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ADHD Differential Diagnosis and the Need for a Medical Second Opinion

We are told to consult a health care professional for our ADHD diagnosis. It sounds like they are all as good as the next. The custom of the “second opinion” is there because medical diagnoses are complex and doctors have different specialities and experiences. This is especially important when the condition is as controversial as ADHD and when there are over 101 conditions with ADHD like symptoms, medical, developmental, emotional and psychological.

With ADHD it is important, for the patient or patient’s parent, to have some basic knowledge of the various alternatives available. You need to be able to decide if you feel comfortable with the doctor in front of you for your specific ailment. ADHD is not something to diagnose lightly and then take powerful Schedule II drugs.

In the end the person responsible for the treatment is you and not your doctor. Your doctor is your professional advisor. If there is a misdiagnosis, then going to court and suing is not the best answer. The damage may already be done.

Definition of Differential Diagnosis:

Differential Diagnosis: The process of weighing the probability of one disease versus that of other diseases possibly accounting for a patient's illness. The differential diagnosis of rhinitis (a runny nose) includes allergic rhinitis (hayfever), the abuse of nasal decongestants and, of course, the common cold.

(Reference: Med Terms)

Examples of well meaning diagnoses, which did not turn out well, are the cases of teenagers on SSRI antidepressants who go on shooting rampages before they commit suicide. How many doctors check if the teen has a potential Borderline Personality Disorder, or worse. SSRIs have the potential to worsen the aggression with this type of person, who should be prescribed the older types of antidepressants. They older antidepressants cost a fraction of the expensive SSRIs.

The diagnostic process with ADHD is a lot like detective work. The reports from school, the parents report and ADHD checklists are the first way to go.

Next is to ask, “What else can it be?” Assessing what else could rationally account for the behavior is very important. If it is not Attention deficit, and ADHD medication is prescribed, then the symptoms will be suppressed, while the actual underlying condition will continue untreated.

A competent ADHD physician will also fit the treatment to the individual. There is no thing as a one-size-fits-all ADHD treatment. The aim is to find a lasting solution for the patient, not a quick fix to please school authorities.

Something that a confident and competent physician will attempt to do is to empower the patient. A doctor who talks down to you is to be avoided. Empowering the patient is important in the diagnosis procedure. Misunderstanding is easy, so when you understand options, why they were brought up and why they were eliminated, you get valuable insights and can give your doctor more clues and point out any apparent misunderstandings.

If the treatment you choose does not work, you may have been misdiagnosed. Misdiagnoses do happen. If you have worked out your diagnosis together with your doctor, then it will be easier to get a more accurate diagnosis with the next try.

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