ADHD Diagnosis - How an Expert Makes a Diagnosis
Adults suffering from ADHD need a thorough evaluation by a doctor who is knowledgeable about the disorder. They will likely ask you about your past and perform a physical examination. They'll also look for conditions that could be a cause of ADHD like mood disorders, learning disorders, or thyroid issues.
The doctor will inquire about your childhood behavior as the American Psychiatric Association's guidelines stipulate that ADHD in adults is not diagnosed without evidence of childhood symptoms. This means getting school records and contacting former teachers, religious leaders or coaches.
Symptoms
If you or a loved one is having trouble keeping up at work, school or at home, is having trouble remembering important dates or appointments, or is struggling to get organized or stay on top of things, you could be suffering from ADHD. A health professional's assessment will help you determine if this is the case, and if so, what treatment options there are.
To qualify for an ADHD diagnosis The symptoms must be present for a minimum of 6 months and be noticeable in at least two settings (school and home, for instance). The symptoms should also be hindering your ability to function, for example, in class, in developing close relationships or working as part of a team. It's important to understand that everyone struggles with keeping track of their time and staying organized sometimes however, these issues are more serious for those with ADHD.
Your provider will ask you questions about your behavior and how it has impacted your life. Providers will also review your family history as well as any previous psychological or medical tests you may have been through. They will check for health problems, like thyroid disorders and seizures, which could cause similar symptoms as ADHD.
Your doctor will want determine if your symptoms began in your early years (technically, before age 12). They'll also be interested in how your symptoms impact you today and how they've affected you in the past. They'll also be interested in knowing whether you've been diagnosed with ADHD before.
It's a good idea to bring a list of symptoms to the appointment, particularly when you've written them down. This will help you to keep track of your symptoms and give your doctor a complete picture about how they affect you. You can also bring documents, such as performance evaluations from work or old report cards from school. Having these records can help your doctor determine if ADHD has been a problem for you throughout your entire life or started just recently. These records can help your provider 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 personality flaw or a sign of laziness. However, with advances in diagnosis and treatments increasing numbers of children are being diagnosed, and the stigma surrounding this disorder is slowly disappearing.
In 1902 Sir George Frederick Still presented a series of lectures to the Royal College of Physicians. He outlined his observations regarding children who were unfocused or who were unable to focus. He also observed that the symptoms were more common for boys than girls and were not related to intelligence or home environments. Still's report has been credited as the first the formal recognition of ADHD.
The first edition of APA's mental health guideline, released in 1952, didn't include ADHD. In 1955, however, the US FDA approved a stimulant drug that became the preferred treatment for ADHD. The APA released its second edition in 1968, which listed several mental health conditions. It included the symptoms of ADHD however they were still referred to as hyperkinetic reaction of childhood.
In 1994, the fourth edition of the psychiatric book was published. This led to greater understanding 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 defines these as manifestations rather than distinct types and states that they are able to change over time.
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 officially recognized adults with ADHD and provided them with healthcare, funding, support and guidance. SIGN (Scottish Intercollegiate Guidelines Network) has also issued guidance on ADHD in children. These two documents are the sole official NHS Scotland recommendations regarding the condition. Other guidance has been developed by private organisations and charities. In recent times, there has been a rising interest in the biological causes of ADHD, and researchers have begun to discover the genes responsible for it. This information can help create better and more specific treatments in the future.
Physical Examination
An expert in ADHD conducts a thorough evaluation to determine if they have the diagnosis. It doesn't matter if they are a physician who is specialized in mental health (such as psychologist or psychiatrist) or an individual doctor who is trained in child and youth health (a paediatrician) They will need to gather details about the patient's life including education, family, and social history. They might review old school records or talk to teachers, coaches, and other professionals that know the person. They will inquire about symptoms and how they interfere with life. They will also examine how the symptoms have changed over time.
The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition of the American Psychiatric Association defines the guidelines 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 particular situation. They will also use a variety of rating scales which examine various aspects of the ADHD symptoms. Some of these ratings are built on the Brown Attention-Deficit Disorder Symptom Assessment Scale for Adults, while others are based on a number of other criteria. They include questions like "Do you find it difficult to sitting still?" and "Do you find it hard to manage your time or tasks?"
They will conduct a physical examination. They will determine if there are any medical conditions that may be contributing to the symptoms or causing them to become worse, like thyroid problem, hearing or vision issues. They will also inquire about the person's diet and lifestyle habits to determine if they could be contributing to the symptoms.
Anyone who is being evaluated for ADHD as an adult will likely be asked to fill out an assessment with their partner or another close friend. This helps to uncover personal insights that checklists and questionnaires are not able to provide. This is particularly beneficial for people with comorbid conditions like anxiety or depression, which often co-occur with ADHD and make the symptoms harder to recognize.
Psychological Evaluation
When a health professional who is evaluating a child adult for ADHD begins by interviewing them, they ask a series of questions regarding how their symptoms affect their daily lives. They also look into the family history of the patient and their mental health.
They usually request that the person bring in their report cards and school records to review, especially those from kindergarten through high school. They may also request copies of previous tests for neuropsychology or psychological, including IQ tests and results from assessments for learning disabilities.
A psychologist, psychiatrist or social worker typically conducts the interview part of an adhd diagnostic evaluation. Additionally, they may interview relatives, friends, teachers or employers as well. It is important to get a comprehensive assessment because people who suffer from ADHD who are not treated can have serious problems. This includes financial problems (impulsive purchases) and marital problems or failure in college or other educational institutions.
During adult diagnosis of adhd , the provider will usually ask the patient to complete standardized behavior rating scales that are designed to identify ADHD symptoms. These tests are based on research that compares the behavior of those suffering from ADHD with those of those who do not suffer from the disorder. These ratings do not constitute the diagnosis of ADHD however they are an important element of the assessment process.
It is important to also evaluate the individual to determine if they have other conditions that could exhibit similar symptoms to ADHD. These include sleep disorders, mood disorders, and addiction to drugs, and medical conditions such as thyroid disease or brain injuries. These conditions are more likely to respond to certain treatments, so it is essential to make sure that a valid diagnosis is made and that the correct treatment is given.
A person of any age must meet certain criteria in the Diagnostic and Statistical Manual of Mental Disorders to be diagnosed with ADHD. They must exhibit symptomatic behavior in more than one setting, like home, school and work, and the symptoms must be affecting their everyday functioning. The symptoms must have appeared in childhood and a psychiatric professional must confirm that the disorder wasn't caused by an illness of the mind or other comorbid conditions.