ADHD Diagnosis - How an Expert Makes a Diagnosis
Adults with ADHD need a thorough evaluation by a specialist who is familiar with the disorder. They'll likely ask questions about your medical history and conduct a physical exam. They will also rule out any conditions that may be similar to ADHD such as mood disorders, learning disorders, or thyroid disorders.
The doctor will also inquire about your childhood behaviors because current American Psychiatric Association guidelines state that adult ADHD cannot be diagnosed without evidence of symptoms from childhood. This could include getting school records and contacting former teachers, religious leaders, or coaches.
Signs and symptoms
If you or someone you love is having trouble keeping up at work, school, or home, has difficulty remembering important dates or appointments, or is unable to organize it could be that you suffer from ADHD. Getting an evaluation by an expert in health care can help you determine whether this is the case and, if it is the case, what treatments are available.
To meet criteria for an ADHD diagnosis, the symptoms have to be present for at least six months and be noticeable in at least two different settings (school and at home, for example). They should also seriously interfere in your ability to function in some ways, such as doing well in school, developing close relationships, or functioning in teams. It is important to recognize that everyone has trouble staying on track and paying attention at times, but these problems are more prevalent in those with ADHD.
Your provider will ask you questions about your behavior and how it has affected your life. Your doctor will also go over your family history and any previous medical or psychological tests you may have had. They will check for health problems, like thyroid disorders or seizures, which could cause similar symptoms as ADHD.
Your doctor will want to know if your symptoms started in childhood (technically prior to age 12). They'll also want to know how your symptoms affect you now and how they've affected you in the past. They'll also be looking to find out whether you've been diagnosed with ADHD before.
Bring your own list of symptoms, especially if they're written down. This will aid in remembering the symptoms and provide your doctor with a an accurate picture of the way your symptoms affect you. You can also bring records such as performance evaluations from work or old school report cards. Having these records can help your provider determine whether ADHD has been a problem for you throughout your entire life or if it started in recent times. They can also assist your doctor to identify other conditions such as anxiety or depression which can have the same symptoms as ADHD.
History
In the past, ADHD has been viewed as a flaw in character. With adhd diagnosis in adults in diagnosis and treatment more children are being diagnosed and the stigma associated with this disorder is diminishing.
In 1902, Sir George Frederick Still presented a series of lectures at the Royal College of Physicians. He outlined his observations regarding children who were inattentive or incapable of concentrating. He also pointed out that these signs were more prevalent for boys than girls, and were not correlated with intelligence or home environment. Still's report is often associated as the beginning of formal recognition of ADHD.
The first version of the psychiatric manual, released in 1952 by the American Psychological Association (APA) did not include ADHD. However, in 1955, the US FDA approved a stimulant drug that was the most commonly used treatment for ADHD. In 1968 the APA released its second edition which included a variety of mental health issues. It included symptoms of ADHD however they were still classified as hyperkinetic reactions of childhood.
The release of the fourth edition of the manual for psychiatric patients in 1994, there was increased acceptance and understanding 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 views these as presentations, not distinct types, and says that they could change over a person's life.
NICE (National Institute for Clinical Excellence) released guidelines on ADHD in adults in 2008. This was the first time that the UK as a whole acknowledged with healthcare support and guidance for adults with ADHD. SIGN (Scottish Intercollegiate Guidelines Network) has also issued a guideline on ADHD in children. These two documents are the sole official NHS recommendations on the condition in Scotland. Other guidance has been produced by private companies and charities. In recent years, there has been a rise in interest in the biological cause of ADHD. Researchers have started to identify the genes that cause ADHD. This information could be helpful in the future to develop more targeted and better treatments.
Physical Examination
A specialist in ADHD will conduct a thorough evaluation to determine the severity of the condition. They will collect information from the past of the patient, including their family, educational and employment history, as well as their social history. They might review old school records or interview coaches, teachers and other professionals who know the person. They will ask questions about the symptoms and how they affect daily life. They will also consider how the symptoms have changed over time.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, lays out the criteria used to diagnose ADHD in children and adults. 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 customized questionnaire to the particular situation will be utilized by the doctor to ask the patient about their symptoms. They may also employ various rating scales that examine different aspects of the ADHD symptoms. Some of these ratings are built on the Brown Attention-Deficit Disorder Symptom Assessment Scale for adults, whereas others are based on a variety of other criteria. They also include questions such as "Do you have difficulty sitting down?" Do you struggle to organize your activities or work?
They will conduct a physical exam. They will look for medical conditions that could be causing the symptoms or causing them to get worse, such as thyroid disorder, hearing or vision issues. They will also ask the person about their dietary and lifestyle habits in order to determine if these may be contributing to the symptoms.
A person who is being evaluated for ADHD as an adult is likely to be asked to complete a questionnaire with their partner or another close friend. This helps to uncover personal insight that checklists and questionnaires are in no way able to provide. This is especially beneficial for those suffering from multiple disorders like anxiety or depression. These often co-occur along with ADHD and can make it difficult to discern the symptoms.
Psychological Evaluation
A health care professional who is evaluating a child's ADHD will ask them a series of questions about the symptoms and how they affect their daily lives. They also look into the family history of the patient and their mental health.
They could request copies of the student's report cards or school records, specifically those from kindergarten through high school. They may also ask for copies of any previous psychological or neuropsychological testing, including results from IQ tests and learning disabilities assessments.
Typically the psychologist, psychiatrist or social worker is the person who conducts the interview portion of an assessment of the diagnosis of adhd. They may also conduct interviews with relatives, friends as well as teachers or employers. It is important to have thorough evaluations because those with untreated ADHD can experience serious problems, including financial problems (impulsive spending) or marital issues, as well as failing in college or other educational institutions.
During the interview, the doctor will usually request that the patient complete standardized behavior rating scales that are designed to detect ADHD symptoms. These tests are based on research that compares the behaviors of people suffering from ADHD and those who do not suffer from the disorder. These ratings do not constitute an indication of ADHD however they play an important element in the process of evaluating.
It is also essential to check the person for other conditions that could be similar to ADHD, such as mood disorders, sleep disorders, substance abuse and medical conditions, like head injuries or thyroid disease. Those conditions are more likely to respond to specific treatments, therefore it is essential that a proper diagnosis is made and the correct treatment is given.
A child or adult must meet the requirements of the Diagnostic and Statistical Manual of Mental Disorders to be diagnosed with ADHD. They must exhibit symptomatic behaviors in at least two settings, such as school, home, or work. The symptoms should also significantly interfere with the functioning of their lives. The symptoms must have appeared in the early years of childhood. A psychiatric professional must confirm that the disorder is not caused by a mental illness or comorbid conditions.