The digital world has made so many aspects of life easier; we can order groceries without going to the store, buy gifts for friends with a click of a button, learn new things, meet with colleagues, connect with distant family members, and so much more. But easy doesn’t always mean better, especially when it comes to receiving a medical diagnosis online and being prescribed medication you’ve never taken before. With the advent of telehealth sites like Cerebral, Done, Circle Medical and Clarity, which all claim to properly diagnose mental health issues through a questionnaire and a Zoom call, getting medication has never been so easy, fast, or affordable. Some websites even offer same-day appointments to streamline the process so you can receive a diagnosis and a prescription in under 20 minutes.1 If you’re considering making an appointment with one of these sites, find out the top 10 reasons why you should be cautious.
1. Telehealth Sites Can be Dangerous for Overprescribing
Since the beginning of the pandemic, demand for prescription medications for mental health issues has been steadily increasing even though experts have warned parents and clinicians to be extra cautious because some conditions, such as inattention, can also be caused by the mere stress of the pandemic.2 Nonetheless, the rise in online diagnosing websites have contributed to this increase in drug use, with some former employees of telehealth companies admitting that the expansion of such websites comes at the cost of patient care.
A report by Bloomberg asked 27 former executives, managers, nurses, and other staff about their experience at the website Cerebral, and they confided that appointments are too short, follow-up sessions too infrequent, advertisements too aggressive, and prescriptions pushed too hard.3 And some websites like Done prey on impressionable users, pushing ADHD medication through TikTok (an app used primarily by Gen Z) and raising concern with doctors who fear that such ads blur the line between taking medication for clinical reasons or merely to improve performance, contributing to the rise of stimulant misuse on college campuses.4, 5
Though Congress passed a bill called the Ryan Haight Act, in 2008, which made it illegal for doctors to prescribe “scheduled” drugs such as opiates and amphetamines without first seeing patients in person, the DEA changed this in 2020 to accommodate stay-at-home mandates.6 Now that doctors can prescribe schedule II through V drugs, which includes ADHD drugs like Adderall and Xanax for anxiety, through the internet, the danger of overprescribing will only keep growing.
2. Less Personable
Though telehealth sites can make it easier for people to get access for treatment, especially if they don’t have transportation or they prefer the comfort and privacy of their home to an office, meeting with a mental health expert online can also be lacking. Many online sessions are short, and according to the Bloomberg report, employees are often overworked, so there isn’t much time and space to get to know a patient properly.7 This can result in misdiagnosis and perhaps a prescription the patient doesn’t actually need. In some cases, such as the website ADHD Online, which hopes to offer medication management “very soon,” patients do not even speak to a doctor at all; they simply fill out a self-assessment, send it to a doctorate-level psychologist, and receive a diagnosis.8
3. Could Be Less Accurate than In-Person
One telehealth visit of 20-30 minutes hardly seems enough time to review one’s family history, medical history, body language, and more to properly diagnose the patient or devise an individualized treatment plan. According to Dr. David Goodman, an ADHD specialist at Johns Hopkins University and the Adult Attention Deficit Disorder Center of Maryland, not everyone who experiences the symptoms of ADHD necessarily suffers from the disorder, and simple screening tests cannot diagnose it.9 He explains to NPR that diagnosing ADHD takes time and doctors should assess symptoms from childhood to adulthood, something that seems unlikely to do in a short telehealth visit. The same is true for patients facing symptoms of anxiety or other mental health conditions; before prescribing medications which may be associated with side effects and dependency, doctors should know their patient thoroughly and have enough time to assess their history.
4. More Objective: There’s No “One Size Fits All” for How to Address Mental Health Issues
With standardized assessments and less personable, short visits, telehealth sites may be quick to offer the same treatment plan over and over instead of tailoring it to each patient’s individualized needs. After all, when it comes to ADHD, depression, and anxiety no two people face the same challenges and it takes time and a close assessment to determine how each patient expresses their symptoms and what treatment plan will help them best. Whether or not a telehealth visit results in a prescription, the patient should also be aware of all the other ways they can manage their symptoms, such as following a healthy diet, getting enough sleep, limiting their screen time, and practicing mindfulness. Without a comprehensive approach that includes healthy lifestyle habits, patients will be missing out on what should be a crucial part of their treatment plan.
5. Receiving Less Details Surrounding Your Unique Case
Short telehealth visits also offer less opportunity for in-depth discussions regarding your unique case. In-person visits can simply be more thorough. This is especially true if you have ADHD with a comorbid condition like depression, anxiety, OCD, ODD, and others. Will the doctor have enough time and training to assess your history with these comorbidities?
6. Not All Websites are High Quality
According to a survey of doctors using telehealth during the pandemic, 60 percent have lingering reservations about the quality of care they can provide remotely.10 These reservations make sense when you consider the varying degrees of quality across telehealth websites, which may include dropped connections, limited access to providers, complicated payment structures, barriers to diagnostic testing and more. These limitations may then lead to poor quality of care, misdiagnosis, or higher rates of follow-up visits. The follow-up visits would be needed only because of the poor quality of the primary visit and/or misdiagnoses. Some ADHD diagnosing sites are also notorious for advertising “hundreds of options” when it comes to therapists, but then not being able to provide even one that meets the patient’s specific needs.11
7. Higher Chance of Being Misdiagnosed
When it comes to the accuracy of diagnosing mental health disorders and ADHD online, Dr. Sanam Hafeez, a neuropsychologist in New York City, says she’s “skeptical.” She explains to CNET that she frequently sees patients who have been diagnosed with ADHD and prescribed medication, but actually have another mental health condition. She warns that a missed diagnosis of bipolar disorder (which can also be diagnosed by the website Cerebral), that is being treated with ADHD medication can be particularly dangerous.12
Other conditions that may lead to a misdiagnosis include learning or cognitive disabilities, hearing and vision impairments, sleep problems, anxiety, depression, and even substance abuse.13
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8. Easier for Patient to Abuse Prescription
When it comes to ADHD, studies show that the symptoms can be believably faked, especially when assessed with symptom checklists you would find online.14 A false diagnosis can lead to a prescription for stimulant medication that can be abused to increase alertness, energy, academic performance, and athletic performance as well as help users lose weight and feel less stressed. It’s also becoming increasingly easy to find tips online about how to answer any nurse’s screening questions to get this false diagnosis. In the same sense, drugs like diazepam, alprazolam, and lorazepam (all benzodiazepines) are commonly misused and abused.15
9. Less Medication Management
Many telehealth sites for ADHD, anxiety, or other mental health issues, offer subscriptions so patients can quickly receive their refills without having to go out of their way. While convenient, this doesn’t leave much room for proper medication management. Medication management appointments are typically brief without sufficient supportive therapy to ensure all of the patient’s needs are being met. It’s also possible that the doctor or nurse may neglect to discuss other medications the patient may be taking that were prescribed by another doctor, potentially leading to a dangerous interaction.
10. Not as Extensive as in-Person Diagnosis
While a source of convenience for many, the internet can also be a source of misinformation. Some online providers don’t have the time, information, or ability to diagnose complex conditions in hasty visits with a patient they’ve never seen before and don’t know much about. Conversely, in-person visits allow providers and patients to get to know each other in a safe and monitored place. The provider has time to assess multiple aspects of the patient’s history and answer any questions that spring up in the moment. This means in-person diagnoses are more extensive, and ultimately, more accurate.
How to Get Properly Diagnosed
Don’t be afraid to be choosy when it comes to picking a professional to assess your symptoms. These professionals should be trained in diagnosing ADHD, anxiety, or other mental health issues and may include clinical psychologists, physicians, or clinical social workers. Gather recommendations before choosing your physician, be sure to read reviews, and trust your instincts when you meet with them to decide whether you’d like to move forward. When it comes to ADHD, keep in mind that some insurance policies cover evaluation from one kind of specialist, but not from another. You should expect your physician to take their time with you, asking you about your current and past symptoms, administering tests, and exploring your family history. They may also order a physical or neurological exam to rule out potential physical causes for symptoms.
Advantages of Taking a Non-Prescription Route with Medication
One reason you want to be cautious when it comes to taking prescription medication for ADHD, anxiety, or other mental health issues, is the likelihood of experiencing side effects. These include sleep problems, decreased appetite, upset stomach, dry mouth, headaches, moodiness, impulse control, and risk for addiction. This is why we always suggest using medication as a last resort after exploring lifestyle adjustments and non-prescription alternatives to prescription medication. One such alternative is Brillia, a non-prescription medication designed to reduce hyperactivity, irritability and restlessness, ease anxiety, and improve focus and attention without harsh, synthetic chemicals. One of the biggest differences in prescription meds vs homeopathic meds is that homeopathic meds like Brillia do not cause harmful side effects. Brillia uses targeted antibodies to the S100B protein, an important regulator of mood, to reduce symptoms at their source without causing a risk of dependency or any dangerous interactions with other medications. The non-prescription medication also works best in tandem with healthy lifestyle factors proven to ease symptoms of ADHD such as eating nutritious food, getting enough sleep, minimizing screen time, and practicing mindfulness and relaxation techniques.