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 medical history and conduct a physical exam. They will also rule out any conditions that could be a cause of ADHD such as mood disorders, learning disorders or thyroid disorders.
The doctor will ask you about your childhood behaviors, since the American Psychiatric Association's guidelines state that ADHD in adults is not diagnosed unless there is evidence of symptoms from childhood. This may include obtaining your school records and contacting previous teachers, coaches, or religious leaders.
Symptoms
If you or someone you love is having trouble keeping up at school, work or at home, and has trouble remembering important dates or appointments, or is struggling to get organized, you may have ADHD. A visit to your health professional can help you determine if this is the case, and, if it is, what treatment options are available.
To qualify for an ADHD diagnosis, the symptoms must be present for a minimum of 6 months and be noticeable in at minimum two different environments (school and at home, as an example). The symptoms should also be affecting your ability to function for instance in class, creating close relationships, or working in a team. It's important to realize that everyone has issues paying attention and staying organized sometimes However, these issues are more serious for those with ADHD.
Your provider will ask you questions about your behavior and how it has impacted your life. The doctors will also review your family history, and any previous psychological or medical tests that you may have taken. They will be looking for health issues such as thyroid issues and seizure disorders, which can cause the similar symptoms as ADHD.
Your doctor will inquire whether you've had symptoms in childhood (technically before 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 want to know whether you've been diagnosed with ADHD in the past.
Bring your own list of symptoms, particularly if they are written down. This will aid in remembering them and give your physician a an accurate description of the way your symptoms affect you. You may also bring older records like old report cards or performance evaluations. These documents can help your doctor determine whether ADHD is a recent issue or has been present for a long period of time. They can also assist your doctor to rule out other problems, such as depression or anxiety which can have the same symptoms as ADHD.
History
In the past, ADHD was thought to be a flaw in character or a sign of laziness. However, with advances in diagnosis and treatments more children are being diagnosed, and the stigma around this disorder is dissolving.
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 and unable to focus. He also observed that the symptoms were more prevalent for boys than girls and were not related intelligence or home environments. Still's report has been considered to be the first official recognition of ADHD.
The first edition of APA's psychotherapy guideline, published in 1952, did not mention ADHD. In 1955, however the US FDA approved stimulant drugs that became the preferred treatment for ADHD. In 1968, the APA published its second edition which listed a number of mental health issues. getting a adhd diagnosis included the symptoms of ADHD however they were still called hyperkinetic reactions of childhood.
After the publication of the fourth edition of the manual for psychiatric patients in 1994, there was an increase in awareness 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 considers these as presentations, not distinct types, and states that they could change over a person's life.
In 2008, NICE (National Institute for Clinical Excellence) issued guidelines on ADHD in adults. It was the first occasion that the UK as an entire recognized adults suffering from ADHD and provided them with funding, healthcare support and guidance. SIGN (Scottish Intercollegiate Guidelines Network) has also issued guidance on ADHD in children. These two documents are the only official NHS Scotland recommendations on the condition. Private organisations and charities have also issued guidance. In recent times, there has been a growing interest in the biological causes of ADHD and researchers have begun to find the genes responsible for it. This knowledge could help in the future to develop more specific and effective treatments.
Physical Exam
A specialist in ADHD will conduct a thorough evaluation to determine the severity of the condition. They collect information about the person's past as well as their family, education, employment and social history. They might review old school records or talk to teachers, coaches and other professionals who know the person. They will inquire about symptoms and how they affect life. They will also examine how the symptoms have changed with time.
The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition of the American Psychiatric Association defines the guidelines for diagnosing ADHD in 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 administered by the doctor to ask the patient about their symptoms. They may also employ different scales of assessment which examine various aspects of the 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 to sit still?" and "Do you struggle to manage your time or tasks?"
They will perform an examination for physical health. They will look for medical conditions that could be creating the symptoms or causing them to get worse, such as thyroid dysfunction or hearing or vision issues. They will also inquire about the individual's diet and lifestyle habits to determine if they might be contributing to the symptoms.
Someone who is being assessed for ADHD as an adult will likely be asked to fill out the questionnaire with their partner or another close friend. This allows for a deeper understanding of the person than checklists and questionnaires cannot provide. This is particularly beneficial for people suffering from comorbid conditions like anxiety or depression that often co-occur with ADHD and make the symptoms harder to recognize.
Psychological Evaluation
A health care professional who is evaluating a child for ADHD will ask them a series of questions about the symptoms and how they impact their daily lives. They also take a look at the family history of the patient and their mental health.
They typically request that the person bring in report cards and school records for review, specifically those from kindergarten to high school. They can also request copies of any previous neuropsychological or psychological tests, including the results of IQ tests and assessments for learning disabilities.
A psychologist, psychiatrist or social worker usually conducts the interview portion of an adhd diagnostic evaluation. They may also interview family members, friends and teachers as well as employers. It is essential to obtain an extensive assessment since people who suffer from ADHD who aren't treated can have serious problems. These include financial problems (impulsive purchases) and marital problems or failure in college or other educational institutions.
During an interview, a doctor may ask the patient to complete standardized behavior rating scales which are designed to help identify ADHD symptoms. These tests are based on research that compares behaviors of those with ADHD and those without the disorder. These scores do not constitute an official diagnosis of ADHD but they are an important aspect of the assessment process.
It is crucial to examine the person to determine if there are other conditions that may have similar symptoms as ADHD. These include sleep disorders, mood disorders and substance abuse as well as medical illnesses such as thyroid disease or brain injuries. These conditions are more likely than other conditions to respond to certain treatments. It is therefore important to establish a proper diagnosis and to get the appropriate treatment.
A child or 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 two or more environments, like home, school and work, and the symptoms must be affecting their daily functioning. Typically, the symptoms must have started in childhood, and a psychiatrist must confirm that the disorder isn't caused by a mental illness or comorbid condition.