ADHD Diagnosis - How an Expert Makes a Diagnosis
Adults with ADHD require a thorough evaluation from a professional who is familiar with the disorder. They'll likely ask you about your previous experiences and conduct a physical examination. They'll also rule out other conditions that could be a cause of ADHD such as mood disorders, learning disorders, or thyroid problems.
The doctor will ask you about your childhood behaviors, because the American Psychiatric Assocation's guidelines stipulate that ADHD in adults cannot be diagnosed unless there is evidence of early signs. This may include getting your school records as well as contacting previous teachers, coaches, or religious leaders.
Symptoms
If you or someone you love is having trouble keeping up at school, work or at home, and has difficulty remembering important dates or appointments, or is unable to stay organized or stay on top of things, you could be suffering from ADHD. A health professional's assessment can help you determine if this is true and, if so what the treatment options are.
To be eligible for an ADHD diagnosis the symptoms have to be present for a minimum of 6 months and be apparent in at least two different settings (school and home, for instance). They must also be a major obstacle in your ability to function in certain ways, such as performing well in school, developing close bonds, or working as a member of a team. It's important to understand that everyone struggles with paying attention and staying well-organized at times however, these issues are more severe for those with ADHD.
To make an assessment, your doctor will conduct an interview and ask you questions about your behavior and how it's affected your life. The doctor will also look over your family history as well as any past medical or psychological tests you've taken. They will check for health issues, such as thyroid disorders and seizures, which can cause similar symptoms as ADHD.
Your provider will ask whether you've had symptoms in childhood (technically prior to the age of 12). They'll also be interested in how your symptoms affect you today and how they have affected you in the past. They'll also be looking to find out whether you've been diagnosed with ADHD before.
It is helpful to bring your own list of symptoms to your appointment, particularly if you have them written down. This will allow you to remember your symptoms and give your doctor a complete picture about how they affect you. adhd undiagnosed in adults can also bring older records like old report cards or performance evaluations. These documents can help your doctor determine whether ADHD is a recent issue or has been present for a long period of time. They can also help your provider determine if you have other issues like anxiety or depression which can have similar symptoms to ADHD.
History
In the past, ADHD was thought to be a flaw in character or laziness. With the advancements in diagnosis and treatment more children are being diagnosed and the stigma associated with the disorder is slowly fading.
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 inattentive and unfocused. He also observed that the symptoms were more prevalent in boys than girls and that they were not related to the quality of education or home environments. Still's report has been credited as the beginning of the formal recognition of ADHD.
The first version of the APA's psychiatric guide, published in 1952, did not mention ADHD. In adult adhd diagnoses , however the US FDA approved stimulant drugs that were the main treatment for ADHD. In 1968, the APA published its second edition that included a list of mental health disorders. The second edition of the APA's manual included a variety of mental health issues, including ADHD symptoms.
After the publication of the fourth edition of the psychiatric manual in 1994, there was a greater 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 presenting symptoms, not distinct types and states that they could change over 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 that the UK as a whole recognized with support from healthcare as well as guidance and funding for adults who suffer from ADHD. SIGN (Scottish Intercollegiate Guidelines Network) has also issued a guideline on ADHD in children. These two documents are the sole official NHS recommendations on the condition in Scotland. Private organizations and charities have also issued guidance. In recent years there has been an increasing interest in the biological causes of ADHD. Researchers have started to find the genes responsible. This knowledge may help to develop better targeted, more effective treatments in the near future.
Physical Exam
A specialist in ADHD conducts a thorough evaluation to establish the diagnosis. They will collect information from the patient's past, including their family, education and employment history as well as social and personal. They might review the old school records, or speak with coaches, teachers, and other professionals that know the person. They will inquire about symptoms and how they interfere with life. They will also look at how the symptoms have changed over time.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, outlines 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 doctor will usually talk to the person about their symptoms by using a questionnaire that is tailored to the specific circumstance. They may also employ various rating scales that look at different aspects of ADHD symptoms. Some of these ratings will be based 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 have trouble organizing your work or activities?
They will perform a physical exam. They will look for medical conditions that may be creating the symptoms or causing them to get worse, such as thyroid problem, hearing or vision issues. They will also inquire about the individual's diet and lifestyle habits to determine if they might be contributing to the symptoms.
If a person is assessed 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 will help to gain the personal insights that questionnaires and checklists are in no way able to provide. This is particularly beneficial for those suffering from comorbid conditions like anxiety or depression. These often co-occur along with ADHD, making it difficult to recognize the symptoms.
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 life. They also review the patient's mental health as well as family history.
They often ask people to bring in their report cards and school records to review, specifically those from kindergarten through high school. They can request copies of any previous tests, such as neuropsychological or psychological such as IQ tests and results from assessments for learning disabilities.
Typically the psychologist, psychiatrist or a social worker conducts the interview part of an assessment of the diagnosis of adhd. 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 may have serious issues that include financial problems (impulsive spending) or marital issues, as well as failing in college or other educational institutions.
During the interview, a doctor will usually ask the patient to fill out the standard behavior rating scales developed to detect ADHD symptoms. These questionnaires are based upon research that compares the behavior of people with ADHD with those of those without the disorder. These scores do not constitute the diagnosis of ADHD but they are an important aspect of the evaluation process.
It is also important to evaluate the individual to determine if they have other conditions that may have similar symptoms as ADHD. These include mood disorders, sleep disorders and substance abuse, and medical conditions such as thyroid diseases or brain injuries. Those conditions are more likely to respond to certain treatments, therefore it is important that a proper diagnosis is made and that the correct treatment is given.
To be considered to have ADHD, either a child or an adult must meet several criteria in the Diagnostic and Statistical Manual of Mental Disorders. They must display symptomatic behavior in at least two different settings, such as school, home, and work. The symptoms must significantly interfere with the functioning of their lives. Generally, the symptoms must have started in the early years of childhood. A psychiatrist must be able to determine that the disorder is not caused by another mental illness or comorbidity.