ADHD Diagnosis - How an Expert Makes a Diagnosis
For adults, diagnosing ADHD requires a thorough evaluation by a specialist in the disorder. They'll likely inquire about your previous experiences and conduct an examination of your body. They will also rule out any conditions that may be similar to ADHD like mood disorders, learning disorders, or thyroid issues.
The doctor will also ask about your childhood behavior because the current American Psychiatric Association guidelines state that adults with ADHD cannot be diagnosed without evidence of symptoms from childhood. This includes getting school records and contacting former teachers, religious leaders or coaches.
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If you or a loved one is struggling to keep up at school, work or at home, is having difficulty remembering important dates or appointments, or can't seem to stay organized or stay on top of things, you could be suffering from ADHD. A health care professional's assessment can help you determine whether this is true and, if it is, what treatment options there are.
The symptoms must be evident in at least two different environments (school and at home, for instance) and for at least six months in order to meet the criteria for an ADHD diagnoses. They should also seriously interfere with your ability to function in certain ways, like doing well in school, developing close bonds, or working as a member of a team. It is important to recognize that everyone has trouble staying organized and paying attention at times, but these issues are more severe in the case of ADHD.
To determine a diagnosis, your provider will interview you and ask you questions about your behavior and how it's affected 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 look for health problems, like thyroid disorders or seizures, which can cause similar symptoms to ADHD.
Your doctor will want determine if your symptoms began in your early years (technically at the age of 12). They'll also be interested in how your symptoms affect you today and how they've affected you in the past. They'll want to know if you've been diagnosed with ADHD in the past.
diagnosis for adhd in adults is helpful to bring your own list of symptoms to your appointment, particularly when you've written them down. This will aid in remembering them and give your provider an accurate description of the way your symptoms affect you. You can also bring documents such as performance evaluations from your job or old school report cards. These documents can help your doctor determine if ADHD is a recent issue or has been present for a long time. These documents can help your doctor to rule out other conditions including anxiety and depression that share similar symptoms to ADHD.
History
In the past, ADHD was thought to be a flaw in character or lazyness. With advances in diagnosis and treatment the number of children diagnosed with ADHD is increasing and the stigma around this disorder is fading.
In 1902, Sir George Frederick Still presented a series of lectures to the Royal College of Physicians. He described his observations about children who were inattentive or who were unable to focus. He also observed that these signs were more prevalent in boys than in girls and were not related to the home environment or intelligence. Still's report has been credited with being the beginning of formal recognition of ADHD.
The first version of the APA's psychiatric guide, published in 1952, did not mention ADHD. In 1955, however, the US FDA approved the use of a stimulant drug, which was the most commonly used treatment for ADHD. In 1968, the APA released its second edition that included a variety of mental health disorders. The second edition of the APA's manual listed several mental health issues, including ADHD symptoms.
With the release of the fourth edition of the manual for psychiatric patients in 1994, there was an increase in awareness 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 presentations rather than distinct types and states that they can change over time.
In 2008, NICE (National Institute for Clinical Excellence) issued guidelines on ADHD in adults. It was the first time that the UK as an entire officially recognized adults with ADHD, providing them with funding, healthcare support and guidance. SIGN (Scottish Intercollegiate Guidelines Network) has also issued guidelines on ADHD in children. These two documents are the sole official NHS Scotland guidelines on the condition. Other guidance has been produced by charities and private organizations. In recent years there has been a growing interest in the biological causes of ADHD, and researchers have begun to find the genes that cause it. This knowledge may help to create better targeted, more effective treatments in the future.
Physical Examination
A specialist in ADHD conducts an extensive assessment to establish a diagnosis. They collect information about the person's past including their family, educational and employment history, as well as their social history. They will look over old school records and interview coaches, teachers and other professionals who know the person. They will ask questions about the symptoms, and how they impact life. They will also examine how the symptoms have changed with time.
The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition of the American Psychiatric Association defines the criteria for diagnosing ADHD in children and adults. 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 specialist will usually interview the person about their symptoms using a questionnaire that is tailored to the specific circumstance. They may also employ different 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 other criteria, such as "Do you find it difficult sitting still?" and "Do you find it hard to organize your time or tasks?"
They will conduct a physical exam. They will determine if there are any medical problems that might be causing or aggravating the symptoms like thyroid dysfunction or vision and hearing issues. They will also inquire with the person about their dietary and lifestyle habits in order to determine if these may contribute to symptoms.
Anyone who is being assessed for ADHD as an adult is likely to be asked to complete a questionnaire with their partner or close friend. This can help uncover personal insight that checklists and questionnaires are not able to provide. This is particularly beneficial for those suffering from comorbid conditions like anxiety or depression. They often co-occur with ADHD and can make it difficult to identify the symptoms.
Psychological Evaluation
If a health care professional who is evaluating a child or adult for ADHD first interviews them, they ask them a series of questions regarding how their symptoms affect their lives. They also look into a patient's family history and their mental health.
They often ask people to bring in their report cards and school records for review, particularly 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 learning disabilities assessments.
Typically an audiologist, psychiatrist, psychologist or a social worker conducts the interview part of an adhd diagnosis evaluation. Additionally, they may interview friends, family members, teachers or employers as well. It is crucial to conduct an extensive evaluation as people who suffer from untreated ADHD may have serious issues that include financial problems (impulsive spending), marital difficulties or failing in college or other educational institutions.
During the interview, the provider will often ask the patient to complete the standard behavior rating scales developed to detect ADHD symptoms. These tests are based on research that compares the behaviors of people with ADHD with those of those without the disorder. These ratings are not a diagnosis of ADHD but they play an important aspect of the process of evaluating.
It is important to also evaluate the individual to determine if there are other conditions that could exhibit similar symptoms to ADHD. These include mood disorders, sleep disorders and substance abuse and medical conditions like thyroid disease or brain injuries. These conditions are more likely than others to respond to specific treatments. It is therefore important to determine the correct diagnosis and receive the right treatment.
To be diagnosed with ADHD, the child or adult must meet a number of criteria in the Diagnostic and Statistical Manual of Mental Disorders. They must show symptoms in two or more environments like school, home or at work, and their symptoms must be affecting their everyday functioning. Typically, the symptoms must be present since the early years of life, and a psychiatrist must confirm that the disorder isn't caused by another mental illness or comorbidity.