Introduction
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: 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 3: 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:
1. Chemotherapy
2. Menopause
3. Sleep apnea
4. Insomnia
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.
FAQ’s
Three common symptoms of ADHD include:
- problems with focus
- distractibility
- challenges with organization
Who can diagnose and treat ADHD?
There are many specialists who can diagnose and treat ADHD including the following:
- Psychiatrist
- Neurologist
- Psychologist
- Neuropsychologist
There are many benefits of seeing a psychiatrist to diagnose and treat ADHD. Only a psychiatrist can provide both medications and strategy-focused therapy. In addition, a psychiatrist can address other common challenges that often occur with ADHD including sleep problems, anxiety, shame, or depression.
Is ADHD genetic?
There are many factors that can lead to ADHD. ADHD is believed to be one of the MOST genetic disorders in psychiatry and has a tendency to run in families. The latest research suggests the heritability is 76%.
Is Adderall or Ritalin better for Adult ADHD?
This is a very interesting question. Both medications are highly effective in ADHD. However, there are a portion of patients who respond better to Adderall and another portion of patients who respond better to Ritalin. However, the majority of people who respond to medications will benefit from either Adderall or Ritalin.
What are common treatments for ADHD in adults?
There are many treatments for ADHD in adults including medications, therapy, and other forms of treatment. According to the research, the most effective treatments for ADHD are medications. These include the stimulants such as Ritalin, Adderall, Focalin, Concerta, and Vyvanse. There are also non-stimulant medication treatments such as Strattera. In my opinion, the stimulants often work more effectively and with less side effects than Strattera. In addition, there are effective non-medication treatments for ADHD including specialized and strategy-focused cognitive behavioral therapy (CBT) by a psychiatrist or therapist who is experienced in treating ADHD.
Conclusion
Following these simple steps, you as a clinician can more effectively diagnose 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.
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