ADHD Assessment: What Actually Happens in a Psychiatrist's Appointment (with Dr Brendan Daugherty)

**This episode is general information only and is not medical advice. If any of it applies to you, please talk it through with your own GP or psychiatrist**Have you ever walked out of a psychiatrist's office more confused than when you walked in? Not sure what just happened, whether you got a diagnosis, what you were supposed to ask, or whether the thing you were terrified of — coming across like you were just there for the stimulants — is exactly what you did. For a lot of women getting an ADHD assessment at 40, the appointment itself is the black box. Nobody tells you the order to see a GP, psychologist and psychiatrist in, what happens if your school reports are gone and your parents have died, why they start you on one medication and not another, or what a drug holiday actually is.So this week Jane sat a psychiatrist down and asked him to open the box. Dr Brendan Daugherty walks through the whole thing — the pathway, the assessment, how they choose your first medication, and the one thing that makes these appointments go better. Bring the questions you've been too embarrassed to ask.CHAPTERS00:00 — Walking out more confused than when you walked in02:36 — GP, psychologist, psychiatrist — the actual order, and when to skip a step04:38 — Have the waitlists really improved? A straight answer05:44 — The two kinds of women who book an assessment — which one are you?09:50 — 'ADHD is a bit like a shield' — and what's underneath when the medication lifts it13:19 — 'I'm scared I'll look like I'm drug seeking' — the post Jane sees every week15:26 — How a psychiatrist spots the woman who's masked her whole life and looks fine16:56 — No school reports, parents gone — how do you even get diagnosed? (evidence before 12)19:15 — The squat-rack phone call that diagnosed Jane's ADHD in real time23:23 — How they actually choose your first medication — first-line vs second-line25:28 — Long-acting or short-acting, and why it's not one-size-fits-all26:18 — Drug holidays: why they're prescribed, and why the evidence is weaker than you think29:34 — What's changing in psychiatry for women — hormones, the cycle, and menopauseWhat We CoverWhy so many women walk out of the appointment with no idea what just happened — and the questions nobody tells you to bringThe actual order to see a GP, psychologist and psychiatrist in, when you can skip a step, and when doubling up is a waste of your moneyThe two completely different reasons women book an assessment — and why knowing which one you are changes where you should bookWhat Brendan means when he says attention problems aren't always ADHD — the medical and hormonal things a rushed assessment misses'ADHD is a bit like a shield' — the conversation about what surfaces when the medication lifts it, and why Jane went back to short-actingThe post Jane sees in the Facebook group every single week — 'I'm terrified I'll look like I'm drug seeking' — and exactly how a psychiatrist actually hears thatHow a psychiatrist recognises the woman who's held it all together on the outside and is burnt out underneathWhat happens when you don't have school reports and your parents have died — how the 'evidence before 12' rule actually works in practiceHow they choose which medication to start you on, first-line versus second-line, long-acting versus short — in plain EnglishDrug holidays — why they get prescribed, why the evidence is weaker than it sounds, and what that means for your Saturday sport chaosWhat's genuinely changing for women in ADHD care — the hormonal picture, the menstrual cycle, and menopauseFree ResourcesPreparing for Diagnosis — for the mum wondering if it's ADHD and what to do next — https://adhdmums.com.au/product/preparing-for-diagnosis/Paid ResourcesPre-Diagnosis Workbook — the deeper version of 'get clear before you spend the money on an assessment' — https://adhdmums.com.au/product/prediagnosisworkbook/Related EpisodesHow to Get a Diagnosis in Australia (Part 1) — S1 EP7, with Dr Jacinta Thomson — https://adhdmums.com.au/podcast_episode/s1-ep7-how-to-get-a-diagnosis-in-australia-part-1/ADHD Medication: Stimulants vs Non-Stimulants — S2 EP40, Jane solo — https://adhdmums.com.au/podcast_episode/episode-40-adhd-medication-stimulants-vs-non-stimulants-solo-episode-with-jane-mcfadden/About the GuestDr Brendan Daugherty is a child, adolescent, adult and forensic psychiatrist and a Fellow of the Royal Australian and New Zealand College of Psychiatrists. He's the co-founder of Pandion Health, an Australian telehealth platform providing specialist-led ADHD assessment and ongoing care for adults and children.You can find Brendan here:Website: https://www.pandionhealth.com.auInstagram: @itsdrbrendan (and the clinic, @pandionhealth)LinkedIn: https://www.linkedin.com/in/brendandaugherty/📬 Listener Questions & Community🎙️ Ask a Listener Question (voice)Voice notes are preferred when possible — hearing your voice helps add context — but you’re very welcome to submit a written question instead.Send a WhatsApp voice or written on 0403 457 313Send a SMS voice or written on 0403 457 313👥 Join the ADHD Mums Facebook Group👥 Receive the episodes in your inbox References & Further ReadingOn dexamphetamine vs methylphenidate (Brendan's 'a little bit better' point, ~24:24):Cortese, S. et al. (2018). Comparative efficacy and tolerability of medications for ADHD in children, adolescents, and adults: a systematic review and network meta-analysis. The Lancet Psychiatry, 5(9), 727–738. https://doi.org/10.1016/S2215-0366(18)30269-4On stimulant 'drug holidays' and growth (~26:18):Drug holidays and the ~2cm growth question are genuinely contested in the literature. The most-cited long-term data is the MTA follow-up (Swanson et al., 2017, Journal of Child Psychology and Psychiatry), which found a small average height reduction associated with consistent stimulant use. Brendan's framing — that it's 'a bit overblown' and the adult evidence for weekend breaks is weak — matches the current consensus.On combined medication + non-medication treatment (~23:23):The MTA Cooperative Group studies remain the reference point for Brendan's 'they work best in combination' statement.