ADHD Diagnosis - How an Expert Makes a Diagnosis
Adults with ADHD require a thorough evaluation from a professional who is well-versed in the disorder. adhd undiagnosed in adults will likely ask you about your previous experiences and conduct physical examination. They'll also rule out any conditions that can mimic ADHD, such as mood disorders, learning disorders, or thyroid problems.
The doctor will also inquire about your childhood habits, since the current American Psychiatric Association guidelines state that adults with ADHD cannot be diagnosed without evidence of signs from childhood. This could include finding school records and getting in touch with former teachers, religious leaders, or coaches.
Signs and symptoms
You could have ADHD if you or someone you know has trouble keeping track of time at work, school or at home. If they can't remember important dates or appointments, or cannot keep their schedules in order, then you might be suffering from ADHD. A visit to a health care provider will help you determine if this is the case, and, if it is the case, what treatments are available.
The symptoms have to be present in at least two settings (school and at home, for example) and for at least six months to satisfy the criteria for an ADHD diagnosis. They should also significantly interfere in your ability to function in certain ways, like doing well in school, developing close relationships, or functioning on teams. It's important to understand that everyone has issues paying attention and staying organized sometimes, but these problems are more serious for those with ADHD.
In order to make a diagnosis, your provider will interview you and ask you questions about your behavior and how it has affected your life. The doctor will also look at your family history and any previous medical or psychological tests that you may have taken. They will check for health issues such as thyroid disorders and seizures, which could cause similar symptoms as ADHD.
Your doctor will ask you if you have ever had symptoms during your childhood (technically before age 12). Your doctor will also want to know 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.
It is helpful to bring a list of symptoms to your appointment, particularly if you've written them down. This will aid in remembering them and give your provider an accurate picture of the way your symptoms affect you. You can also bring records such as performance evaluations from work or old report cards from school. These documents can help your doctor determine whether ADHD is a recent issue or has been present for a long time. They can also help your doctor identify other conditions, such as depression or anxiety which can have similar symptoms to ADHD.
History
In the past, ADHD has been viewed as a flaw in the character of a person. But, with advancements in diagnosis and treatment increasing numbers of children are being diagnosed, and the stigma associated with 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 unfocused or who were unable to focus. He also observed that these signs were more common for boys than girls, and were not correlated with intelligence or the environment in which they lived. Still's report has been credited with being the first formal recognition of ADHD.
The first version of the APA's mental health guideline, released in 1952, did not mention ADHD. In 1955, however, the US FDA approved stimulant medications which were prescribed as the primary treatment for ADHD. The APA published its second edition in 1968. It listed a number of mental health conditions. The second edition of the APA's manual listed a number of mental health issues, including ADHD symptoms.
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 presenting symptoms, not distinct types and states that they may change over the course of a person's life.
NICE (National Institute for Clinical Excellence), published guidelines on ADHD in adults in 2008. This was the first time the UK as a whole recognised with healthcare support as well as guidance and funding for adults who suffer from ADHD. SIGN (Scottish Intercollegiate Guidelines Network) has also issued advice on ADHD in children. These two documents are the only official NHS Scotland recommendations on the condition. Other guidelines have been created by charities and private organizations. In recent years, there has been an increase in interest in the biological causes of ADHD and researchers have begun to find the genes responsible for it. This information could be helpful in the future to develop more targeted and effective treatments.
Physical Examination
A specialist in ADHD will conduct a thorough assessment to identify the problem. If they are a doctor who specializes in mental health (such as a psychiatrist or psychologist) or a doctor trained in child and youth health (a paediatrician) They will need to collect a range of details about the person's past, including the family, educational, work and social histories. They might look over the old school records, or speak with teachers, coaches and other professionals who know the person. They will inquire about symptoms and how they interfere with life. They will also consider how symptoms have changed with time.
The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition of the American Psychiatric Association defines the criteria to diagnose 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 the appropriate questionnaire to the specific circumstance. They also employ various ratings scales to assess various aspects of ADHD symptoms. Some of these ratings will be based on the Brown Attention Deficit Disorder Symptom Assessment Scale For Adults, while others will be based on different criteria, including questions like "Do you find it difficult sitting still?" and "Do you have difficulty to manage your work or activities?"
They will perform a physical exam. They will determine if there are any medical conditions that could be contributing to the symptoms or causing them to get worse, such as thyroid problem, hearing or vision issues. They will also ask the person about their dietary and lifestyle habits in order to determine if these may contribute to symptoms.
If a person is being assessed for ADHD at the age of adulthood, they will be asked to complete an assessment with a partner or a close friend. This will allow for a greater understanding of the person that checklists and questionnaires cannot provide. This is particularly beneficial for people who have comorbid conditions like depression or anxiety. These are often associated with ADHD and can make it difficult to discern 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 look over the patient's mental health and family history.
They may ask for an original copy of the student's report card or school records, especially those from kindergarten through high school. They can also request copies of any previous neuropsychological or psychological testing, such as results from IQ tests and assessments for learning disabilities.
Typically an audiologist, psychiatrist, psychologist or social worker is the person who conducts the interview part of an evaluation of the severity of adhd. In addition, they could interview family members, friends, teachers or employers as well. It is important to get an accurate assessment as people who suffer from ADHD who are not treated can have serious problems. This includes financial issues (impulsive purchases) or marital issues, or failure at colleges or other educational institutions.
During an interview, the provider might ask the patient to complete standardized behavior rating scales that are designed to identify ADHD symptoms. These questionnaires are based upon research that compares the behavior of individuals with ADHD to those of people who do not suffer from the disorder. These ratings are not the diagnosis of ADHD however they are an important element of the evaluation process.
It is important to also assess the individual to determine if there are 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. Those conditions are more likely to respond to specific treatments, so it is essential that a proper diagnosis is made and the appropriate treatment is provided.
A child or adult must meet the requirements of the Diagnostic and Statistical Manual of Mental Disorders to be diagnosed with ADHD. They must exhibit symptomatic behaviors in at least two settings that include school, home, and work. The symptoms must also significantly interfere with the functioning of their lives. Generally speaking, the symptoms should have started in the early years of childhood. A psychiatric provider must determine that the disorder isn't caused by another mental illness or comorbid condition.