ADHD Diagnosis - How an Expert Makes a Diagnosis
Adults with ADHD require a thorough evaluation by a specialist who is familiar with the disorder. They'll likely ask questions about your history and do a physical exam. They will also look for conditions that can mimic ADHD such as mood disorders, learning disorders, or thyroid issues.
The doctor will ask you about your childhood behavior, as the American Psychiatric Association's guidelines state that ADHD in adults is not diagnosed unless there is evidence of early signs. This could mean 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 work, school or at home, and has difficulty remembering important dates or appointments, or can't seem to get organized, you may have ADHD. A health professional's assessment will help you determine if this is the case, and, if so what your treatment options are.
The symptoms must be present in at least two settings (school and at home, for example) and for at least six months to satisfy the criteria for an ADHD diagnosis. The symptoms must also be hindering your ability to function for example, in class, in creating close relationships, or working in a group. It's important to understand that everyone struggles with paying attention and staying organized sometimes, but these problems are more severe for those with ADHD.
Your doctor will ask questions about your behavior, and how it has impacted your life. Providers will also review your family history as well as any past medical or psychological tests you've taken. They will be looking for health problems such as thyroid issues and seizure disorders, that could cause the similar symptoms as ADHD.
Your provider will ask if you have ever had symptoms during your childhood (technically prior to the age of 12). They'll also want to know how your symptoms affect you today and how they have affected you in the past. They'll want to know whether you've been diagnosed with ADHD in the past.
It's helpful to bring a list of symptoms to the appointment, especially if you've written them down. This will aid in remembering the symptoms and provide your doctor with a an accurate description of the way your symptoms affect you. You may also bring in old records, such as old report cards or performance evaluations. Having these records can help your doctor determine if ADHD has been a problem for you throughout your entire life or if it started just recently. undiagnosed adhd in adults can help your doctor determine if there are other issues, such as depression and anxiety that share similar symptoms as ADHD.
History
In the past, ADHD was thought to be a character flaw or a sign of laziness. However, with advances in diagnosis and treatment increasing numbers of children are being diagnosed and the stigma associated with this disorder is slowly disappearing.
In 1902, Sir George Frederick Still presented a series of lectures to the Royal College of Physicians. He shared his observations of children who were unfocused or unable to concentrate. He also pointed out that these signs were more prevalent in boys than girls, and were not correlated with the home environment or intelligence. Still's report has been credited with being the first step towards the formal recognition of ADHD.
The first version of the APA's psychiatric guide, published in 1952, didn't include ADHD. In 1955, however, the US FDA approved stimulant medications that were used as the primary treatment for ADHD. The APA released its second edition in 1968. It listed a number of mental health conditions. It included symptoms of ADHD even though they were still classified as hyperkinetic reaction of childhood.
After the publication of the fourth edition of the manual on psychiatry in 1994, there was an increase in 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 the course of a person's life.
NICE (National Institute for Clinical Excellence), published guidelines on ADHD in adults in 2008. This was the first time the UK as a whole formally acknowledged with healthcare support and guidance for adults who had ADHD. SIGN (Scottish Intercollegiate Guidelines Network) has also issued a guideline on ADHD in children. These two documents are the sole official NHS recommendations regarding the condition in Scotland. Private and non-profit organizations have also developed guidelines. In recent years there has been a rise in interest in the biological causes of ADHD. Researchers have begun to find the genes responsible. This knowledge will help in the future to create more targeted and better treatments.
Physical Examination
A specialist in ADHD will conduct a thorough examination to identify the problem. It doesn't matter if they are a physician who is specialized in mental health (such as a psychologist or psychiatrist) or a doctor trained in child and young health (a paediatrician) They will need to collect a range of information about the person's history, including family, educational, work and social histories. They will review the school records from the past and interview teachers, coaches and other professionals who know the person. They will ask questions about the symptoms and how they impact life. They will also consider how symptoms have changed over time.
The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition of the American Psychiatric Association defines the criteria to diagnose 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 customized questionnaire to the specific situation will be administered by the specialist to talk to the patient about their symptoms. They also employ various ratings scales to assess different aspects ADHD symptoms. Some of these ratings will be basing on the Brown Attention Deficit Disorder Symptom Assessment Scale For Adults while others will be based on different criteria, such as "Do you have difficulty sitting still?" Do you struggle to organize your time or activities?
They will conduct a physical examination. They will determine if there are any medical conditions that could be causing the symptoms or causing them to become worse, such a thyroid disorder, hearing or vision issues. They will also ask about the person's diet and lifestyle habits to determine if they may be contributing to the symptoms.
If a person is being assessed for ADHD in adulthood, they will be asked to fill out a questionnaire together with their partner or a trusted friend. This will help to gain the personal insights that questionnaires and checklists in no way able to provide. This is especially beneficial for those suffering from comorbid disorders such as depression or anxiety which are often associated with ADHD and make the symptoms harder to spot.
Psychological Evaluation
A health professional who is evaluating a child's ADHD will ask them a series of questions about the symptoms and how they impact their daily lives. They also take a look at a patient's family history and their mental health.
They usually ask people to bring in report cards and school records for review, specifically those from kindergarten to high school. They may also ask for copies of any previous neuropsychological or psychological tests, including the results of IQ tests and assessments for learning disabilities.
Typically an audiologist, psychiatrist, psychologist or social worker will conduct the interview portion of an assessment of the diagnosis of adhd. They might also interview friends, family members and teachers as well as employers. It is important to have an extensive evaluation as people who suffer from untreated ADHD are susceptible to serious issues such as financial problems (impulsive spending) or marital issues, as well as failing in college or other educational institutions.
During an interview, the doctor might ask the patient to complete standardized behavior rating scales that are designed to identify ADHD symptoms. These questionnaires are based on research that compares the behaviors of people with ADHD and those who do not suffer from the disorder. These ratings do not constitute an official diagnosis of ADHD but are an important aspect of the assessment process.
It is also crucial to evaluate the individual for other ailments that may be similar to ADHD like mood disorders, sleep disorders, substance use disorders and medical conditions, like head injuries or thyroid disease. These conditions are more likely than other conditions to respond to specific treatments. Therefore, it is crucial to determine the correct diagnosis and receive the right treatment.
To be considered to have ADHD, the child or adult must meet several requirements in the Diagnostic and Statistical Manual of Mental Disorders. They must display symptomatic behavior in at least two settings, such as home, school, and work. The symptoms must severely hinder the normal functioning of their lives. Generally speaking, the symptoms should begin in childhood, and a psychiatrist must confirm that the disorder is not caused by a mental illness or comorbid condition.