What is ADHD?
ADHD stands for Attention Deficit Hyperactivity Disorder. It is a neurodevelopmental disorder characterized by inattention, hyperactivity and impulsivity that affects people’s day-to-day functioning. Some key facts about ADHD:
- ADHD begins in childhood and can persist into adulthood.
- It affects around 5% of children and 2.5% of adults.
- ADHD occurs more frequently in males than females.
- There are 3 subtypes of ADHD: predominately inattentive, predominately hyperactive-impulsive, and combined type.
- ADHD is highly heritable and genetics play a major role.
- Differences in brain structure and function have been associated with ADHD.
- ADHD often co-occurs with other disorders like anxiety, depression and learning disabilities.
While ADHD can’t be cured, it can be effectively managed with proper treatment and interventions. But first, people need to get diagnosed accurately.
Why is getting an ADHD diagnosis difficult?
There are many reasons why getting properly diagnosed with ADHD can be challenging:
Lack of awareness and misunderstanding
ADHD is one of the most misunderstood disorders. Many people think ADHD is just about not being able to pay attention or sit still. But its symptoms and impact are far more complex. Increased awareness and education is critical for proper diagnosis.
Overlapping symptoms
Many symptoms of ADHD like inattention, impulsivity, disorganization overlap with other conditions like anxiety, depression, autism spectrum disorder. This makes teasing apart what’s actually ADHD vs something else difficult.
Bias against diagnosing ADHD
Some doctors remain biased against diagnosing ADHD due to misconceptions that it is overdiagnosed, not real, or only affects children. They may dismiss symptoms as laziness or bad parenting.
No single, definitive test
There is no blood test, brain scan or genetic test that can conclusively diagnose ADHD currently. Doctors need to rely on clinical judgement based on symptoms, history and impairment. This can lead to inconsistencies.
Gender disparities
ADHD often manifests differently in females with less externalized hyperactivity. Girls are more likely to be overlooked and underdiagnosed. Doctors need better awareness of female symptom presentation.
Racial and ethnic disparities
Black and Hispanic children are less likely to receive an ADHD diagnosis compared to white children displaying identical symptoms. Culturally competent assessments are important.
Access to specialists
ADHD diagnosis requires a licensed mental health professional like a psychologist or psychiatrist. Long wait times and poor access to specialists makes getting diagnosed tough for many.
High costs of diagnosis
Between neuropsych testing, doctor visits and prescription costs, getting an ADHD diagnosis can be prohibitively expensive without good insurance coverage. The costs deter proper assessment.
Changing symptoms with age
Hyperactivity often diminishes by adulthood while inattentive aspects persist. Doctors not trained in ADHD may dismiss an ADHD diagnosis in older teens and adults due to the changing nature of symptoms.
The steps for getting an ADHD diagnosis
While challenging, getting an accurate ADHD diagnosis is possible by going through proper assessment steps:
Check for childhood symptoms
As ADHD begins in childhood, evaluation requires establishing you had disabling levels of inattention, hyperactivity or impulsivity as a kid. Speaking with parents and looking through old report cards is key.
Rule out other conditions
Differential diagnosis is important to exclude other possibilities causing symptoms like thyroid disorders, sleep apnea or mental health conditions. Concurrent conditions should also be identified.
Neuropsychological testing
Completing standardized tests designed to measure attention span, impulse control, working memory and other cognitive abilities impacted by ADHD provides objective data to support a diagnosis.
Questionnaires and scales
Validated clinical scales and questionnaires that screen for ADHD symptoms should be filled out by the patient, parents, teachers, spouse etc. Examples include the Adult ADHD Self-Report Scale and Conners Rating Scale.
Physical exam and medical history
A medical exam and investigation into personal and family history helps identify any physical factors that could explain symptoms like trauma, drug abuse, cheating thyroid levels or genetic predisposition.
Clinical interview
A detailed clinical interview conducted by a psychologist or psychiatrist is considered the gold standard for diagnosing ADHD. This allows an expert assessment of symptoms, onset, impairment and ability to rule out other explanations.
| ADHD Evaluation Steps | Description |
|---|---|
| Check for childhood symptoms | Confirm disabling inattention, hyperactivity or impulsivity before age 12 |
| Rule out other conditions | Exclude other possible causes through tests and evaluation |
| Neuropsych testing | Objectively measure cognitive deficits associated with ADHD |
| Questionnaires and scales | Fill out clinical scales screening for ADHD traits |
| Physical exam and history | Identify any physical factors contributing to symptoms |
| Clinical interview | Expert assessment of case history and symptom evaluation |
Tips for getting an ADHD diagnosis
Here are some tips that can help in obtaining an accurate ADHD evaluation:
Get evaluated sooner than later
Early diagnosis and treatment is important for the best outcomes. Don’t delay getting assessed if ADHD is suspected.
Find an ADHD specialist
Seeing a clinician who understands adult ADHD specifically is key. Ask around for recommendations and verify expertise.
Come prepared and organized
Have school records, medical documents, symptom checklists ready. Write down notes and key examples beforehand.
Bring someone close to provide collateral
Have your partner, parent or friend who knows you well provide input to the doctor on your symptoms.
Be your own advocate
Don’t downplay your struggles. Be assertive about getting the necessary testing and evaluation done.
Document daily impairments
Keep a log tracking how ADHD symptoms impair your school, work, relationships and life. Share this record.
Consider combining assessments
The most accurate diagnoses use multiple data sources like interviews, medical history, neuropsych tests etc.
Look into financial assistance
Many non-profits and community mental health centers provide low or no cost assessment if cost is an issue.
Seek support groups
Connecting with other adults struggling with undiagnosed ADHD can provide tips and emotional support.
Don’t self-diagnose
While checklists and online tests can be useful, avoid assumptions as only a trained professional can accurately diagnose ADHD.
Conclusion
Obtaining an accurate, well-supported ADHD diagnosis can be challenging but is worth the effort. Working with experienced specialists, leveraging multiple sources of information, ruling out other factors and using objective assessments provides the best chance. Being organized, finding social support and advocating for yourself also helps overcome barriers to diagnosis like costs and bias. While it may take some time and patience, getting properly diagnosed leads the way to effective treatment and life improvements for those living with ADHD.