**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.

CHAPTERS

00:00 — Walking out more confused than when you walked in

02:36 — GP, psychologist, psychiatrist — the actual order, and when to skip a step

04:38 — Have the waitlists really improved? A straight answer

05:44 — 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 it

13:19 — 'I'm scared I'll look like I'm drug seeking' — the post Jane sees every week

15:26 — How a psychiatrist spots the woman who's masked her whole life and looks fine

16:56 — 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 time

23:23 — How they actually choose your first medication — first-line vs second-line

25:28 — Long-acting or short-acting, and why it's not one-size-fits-all

26:18 — Drug holidays: why they're prescribed, and why the evidence is weaker than you think

29:34 — What's changing in psychiatry for women — hormones, the cycle, and menopause

What We Cover

Why so many women walk out of the appointment with no idea what just happened — and the questions nobody tells you to bring
The 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 money
The two completely different reasons women book an assessment — and why knowing which one you are changes where you should book
What 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-acting
The 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 that
How a psychiatrist recognises the woman who's held it all together on the outside and is burnt out underneath
What happens when you don't have school reports and your parents have died — how the 'evidence before 12' rule actually works in practice
How they choose which medication to start you on, first-line versus second-line, long-acting versus short — in plain English
Drug holidays — why they get prescribed, why the evidence is weaker than it sounds, and what that means for your Saturday sport chaos
What's genuinely changing for women in ADHD care — the hormonal picture, the menstrual cycle, and menopause

Free Resources

Preparing for Diagnosis — for the mum wondering if it's ADHD and what to do next — https://adhdmums.com.au/product/preparing-for-diagnosis/

Paid Resources

Pre-Diagnosis Workbook — the deeper version of 'get clear before you spend the money on an assessment' — https://adhdmums.com.au/product/prediagnosisworkbook/

Related Episodes

How 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 Guest

Dr 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.au

Instagram: @itsdrbrendan (and the clinic, @pandionhealth)

LinkedIn: https://www.linkedin.com/in/brendandaugherty/

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References & Further Reading

On 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)30269-4

On 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.