So, you've been diagnosed with ADHD but haven't yet taken the leap into trying medication. Maybe you've been managing (or not managing) in other ways, or perhaps you're a bit wary of the whole western medicine idea. Whatever your reasons, you're here because you're considering talking to your doctor about it. Good for you!

But let's be real - Discussing ADHD medication with your doctor can be intimidating. What if they don't take you seriously? What if they don't know much about a medication, but prescribe it anyway? What if they think you're drug-seeking? What about the fact that you have general anxiety about starting new things?!

Fear not! I also have anxiety and I happen to love rambling about ADHD medication and the associated stigma. This guide cuts through the BS and gives you practical, validating, no-nonsense advice on how to approach this important conversation with your doctor.

DISCLAIMER: This information may not be applicable to all readers, as medical systems and regulations vary by country. Please note that I'm writing from the perspective of a U.S. citizen.

Here's the thing about doctors and ADHD medication...

First things first: Do you trust your provider? Do you respect them? Do they respect you? It's important you have confidence in their decisions and beliefs about mental health.

What about their likelihood of hearing you out? Do you know if they've prescribed ADHD meds to other patients? If you have a general practitioner who's not well-versed in ADHD treatment, it might be worth finding a psychiatrist who specializes in it. You can do this without burning bridges with your primary doctor. Just remember, depending on your insurance, you may need a referral to see a specialist.

What to do before your talk

Research medication options.

Before you even step into your doctor's office, do some homework. You should know about the types of ADHD medications available in your country.

Here are a few questions you should be able to answer before your chat:

• Which medication do I want to try first? Why?

• Are there currently any medication shortages in my country?

• Which medications are covered by my insurance? What's the copay?

• If they're not covered by insurance, what's the out-of-pocket cost?

• Do I have pre-existing conditions or do I take other meds that disqualify me from certain ADHD medications? (For example, some heart conditions can disqualify patients from taking stimulants.)

  
  

Document your ADHD symptoms.

Log your symptoms for a few weeks. Note when they occur, their severity, and how they impact your daily life. This can be useful when discussing medication options and starting dosage.

Plus, some medications are better for certain symptoms. For example, people struggling with severe emotional dysregulation or rejection sensitive dysphoria (RSD) have reported the most luck with alpha-2 receptor agonists, which include guanfacine (Intuniv) and clonidine (Kapvay.)

Note any ADHD management strategies you've tried.

Make a list of other ADHD management methods you've tried and how well they worked (or didn't work.) This includes things like diet changes, exercise, mindfulness practices, or over-the-counter supplements. It's okay if nothing has worked yet! Still include it in your list; it could help your doctor narrow down options that might work better for you.

Not to mention, treating mental health conditions should be approached holistically. So even a previous strategy did help, that doesn't mean medication is off the table as a treatment option. You deserve an entire toolbox of management strategies. Medication is just one of the tools.

List your concerns or questions.

Write down any worries or questions you have about ADHD medication so you don't forget!

Here are sample questions you can ask:

• What side effects have your patients reported for this medication?

• Will I have a titration schedule?

• What if it doesn't work? How will I know?

• Do I need to give a urine test while I'm on this drug? Why? How often?

• Do you have any coupons for this medication? (Some are expensive!)

  
  

Red flags to watch for during your discussion

Here are some warning signs that might indicate it's time to find a new healthcare provider to help with your ADHD treatment journey:

Dismissiveness.

If your doctor dismisses your interest in trying ADHD medication without a thorough discussion, that's a problem. You deserve to have your concerns taken seriously.

If they brush off your symptoms, suggest it's "all in your head," or fail to explore the option of medication without good reason, it might be time to look for help elsewhere.

Lack of knowledge.

If the provider seems unfamiliar with ADHD medications or ADHD itself, you might not be in the right place.

Here are indicators that they're uneducated or misinformed about ADHD:

• Makes generalizations. If they say things like "ADHD patients always..." or "People with ADHD never...," they don't understand that ADHD affects everyone differently. In this case, they're probably not the best person to counsel you through your treatment.

• Believes ADHD medication myths. If they repeat myths about ADHD medication—that ADHD meds change your personality, that everyone becomes addicted, or that it's "essentially meth,"—that's a huge red flag. They've clearly already made up their mind about how it will go for you before you've even started, which is the opposite of what you need.

• Perpetuates ADHD stereotypes and misinformation. This one should be a given. If your practitioner casually says things like, "ADHD is less common in women," or "you seem fine," just because you're not bouncing off the walls and pointing out all of the squirrels outside? Yeah, they need a fact check and you need a new prescribing doctor.

  
  

Reluctance to discuss options.

If they're unwilling to discuss medication as a treatment option or explain their reasoning for saying no to you, that's a red flag. You should feel like an active participant in your treatment journey, not a passive recipient.

A good doctor will take the time to explain why they recommend (or don't recommend) certain medications and be open to discussing alternatives.

What if my doctor thinks I'm drug-seeking?

There's a lot of stigma associated with ADHD medication. If there wasn't, you probably wouldn't be reading this right now. One flavor of this stigma is the misconception that people who ask for ADHD medication only want it so they can "get high on Adderall."

This is obviously not true. But it's also not completely untrue.

Adderall is one of the most commonly misused and abused prescription medications in the United States, which is why it's a Schedule II (2) controlled substance. Stimulants can be dangerous if taken incorrectly, and it's important to recognize that.

But guess what? Adderall isn't the only ADHD medication out there. For example, the chemical composition of Vyvanse (Elvanse) makes it less likely to be abused. Not to mention, there are plenty of nonstimulant options that aren't controlled drugs.

...said every ADHDer ever.

The problem with this drug-seeking stigma is that it's made people with ADHD actually second-guess themselves and their intentions. In severe cases, they may even question the validity of their ADHD diagnosis altogether.

As someone who's been diagnosed for 6 years, I still sometimes think, "What if I'm just faking ADHD so I can get drugs?" Realistically, I know that's just the stigma talking. But sometimes, when I'm deep in the imposter syndrome, I actually start to believe that I'm a drug-seeker.

(I'm not, by the way.)

Needless to say, you're not alone for worrying that you may be labeled as a drug-seeker and get sent on your merry way without being helped. Although, I'm not sure if it makes you feel better or worse knowing that. (Sorry if it's the latter.)

Maybe they don't actually think that.

Be realistic for a moment: What are the odds that your doctor actually thinks you're seeking drugs? Have they given you any indication that they think this about you? If you haven't talked to them yet, keep an open mind.

Try not to go into the appointment with the preconception that they're going to dismiss you in this way. Otherwise, your tone and body language could betray you, potentially making your assumption come true. Don't let your stigma-fueled insecurities become a self-fulfilling prophecy.

Know your rights.

As a human, you have the right to medical care. If you don't feel like you can trust your usual doctor with your ADHD treatment, you're allowed to look for outside care without leaving your provider's practice. In this case, you may need a referral.

However, if you've had negative experiences with your doctor regarding ADHD treatment, it might be time to look for a second opinion with a new general provider.

In either case, you should be aware of your rights and know how to proceed with a different healthcare professional.

Request a copy of your medical records.

According to HIPAA, you have the legal right to see and request copies of your medical records (and any notes taken at your appointments.) These days, most medical practices have online portals for patients where they can access their records. If not, you can request them by phone or email.

⚠️ This part is important: Make sure you review any notes taken by your provider during appointments where ADHD treatment was discussed. You should also go back to check notes from when you were diagnosed with ADHD (if possible; adults' files are usually destroyed after 7 years.)

You'd be surprised what some of these practitioners write, and how their notes can negatively affect you and your care in the long-run.

Personal anecdote!

I experienced trauma in Spring 2021. When I wasn't getting better by late summer, my doctor referred me to a psychiatrist to see if I could be experiencing PTSD. Despite getting a PTSD diagnosis and a short-term prescription that actually helped, I still got bad vibes from the psychiatrist.

One day, I stumbled upon some documents in a patient portal that I forgot existed. Turns out, I was right to have bad vibes about her: Her appointment notes mentioned how I'm likely schizophrenic (I'm not) and how I should be taken off ADHD medication—literally the only thing that was helping me not fall apart at the time. (And I told her that!) She even ordered tests for my upcoming appointment (which I obviously canceled) to check for methylphenidate. (I was on Adderall, an amphetamine. From what I gathered, she had assumed I was abusing drugs I'm not even prescribed.) Nowhere in her notes was there anything about what I actually went to her for: trauma recovery.

In typical ADHD fashion, I obsessed over it for a few months and doubted everything I ever thought I knew about myself. It wasn't until therapy the following year where I was able to see that experience for what it really was: A whole bunch of bullshit.

If you find something in your records that is incorrect, or it's something you want omitted, there's a process for making changes to them. You are legally allowed to request these changes.

👉 This article from Verywell Health explains the steps to take!

Let's wrap this up.

You made it to the end! Hopefully you feel a little less anxious about talking to your provider about ADHD medication. Don't forget that this requires work on your end! Make sure you arrive prepared. You should also have realistic expectations - and standards - for your doctor with regard to their knowledge and attitude about ADHD treatment.

Starting a new medication isn't something to take lightly. If it's wrong for you, it could cause serious consequences. But if it's right for you? It could literally be life-changing.

I'm proud of you for taking this step in your ADHD treatment journey! I'm wishing you the best of luck with everything. 💜