, neuropsychologists, and nurse practitioners. 

First, neurologists… and I’m only mentioning them here because a lot of people ask about them. Neurologists typically aren’t the kind of specialist you’d start out with to get an ADHD diagnosis. But they might diagnose you with ADHD if you go see them to rule out something else, like a seizure disorder or some other medical condition. 

Next, neuropsychologists. They’re really good at figuring out if you have, say, a learning difference like dyslexia. For example, they can tell if you’re a slow reader because you’re having trouble processing the words or because you’re having trouble paying attention or some other reason

Neuropsychologists can also diagnose ADHD. But because they can test a wide variety of skills including intelligence, memory, and other specialized skills, it can often take longer to get an appointment with them. And they might not include as much information about different aspects of your life, like trouble at work or managing your relationships. There’s also some research that suggests neuropsych testing might not pick up on ADHD in some people, because the tests are often done in distraction-free environments that aren’t anything like normal, day-to-day settings.

And last but not least, nurse practitioners. If you’re going to see a nurse practitioner for help with ADHD, look for one with advanced training in psychiatry. 

They’re often called psychiatric mental health nurse practitioners or PMHNP for short — whew, that’s a mouthful! They’re also called advanced psychiatric nurse practitioners. And they can diagnose ADHD, prescribe medication, and provide counseling. This can be a great choice if this kind of nurse practitioner lives in your area.

How much does it cost to get an ADHD diagnosis? [07:01]

The answer depends a lot on where you live, who you’re going to see, and how long you can wait. 

If you have insurance, then your only cost may be the co-pay to see a doctor who’s “in network.”

Some specialists may be “out of network” or might not take insurance, so you may have to shoulder a hefty out-of-pocket cost that can be hundreds of dollars. Or in the case of a full range of neuropsychological testing, it may even cost thousands of dollars. 

One possible way to lower the cost of ADHD testing is to call up a college or university near you. It’s very common for schools that have graduate programs in clinical psychology to also have free or low-cost clinics where students do their training. You’d be evaluated by a grad student, but that person would be closely supervised by an expert. And in many cases, your evaluation will be reviewed by more than one highly trained professional.

The same is true for medical universities that are training future psychiatrists and other kinds of specialists. Hospital clinics are likely to accept a large number of insurance plans. Some hospital-based clinics also offer free evaluations or use a sliding scale that charges lower fees to people with lower income levels.

Is it worth waiting longer for a specialist? [08:15] 

There are a lot more primary care doctors than there are specialists, so the wait times are going to be longer. Is it worth the wait? 

This is a really tough question, and the answer depends on several important factors: 

First, how are you doing? Are you in crisis? Is there a medical problem or addictive behavior you’re struggling with? If so, the sooner you get an appointment with a provider the better. 

Also, think about how quickly you may need a diagnosis so you can start getting formal accommodations at work or school, or if there’s something urgent going on at home and you need to start taking steps to help heal your relationships. 

One option is to start working with your primary doctor now and get on a list to be evaluated and treated by a specialist in a few months.

Key takeaway, next episode, and credits [09:05]

OK, that’s it for Episode 2. The key takeaway I’m hoping sticks with you is the importance of getting a diagnosis from a professional who has training and expertise in ADHD.

• Remember that not all medical doctors or psychologists have this kind of experience. It may take some work to figure out who you can see and balance that with your finances. Even with long wait times, don’t let that discourage you from getting a diagnosis that could set you on a path to a better life. 

Thanks for listening to this episode of Understood Explains. And I hope you’ll join me for Episode 3, where we’re going to cover in-depth what kinds of questions to expect in an ADHD evaluation.

You've been listening to Season 2 of Understood Explains from the Understood Podcast Network. If you want to learn more about the topics we covered today, check out the show notes for this episode. We include more resources, as well as links to anything we've mentioned in the episode. 

One important note: I don’t prescribe ADHD medication and I don’t have any affiliation with pharmaceutical companies — and neither does Understood. This podcast is intended solely for informational purposes and is not a substitute for a professional diagnosis or for medical advice or treatment. Talk with your health care provider before making any medical decisions.

Understood Explains is produced by Julie Rawe and Cody Nelson, who also edited the show. Briana Berry is our production director. Our theme music was written by Justin D. Wright, who also mixes the show.

For the Understood Podcast Network, Laura Key is our editorial director, Scott Cocchiere is our creative director, and Seth Melnick is our executive producer. 

Understood is a nonprofit organization dedicated to helping people who learn and think differently discover their potential and thrive. Learn more at understood.org/mission.