How is attention deficit hyperactivity disorder (ADHD) diagnosed in adults?

How ADHD is diagnosed in adults in the real world, and a gold standard for diagnosing ADHD in adults are two different things. Many adults get a diagnosis by going to a psychiatrist and after one interview will have a diagnosis and a prescription. This falls short of the gold standard.

Ideally, an adult should fill out lots of paperwork to measure ADHD symptoms, executive functioning symptoms (I use Barkley's rating scales) and a thorough screen of all related diagnoses such as depression, anxiety and trauma-related diagnoses (I use David Burns EASY diagnostic system and Toolkit).

A gold standard evaluation would include 3 hours of interview to rule out alternative explanations for the symptoms (drinking 2 bottles of wine a night) and alternative diagnoses. For example a person with Generalized Anxiety Disorder has a difficult time concentrating, focusing and paying attention to details but for different reasons.

Additionally, you should have other people give feedback to show that the symptoms are observable to others and impact relationships. The time taken also allows for a throrough review of academic and professional functioning across the lifespan. A diagnosis of an adult with ADHD requires evidence that the symptoms of ADHD were present as a child.

A gold standard evaluation is necessary because most adults have some of the symptoms of ADHD some of the time! A diagnosis requires an impairment in functioning. This means that there are serious consequences to the symptoms. For example, if you have many of the symptoms but are high functioning and have career and relationship success you would not meet criteria. Remember that ADHD is a real Mental Disorder, it is not a hip new fad as it seems in some circles.

Another reason for meeting with a professional for 3 or more sessions is to determine if another disorder better explains your disorder or if you have more than one disorder. For example, a person's symptoms could be caused by PTSD or a mood disorder. It is common for adults with ADHD to have more than one disorder, typically depression or anxiety will go together with ADHD due to the toll the ADHD has taken on the person's life.

And finally, I use the evaluation time to educate clients about the treatment options for ADHD, ideally they would gain information about ADHD Coaching, psychotherapy and support groups in addition to standard medications. For example, exercise increases the same neurotransmitters as many of the ADHD medications.

Like children, adults who suspect they have ADHD should be evaluated by a licensed mental health professional. But the professional may need to consider a wider range of symptoms when assessing adults for ADHD because their symptoms tend to be more varied and possibly not as clear cut as symptoms seen in children.

To be diagnosed with the condition, an adult must have ADHD symptoms that began in childhood and continued throughout adulthood. Health professionals use certain rating scales to determine if an adult meets the diagnostic criteria for ADHD. The mental health professional also will look at the person's history of childhood behavior and school experiences, and will interview spouses or partners, parents, close friends, and other associates. The person will also undergo a physical exam and various psychological tests.

For some adults, a diagnosis of ADHD can bring a sense of relief. Adults who have had the disorder since childhood, but who have not been diagnosed, may have developed negative feelings about themselves over the years. Receiving a diagnosis allows them to understand the reasons for their problems, and treatment will allow them to deal with their problems more effectively.

This answer is based on source information from the National Institute of Mental Health.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.