ADHD Diagnosis - How an Expert Makes a Diagnosis
Adults suffering from ADHD require a thorough assessment from a professional who is knowledgeable about the disorder. They will likely ask you about your history and conduct a physical examination. They'll also look for conditions that could be a cause of ADHD like mood disorders, learning disorders, or thyroid disorders.
The doctor will ask you about your childhood behaviors, since the American Psychiatric Association's guidelines stipulate that ADHD in adults cannot be diagnosed absent evidence of childhood symptoms. This could include obtaining your school records and contacting previous teachers or coaches as well as religious leaders.
Symptoms
You could have ADHD in the event that you or someone you love is having trouble keeping up at school, work, or at home. If they are unable to remember important dates or appointments, or aren't able to stay organized and on track, then they could be suffering from ADHD. A health care professional's assessment can help you determine if this is the case and, if it is what the treatment options are.
To qualify 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 at home, for example). The symptoms should also be hindering your ability to function for example in class, creating close relationships, or working in a team. It's important to realize that everyone struggles with keeping track of their time and staying organized sometimes however, these issues are more serious for those with ADHD.
Your doctor will ask you questions about your behavior and how it has affected your life. The doctor will also review your family history and any previous medical or psychological tests you've taken. They will be looking for health problems such as thyroid issues and seizure disorders, that can cause the similar symptoms as ADHD.
Your doctor will want be aware of whether your symptoms began in childhood (technically, before age 12). Your provider will also want to know how your symptoms affect you now and in the past. They'll also be looking to find out if you've ever been diagnosed with ADHD before.
Bring your own list of symptoms, especially if they are written down. This will help you recall your symptoms and provide your doctor a complete picture about how they affect you. You can also bring older records like old reports or performance evaluations. These documents can help your doctor determine if ADHD is a recent problem or has been present for a long period of time. These records can help your doctor determine if there are other issues including depression and anxiety, which have similar symptoms as ADHD.
History
In the past, ADHD has been viewed as a flaw in character. With advancements in diagnosis and treatment more children are being diagnosed and the stigma associated with this disorder is diminishing.
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 unable to pay attention or incapable of concentrating. He also observed that these symptoms were more common for boys than girls and were unrelated to intelligence or the environment in which they lived. Still's report has been considered to be the first formal recognition of ADHD.
The first edition of APA's psychotherapy guideline, published in 1952, did not include ADHD. In 1955, however, the US FDA approved stimulant medications that were the main treatment for ADHD. The APA released its second edition in 1968, and listed several mental health conditions. It also included symptoms of ADHD however they were still referred to as hyperkinetic reaction of childhood.
In 1994 the fourth edition of psychiatric book was published. This led to a 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 says that they may change over time.
In 2008, NICE (National Institute for Clinical Excellence) published guidance on ADHD in adults. It was the first time that the UK as an entire recognized adults suffering from ADHD and provided them with financial aid, healthcare assistance and guidance. SIGN (Scottish Intercollegiate Guidelines Network), has also released advice on ADHD in children. adhd undiagnosed in adults are the only official NHS Scotland recommendations regarding the condition. Other guidelines have been created by private companies and charities. In recent years there has been a rising interest in the biological causes of ADHD and researchers have begun to find the genes responsible for it. This information could help create better and more specific treatments in the near future.
Physical Examination
A specialist in ADHD will conduct a thorough evaluation to identify the problem. If they are a doctor 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 want to gather a variety of information about the person's history that includes family, educational, work and social histories. They will go through the school records from the past and interview coaches, teachers and other professionals who know the person. They will ask questions about symptoms and how they impact life. They will also look at how symptoms have changed with time.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, lays out the criteria for determining 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. A questionnaire tailored to the particular situation will be utilized by the specialist to interview the patient about their symptoms. They may also employ different rating scales to look at different aspects ADHD symptoms. Some of these ratings are based on the Brown Attention-Deficit Disorder Symptom Assessment Scale for adults, whereas others are based on a range of other criteria and include questions like "Do you have difficulty sitting still?" and "Do you have difficulty to organize your work or activities?"
They will perform an examination for physical health. They will check to see if there are any medical problems that could be causing or making the symptoms worse for example, thyroid dysfunction or vision or hearing issues. They will also ask about the person's diet and lifestyle habits to determine if they may be contributing to the symptoms.
If a person is evaluated for ADHD in adulthood, they will be asked to complete the questionnaire with their partner or a close friend. This will allow for a greater understanding of the individual that checklists and questionnaires cannot provide. This is especially beneficial for people who have co-occurring conditions such as anxiety or depression. These are often associated with ADHD which makes it difficult to identify the symptoms.
Psychological Evaluation
A health care professional who is evaluating a child for ADHD will ask them a series of questions about the symptoms and how they affect their daily lives. They also examine the history of the patient's family and mental health.
They typically ask people to bring in their report cards and school records to review, especially those from kindergarten to high school. They can also request copies of any previous psychological or neuropsychological testing, such as results from IQ tests and learning disabilities assessments.
A psychologist, psychiatrist or social worker typically is the person who conducts the interview portion of an adhd diagnostic evaluation. They may also conduct interviews with relatives, friends and teachers as well as employers. It is important to get an accurate assessment as people who suffer from ADHD who aren't treated can have serious problems. These include financial issues (impulsive purchases), marital difficulties, or failure to attend college or other educational institutions.
During the interview, the doctor will often ask the patient to fill out standardized behavior rating scales designed to help identify ADHD symptoms. These questionnaires are based on research that compares behaviors of those with ADHD and those who do not suffer from the disorder. These scores are not a diagnosis of ADHD however they play an important aspect of the process of evaluating.
It is important to also examine the person to determine if there are other conditions that could be similar to ADHD. These include mood disorders, sleep disorders, and addiction to drugs, and medical conditions like thyroid disease or brain injuries. These conditions are more likely to respond to specific treatments. It is therefore crucial to make a correct diagnosis and to get the appropriate treatment.
To be able to be diagnosed with ADHD, the child or adult must meet several requirements in the Diagnostic and Statistical Manual of Mental Disorders. They must exhibit symptomatic behaviors in at least two environments, such as school, home, or work. The symptoms should also substantially affect the way they live of their lives. Typically, 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 a mental illness or comorbidity.