Diagnosing, Medicating and Talking About Your ADHD

Diagnosing, Medicating and Talking About Your ADHD

What does it mean when you’re one symptom short of an ADHD diagnosis? Does that mean you don’t have it? Dr. H answers this and other listener questions including the difference between short-acting and long-acting medications, how to explain ADHD to family members, and what to do when your child doesn’t like their doctor. Our producer, Sarah Guertin, joins Ned in this episode to read him your questions!

Reach out to us at [email protected].

Distraction is created by Sounds Great Media. This episode was produced by Sarah Guertin and recorded and mixed by Scott Persson. It was originally released in October 2020.

Season 6 is coming in August! 

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There Is No Test for ADHD

There Is No Test for ADHD

We received an email from a listener who asked, “How effective is the T.O.V.A. (Test of Variables of Attention) as a diagnostic tool for ADHD?” The listener was administered this test by a therapist but the results did not indicate she had ADHD. Years later, the listener is being treated for ADHD and said it “helped immensely” but is second guessing her ADHD diagnosis because of her T.O.V.A. results.

Ned shares that tests like the T.O.V.A. should not solely be used to diagnose ADHD, and talks about the method he’s found to be a much more reliable and accurate diagnostic tool.

If you have a question or comment you’d like Dr. Hallowell to address in an episode please reach out to us! Write an email or record a voice memo on your phone and send it to [email protected].  

Check out our sponsor, OmegaBrite Wellness, creators of the #1 Omega-3 supplements for the past twenty years. Ned and his wife, Sue, take them every day! Distraction listeners can SAVE 20% on their first order with the code: Distraction at OmegaBriteWellness.com.

Students who learn differently love Landmark College and so does Ned! Sign up now for one of their summer programs! Landmark College in Putney, Vermont is the college of choice for students who learn differently.

Get a copy of Ned’s newest book, ADHD 2.0 at DrHallowell.com or by clicking HERE.

Distraction is created by Sounds Great Media. Our recording engineer/editor is Scott Persson and our producer is Sarah Guertin.

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Questions Practitioners Ask When Diagnosing ADHD

Questions Practitioners Ask When Diagnosing ADHD

Angel Gambino is a serial entrepreneur with an insanely organized refrigerator who recently realized she might have ADHD.

Angel shares her story with Dr. H in a conversation that illustrates the kinds of questions a practitioner would ask as part of the process to determine if someone has ADHD.  

Angel’s good friend, Freda, joins the conversation to share additional insights about Angel, as Ned always recommends including a close friend or relative in this kind of discussion. 

The purpose of this conversation is to demonstrate the kinds of questions a practitioner would ask as part of a lengthier process to diagnose a person with ADHD. Therefore, Dr. Hallowell does not diagnose Angel with ADHD in this episode. He just strongly suspects she has it! 

Keep listening at the end of this episode for a special feature from Dr. Carol Locke of OmegaBrite Wellness. Dr. Locke shares some of the latest information about the Covid vaccine, and herd immunity in particular. 

Get a copy of Ned and John Ratey’s newest book, ADHD 2.0 at DrHallowell.comJohnRatey.com, or by clicking HERE. You can also find it wherever books are sold!  

If you have a question or comment you’d like Dr. Hallowell to address in an episode reach out to us! Write an email or record a voice memo and send it to [email protected].  

Check out our sponsor, OmegaBrite Wellness! Distraction listeners SAVE 20% on their first order with the code: Distraction at OmegaBriteWellness.com.

Learn what it’s like to be a student at Landmark College during their Virtual Open House on March 19th! Register HERE. Landmark College in Putney, Vermont is the college of choice for students who learn differently. 

Distraction is created by Sounds Great Media. Our recording engineer/editor is Scott Persson and our producer is Sarah Guertin.

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Who Can Diagnose and Treat ADHD?

Who Can Diagnose and Treat ADHD?

Ned clears up some common misconceptions about who can diagnose ADHD, the types professionals you might encounter on your treatment journey, and what questions you should ask any professional before working with them.

Dr. Hallowell’s new book, ADHD 2.0, comes out January 12th. Pre-order Now!  Click here to pre-order your copy of ADHD 2.0.

Check out #NedTalks on TikTok! @drhallowell

Do you have a question or guest suggestion? Send an email with your thoughts to [email protected].

Thanks to our sponsor, OmegaBrite Wellness!

Now is a great time to try OmegaBrite as Ned has arranged for a special offer for the first 250 Distraction listeners who respond. Distraction listeners who buy one bottle of 70/10 MD Omega-3, will get a FREE bottle of CBD Full Spectrum 25mg Softgels with the promo code: NED. You’ll get FREE shipping too! These are the same supplements that Dr. H takes every day.

Just enter the code: NED after adding the Omega-3 to your cart and the FREE bottle of CBD and FREE shipping will be automatically applied.

Click HERE to learn more about our other amazing sponsor, Landmark College, in Putney, Vermont. It’s the college of choice for students who learn differently!

Distraction is created by Sounds Great Media. Our producer is Sarah Guertin and our recording engineer/editor is Scott Persson.

Check out this episode!

A transcript of this episode is below.


Dr. Ned Hallowell:
This episode is sponsored by Omega Brite Wellness. Get a free bottle of Omega Brite CBD full-spectrum soft gels with free shipping when you buy one bottle of their 7010 MD Omega-3. Use offer code Ned, that’s my name Ned, @omegabritewellness.com.

Dr. Ned Hallowell:
Distraction is also sponsored by Landmark College in Putney, Vermont, the college of choice for students who learn differently. Learn more @lcdistraction.org.

Dr. Ned Hallowell:
Hello, and welcome to Distraction. I’m your host, Dr. Ned Hallowell. Today, we’re going to do a mini based on a few questions that come up all the time in my practice, in many people’s practice and in your lives, as you wonder about ADHD and how to get help so let me address them. I’m going to talk about who is qualified to diagnose ADHD, who is qualified to treat ADHD and what the difference is between a psychiatrist, psychologist and a therapist.

Dr. Ned Hallowell:
Let’s start with that last one. A psychiatrist, which is what I am, has an MD. In other words, I went to medical school, and then I did a medical internship, taking care of heart attacks and GI bleeds, and that sort of thing. Then I did a residency in adult psychiatry for two years and followed that with a fellowship in child psychiatry for two more years. So it was four years of medical school, a year of internship, and then four years of residency and fellowship for a total of nine years after college, before I was set out upon the world to do what I wanted to do, not that I wasn’t happy doing what I was doing as a resident.

Dr. Ned Hallowell:
But a psychologist, on the other hand, has a PhD. So a psychologist does not receive medical training unless he or she goes out of his way or her way to get into biological psychology. So a psychologist has a PhD and in order to get a PhD, you have to go to grad school, take some courses, traditional courses, and then write a thesis, write a dissertation. If you ever hear of a psychologist saying I’m ABD, that means all but dissertation. He or she has done everything, but write the dreaded dissertation, and it becomes kind of a rite of passage for these folks.

Dr. Ned Hallowell:
Then in the grouping of therapists, there’s many different stripes. I think if I were to advise a young person to go into the field, I’d advise them to get an MSW, master in social work. That takes two years. Once you get that, then you have to do some thousand hours, it varies from state to state, to get licensed and become an LICSW, licensed independent clinical social worker. The beauty of their training is it’s very strength-based, unlike psychiatry and psychology, which are skewed toward pathology.

Dr. Ned Hallowell:
Then there are many other people who can do therapy. In fact, anyone can do therapy. You can not even have a high school diploma and put a sign out saying “I’m a therapist.” So, there is zero quality control unless you get into one of the licensed disciplines like social work, nurse practitioner, physician’s assistant.

Dr. Ned Hallowell:
Then there are licensed marital therapists, there licensed counselors. Again, it varies from state to state. But once you see the word ‘licensed’ in front of somebody, that means they had to pass some requirements set by the state board, usually including an exam. Then they have to answer to that board so there’s some quality control and supervision.

Dr. Ned Hallowell:
The word ‘licensed’, not anybody can call themselves a licensed therapist, but truly anyone can call themselves a therapist, which is both good and bad. It does open the door for a lot of people who really shouldn’t be doing it. But then there are some people who were gifted and do a great service.

Dr. Ned Hallowell:
But to review, psychiatrist, someone like me has an MD, and we’re very trained in the medical sciences, the biology of the mind, as well as the psychology. Psychologists do not have the medical background and as a result, unless you have an MD, you can’t write prescriptions. So psychologists have a PhD, but they’re not allowed to write prescriptions with some exceptions. Some states have opened the door for psychologists to write prescriptions, but that’s more the exception than the rule.

Dr. Ned Hallowell:
The only non-MDs who can write prescriptions are nurse practitioners and physician’s assistants, and they are allowed to write prescriptions. They are usually under the supervision of an MD, again, depending upon the state licensing requirements.

Dr. Ned Hallowell:
Then the therapist, as I said, there are many stripes of therapists, but licensed independent clinical social worker, LICSW, is a reliable one, licensed couples therapists, licensed counselor, licensed family therapist. Those are all sort of a summary of the mental health professionals, including nursing.

Dr. Ned Hallowell:
Then occupational therapists who often do get involved in the treatment of ADHD. Don’t want to leave them out, nor the addiction counselors. They do tremendous work, licensed addiction counselor and addiction counselors in general, tremendous amount of work to do there because there’s a big overlap between ADHD and people who have what’s now called substance use disorder. We don’t use the term ‘addiction’ because it’s so pejorative. We go with substance use disorder, which is true. It is a disorder, a disease and needs to be respected and treated as such.

Dr. Ned Hallowell:
Now, who is qualified to diagnose ADHD? Well, the answer is any professional, preferably licensed professional, who has experience in working with children and adults who have ADHD.

Dr. Ned Hallowell:
Now that’s a wide swath, but you can’t, just based on the person’s initials after their name, know whether they have experience so you ought to ask. The people who have the most training in ADHD are the people who are from my discipline, which is child psychiatrists. That’s an MD who’s done extra training in child psychiatry. We get the most training of any professional in ADHD, but we’re rare as hen’s teeth. It’s very hard to find child psychiatrist.

Dr. Ned Hallowell:
But you don’t need to have one. A diagnosis can be made by a pediatrician, family physician, neurologist. Anyone with an MD can do it as long as they have experience in working with ADHD. As I said, among the MDs, among all professionals, the child psychiatrists have the most training and the most experience.

Dr. Ned Hallowell:
A psychologist can also diagnose this condition, so can a social worker, so can any licensed therapist.

Dr. Ned Hallowell:
What you want to do is ask the person you’re seeing how much experience do they have. I’ve treated tens of thousands of people over my 40 years. It’s pretty hard to find someone with my level of experience. But you can certainly find someone who’s treated a thousand people, or even 500. That is what you’re looking for.

Dr. Ned Hallowell:
If you’re having trouble finding somebody, and the best way to get a referral is from somebody who’s seen that person already, but call the nearest medical school. Medical schools are good quality control clearing houses. Call the nearest medical school and ask for the department of psychiatry.

Dr. Ned Hallowell:
If you’re an adult looking for an adult referral, say, “Do you know of any adult psychiatrists on your staff or on your referral base who treat adults with ADHD?” If you’re looking for a child, ask for who on your staff or in your clinic or in your referral base is good with children who have ADHD. That’s a good quality control measure.

Dr. Ned Hallowell:
Every state has a medical school. So no matter where you live, you are within somewhat striking distance of a medical school and a state medical society and a state psychiatric society. You can call all of those people, and those are good resources.

Dr. Ned Hallowell:
Finally, who is qualified to treat ADHD? Well, again, anyone who has experience, the more, the better, in working with children and adults who have it. Now, only MDs or nurse practitioners and physician’s assistants can write prescriptions. So if you want to get medication, and medication is a standard tool in the toolbox of treating ADD, then you have to see an MD or someone who works with an MD.

Dr. Ned Hallowell:
Most psychologists, PhD psychologists, who treat ADD, and most social workers and other professionals who treat ADHD are affiliated with an MD who can prescribe. So if you happen to be with a psychologist, that psychologist almost always has an MD who he can refer you to, if you want to get a trial of medication. You don’t have to reinvent the wheel, and go find an MD and get diagnosed all over again. That’s the way most of those folks take care of that issue.

Dr. Ned Hallowell:
To summarize, who is qualified to diagnose and who’s qualified to treat? Bottom line is a licensed professional who has a lot of experience in doing it and, again, I reviewed which those people are. Then in treatment, the same thing. Find someone who has a lot of experience.

Dr. Ned Hallowell:
Make sure you don’t see a one-trick pony, someone who can only prescribe medication, for example, because there’s a lot more to the treatment of ADHD than prescribing medication. You want to see someone who takes a more inclusive, multimodal approach, where you use some of everything, whether it’s exercise-based treatment or meditation or coaching or cognitive behavioral therapy or medication, all of those treatment modalities you want, whoever you see, to have experience with all of those, or at least many of those. Don’t just see someone who’s pushing one kind of treatment, someone who just does neurofeedback, for example, who just does nutritional counseling. Whatever the angle might be, you want someone who is more eclectic and goes by my motto, which is whatever works. As long as it’s safe and it’s legal, I will do whatever works. That’s the kind of approach you’re looking for.

Dr. Ned Hallowell:
So we’ve reviewed what’s the difference between a psychiatrist, psychologist and a therapist, and we’ve reviewed who’s qualified to treat ADHD and who’s qualified to diagnose ADHD.

Dr. Ned Hallowell:
Before I go, I’d like to thank our sponsor, Omega Brite Wellness. Get a free bottle of Omega Brite CBD full-spectrum soft gels with free shipping when you buy one bottle of their 7010 MD Omega-3. Use offer code Ned, that’s my name @omegabritewellness.com.

Dr. Ned Hallowell:
Please reach out to us with your questions and comments by emailing [email protected] That’s [email protected]

Dr. Ned Hallowell:
If you happen to be on TikTok, my new favorite platform, you can find me there with the username @drhallowell. I’ve posted a whole bunch of videos about common ADHD issues, and they’re only 60 seconds apiece. Take a look and let me know what you think.

Dr. Ned Hallowell:
Distraction is created by Soundscape Media. Our recording engineer and editor is the estimable Scott Persson, and our producer is the very talented Sarah Guertin. I’m Dr. Ned Hallowell, until next time.

Dr. Ned Hallowell:
The episode you just heard, just now heard, was made possible by my good friends at Omega Brite Wellness. Get a free bottle of Omega Brite CBD full-spectrum soft gels with free shipping when you buy one bottle of their 7010 MD Omega-3. Use offer code Ned @omegabrite wellness.com.

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The What, When & Why of Neuropsychological Testing for ADHD

The What, When & Why of Neuropsychological Testing for ADHD

The process of reaching an ADHD diagnosis rests primarily on your    personal history. However neuropsychological testing can reveal a ton of useful information for expanding your understanding of your own ADHD. As Dr. H says in this ep, “It’s the closest thing we have to an MRI of your mind.” But as Ned also points out, this type of testing is not necessary for a diagnosis.

Dr. Hallowell’s new book, ADHD 2.0, comes out January 12th. Pre-order Now!  Click here to pre-order your copy of ADHD 2.0.

Check out #NedTalks on TikTok! @drhallowell

Do you have a question or guest suggestion? Send an email with your thoughts to [email protected].

Click HERE to learn more about our sponsor, Landmark College, in Putney, Vermont. It’s the college of choice for students who learn differently!

Thanks to our sponsor, OmegaBrite Wellness! Dr. H takes OmegaBrite supplements every day and that’s why he invited them to sponsor his podcast. SAVE 20% on your first order at OmegaBriteWellness.com with the promo code: Podcast2020.

Distraction is created by Sounds Great Media. Our producer is Sarah Guertin and our recording engineer/editor is Scott Persson.

Check out this episode!

A transcript of this episode is below.


Dr. Ned Hallowell:
This episode is made possible by our sponsor, OmegaBrite Wellness. I’ve taken their Omega-3 supplements for many years, and so has my wife, and that’s why I invited them to sponsor my podcast, I’m proud to have them. You can find all of their products online at omegabritewellness.com and brite is intentionally misspelled, B-R-I-T-E, omegabritewellness.com. This episode is also sponsored by Landmark College, another institution that I have warm personal relationship with in Putney, Vermont. It’s the college of choice for students who learn differently. Learn more at lcdistraction.org.

Dr. Ned Hallowell:
Hello, this is Dr. Ned Hallowell and welcome to Distraction. Today I’m going to do a very short mini on a very important question that comes up all the time in practices around the country and around the world, namely, when, and why, and how much do you get neuropsychological testing? First of all, what is it? There’s psychological testing, and then there’s neuropsychological testing. Well, psychological testing is the kind of thing, you’ve heard of the Rorschach test with the inkblots, and you say what you see there. You maybe have heard of the MMPI, the Minnesota Multiphasic Personality Inventory. You have certainly heard of IQ tests, many different kinds of IQ tests, the Wechsler probably being the most famous, these are all examples of psychological testing.

Dr. Ned Hallowell:
It’s a series of questions that have been researched and normed. So they have some degree of validity in answering descriptions, all trying to give a description of the mind that the individual can’t self-report. They try to get at parts of yourself that are unconscious or out of memory, or simply not part of your everyday self-awareness, for example, your processing speed or the difference between your immediate memory, your recent memory and your distant memory, things like that you can’t self-report, or intelligence, whatever that means, different kinds of intelligence you can’t self-report.

Dr. Ned Hallowell:
So psychological testing is aimed at asking questions or getting you to perform exercises and tests that will help us quantify different elements of cognitive and emotional life, then neuropsychological testing adds an element of neurology. So this gets more at things like processing speed, or evidence of past head injury, or deficits in memory, the neurological elements. Well, the Rorschach can be used that way too, but neuropsychological testing adds in more of the biological exploration to the psychological exploration. And neuropsychological testing is what is commonly offered as part of the diagnostic workup for ADHD.

Dr. Ned Hallowell:
Now, this is a very important point that I’m about to make, and it’s widely misunderstood, so listen carefully. You do not need neuropsychological testing or any psychological testing to make a diagnosis of ADHD. There is no test for ADHD. Many people come to me and say, “Well, I don’t have it, I was tested and I don’t have it.” There is no test that can tell you whether you have it or you don’t have it, really important point. The closest thing we have to a definitive test for ADHD is your history, the story of your life beginning when you were born. And the diagnostic criteria are laid out in the DSM-5 and two sets of nine symptoms. And if you have six out of nine on one or both set, then you by definition have the diagnosis.

Dr. Ned Hallowell:
So the process of reaching a diagnosis rests primarily on asking you questions about your childhood and your immediate life and comparing them to the criteria as set out in the diagnostic manual, that’s it. Sure, there are qualifiers, you need to make sure it’s not something else, you need to make sure you’re in proper shape to offer your history. Usually best taken from two people, because people with ADD are not good self observers. With all of those qualifiers, it still comes down to your history and that is the truth.

Dr. Ned Hallowell:
Now, why do we offer neuropsychological testing? Because it can reveal a ton of important, useful information, not necessary for diagnosis, but certainly helpful in expanding your understanding of yourself or your child. Neuropsych testing is really the closest thing we have to an MRI of your mind. It gets at all sorts of things that you can’t self-report. You can’t self-report processing speed, memory scales, unconscious biases, a specific reading problem, a specific math problem. You can generally report them, but you can’t get more specific and detailed about them.

Dr. Ned Hallowell:
So neuropsychological testing is very valuable, but it is not necessary. And this becomes important because it is expensive. And [inaudible 00:06:31] what city you’re in, the ballpark of $5,000. Now, if insurance doesn’t cover it, and some insurance policies will, some won’t, then you have to think long and hard before you want to plunk down $5,000. Now, if money is no object to you, please get it, it’s worth it, it’s always nice to have. But if you have to decide between spending the 5,000 on neuropsych testing or spending the 5,000 on followup treatment, coaching, tutoring, additional services, by all means, spend it on the additional services, the coaching and the tutoring, not on neuropsych testing. It’s a wonderful thing to have if you can afford it, but it’s not necessary. You do not have to have it in order to make this diagnosis, nor is it definitive.

Dr. Ned Hallowell:
And if the history, for example, says, yes, this is ADHD, but the neuropsych testing says, no, it is not ADHD, believe the history, because neuropsych testing is notorious for producing false negatives, that’s because the combination of structure, motivation, and novelty creates focus, essentially treats ADHD. For example, a video game full of novelty, full of structure, and you’re motivated, you want to win the game, so you focus. Kids with ADHD can focus for hours on a video game.

Dr. Ned Hallowell:
Well, neuropsych testing includes the same three elements. It’s done one-on-one, nothing could be more structured, it’s full of puzzles and games, novelty, and there’s a natural motivator because you want to beat the test, and that’s why a lot of kids and adults who have ADHD on the testing look as if they don’t, because the test itself treats the condition it’s trying to diagnose.

Dr. Ned Hallowell:
That’s a quick summary of neuropsych testing, when to get it, why to get it. And I think the most important point for you to understand is it’s a wonderful thing to have if you can afford it. It’s expensive, but it is not necessary in order to make the diagnosis in a child or in an adult.

Dr. Ned Hallowell:
Well, that’s it for me for this mini episode of Distraction. Thanks to our sponsor, OmegaBrite Wellness. Save 20% on your first order at omegabytewellness.com with the promo code podcast2020. And please reach out to us with your questions and comments by emailing [email protected] And if you’re on TikTok, you can find me there with the username @Dr.Hallowell. I’ve posted lots of videos about common ADHD issues, each one only 60 seconds. Take a look and let me know what you think. Distraction is created by Sounds Great Media. Our recording engineer and editor is the wonderful Scott Persson, and our producer is the also wonderful Sarah Guertin. I’m Dr. Ned Hallowell, until next time when I will still be Dr. Ned Hallowell.

Dr. Ned Hallowell:
The episode you just heard was made possible by my good friends at OmegaBrite Wellness. I take their supplements every day, and that’s why I invited them to sponsor my podcast. Shop online at OmegaBrite, and that’s britewellness.com.

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