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When I was on Kaiser, it was an absolute nightmare trying to get any traction. They had me do a computer test and, I guess because the results of it (which aren't disclosed to you) did not indicate ADHD, they would not consider the wealth of documentation I had ready to take a look at my old school records. I asked for a second opinion and the next psychiatrist they assigned to me was aloof and refused to consider anything, either. They did give prescribe me bupoprion which did absolutely nothing for me (though I have heard it works for others).

I'm now on a PPO plan and have been using Vyvanse for over a year now. It's lead to a dramatic improvement in my quality of life. I grieved for the time and opportunities I had lost due to not having been diagnosed and treated in childhood.

HMOs have a lot of upsides, but Kaiser's behavioral healthcare is awful (at least in the DC Metro area) and there's not much recourse unless you want to/can afford to pay out of pocket.

There's so much cynicism about ADHD even existing, even among healthcare professionals. Any time on HN any mention of ADHD seems to invite a lot of cynicism as well. That, compounded with that one of the most effective treatments for it is something that pretty much everyone can see a positive effect from (stimulant medication), makes it really difficult to navigate.

I hope that you can find a better option because it seems like Kaiser is just very antagonistic towards ADHD.

I didn't get a diagnosis at Kaiser SF, but I was able to get meds through them. Maybe this will be of use to you.

I was diagnosed by a non-Kaiser psychiatrist I found on my own. After trying different prescriptions, we eventually settled on Concerta. I stayed on that (and continued seeing the same psychiatrist, whose service I paid for out of pocket) for about 4 years.

Then my psychiatrist had some family stuff come up and had to move out of California. Since she was no longer going to be licensed here, she couldn't keep prescribing my meds to me. But she was able to write a letter describing my situation and laying out how she'd arrived at the prescription I was on, with particular emphasis on the fact that she hadn't seen any evidence of misuse on my part. I gave that letter to my Kaiser primary care doctor, who agreed to take over the prescription. After that I was able to get my meds from Kaiser each month without any issues.

I imagine this kind of setup depends on your primary care doctor; I may have just gotten lucky with mine.

Too many psychiatrists do very little continuing education in their practice. I have heard more than a few try to asset that ADHD can only be diagnosed for children.

As if a neurodevelopmental disorder just magically vanishes when you hit age of majority.

It's pretty wild that despite it being a disorder that has been documented for hundreds of years, people still make the argument that people are just lying.

I saw a (alleged) medical student claim on reddit that its childhood-only just last year. So that indoctrination appears to be ongoing.

I think a lot of people see "developed coping strategies and learned to tell people what they want to hear" as "grew out of it".

The Olds probably remember when it wasn't even in the DSM and the Scientologists were busy demonizing Ritalin.

Apparently showing up in the DSM has fixed fuckall.

This is exactly my experience. I got diagnosed as some variant of bipolar 9 years ago and put on a mood stabilizer, but the symptoms never really fit. I’m in general high functioning and got great grades up through postsecondary, didn’t start really having a problem until I started experiencing burnout after having kids during the pandemic. Got evaluated for ADHD, psychiatrist focused on childhood symptoms. Refused to prescribe anything for ADHD because ADHD meds can cause manic episode in bipolar patients, they put me on Wellbutrin instead. Wellbutrin (which affects different people very differently) caused me to have a crisis and spent a week in inpatient care at a non-Kaiser facility.

It was the best thing that has happened to me in years. Inpatient psychiatrist disagreed with the bipolar diagnosis and said that inpatient care was a safe space so we could try Adderall and a different antidepressant (Lexapro). On Adderall I feel calmer, less anxious, and if I’m tired it actually puts me to sleep, which is all in line with ADHD patients. I can focus at work again and have my life back.

I don’t feel like I’ve “lost” anything on Adderall, I would describe my experience with ADHD as having a buggy thread scheduler that would overallocate CPU time to background threads. On Adderall I feel like I have control again. I can still daydream, but all 5 trains of thought are not trying to enter the station at the same time.

I’ve had 3 different Kaiser psychiatrists and all have been sub-par, refusing to re-visit prior diagnoses, being aggressive and overly rigid in their own opinions, and sometimes just being plain incompetent. My recommendation is to seek mental health care from somewhere outside Kaiser that accepts Kaiser insurance. Kaiser’s mental health division is oversubscribed and probably underpaid. Overall our experience with Kaiser has been that no matter which division you’re dealing with, you have to be pushy and advocate for yourself or they’ll just slap the easy label on you and throw medications at the problem that may or may not actually address the root cause.

I’m very open about my experience because mental health issues are highly stigmatized in this country and there are a lot of people who don’t get the care they need. Accepting that I needed inpatient care was one of the most difficult things I’ve ever done, but coming out the other side it was nothing but a positive experience and I feel like I have my life back.

I made an account just to post this as I’ve gone through something similar. Get a formal psychiatric evaluation done out of network by a neurologist who specializes in ADHD. The exam will take a few hours and they will send you a full report and diagnosis. This paperwork will help you a LOT. I’ve used it multiple times when I’ve had difficulties getting care and was well worth the time and money.

I don't even know why they have formal tests. Any health professional and half of the repairmen I've had to my house that has talked to me for more than two hours knows I have it. And probably you too.

What do I look up to find places and providers that do this especially if I don’t have a relationship established with the place already.

Personally I had success with my primary care doctor. But you could also look into online telehealth diagnosis. That was my backup plan to ensure I have access to medical treatment.

You in California by chance? I can recommend an online provider here, but they only serve CA patients.

Try to talk your doctor into gaunfacine. It was an attempted BP medication that had stronger action on the prefrontal cortex, reducing rejection dysphoria (which exacerbates executive function issues). At the very least it might make it easier to confront your doctor about not prescribing stimulants. It's also compatible with Wellbutrin.

Downside is you have to absolutely avoid grapefruit unless you want to find out what bradycardia feels like.

I had pretty much the exact same experience even with a childhood diagnosis and extensive records indicating I only responded well to stimulant-based medication.

The whole process became so burdensome I just gave up and now I self medicate with Nicotine pouches.

Not proud of it and probably not the best alternative but it helps me focus and keeps me out of the stress of the constant back and forth that healthcare providers put you through.

> Curious if anyone has gone through the process of an adult adhd diagnosis at Kaiser SF.

Yep. It appears to be different by region. When I left the bay area and moved to a different kaiser region, they didn't accept any of the medical history from the bay and I had to start over again. Yes, I did have the prescribing pshyc from the bay area send the detailed clinical notes to kaiser but because I didn't take _their preferred_ computer diagnostic tests, I had to start over. Nevermind that the psych I was seeing in the bay area has been treating ADHD since Reagan was in office, the computer test was worth more than the medical professional's experience and opinion!

That makes me want to scream on your behalf.

"I believe in my heart of hearts you suck at your job as a psychiatrist."

try a nicotine patch