DEENفا
Request an appointment
Deutsch English فارسی
Areas of work
ADHD in adults Anxiety & OCD Burnout & exhaustion Couples therapy Group therapy
Practice
About me How it works Fees Blog Contact
Request an appointment
Blog · ADHD

ADHD diagnosis in adults: what the process really looks like.

With me, an ADHD assessment for adults consists of three appointments: a 30-minute history-taking conversation, a structured interview lasting 90 minutes, and a feedback appointment in which you receive the written report.

On top of that come questionnaires and your old school reports, which you send in beforehand. From the first appointment to the finished report, it usually takes three to four weeks, depending on availability. What comes after that is described on the ADHD in adults page.

The process

Three appointments, and what happens in each of them.

  1. Beforehand: questionnaires and reports

    Before the first appointment you receive questionnaires. You fill those in at home, in your own time. They are not a test you can pass or fail, but a structured way of describing yourself. I also ask you for your school reports, as far as you can still find them.

  2. History-taking conversation, 30 minutes

    This is about your story: why you are coming now, how long you have been noticing something, what isn't working in everyday life. We also talk about what you have already tried and which diagnoses have been raised so far.

  3. Structured interview, 90 minutes

    The second appointment is the long one. The structured interview is the actual diagnostic core.

  4. Feedback appointment

    I tell you what I found and what I did not, and how I arrived at that assessment. You go home with a written report, not with one sentence at the door.

The interview

The long interview, and the old school reports.

In the structured interview we go through the diagnostic criteria for adult ADHD together, each of them twice: once for your childhood, once for your life today.

For every criterion we look for concrete examples: work or studies, the household and paperwork, relationships, free time, handling money, self-esteem. Not “do you find it hard to concentrate?” but: what does a Tuesday afternoon look like for you when a tax return needs to be finished?

That is why this part takes 90 minutes. A questionnaire off the internet cannot do this work, and neither can a twenty-minute conversation.

ADHD is a developmental disorder. It does not begin at 34, even if it often only becomes noticeable at 34. For the diagnosis, there must have been signs of symptoms in childhood already, before the age of twelve.

Memory alone is an unreliable source for that, especially in people who learned early on to adapt. Teachers' remarks in school reports are often the best surviving evidence: “disrupts the lesson”, “is often distracted”, “works very inconsistently”.

Sentences like these are indications, not proof. They are weighed together with everything else, never on their own. If you no longer have any reports, the assessment is still possible. It simply takes a little more work.

Differential diagnosis

What gets examined first, before ADHD is on the table.

Concentration problems, inner restlessness and exhaustion are unspecific. They can also have physical causes: a thyroid disorder, iron deficiency, untreated sleep apnoea, side effects of medication.

That work-up belongs in medical hands, not mine. I work together with medical colleagues on this and tell you specifically what it makes sense to have investigated. At the latest when medication is being considered, a physical examination is necessary in any case. So it makes sense not to push it to the end.

Here I have to be honest: ADHD is both overlooked and handed out too quickly. Both happen often, and both have consequences.

Anxiety disorders, depression, the after-effects of distressing experiences and chronic sleep problems produce pictures that look very much like ADHD. Someone who has slept badly for months cannot concentrate. Someone under constant tension seems restless and forgetful. An assessment that does not seriously examine these possibilities is not an assessment.

The reverse is just as true: many people are treated for depression for years while the ADHD underneath goes unrecognised. This particularly often affects women, whose symptoms are turned inwards and who learned early to cover up the chaos.

And often it is not one or the other. ADHD together with an anxiety disorder or a depressive episode is more the rule than the exception. That is precisely why this question needs three appointments.

The report

At the end there is a document that belongs to you.

You receive a written report. It sets out which criteria are met and which are not, what that assessment rests on, which other explanations were examined and why they were ruled out or named alongside, and which next steps I recommend.

This document belongs to you. You can present it to your GP, to a psychiatric practice, to your Krankenkasse (your statutory health insurer) or to a therapist you see later on.

It may also be that at the end there is no ADHD diagnosis. That too is a result, not a failure. It does not mean your difficulties are imagined, only that they have a different name and a different route to treatment.

Once the diagnosis is there, it is about treatment. In psychotherapy we work on what actually jams in everyday life: structure and time, putting things off, regulating emotions, being overwhelmed at work, and very often on self-esteem after many years of being misunderstood.

I cannot and may not prescribe medication. Starting and monitoring medication lies with medical colleagues I work with. If you want to go that route, I make the contact, and the report goes with you. The two do not rule each other out, and neither of them is compulsory.

Fees

What the assessment costs, and who pays for it.

All rates at a glance
  • ADHD assessment, three appointments History-taking, the structured interview and the feedback appointment with a written report. I offer the assessment as a self-pay service; it is not billed to your insurer. 590 €

Because the assessment does not go through an insurer, no diagnosis is reported, and nothing about the assessment is recorded with your health insurer. For psychotherapy afterwards, private health insurance, Beihilfe (the reimbursement scheme for German civil servants) and self-payment are possible, and with statutory insurance the Kostenerstattung route under § 13 (3) SGB V.

Common questions

Asked briefly, and answered briefly.

Can you prescribe medication for me?
No. As a licensed psychotherapist (Psychologische Psychotherapeutin), not a physician, I am not allowed to prescribe medication. Starting and monitoring medication belongs with medical colleagues I work with. If you want to go that route, I make the contact and pass on the report.
What if I can't find my school reports any more?
Then it works anyway. School reports are a very helpful source, but not a requirement. Schools and education authorities often still issue duplicates decades later, so a phone call is worth it. If they are gone for good, we work more with your own biography and, where possible, with the memories of someone who knew you as a child.
Can the assessment take place by video?
I hold the first appointment at the practice. Depending on the situation, the further appointments can also take place by video; that does not change the price. What makes sense in your case is something we decide together at the first appointment.
How long does the whole thing take?
From the first appointment to the finished report it usually takes three to four weeks, depending on availability. You send in the questionnaires and the school reports beforehand; the rest is spread across the three appointments.
A beginning

Three lines are enough.

Tell me roughly what it is about. I will get back to you within two working days. If I am not the right person for you, I will say so and suggest someone better suited.

Request an appointment

Please do not put diagnoses or sensitive details in the form.