ADHD Diagnosis - How an Expert Makes a Diagnosis
Adults with ADHD require a thorough assessment by a doctor who is familiar with the disorder. They'll likely inquire about your medical history and conduct an examination of your body. They'll also rule out conditions which could be a cause of ADHD such as mood disorders, learning disorders or thyroid issues.
The doctor will ask you about your childhood behavior because the American Psychiatric Assocation's guidelines stipulate that ADHD in adults is not diagnosed without evidence of early signs. This could mean obtaining your school records and contact with your former teachers and coaches or religious leaders.
Symptoms
If you or a loved one is struggling to keep up with school, work or at home, and has difficulties remembering important dates and appointments, or is struggling to stay organized, you may have ADHD. A health professional's assessment will help you determine if this is the case, and, if so, what treatment options there are.
The symptoms must be evident in at least two different environments (school and at home, for example) and for at least six months to meet the criteria for an ADHD diagnoses. They must also be a major obstacle in your ability to function in some ways, like doing well in class, developing close relationships, or functioning on teams. It is important to recognize that everyone struggles with staying focused and well-organized at times However, these issues are more serious with ADHD.
In order to make a diagnosis, your physician will conduct an interview and ask you questions about your behavior and how it has affected your life. The providers will also examine your family history, and any previous medical or psychological tests that you may have taken. They will be looking for health issues like thyroid issues and seizure disorders that can cause the same symptoms as ADHD.
Your provider will ask whether you've ever experienced symptoms in your childhood (technically before the age of 12). They'll also want to know how your symptoms affect you now and how they have affected you in the past. They'll also be interested in knowing if you've ever been diagnosed with ADHD before.
Bring your own list of symptoms, especially when they are 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 documents like the performance evaluations you receive from work or old report cards from school. These records can help your doctor determine whether ADHD has been a problem for you throughout your entire life or was diagnosed recently. They can also help your provider identify other conditions such as depression or anxiety that often exhibit similar symptoms to ADHD.
History
In the past, ADHD has been viewed as a flaw in character. With More in diagnosis and treatment more children are being diagnosed and the stigma associated with this disorder is fading.
Sir George Frederick Still gave a series of lectures in 1902 at the Royal College of Physicians. He described his observations of children who were inattentive and incapable of focusing. He also noted that these signs were more prevalent in boys than in girls, and were not correlated with the home environment or intelligence. Still's report has been credited as the beginning of official recognition of ADHD.
The initial version of the psychiatric manual, published in 1952 by the American Psychological Association (APA) did not contain ADHD. In 1955, however, the US FDA approved stimulant drugs that were prescribed as the primary treatment for ADHD. The APA published its second edition in 1968, and listed several mental health conditions. It included the symptoms of ADHD even though they were still classified as hyperkinetic reaction of childhood.
After the publication of the fourth edition of the manual for psychiatric patients in 1994, there was an increase in 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 recognizes these as manifestations rather than distinct types and states that they are able to change over the course of a person's life.
NICE (National Institute for Clinical Excellence) released guidelines on ADHD in adults in 2008. This was the first time that 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 guidelines on the condition in Scotland. Other guidance has been produced by private companies and charities. In recent years, there has been a growing interest in the biological causes of ADHD and researchers have begun to discover the genes that cause it. This knowledge may help to develop better and more specific treatments in the future.
Physical Exam
An expert in ADHD conducts a thorough evaluation to establish a diagnosis. They collect data from the past of the patient including their family, education and employment history, as well as their social history. They might look over old school records or interview 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 symptoms have changed over time.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, lays out the criteria used to diagnose ADHD in 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 specific questionnaire adapted to the specific situation will be administered by the specialist to interview the patient about their symptoms. They also employ various rating scales to evaluate various aspects of ADHD symptoms. Some of these ratings are based 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 have difficulty sitting still?" Do you have trouble organizing your activities or work?
They will conduct a physical examination. They will check for any medical conditions that could be causing the symptoms or causing them to get worse, such as thyroid disorder, hearing or vision problems. They will also ask about the individual's diet and lifestyle habits to determine if they may be contributing to the symptoms.
If a person is being assessed for ADHD in adulthood, they will be asked to complete the questionnaire with their partner or a trusted friend. This will allow for a greater understanding of the person that checklists and questionnaires cannot provide. This is particularly beneficial for those suffering from comorbid disorders such as depression or anxiety which are often associated with ADHD and make the symptoms more difficult to identify.
Psychological Evaluation
If a health care professional who is evaluating a child or adult for ADHD begins by interviewing them, they ask a series of questions on how the symptoms impact their lives. They also look into the history of the patient's family and their mental health.
They could request 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 tests, including the results of IQ tests and assessments for learning disabilities.
Typically, a psychologist, psychiatrist or social worker will conduct the interview part of an assessment of the diagnosis of adhd. They may also interview family members, friends, teachers, or employers. It is important to have a comprehensive evaluation because people who are not treated for ADHD may have serious issues that include financial problems (impulsive spending), marital difficulties or failing in college or other educational institutions.
During the interview, a doctor will often ask the patient to fill out standardized behavior rating scales that are designed to help identify ADHD symptoms. These tests are based on research that compares the behavior of people with ADHD to those of individuals who do not suffer from the disorder. These ratings do not constitute an official diagnosis of ADHD, but they are an important element in the evaluation process.
It is also essential to check the person for any other medical conditions that may be similar to ADHD like sleep disorders, mood disorders, substance use disorders and medical conditions, like thyroid disease or head injuries. These conditions are more likely to respond to specific treatments, therefore it is crucial that a correct diagnosis is made and that the appropriate treatment is provided.
A person who is a child or an adult must meet certain criteria in the Diagnostic and Statistical Manual of Mental Disorders to be diagnosed with ADHD. They must show symptoms in two or more environments such as school, home, or at work, and their symptoms must seriously affect their daily functioning. The symptoms must have appeared in childhood and a psychiatric professional must confirm that the disorder was not caused by a mental illness or comorbid conditions.