ADHD Diagnosis - How an Expert Makes a Diagnosis
For adults diagnosing ADHD requires a thorough assessment by a specialist who is trained in the disorder. They'll likely ask questions about your history and perform a physical exam. They'll also look for conditions that can mimic ADHD like mood disorders, learning disorders, or thyroid conditions.
The doctor will inquire about your childhood behaviors, since the American Psychiatric Association's guidelines stipulate that ADHD in adults cannot be diagnosed absent evidence of early signs. This could include getting school records and contacting former teachers, religious leaders or coaches.
Signs and symptoms
If you or someone you love struggles to keep up with school, work, or home, has difficulties remembering important dates and appointments, or is struggling to stay organized or stay on top of things, you could be suffering from ADHD. A health professional's assessment can help you determine if this is true and, if it is what your treatment options are.
The symptoms must be evident in at least two different environments (school and at home, for instance) and for at least six months to satisfy the criteria for an ADHD diagnoses. The symptoms should also be hindering your ability to function for instance in class, creating close relationships, or working as part of a team. It's important to realize that everyone has issues staying focused and organized sometimes However, these issues are more serious for those with ADHD.
Your doctor will ask you questions about your behavior and how it has affected your life. Providers will also review your family history and any previous psychological or medical tests you've had. They will look for health issues such as thyroid issues and seizure disorders, which could cause the same symptoms as ADHD.
Your provider will ask whether you've ever experienced symptoms in your childhood (technically before age 12). Your doctor will also want to know how your symptoms affect you now and in the past. They'll want to know whether you've been diagnosed with ADHD in the past.
It's helpful to bring your own list of symptoms to the appointment, especially when you've written them down. This will help you remember them and give your physician a an accurate picture of the way your symptoms affect you. You may also bring in old records such as old reports or performance evaluations. Having these records can help your provider determine whether ADHD has been a problem throughout your entire life or was diagnosed recently. These records can help your doctor determine if there are other issues like depression and anxiety, which have similar symptoms to ADHD.
History
In the past, ADHD was thought to be a character flaw or lazyness. With advancements in diagnosis and treatment more children are being diagnosed and the stigma associated with this disorder is diminishing.
Sir George Frederick Still gave a series of lectures in 1902 at the Royal College of Physicians. He described his observations about children who were inattentive or who were unable to focus. He also noted that these signs were more prevalent in boys than girls and were not related to the home environment or intelligence. Still's report is often credited as the beginning of the formal recognition of ADHD.
The initial version of the psychiatric manual, published in 1952 by the American Psychological Association (APA) did not contain ADHD. In 1955, however the US FDA approved stimulant medications that were used as the primary treatment for ADHD. In 1968, the APA released its second edition that listed a number of mental health issues. It included symptoms of ADHD even though they were still referred to as hyperkinetic reaction in childhood.
In 1994 the fourth edition of the psychiatric book was published. This led to greater understanding and acceptance of ADHD. Its name was changed to Attention Deficit Disorder with or without hyperactivity and the standard definition of three types of ADHD symptoms was established: mostly inattentive, mainly hyperactive-impulsive, and combined. The current DSM-5 recognizes these as manifestations rather than distinct types and says that they may change over the course of a person's life.
NICE (National Institute for Clinical Excellence), published guidelines on ADHD in adults in 2008. It was the first time that the UK as a whole recognized adults suffering from ADHD by providing them with financial aid, healthcare support and guidance. SIGN (Scottish Intercollegiate Guidelines Network), has also released guidance on ADHD among children. These two documents are the sole official NHS Scotland recommendations on the condition. Private organisations and charities have also developed guidelines. In recent years, there has been a growing interest in the biological causes of ADHD and researchers have begun to discover the genes that cause it. This knowledge will help in the near future in developing more specific and effective treatments.
Physical Examination
A specialist in ADHD will conduct a thorough assessment to determine the severity of the condition. They collect data about the person's past including their family, education, employment and social history. They might look over the old school records, or speak with teachers, coaches and other professionals who know the person. They will ask about the symptoms and how they impact life. They will also look at how the symptoms have changed over time.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, defines the criteria used to diagnose ADHD in both adults and children. To meet these criteria, the symptoms of inattention and hyperactivity-impulsivity must be present in multiple settings, cause significant impairment and have started before age 12. A specific questionnaire adapted to the situation will be used by the specialist to interview the patient about their symptoms. They may also employ different ratings scales to assess various aspects of ADHD symptoms. Some of these ratings will be based on the Brown Attention Deficit Disorder Symptom Assessment Scale For Adults, while others will be based on different criteria, including questions like "Do you find it difficult sitting still?" Do you struggle with organizing your work or activities?
They will perform an examination of the body. They will look for medical conditions that could be creating the symptoms or causing them to become worse, such a thyroid problem, hearing or vision problems. They will also ask about the individual's diet and lifestyle habits to determine if they may be contributing to the symptoms.
Someone who is being evaluated for ADHD as an adult will likely be asked to fill out the questionnaire with their partner or another close friend. This provides a deeper understanding of the person that checklists and questionnaires can't provide. This is particularly beneficial for people with comorbid conditions such as depression or anxiety which are often associated with ADHD and make the symptoms harder to recognize.
Psychological Evaluation
A health professional who is evaluating a child for ADHD will ask them a series of questions about the symptoms and how they affect their daily lives. They also look into the history of the patient's family and mental health.
They often ask people to bring in report cards and school records for review, particularly those from kindergarten through high school. adhd adults diagnosis can request copies of any previous tests for neuropsychology or psychological such as IQ tests and results from assessments of learning disabilities.
A psychiatrist, psychologist or social worker usually conducts the interview part of an adhd diagnostic assessment. In addition, they might interview friends, family members and teachers, as well. It is essential to obtain an extensive assessment since people who suffer from ADHD who aren't treated may face serious issues. These could include financial issues (impulsive purchases) or marital issues, or failure in colleges or other educational institutions.
During the interview, the doctor will often request that the patient complete the standard behavior rating scales developed to help identify ADHD symptoms. These questionnaires are based on research that compares the behaviors of individuals with ADHD to those of people who do not suffer from the disorder. These ratings are not an official diagnosis of ADHD however they play an important aspect of the assessment process.
It is also crucial to evaluate the individual for other conditions that could exhibit similar symptoms to ADHD like mood disorders, sleep disorders, substance abuse and medical conditions, like head injuries or thyroid disease. These conditions are more likely to respond to certain treatments, therefore it is essential to make sure that a valid diagnosis is made and that the right treatment is offered.
To be able to be diagnosed with ADHD, either a child or an adult must meet a number of requirements in the Diagnostic and Statistical Manual of Mental Disorders. They must show symptoms in two or more environments such as school, home, and at work, and the symptoms must seriously affect their daily functioning. The symptoms must have manifested in the early years of childhood. A psychiatric professional must confirm that the disorder is not caused by mental illness or other co-occurring conditions.