ADHD Diagnosis - How an Expert Makes a Diagnosis
For adults, diagnosing ADHD requires a thorough evaluation by a specialist in the disorder. They'll likely inquire about your history and do a physical exam. They'll also look for conditions that can mimic ADHD such as mood disorders, learning disorders or thyroid conditions.
The doctor will ask you about your childhood behavior because the American Psychiatric Assocation's guidelines stipulate that ADHD in adults is not diagnosed unless there is evidence of early signs. This could include obtaining your school records and contacting previous teachers and coaches or religious leaders.
Symptoms
If you or a loved one struggles to keep up at work, school or at home, is having difficulty remembering important dates or appointments, or is struggling to stay organized or stay on top of things, you could be suffering from ADHD. A health professional's assessment will help you determine if this is true and, if it is what the treatment options are.
To qualify for an ADHD diagnosis, the symptoms must be present for at least six months and be apparent in at minimum two different environments (school and home, for instance). They must also be a major obstacle in your ability to function in certain ways, such as doing well in class, developing close bonds, or working in teams. It is important to recognize that everyone struggles to stay focused and organized at times, but these issues are more prevalent in those with ADHD.
To determine a diagnosis, your physician will interview you and ask you questions about your behavior and how it has affected your life. The doctors will also review your family history, as well as any previous medical or psychological tests that you may have taken. They will look for health problems like thyroid issues and seizure disorders, that can cause the similar symptoms as ADHD.
Your doctor will want determine if your symptoms began in your early years (technically at the age of 12). Your doctor will also be interested in knowing how your symptoms are affecting you at the moment and in the past. They'll also be looking to find out whether you've been diagnosed with ADHD before.
It's a good idea to bring your own list of symptoms to the appointment, especially if you've written them down. This will help you remember them and give your physician a an accurate picture of how your symptoms affect you. You can also bring old records, such as old report cards or performance evaluations. Having these records can help your doctor determine whether ADHD has been a problem throughout your entire life or was diagnosed recently. These records can help your doctor rule other problems out including depression and anxiety that have similar symptoms as ADHD.
History
In the past, ADHD was thought to be a flaw in character or lazyness. With the advancements in diagnosis and treatment more children are being diagnosed and the stigma associated with the disorder is slowly fading.
Sir George Frederick Still gave a series of lectures in 1902 at the Royal College of Physicians. He shared his observations of children who were inattentive or incapable of concentrating. He also noted that these signs were more common for boys than girls and were unrelated to intelligence or home environment. The report is often credited with the first formal recognition of ADHD.
The initial version of the psychiatric manual, released in 1952 by the American Psychological Association (APA) did not include ADHD. But in 1955 the US FDA approved a stimulant drug that was the most popular treatment for ADHD. The APA released its second edition in 1968. It listed a number of mental health conditions. It included the symptoms of ADHD however they were still referred to as hyperkinetic reaction of childhood.
The release of the fourth edition of the manual on psychiatry 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 considers these as presentations, not distinct types and states that they can change throughout the course of a person's lifetime.
NICE (National Institute for Clinical Excellence) released guidelines on ADHD in adults in 2008. This was the first time the UK as a whole formally recognised with healthcare support as well as guidance and funding for adults with ADHD. SIGN (Scottish Intercollegiate Guidelines Network), has also released advice on ADHD in children. These two documents are the sole official NHS Scotland recommendations on the condition. Private organisations and charities have also produced guidance. In recent years there has been a rise in interest in the biological causes of ADHD. Researchers have begun to discover the genes responsible. This knowledge could help in the future to develop more targeted and better treatments.
Physical Examination
A specialist in ADHD will conduct a thorough assessment to determine the severity of the condition. They collect information from the past of the patient as well as their family, educational and employment history, as well as their social history. They will look over old school records and may interview coaches, teachers, and other professionals who know the person. They will ask questions about 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 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. The specialist will typically interview the person regarding their symptoms using an assessment that is adapted to the specific situation. They may also employ different rating scales to look at different aspects ADHD symptoms. Some of these ratings are based on the Brown Attention-Deficit Disorder Symptom Assessment Scale for Adults, while others are based on a number of other criteria. They include questions like "Do you have difficulty sitting still?" Do you struggle with organizing your time or activities?
They will perform an examination for physical health. They will look to determine if there are any medical conditions that could be causing or aggravating the symptoms like thyroid dysfunction or vision and hearing issues. adhd adults diagnosis will also ask the person about their diet and lifestyle habits in order to determine if these could contribute to symptoms.
Anyone who is being evaluated for ADHD as an adult is likely to be asked to complete a questionnaire together with their partner or a close friend. This can help uncover the personal insights that checklists and questionnaires are not able to provide. This is especially useful for people who have comorbid conditions like depression or anxiety. They often co-occur with ADHD and can make it difficult to identify the signs.
Psychological Evaluation
When a health care professional who is evaluating a child adult for ADHD begins by interviewing them, they ask them a series of questions about how the symptoms affect their daily lives. They also review the patient's mental health as well as family history.
They may ask for an original copy of the student's reports or school records, particularly those from kindergarten to high school. They may also ask for copies of any previous psychological or neuropsychological tests, including the results of IQ tests and assessments for learning disabilities.
Typically the psychologist, psychiatrist or social worker will conduct the interview part of an adhd diagnosis evaluation. In addition, they might interview relatives, friends and teachers, as well. It is important to have an extensive evaluation as people who suffer from untreated ADHD may have serious issues, including financial issues (impulsive spending) and marital problems, as well as failing in colleges or other educational institutions.
During an interview, the provider may ask the patient complete standardized behavioral ratings scales that are designed to identify ADHD symptoms. These questionnaires are based upon research that compares the behavior of individuals with ADHD with those of those who do not suffer from the disorder. These ratings are not a diagnosis of ADHD but they play an important part in the assessment process.
It is also crucial to evaluate the individual for other ailments that may exhibit similar symptoms to ADHD, such as mood disorders, sleep disorders, substance use disorders and medical illnesses, such as thyroid disease or head injuries. These conditions are more likely to respond to specific treatments, so it is essential that a correct diagnosis is made and that the right treatment is offered.
A person who is a child or an adult must meet certain criteria in the Diagnostic and Statistical Manual of Mental Disorders to be diagnosed with ADHD. They must display symptomatic behavior in at least two different settings that include school, home, and work. The symptoms must substantially affect the way they live of their lives. adhd adults diagnosis must have manifested in childhood and a psychiatric professional must confirm that the disorder is not caused by an illness of the mind or other concomitant conditions.