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 inquire about your previous experiences and conduct physical examination. They'll also rule out conditions that could be a cause of ADHD such as learning disorders, mood disorders, or thyroid problems.
The doctor will inquire about your childhood behavior, since the American Psychiatric Association's guidelines state that ADHD in adults cannot be diagnosed absent evidence of early signs. getting diagnosed with adhd as an adult could include obtaining your school records and contact with your former teachers and coaches or religious leaders.
Symptoms
If you or a loved one struggles to keep up at school, work, or home, has trouble remembering important dates or appointments, or is unable to organize, you may have ADHD. A health care professional's assessment can help you determine if this is true and, if it is, what treatment options there are.
To qualify for an ADHD diagnosis, the symptoms have to be present for at least 6 months and be noticeable in at minimum two different environments (school and at home, for instance). They must also be a major obstacle in your ability to function in certain ways, like doing well in class, developing close bonds, or working on teams. It's important to realize that everyone has issues paying attention and staying organized at times However, these issues are more serious with ADHD.
Your doctor will ask you questions about your behavior, and how it has affected your life. Your doctor will also go over your family history and any previous medical or psychological tests you may have taken. They will be looking for health problems, such as thyroid problems and seizure disorders, which could cause the similar symptoms as ADHD.
Your provider will want to be aware of whether your symptoms began in your early years (technically at the age of 12). Your provider will also be interested in knowing how your symptoms are affecting you right now and in the past. They'll want to know if you've been diagnosed with ADHD in the past.
It's helpful to bring a list of symptoms to the appointment, particularly if you have them written down. This will help you remember them and give your provider a complete picture of how your symptoms impact you. You can also bring documents like performance evaluations from work or old school report cards. These records can help your provider determine whether ADHD is a recent issue or has been present for a long period of time. They can also assist your doctor to identify other conditions, such as anxiety or depression that often exhibit the same symptoms as ADHD.
History
In the past, ADHD has been viewed as a flaw in character. But, with advancements in diagnosis and treatment increasing numbers of children are being diagnosed, and the stigma around the disorder is fading away.
In 1902, Sir George Frederick Still presented a series of lectures at the Royal College of Physicians. He described his observations about children who were unable to pay attention or unable to concentrate. He also noted that these signs were more common for boys than girls and were not related to intelligence or the environment in which they lived. Still's report is often associated as the beginning of official recognition of ADHD.
The first edition of the psychiatric handbook, published in 1952 by the American Psychological Association (APA), did not include ADHD. In 1955, however, the US FDA approved stimulant medications which were prescribed as the primary treatment for ADHD. The APA published its second edition in 1968, and listed a number of mental health conditions. The second edition of the manual included a variety of mental health conditions, including ADHD symptoms.
In 1994 the fourth edition of the psychiatric book was published. This led to 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 recognizes these as different types of presentations and states that they can 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 that the UK as a whole recognized with support from healthcare as well as guidance and funding for adults with ADHD. SIGN (Scottish Intercollegiate Guidelines Network) has also issued guidance on ADHD in children. These two documents are the only official NHS recommendations regarding the condition in Scotland. 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 identify the genes responsible for it. This information could help create better targeted, more effective treatments in the future.
Physical Examination
A specialist in ADHD will conduct a thorough examination to determine the severity of the condition. It doesn't matter if they are a physician who specializes in mental health (such as a psychologist or psychiatrist) or an individual doctor who is trained in child and youth health (a paediatrician), they will want to gather a variety of details about the person's past including family, educational, work and social history. They will go through old school records and interview teachers, coaches and other professionals who know the person. They will inquire about symptoms and how they interfere with life. They will also consider how the symptoms have changed over time.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, lays out the criteria used to diagnose 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. The doctor will usually talk to the person about their symptoms by using the appropriate questionnaire to the specific circumstance. They will also use various rating scales that examine different aspects of ADHD symptoms. Some of these ratings will be basing on the Brown Attention Deficit Disorder Symptom Assessment Scale For Adults. Other ratings will be based on different factors, including questions such as "Do you find it difficult to sit still?" and "Do you struggle to organize your time or tasks?"
They will perform an examination for physical health. They will determine if there are any medical conditions that could be contributing to the symptoms or causing them to become worse, like thyroid problem, hearing or vision issues. They will also ask the patient about their diet and lifestyle habits to determine if they could be contributing to symptoms.
A person who is being evaluated for ADHD as an adult may be asked to fill out an assessment with their partner or another close friend. This helps to uncover personal insight that questionnaires and checklists in no way able to provide. This can be particularly useful for people with comorbid conditions 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 affect their daily lives. They also look into the family history of the patient and mental health.
They usually ask people to bring in their report cards and school records for review, especially those from kindergarten to high school. They might also request copies of any previous neuropsychological or psychological testing, such as results from IQ tests and learning disabilities assessments.
Typically, a psychologist, psychiatrist or social worker is the person who conducts the interview portion in an evaluation of the severity of adhd. Additionally, they may interview relatives, friends and teachers as well. It is important to have a comprehensive evaluation because people who are not treated for ADHD can experience serious problems such as financial problems (impulsive spending) or marital issues, as well as failing in colleges or other educational institutions.
During the interview, the doctor will typically ask the patient to complete standardized behavior rating scales designed to help identify ADHD symptoms. These questionnaires are based on research that compares behaviors of people suffering from ADHD and those without the disorder. These scores do not constitute a diagnosis of ADHD but are an important aspect of the assessment process.
It is also crucial to examine the patient for any other medical conditions that may be similar to ADHD like sleep disorders, mood disorders, substance use disorders and medical conditions, like head injuries or thyroid disease. These conditions are more likely to respond to certain treatments, therefore it is important that a proper diagnosis is made and that the appropriate treatment is provided.
To be diagnosed with ADHD, the child or adult must meet several requirements of the Diagnostic and Statistical Manual of Mental Disorders. They must display symptomatic behavior in more than one setting like school, home and work, and the symptoms must be affecting their life functioning. Typically, the symptoms must have started in the early years of childhood. A psychiatrist must confirm that the disorder isn't caused by a mental illness or comorbidity.