Attention Deficit Disorder is an important problem that has been recognized more in the past few decades, but has also garnered controversy. This is a disorder of attention and ability to shift attention. Diagnosis is made through history and interview, not a specific test. Many things may adversely affect attention and impulsivity including substance abuse, poor sleep habits, sleep disorders, adverse effects of medications and other causes. ADD may occur along with anxiety and depressive disorders. Untreated ADD may increase risk of substance abuse and other risky behaviors.
The following is written by a friend from her practice in another state. It is copied with her permission anonymously:
ABOUT requests for ADDERALL
When Prozac arrived on the market in 1987, buzz soon spread, and many people asked doctors for Prozac prescriptions. Today, there is buzz about Adderall, which is quite different from Prozac. (If you’re not convinced that Adderall is in the news, please search http://www.nytimes.com to read the huge two and one half page spread about Adderall, on the front page of Sunday’s paper, in June of 2012.)
Many people have heard about Adderall and its use for ADHD and energy, and some people ask for Adderall prescriptions specifically. The fact of the matter is that there are standardized ways to diagnose (and treat ADHD), and there are specific approved uses for Adderall and other stimulants. There are many ways to treat ADHD, and Adderall is not the only way to treat properly-diagnosed ADHD. Nor is it the best treatment for everyone at all times. There are other reasons why psychiatrists sometimes prescribe stimulants, including Adderall, but we will not get into that complicated topic here.
What’s important now is that many people ask for Adderall prescriptions either for “energy” or because they are not doing as well as they want in their jobs or their studies. Sometimes, their dips in energy result from depression, anxiety, or other causes that have more specific and more effective treatments.
This office is happy to do a “differential diagnosis” of your symptoms, to help relieve them in the fastest and safest ways possible. Up to 85% of people who think that they have ADHD actually have another disorder that is solely or partly responsible for their symptoms. It is bad medicine to ignore those other treatable conditions, especially when proper diagnosis and treatment can improve your life so much.
Please note that this office does not offer “cosmetic psychiatry” or “performance psychiatry.” In other words, when someone requests Adderall or other stimulants for added “energy” or for improved performance (in the absence of a diagnosed psychiatric disorder), we cannot honor that request. Also, please recall that insurance companies do not cover “cosmetic psychiatry”—for the same reasons that they do not cover “cosmetic surgery.” Our goal is to diagnose and treat medical or psychiatric disorders.
In short, if your only goal in scheduling an appointment is to obtain a prescription for Adderall (without undergoing a comprehensive evaluation, where we offer recommendations for your best treatments), this is NOT the office for you. If your goal is to relieve distressing symptoms and to explore the best treatment options—after a full review of medical, psychiatric, and social factors–we are happy to help.