#123đ©ș The Diagnosis Experience: What Getting Diagnosed Feels Like
Why every provider is different, and why thatâs okay.
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I am an ADHD and product management coach, helping you change one belief and take one action each week.
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Part 2 of the Things I Wished I Knew Sooner Series
đŠ The Takeaways
Belief: The diagnosis process is straightforward and standardized.
Reality: Every provider diagnoses differently, and itâs mostly behavioral questions.
Action: If you donât like your diagnosis experience, get a second opinion.
âïž Introduction
Welcome back to Things I Wished I Knew Sooner. Last week, I talked about what led me to get assessed as an adult. Today, I want to talk about what the assessment experience itself was actually like.
Iâm going to share my personal experience across multiple providers. In a future issue, Iâll bring on a psychiatrist to talk about the clinical perspective, but for now, I want to focus on what itâs like from the patientâs perspective.
Let's talk about going through an imperfect diagnostic process for a disorder can be easy to miss.
đ”âđ« The Belief - Diagnosis Is a Clear, Scientific Process
Most people assume that getting diagnosed with ADHD is like getting diagnosed with strep throatâthereâs a test, you get a clear answer, and every doctor follows the same protocol.
I certainly thought the diagnosis would be straightforward. After all, this is medicine. There must be standards, right?
But there are common misconceptions that shape the diagnosis process:
The hyperactive boy stereotype. ADHD means you canât sit still, youâre disruptive in class, and you have terrible grades. I wasnât that kid. I stayed in my seat, and it wasnât disruptive to my classes. If you donât match that picture, you assume you donât have ADHD.
The âsmart people canât have ADHDâ myth. Good grades mean youâre fine. High achievement means youâre neurotypical. I had good grades but struggled when things got hard. I disappointed people with my âlack of fulfilled potentialâ, but never failed enough at school to be a true concern.
The assumption that attention is the core issue. We talk about ADHD like itâs purely about concentration and procrastination. But my biggest struggles werenât about focusâthey were emotional dysregulation and the way feelings could spiral out of control. I always thought I was the broken one. That emotional piece gets left out entirely.
These misconceptions shape how providers diagnose, what questions they ask, and what symptoms they look for. And because thereâs no definitive test (at least that I know of in the US), these biases matter.
đ€ The Reality - Itâs Behavioral Questions, and Everyone Does It Differently
An ADHD diagnosis in the US is primarily based on behavioral questions and personal history administered by a psychiatrist or a psychiatric ARNP. Thereâs no official blood test, no brain scan, or online test for you to take that definitively diagnoses you (despite what some sites may sell to you). Itâs a clinical assessment based on your experiences and how they match diagnostic criteria.
Iâve been evaluated by five different providers to date. And while there was some overlap in their approaches, each one brought their own questions and style to the evaluation.
My first diagnosis was done remotely with questions about childhood, school, and attention in class. But I didnât fit the stereotype. I had good grades, a graduate degree, a Fulbright Scholarship, and scientific publications. On paper, I look great. However, inside, I struggled to get by every day.
Even though I did what I enjoyed, I was constantly afraid of being exposed as a fraud and thrown out. I kept achieving because I had a fear that if I didnât, Iâd be unloved. Thatâs something I learned from my Asian immigrant parents that was amplified by my ADHD rejection sensitivity dyphoria.
Iâm a combined type ADHD, but I masked well. I was constantly working in my parentsâ restaurants, always on the move. The signs were hidden by constant physical activity.
One therapist told me, âYou only show up when youâre injured.â In 20 years of therapy, I really engaged whenever I got injuredâbecause I couldnât exercise and couldnât regulate my emotions. I have to exercise in the morning, otherwise my emotional regulation and focus are off.
What I learned from multiple evaluations:
When I moved to my second provider, I learned I also have OCD traits. What I thought was rumination were similar experiences but different treatment pathways. With each provider, I articulated my needs more clearly and learned more about my needs and behaviors. Having that language enabled getting better care.
My biggest challenge with ADHD isnât even in the DSM-5. Emotional regulation is not officially recognized in the U.S as a symptom of ADHD. However, European standards do include it.
The diagnosis process is imperfect, but it enables you to learn the language of your needs. By doing so, you increase your likelihood of finding the most effective treatments for you.
đ ïž The Action - Get a Second Opinion If You Need One
If something doesnât feel right about your diagnosis experienceâif you feel dismissed, if the questions didnât capture your experience, if you disagree with the outcomeâget evaluated again by someone else. Itâs OK to ask for a second opinion, and you might learn something new.
1. Keep notes on your experience
Write down what questions were asked, what felt accurate or inaccurate, what you wish had been discussed, and how you felt during the process. (Or record a voice memo if you prefer not to write)
2. Seek providers with relevant expertise
Look for specialists in adult ADHD (not just pediatric), your identity (gender, people of color, LGBTQ+ folks present differently), and any comorbid conditions you suspect. I tend to learn towards providers who are people of color with experience with immigrant families because thatâs my background.
3. Come prepared with your own observations
If emotional regulation is your biggest challenge, say that. If youâve noticed patterns around sleep, executive function, or rejection sensitivity, bring them up. Donât wait for the perfect question.
4. Remember what diagnosis gives you
Each evaluation taught me more about myself. I could articulate my needs better. Knowing I have dyscalculia and dyslexia meant I could be kinder to myselfâitâs not about trying harder. There are tools to help. I use AI (Claude + Grammarly) to help me write and spellcheck because of my dyslexia.
The power is in having language to describe what youâre experiencing, which helps you find the right tools to help
âš Conclusion
One thing I wish Iâd known sooner: you can talk to multiple providers and get different opinions. The more you know about yourself, the more you can describe your behaviors and experiences, the more you increase your likelihood of effective treatment. We all experience things differently, and thatâs OK.
The diagnosis process isnât perfect. Itâs not standardized the way you might expect. But itâs still worth doingâand if the first experience doesnât feel right, you can try again.
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âïž Next Week
What it was like for me to start medicationâand the unexpected feelings that came with it.