ADHD Diagnosis - How an Expert Makes a Diagnosis
Adults with ADHD require a thorough assessment by a specialist who is knowledgeable about the disorder. They'll likely inquire about your history and conduct a physical examination. They'll also rule out other conditions that can mimic ADHD such as mood disorders, learning disorders, or thyroid problems.
The doctor will ask you about your childhood behaviors, since the American Psychiatric Association's guidelines state that ADHD in adults cannot be diagnosed without evidence of symptoms from childhood. This includes finding school records and getting in touch with former teachers, religious leaders, or coaches.
Signs and symptoms
You could be suffering from ADHD if you or someone you love has trouble keeping track of time at school, work, or at home. If they're unable to remember important dates or appointments, or aren't able to stay organized it is possible that they are suffering from ADHD. A health care provider's evaluation can help you determine if this is the case, and, if so, what treatment options there are.
To meet criteria for an ADHD diagnosis the symptoms have to be present for at least 6 months and be apparent in at least two different settings (school and at home, as an instance). 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 is important to recognize that everyone has issues staying focused and well-organized at times however, these issues are more severe for those with ADHD.
Your provider will ask you questions about your behavior, and how it has impacted your life. The doctors will also look at your family history, as well as any previous medical or psychological tests that you may have taken. They will also look for health issues such as thyroid disorders and seizures, which could cause similar symptoms to ADHD.
Your doctor will want to be aware of whether your symptoms began in your childhood (technically at the age of 12). They'll also want to know how your symptoms affect you today and how they've affected you in the past. They'll also be interested in knowing whether you've been diagnosed with ADHD before.
It's helpful to bring a list of symptoms to the appointment, particularly if you have them written down. This will help you to keep track of your symptoms and give your doctor a complete picture of how they impact you. You can also bring documents, such as performance evaluations from your job or old school report cards. Having these records can help your doctor determine if ADHD has been a problem for you throughout your entire life or began in recent times. These records can help your provider determine if there are other issues, such as depression and anxiety that share similar symptoms as ADHD.
History
In the past, ADHD has been viewed as a flaw in character. With advancements in diagnosis and treatment, more children are diagnosed and the stigma around the disorder is slowly fading.
Sir George Frederick Still gave a series of lectures in 1902 at the Royal College of Physicians. He described his observations of children who were inattentive and incapable of focusing. He also pointed out that these symptoms were more common in boys than in girls and were unrelated to intelligence or the environment in which they lived. Still's report has been credited with being the first step towards the formal recognition of ADHD.
The first edition of APA's psychiatric guide, published in 1952, didn't include ADHD. In 1955, however the US FDA approved the use of a stimulant drug, which was the most popular treatment for ADHD. In 1968, the APA published its second edition that included a list of mental health conditions. It included the symptoms of ADHD however they were still classified as hyperkinetic reaction of childhood.
With the release of the fourth edition of the manual for psychiatric patients in 1994, there was increased 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 considers these as presentations, not distinct types, and says that they can change throughout the course of a person's lifetime.
NICE (National Institute for Clinical Excellence) has released guidelines on ADHD in adults in 2008. This was the first time the UK as a whole recognised 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 only official NHS guidelines regarding the condition in Scotland. Private organisations and charities have also developed guidelines. In recent years, there has been a rise in interest in the biological cause of ADHD. Researchers have started to identify the genes that cause ADHD. adhd diagnosing could help create better targeted, more effective treatments in the near future.
Physical Examination
A specialist in ADHD conducts an extensive assessment to determine if they have the diagnosis. Whether they are a physician who is specialized in mental health (such as psychologist or psychiatrist) or an individual doctor who is trained in child and young health (a paediatrician), they will want to collect a range of information about the person's history that includes the family, educational, work and social history. They will review the school records from the past and interview coaches, teachers and other professionals who know the person. They will inquire about symptoms and how they impact life. They will also look at how symptoms have changed over time.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, defines the criteria for determining 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. A specific questionnaire adapted to the specific situation will be administered by the doctor to ask the patient about their symptoms. They will also use different rating scales to look at various aspects of ADHD symptoms. Some of these ratings will be built on the Brown Attention Deficit Disorder Symptom Assessment Scale For Adults while others will be based on other factors, including questions such as "Do you have difficulty sitting still?" and "Do you find it hard to organize your activities or work?"
They will conduct a physical exam. They will check to see if there are any medical problems that might be causing or aggravating the symptoms like thyroid dysfunction or vision or hearing 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 evaluated for ADHD at the age of adulthood, they will be asked to fill out an assessment with a partner or a close family member. This can help uncover the personal insights that questionnaires and checklists are unable to provide. This is especially useful for those with comorbid conditions like anxiety or depression. These are often associated with ADHD, making it difficult to discern the signs.
Psychological Evaluation
A health care professional who is evaluating a child for ADHD will ask them a series questions about the symptoms and how they affect their daily lives. They also look over a patient's mental health and family history.
They can request copies of the student's report cards or school records, specifically those from kindergarten to high school. They may also request copies of previous psychological or neuropsychological tests such as IQ tests and results from learning disabilities assessments.
A psychologist, psychiatrist or social worker usually will conduct the interview part of an adhd diagnostic assessment. They may also conduct interviews with relatives, friends and teachers as well as employers. It is crucial to conduct thorough evaluations because those with untreated ADHD can experience serious problems that include financial issues (impulsive spending), marital difficulties or failure in college or other educational institutions.
During an interview, the provider may ask the patient to complete standardized behavior rating scales which are designed to help identify ADHD symptoms. These questionnaires are based on research that compares behaviors of people suffering from ADHD and those who do not suffer from the disorder. These ratings do not constitute an official diagnosis of ADHD however they are an important part of the evaluation process.
It is crucial to assess the individual to determine if there are other conditions that might be similar to ADHD. These include mood disorders, sleep disorders and substance abuse and medical conditions such as thyroid diseases or brain injuries. These conditions are more likely to respond to specific treatments. It is therefore crucial to make a correct diagnosis and receive the right treatment.
A person of any age must meet certain criteria in the Diagnostic and Statistical Manual of Mental Disorders to be diagnosed with ADHD. They must display symptoms in two or more environments such as school, home, and at work, and the symptoms must be affecting their daily functioning. The symptoms must have appeared in childhood, and a psychiatrist must confirm that the disorder is not caused by an illness of the mind or other comorbid conditions.