The proper diagnosis of Adult ADHD can be confusing and overwhelming; many of the symptoms overlap with other disorders and many of the symptoms are set along a wide spectrum. Additionally, most clinicians have not been extensively trained in the accurate diagnosis of Adult ADHD.
This is a brief and simple step-by-step guide to the diagnosis of Adult ADHD so that you can feel more confident in assigning the diagnosis and referring to a therapist and/or psychiatrist who specializes in the comprehensive treatment of Adult ADHD.
Step 1: Ask these key screening questions:
1. Do you have difficulty reading magazines, books, or maps?
2. Do you have a messy office or home?
3. Do you have trouble starting and/or completing projects?
4. Do you often feel mentally “foggy” or “in a haze”?
5. Do others say you tend to jump from topic to topic in conversation
6. Have you received negative feedback, such as inconsistent performance, in your school or work reviews?
7. Have you had any or all of these problems since childhood?
8. Which family members, if any, have depression, anxiety, mood swings, or problems with attention and focus?
Step 2: Administer the ADHD Screening Exams called the ASRS v1.1 and the Epsworth inventory on all patients.
Step 3: Gather collaborative information:
Many young adults may try to receive a diagnosis of ADHD in order to get stimulant medications even when they do not have ADHD, so it is critical to review collaborative information whenever practical.
Assess past report cards and performance reviews for clues pointing toward ADHD.
Always speak to family members, whenever possible.
Step 4: Administer the Conners Test
This is the gold standard for inventories and is, in fact, superior to neuropsychiatric testing. The diagnosis of ADHD is a clinical diagnosis and does not require neuropsychiatric testing unless you are also evaluating for learning disabilities.
Step 5: Rule out medical or psychiatric disorders that can mimic or coexist with Adult ADHD:
There are many medical and psychiatric disorders that can mimic the symptoms of Adult ADHD. These are a few conditions that may exhibit similar symptoms:
3. Sleep apnea
5. Bipolar Disorder, depression or substance abuse
6. Medications such as blood pressure medications and antibiotics
7. Multiple Sclerosis, seizures, HIV, head injuries
How do you distinguish these scenarios from Adult ADHD? After taking a detailed history, determine whether the symptoms began after early adolescence. If so, it is NOT ADHD. If the symptoms fluctuate, it is NOT ADHD.
It should be noted that in certain situations, such as menopause, depression, or chemotherapy, stimulants are commonly used and are effective for the treatment of poor focus and attention, distractibility, and low motivation.
Following these simple steps, you as a clinician can more effectively diagnosis and refer your patients who likely have Adult ADHD or present with similar symptoms. It is important that this provider has had specialized training in the diagnosis and treatment of Adult ADHD.