ADHD Diagnosis For Adults
Many adults struggle to receive an ADHD diagnosis, as doctors apply a different set of guidelines for treating the disorder than they do for children and teens. The diagnosis requires a minimum of five symptoms that fall within the categories of inattention, hyperactivity and an impulsive nature.
Evaluations by professionals will ask you questions about your childhood, work and academic life, drug and alcohol usage, and family history. They may also discuss your relationship with your spouse or family members.
What is ADHD?
It's not always a good thing to get an ADHD diagnosis in your adulthood, whether you're constantly losing your keys, have difficulty with work or school or are having trouble staying focused during conversations. "You aren't crazy, and this puts you in better position to deal with it," says pediatrician Mary V. Solanto, Ph.D. who is professor of psychiatry and psychology at the Hofstra-Northwell School of Medicine on Long Island, New York.
The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Text Revision of the American Psychiatric Association (DSM-5) is a guideline for doctors to diagnose ADHD. Adults need to meet a lower threshold of symptoms than children -- 5 out of 9 over the past 6 months -- to be diagnosed with either inattentive or hyperactive/impulsive ADHD, or a combination.
An ADHD evaluation typically begins with a face-to-face interview with your doctor who will discuss your symptoms and the impact they have on your life. Bring any report cards from your childhood to help the provider understand your history of ADHD. Your doctor may also request to talk to your spouse or family member, a co-worker or a close friend who know you well. They could inquire about your relationship as well as their observations of your behavior and how it affects them, as well as how your ADHD symptoms can be linked to other disorders like anxiety or depression.
The interview is likely to include questions about your life such as the frequency you fail to pay bills or make appointments, and whether you struggle with time management or organization skills. It's essential to be honest with your answers and to consider how these habits affect your daily life. Ask your healthcare provider for a referral to a different specialist or therapist if are unsure about the symptoms. Self-tests and rating systems are accessible online, but these are not as reliable as an interview conducted by a trained professional. Some of these tests can even result in the wrong diagnosis, so it's best to speak with your healthcare provider first.
Symptoms
If you suspect that you have ADHD, start by speaking to your primary care physician. They may refer you to an expert in mental health, such as a psychologist or psychiatrist, for evaluation. The American Psychiatric Association provides clinical guidelines for diagnosis in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Text Revision (DSM-5). It's crucial to give your provider as much information as possible about your symptoms, so they can make an accurate diagnosis.
The person doing the evaluation will examine your mental, psychological and medical history, including past problems and ask you about how your symptoms impact your life. The person conducting the evaluation could also interview your spouse and children and teachers, coworkers, and other people who know you. Your assessment could include neuropsychological, behavioral, or learning disability tests. These tests can provide your provider additional information about how your ADHD symptoms affect you and can help rule out other conditions that can cause similar symptoms.
In addition to evaluating your current symptoms, the professional will determine whether you have predominantly inattentive, hyperactive-impulsive or combined type ADHD. To receive a diagnosis, you must show that you have at least six of the nine symptoms for either the inattentive or hyperactive-impulsive presentation.
The symptoms of the primarily inattentional type include difficulty paying attention, not noticing details or making careless mistakes. The person who is conducting the assessment will also look at how these symptoms impact school, work and social life. The impulsive/hyperactive/impulsive symptoms of ADHD include fidgeting, difficulty sitting still or squirming in the chair, excessive talking and interrupting others, frequent blurting out answers before questions are finished and difficulty playing or engaging in leisure activities quietly.
These symptoms typically manifest in childhood. They can also develop in later life. Adults may notice their own ADHD symptoms when their children are diagnosed or after changes in their lives like a job, marriage or moving into their own home. In other cases the condition is not recognized until the adult experiences major issues at work or with their relationships. This can include being fired, facing financial problems or getting into trouble with the law.
Diagnosis
A screening is the first step you should do in the event that you suspect you might are suffering from ADHD. A licensed mental health professional will meet with you and review your symptoms, medical history, and family history. The interview may also include questions about work and school performance and how the symptoms affect your home life and in relationships. You may want to bring copies of your report cards, teacher comments and any other information that might be relevant.
The psychiatric specialist will use the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to assist to determine the diagnosis. The symptoms of ADHD must be present for at least six months, and they must interfere with development or functioning in more than one setting, such as school or at home. Additionally, the symptoms are not better explained by a mental disorder that is not related to ADHD, such as an anxiety disorder or mood disorder.
Many people with ADHD are still struggling throughout their adulthood. Symptoms can impact work and school, lead to poor health and financial issues and can cause stress in relationships. Getting diagnosed and treated can improve the quality of your life.
Some signs of ADHD change with age, for example inattentive symptoms may be more apparent as you age and impulsivity and hyperactivity could decrease with age. Other factors can also cause problems. For example the condition known as obstructive sleep apnea is more common in adults with ADHD. Poor sleep habits can also cause ADHD symptoms.
People suffering from ADHD frequently have co-occurring disorders, such as anxiety, depression, bipolar disorder and learning disabilities. Sometimes, treating the root condition can eliminate the symptoms of ADHD. If you have other issues, it is essential to inform your mental health professional as this can affect the effectiveness of your treatment.
It is essential to talk to your primary doctor who can refer you to a health professional trained in ADHD assessments for adults. Find out if there are support groups for adults suffering from ADHD in your area. They can provide resources as well as a list by specialization of professionals. You can also reach out to the insurance company that you have to determine which health care providers are covered under your policy.
Treatment
The most effective approach to diagnose adult ADHD is a thorough evaluation by a health care professional. The evaluation should include questions about your childhood, questions about your current life, and a screening for ADHD symptoms. You may be asked whether your ADHD symptoms have caused you to have problems at school, at work or in your relationships.
Counseling and medication are two of the many options available for adults with ADHD. Counseling can be described as psychotherapy (also known as talk therapy) and cognitive behavioral therapy. These therapies teach you how to manage your symptoms, and how to transform negative patterns of thinking into positive ones. They can also assist in addressing other mental health issues, such as depression and anxiety, that frequently co-occur with ADHD.
Psychostimulants such as dextroamphetamine and methylphenidate are often utilized to treat adults suffering from ADHD. These medications alter the way certain chemicals within your brain communicate and regulate behavior. Your doctor will recommend a medication that is appropriate for your body and symptoms and adjusts the dosage and frequency when needed. Nonstimulants can also be used to treat adults suffering from ADHD. They are not able to affect the same brain pathways in the same way that psychostimulants do. Examples of nonstimulant drugs are atomoxetine and guanfacine.
Other options for treatment for adults suffering from ADHD can include mentoring or coaching to help you learn strategies and coping techniques. You might learn how to make use of a diary or planner, or you may be taught strategies for managing time. You may also benefit from adjusting your lifestyle to accommodate your ADHD symptoms, such as working from home rather than in a workplace or using apps on your smartphone to monitor your tasks or scheduling appointments for times that aren't as busy. You might also want to ask about participating in a clinical trial, which is a research study designed to test new methods of treating ailments and diseases. (NIMH has read here on clinical trials.)
Sometimes, your family physician will recommend you to a mental health specialist or another health medical professional to conduct an evaluation of your ADHD. You can also ask a family member or friend for recommendations, or contact a local support group for people with ADHD.