ADHD Diagnosis - How an Expert Makes a Diagnosis
Adults suffering from ADHD need a thorough evaluation from a professional who is well-versed in the disorder. They'll likely ask about your medical history and conduct a physical exam. They will also rule out conditions which could be a cause of ADHD like mood disorders, learning disorders, or thyroid disorders.
The doctor will inquire about your childhood behavior since the American Psychiatric Association's guidelines stipulate that ADHD in adults is not diagnosed unless there is evidence of symptoms from childhood. This could mean obtaining your school records and contact with your former teachers or coaches as well as religious leaders.
Symptoms
You could be suffering from ADHD if you or someone you love is struggling to keep up at work, school or home. If they're unable to remember important dates or appointments or aren't able to stay organized, then you might be suffering from ADHD. A health professional's assessment can help you determine if this is true and if so, what treatment options there are.
To meet criteria for an ADHD diagnosis, the symptoms have to be present for a minimum of 6 months and be apparent in at least two settings (school and home, for example). They should also significantly interfere in your ability to function in some ways, such as performing well in school, developing close bonds, or working as a member of a team. It's important to realize that everyone has issues staying focused and organized sometimes, but these problems are more serious with ADHD.
To make a diagnosis, your provider will interview you and ask questions about your behavior and how it's affected your life. The providers will also examine your family history, and any previous medical or psychological tests you've taken. They will check for health problems, such as thyroid disorders and seizure disorder, which can cause similar symptoms to ADHD.
Your doctor will ask you whether you've ever experienced symptoms in your childhood (technically before the age of 12). They'll also be interested in how your symptoms affect you now and how they've affected you in the past. They'll want to know if you've been diagnosed with ADHD in the past.
It's helpful to bring your own list of symptoms to the appointment, particularly when you've written them down. This will help you recall your symptoms and provide your doctor a complete picture about how they impact you. You can also bring documents like the performance evaluations you receive from work or old school report cards. Having these documents can help your doctor determine whether ADHD has been a problem throughout your entire life or started just recently. These records can help your provider rule other problems out including anxiety and depression that have similar symptoms to ADHD.
History
In the past, ADHD was thought to be a flaw in character or lazyness. With advancements 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 to the Royal College of Physicians. He outlined his observations regarding children who were unable to pay attention or incapable of concentrating. He also pointed out that the symptoms were more prevalent for boys than girls and were not related to intelligence or home environments. Still's report has been credited with being the beginning of the formal recognition of ADHD.
The first edition of APA's mental health guideline, released in 1952, didn't include ADHD. In 1955, however the US FDA approved stimulant drugs which were prescribed as the primary treatment for ADHD. The APA published its second edition in 1968, which included a variety of mental health issues. It included symptoms of ADHD even though they were still called hyperkinetic reactions of childhood.
In 1994, the fourth edition of psychiatric book was published. This led to a 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 defines these as presentations, rather than 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. This was the first time the UK as a whole recognized with support from healthcare as well as guidance and funding for adults who suffer from ADHD. SIGN (Scottish Intercollegiate Guidelines Network) has also issued guidelines on ADHD among children. These two documents are the only official NHS recommendations on the condition in Scotland. Private organisations and charities have also developed guidelines. In recent times, there has been a growing interest in the biological causes of ADHD, and researchers have begun to discover the genes responsible for it. This information could help create better and more specific treatments in the future.
Physical Exam
A specialist in ADHD will conduct a thorough examination to diagnose the condition. They collect information from the past of the patient including their family, education, employment and social history. They might look over old school records or talk to coaches, teachers, and other professionals that know the person. They will ask questions about the symptoms and how they affect life. They will also consider how the symptoms have changed with time.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, defines the criteria for determining 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 particular situation will be used by the specialist to talk to the patient about their symptoms. They may also employ different rating scales to look at various aspects of ADHD symptoms. Some of these ratings are basing on the Brown Attention Deficit Disorder Symptom Assessment Scale for adults, whereas others are based on a range of other criteria and include questions like "Do you have difficulty sitting down?" and "Do you struggle to manage your activities or work?"
They will conduct a physical examination. They will look to determine if there are any medical issues that could be causing or aggravating the symptoms like thyroid dysfunction or vision and hearing issues. They will also ask about the person'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 together with their partner or a close friend. This provides a deeper understanding of the person than checklists and questionnaires do not provide. This can be particularly useful for people suffering from comorbid conditions such as depression or anxiety that often co-occur with ADHD and make the symptoms harder to spot.
Psychological Evaluation
When a health care professional who is evaluating a child or adult for ADHD begins by interviewing them, they ask them a series of questions regarding how the symptoms affect their daily lives. They also go over the patient's mental health and family history.
They typically request that the person bring in report cards and school records to review, specifically those from kindergarten through high school. They may also ask for copies of any previous psychological or neuropsychological testing, such as results from IQ tests and learning disabilities assessments.
Typically an audiologist, psychiatrist, psychologist or social worker will conduct the interview portion in an adhd diagnosis evaluation. In addition, they could interview family members, friends and teachers, as well. It is essential to obtain an accurate assessment as people with ADHD who are not treated can have serious problems. This includes financial issues (impulsive purchases) or marital issues, or failure in college or other educational institutions.
During adhd in adults undiagnosed , the provider may ask the patient complete standardized behavior rating scales that are designed to identify ADHD symptoms. These questionnaires are based on research that compares the behaviors of individuals with ADHD with those of those who do not suffer from the disorder. These scores do not constitute a diagnosis of ADHD however they are an important aspect of the assessment process.
It is also important to examine the person to determine if there are other conditions that may be similar to ADHD. These include mood disorders, sleep disorders, and addiction to drugs, as well as medical illnesses such as thyroid disease or brain injuries. These conditions are more likely to respond to certain treatments, so it is essential that a correct diagnosis is made and that the appropriate treatment is provided.
A person of any age must meet the requirements of the Diagnostic and Statistical Manual of Mental Disorders to be diagnosed with ADHD. They must display symptoms in two or more environments, like home, school and work, and the symptoms must seriously affect their daily functioning. Typically, the symptoms must have started in childhood, and a psychiatrist must be able to determine that the disorder is not caused by a mental illness or comorbid condition.