Preparing your first ADHD consultation — the user manual

Why we prepare a consultation — and why it’s especially true for ADHD brains

You waited 3, 6, sometimes 12 months for this appointment. You don’t want to walk out with the sense that you “forgot the essential”. It’s a very classic scenario, for a simple reason: ADHD itself makes preparation and self-narration hard in an appointment setting.

Concretely:

• Forget-anxiety — you know you have tons to say, you panic about skipping 80% of it, and the panic blocks your memory.
• Time blindness during the session — 45 minutes feels like 10, or the opposite. You get stuck on a detail, and there’s no time left for the real topic.
• Initiation paralysis — “where do I even start?”, and the silence settles in.
• Hard to narrate your own story — in the moment, everything feels blurry or banal. “I’m fine, I’ve always been like this, it’s normal.”
• Tendency to minimise — you don’t want to “exaggerate” or “look sick”, so you shorten, round off, and say “I’m OK”.

Preparing your appointment isn’t being over-diligent. It’s granting yourself a reasonable accommodation so your psychiatrist can actually hear you.

Before the appointment

1) List your symptoms by DSM cluster

The DSM-5-TR ^[6] organises ADHD symptoms into two big columns: inattention and hyperactivity-impulsivity. Structuring your notes this way helps the psychiatrist map you against the diagnostic criteria.

Inattention column — examples of difficulties:

• Can’t hold sustained attention on a boring task.
• Careless errors, missed details.
• Doesn’t listen when someone speaks directly to you.
• Doesn’t finish what you start.
• Trouble organising, planning, prioritising.
• Avoids or postpones tasks that require sustained mental effort (paperwork, accounting, etc.).
• Loses things (keys, phone, papers).
• Distracted by external or internal stimuli.
• Forgets in daily activities (appointments, promises).

Hyperactivity-impulsivity column — examples:

• Constantly fidgeting, can’t sit still, tapping a foot.
• Feeling “wired to the mains”, can’t disconnect.
• Talks a lot, hard to listen without interrupting.
• Answers before the end of questions.
• Impulsive decisions (purchases, travel, career switches).
• Hard to wait your turn (queue, conversation).
• Cuts into conversations, intrudes on others’.

2) Gather concrete examples from your daily life

Not this: “I often forget, I’m disorganised, I can’t concentrate.”

This, yes:

• “This week I forgot my keys 4 times: Tuesday at the gym, Wednesday coming home, Thursday at work, and this morning on the way out. I had to call the building manager twice.”
• “My work report was due Thursday. I’ve been thinking about it for 3 weeks, I’ve opened the doc 17 times, I wrote nothing. I finished it at 4 a.m. Thursday, in panic mode.”
• “Yesterday I interrupted my partner 3 times without noticing. I only got it when they left the room in silence.”

Concrete beats adjectives by a mile. Your psychiatrist has seen 1,000 people say “I’m disorganised”. They haven’t seen 1,000 describe a specific Monday.

Goal: 1 or 2 concrete examples per main symptom.

3) Ask for a third-party perspective if you can

ADHD has a persistence and impact criterion, and outside observation weighs a lot in the assessment ^[5] . If possible, ask one or two people who know you well (parent, partner, long-standing best friend):

• How long have you seen me like this?
• What do you concretely notice?
• Is there a recent moment or example that struck you?

You can ask them to write 5-10 lines you’ll bring to the session, or if you’re close to them, to come with you to testify if the psychiatrist offers. Not mandatory, often very useful.

4) Bring school reports if you can find them

An official diagnostic criterion (DSM-5-TR): symptoms must be present since childhood (before age 12). School reports are frequent written evidence of this persistence ^[2] .

What you often find there: “daydreams too much”, “distracted”, “potential not reached”, “chatty”, “lacks attention”, “doesn’t finish work”, “needs to concentrate more”. Even partial, even lost in an attic, anything that surfaces helps.

If you don’t have any: no big deal, it’s not a blocker. Your childhood narrative (which you can workshop with a parent, if possible) is enough.

5) List your current medications + past treatments

The psychiatrist will need to know:

• All current treatments, dose and duration.
• Any psychiatric medications you may have taken (antidepressants, anxiolytics, sleep meds — whether they “worked” or not).
• Therapies you’ve done (CBT, psychoanalysis, EMDR, coaching).
• Any previous diagnoses (depression, anxiety, burnout, eating disorder, sleep disorder, etc.).

Many adult ADHDers were diagnosed with “treatment-resistant depression” or “anxiety disorder” before ADHD was named — this info helps differential diagnosis.

6) Note functional impact by domain

ADHD is only diagnosed if there’s significant functional impairment in at least two domains. Do the rounds:

• Work / studies: late deliverables, forgetting, conflicts with managers, sense of under-performing compared to your potential, compensation-exhaustion?
• Couple / family: recurring conflicts on the same theme (“you never listen”, “you forget everything”, “you don’t start anything”), tensions on household tasks, sense of not pulling your weight?
• Parenting (if relevant): constant overwhelm, massive guilt?
• Social life: forgetting birthdays, cancelling last minute, not calling back, avoiding invitations for fear of mishandling?
• Money: overdrafts from forgetting, impulsive purchases, late bills, inability to follow a budget?
• Body / health: missed medical appointments, missed medication doses, chaotic sleep, erratic eating?

A few sentences per domain is enough. Goal: make it visible that this isn’t just “being lazy”.

7) Fill in standardised tools if you can

• ASRS v1.1 (WHO / Kessler et al.) ^[3] : self-assessment questionnaire with 6 + 12 items. Free, online or downloadable. Your psychiatrist knows it and probably uses it. Bringing it pre-filled saves time.
• DIVA-5 ^[4] : longer structured interview, used in clinical evaluation. Find it on divacenter.eu and start it at home to prepare your examples. Not mandatory — your clinician will do their own assessment.
• Wender Utah Rating Scale: retrospective evaluation of childhood symptoms. Useful if you don’t have school reports.

You can also note if you’ve done any ASD (autism) screening — especially if you suspect AuDHD.

8) Prepare your questions

Write them in advance. You will blank otherwise. Classic examples:

• What do you expect from this first appointment?
• How many sessions before a possible diagnosis?
• Do you use structured tools (ASRS, DIVA-5, CAARS)?
• What happens if you confirm ADHD? And if you rule it out?
• Do you also assess autism if I ask?
• Do you accept questions by email between sessions?
• What’s your fee, and how much is reimbursed?

During the session — how it goes well

Bring your notes, no shame

Many ADHDers arrive thinking “I’ll remember everything”. No. Arrive with your 2-3 pages. Tell the psychiatrist explicitly: “I’ve prepared notes, I’d rather lean on them because otherwise I forget half.” You’ll see: psychiatrists trained in ADHD love that. It’s a sign you understand how your brain works.

Ask to record if you want

You have the right to ask to record the consultation to re-listen to it later. The psychiatrist can refuse — that’s their right. But many agree, especially for a first appointment. Simple phrasing:

“Could I record the session to listen back after? I know I’ll forget important things.”

If they refuse: ask if you can take notes during. Either way, write immediately after (see below).

Speak in examples, not labels

If you prepared, this is easy. “I’m a procrastinator” becomes “I handed in my report at 4 a.m. after 3 weeks of panic”. The psychiatrist will produce the labels themselves. You bring the raw material.

Ask your questions

At least two. In particular: “What are the next steps?” and “What are you basing your assessment on?” A clinician who freezes on these questions, that’s a signal.

Don’t be afraid to cry

Many people cry while telling their story for the first time. That’s normal. A trained psychiatrist is used to it and doesn’t read it as performance. You don’t need to hold a “calm and rational” face to be believed.

I had prepared three pages. I cried at the second line. My psychiatrist said: “take your time, your notes are perfect, I’ll read them while you settle.” That’s when I understood I wasn’t crazy. Just exhausted.

After the session — the critical 30 minutes

Write everything down within 30 minutes

Time blindness + emotion + fatigue mean that in 2 hours, you’ll have forgotten half. Plan to sit down somewhere right after (café, bench, car) and write:

• What the psychiatrist said (diagnosis, hypotheses, plan).
• The questions they asked you that surprised you.
• The next steps announced.
• The documents requested (school reports, tests, further assessment).
• Your overall feel (trust / mistrust / confusion).

These notes will feed the next appointment, and any discussion with your close people or your GP.

If medication is offered

Don’t leave with the prescription without at least:

• Knowing the exact name (molecule + brand).
• Understanding why this one rather than another.
• Knowing which alternatives exist and why they were set aside.
• Knowing the main side effects and which ones should prompt a call.
• Knowing when you come back and how efficacy is evaluated.

If you can’t remember your questions: you can ask to call back later in the day or email. Totally legitimate.

If the answer is “no diagnosis”

That’s possible, and it isn’t an end in itself. Ask:

• On what criteria are you ruling out ADHD?
• What do you think explains my symptoms?
• Can we explore another lead? (ASD, mood disorder, attachment, sleep, hormones…)
• Do you think a second opinion would be useful?

A serious clinician accepts the idea of a second opinion. If they bristle: that’s a signal, not a shame.

Practical tools — downloadable or listed

Preparation template

A skeleton you can copy into your favourite tool (Notes, Google Docs, paper notebook).

1. MY SYMPTOMS — INATTENTION
- Concrete example 1:
- Concrete example 2:
- Concrete example 3:

2. MY SYMPTOMS — HYPERACTIVITY-IMPULSIVITY
- Concrete example 1:
- Concrete example 2:

3. SINCE WHEN
- Childhood memories:
- Notable school report:
- Close-person testimony:

4. FUNCTIONAL IMPACT
- Work:
- Couple/family:
- Social:
- Money:
- Health/body:

5. MEDICAL HISTORY
- Current treatments:
- Past treatments:
- Previous diagnoses:
- Therapies done:

6. MY QUESTIONS
-
-
-

Useful standardised tools

• ASRS-v1.1 (WHO) ^[3] — short self-questionnaire, available at hcp.med.harvard.edu/ncs/asrs.php.
• DIVA-5 ^[4] — full structured interview, divacenter.eu/DIVA.aspx. Available in multiple languages, paid for clinicians, often free for patients.
• Wender Utah Rating Scale — retrospective evaluation of childhood symptoms.

Resources by region

• France: HyperSupers TDAH France ^[1] — national reference association. Clinician directory, resources, local groups. tdah-france.fr. Partner associations ^[7] . Expert adult ADHD centres: Sainte-Anne (Paris), Pitié-Salpêtrière (Paris), Nantes ADHD unit, Le Vinatier (Lyon), CHU Montpellier, CHU Bordeaux, CHU Strasbourg among others.
• UK: ADHD UK, AADD-UK, NICE NG87. Right to Choose can bypass long NHS waits.
• US: CHADD, ADDA. Use Psychology Today’s therapist finder to filter by “Adult ADHD”.
• Canada: CADDRA (clinicians), CADDAC (advocacy).
• Australia: ADHD Australia, AADPA.
• Peer groups: Discord and Facebook communities. Useful to find clinicians and share experience, not to diagnose.

If you’re arriving with nothing prepared

It happens. Emergency hierarchy if you’re reading this on the bus on your way there:

1. Note in your phone 3 concrete examples from this week (a forgetting, a procrastination, an emotional crisis).
2. Note one childhood phrase you were often told (school, parents).
3. Note your main question: “I’d like to assess whether I have ADHD / AuDHD”.
4. Breathe. If you arrive empty-handed, it’s not serious — the psychiatrist is there to help you phrase things. You can even say: “I tried to prepare but couldn’t get started — that’s actually one of the reasons I’m here.”

That’s clinical data in itself. Not shame.

Signs your psychiatrist isn’t the right match

If this happens: don’t push, don’t make a drama. Change clinician. Not a failure, a filter.

Takeaways

Go further

• What ADHD actually is
• AuDHD — when ADHD and autism coexist
• The diagnostic pathway — overview
• If you can’t access a specialist