ADHD Diagnosis - How an Expert Makes a Diagnosis
Adults suffering from ADHD require a thorough assessment by a specialist who is familiar with the disorder. They'll likely ask about your medical history and conduct a physical exam. They'll also rule out conditions that can mimic ADHD, such as mood disorders, learning disorders, or thyroid problems.
The doctor will inquire about your childhood behaviors, as the American Psychiatric Association's guidelines state that ADHD in adults is not diagnosed absent evidence of early signs. This could include finding school records and getting in touch with former teachers, religious leaders or coaches.
Symptoms
You could have ADHD If you or someone you love is struggling to keep up at school, work, or home. If they are unable to remember important dates or appointments or cannot keep their schedules in order, then you might be suffering from ADHD. A health care provider's evaluation can help you determine if this is the case, and, if it is what your treatment options are.
To qualify for an ADHD diagnosis the symptoms must be present for at least 6 months and be apparent in at least two settings (school and home, for instance). The symptoms must also be impacting your ability to perform, for example, in class, in forming close relationships or in working as part of a team. It is important to recognize that everyone has trouble staying organized and paying attention at times, but these problems are more severe in the case of ADHD.
To make an assessment, your doctor will interview you and ask 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 be looking for health issues, such as thyroid problems and seizure disorders, which can cause the similar symptoms as ADHD.
Your doctor will ask you if you have ever had symptoms in your childhood (technically prior to the age of 12). Your provider will also be interested in knowing what your symptoms are doing to you now and in the past. They'll want to know if you've been diagnosed with ADHD in the past.
Bring your own list of symptoms, especially if they're written down. This will help you remember them and give your physician a an accurate picture of how your symptoms affect you. You can also bring older records like old reports or performance evaluations. These documents can help your doctor determine whether ADHD is a new issue or has been present for a long time. They can also assist your doctor to determine if you have other issues, such as depression or anxiety that often exhibit the same symptoms as ADHD.
History
In the past, ADHD was thought to be a flaw in character or a sign of laziness. However, with the advancement of diagnosis and treatments more children are being diagnosed, and the stigma surrounding this disorder is slowly disappearing.
In 1902, Sir George Frederick Still presented a series of lectures at the Royal College of Physicians. He shared his observations of children who were unable to pay attention or incapable of concentrating. He also observed that these signs were more prevalent in boys than in girls, and were not correlated with intelligence or home environment. Still's report has been credited as the first step towards formal recognition of ADHD.
The first version of the APA's mental health guideline, released in 1952, didn't include ADHD. In 1955, however, the US FDA approved stimulant drugs which were prescribed as the primary treatment for ADHD. The APA published its second edition in 1968, which included a variety of mental health issues. The second edition of the manual included a variety of mental health conditions, such as ADHD symptoms.
With the release of the fourth edition of the manual for psychiatric patients in 1994, there was a greater 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 manifestations rather than distinct types and states that they are able to change throughout a person's lifetime.
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 adults with ADHD, providing them with healthcare, funding, support and guidance. SIGN (Scottish Intercollegiate Guidelines Network) has also released guidelines on ADHD in children. These two documents are the sole official NHS recommendations regarding the condition in Scotland. Private and non-profit organizations have also produced guidance. In recent years there has been a rise in interest in the biological cause of ADHD. Researchers have begun to find the genes responsible. This information could help develop better and more specific treatments in the near future.
Physical Exam
A specialist in ADHD conducts a thorough assessment to establish a diagnosis. If they are a doctor who is specialized in mental health (such as a psychologist or psychiatrist) or a doctor trained in child and young health (a paediatrician) They will need to gather a variety of details about the person's past that includes education, family, and social histories. They will look over old school records and may interview coaches, teachers, and other professionals who know the person. They will inquire about the symptoms and how they affect life. They will also examine how the symptoms have changed with time.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, outlines 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 specialist will usually interview the person regarding their symptoms with a questionnaire that is tailored to the particular situation. They may also employ different rating scales to evaluate various aspects of ADHD symptoms. Some of these ratings are basing on the Brown Attention Deficit Disorder Symptom Assessment Scale for adults, whereas others are based on a variety of other criteria. They include questions such as "Do you have difficulty sitting down?" Do you struggle with organizing your activities or work?
They will conduct a physical exam. They will check for any medical conditions that may be contributing to the symptoms or making them worse, such as thyroid problem, hearing or vision problems. They will also inquire with the patient about their diet and lifestyle habits in order to determine if they could contribute to symptoms.
Someone who is being evaluated for ADHD as an adult may be asked to complete the questionnaire together with their partner or a close friend. This can help uncover personal insights that checklists and questionnaires are not able to provide. This is especially useful for those with comorbid conditions like anxiety or depression. They often co-occur with ADHD and can make it difficult to recognize the symptoms.
Psychological Evaluation
A health care professional who is evaluating a child's ADHD will ask them a series questions about the symptoms and how they affect their daily lives. They also take a look at the family history of the patient and mental health.
They typically request that the person bring in their report cards and school records for review, especially those from kindergarten through high school. They may also ask for copies of any previous neuropsychological or psychological testing, such as results from IQ tests and learning disabilities assessments.
A psychologist, psychiatrist or social worker usually is the person who conducts the interview part of an adhd diagnostic assessment. diagnosed with adhd may also interview family members, friends as well as teachers or employers. It is important to have thorough evaluations because those who suffer from 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 an interview, the provider may ask the patient to fill out standardized behavior ratings scales that are designed to identify ADHD symptoms. These questionnaires are based on research that compares the behaviors of individuals with ADHD to those of individuals without the disorder. These scores are not a diagnosis of ADHD however they play an important element in the process of evaluating.
It is crucial to examine the person to determine if they have other conditions that might be similar to ADHD. These include sleep disorders, mood disorders and substance abuse as well as medical illnesses such as thyroid diseases or brain injuries. These conditions are more likely to respond to specific treatments, therefore it is important to make sure that a valid diagnosis is made and the right treatment is offered.
A person who is a child or an adult must meet the requirements of the Diagnostic and Statistical Manual of Mental Disorders to be diagnosed with ADHD. They must exhibit symptomatic behavior in two or more environments like school, home or at work, and their symptoms must seriously affect their daily functioning. Generally speaking, the symptoms should begin in childhood, and a psychiatric provider must determine that the disorder isn't caused by another mental illness or comorbid condition.