ADHD Diagnosis - How an Expert Makes a Diagnosis
Adults suffering from ADHD require a thorough evaluation by a specialist who is knowledgeable about the disorder. They'll likely ask questions about your medical history and conduct a physical exam. They'll also rule out other conditions that could be a cause of ADHD like learning disorders, mood disorders, or thyroid problems.
The doctor will ask you about your childhood behavior as the American Psychiatric Association's guidelines stipulate that ADHD in adults is not diagnosed without evidence of early signs. This could mean obtaining your school records and getting in touch with former teachers or coaches as well as religious leaders.
Signs and symptoms
You may have ADHD If you or someone you know has trouble keeping track of time at school, work, or at 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 professional's assessment can help you determine if this is true and, if so what your treatment options are.
To be eligible for an ADHD diagnosis the symptoms must be present for at least six months and be apparent in at least two settings (school and at home, for instance). The symptoms should also be impacting your ability to perform for example in class, forming close relationships or in working in a group. It's important to understand that everyone has issues paying attention and staying organized at times however, these issues are more severe for those with ADHD.
Your doctor will ask you questions about your behavior, and how it has impacted your life. The providers will also review your family history, and any previous medical or psychological tests you've taken. They will look for health issues, such as thyroid disorders and seizures, which can cause similar symptoms to ADHD.
Your doctor will want to be aware of whether your symptoms began in your early years (technically at the age of 12). Your doctor will also be interested in knowing how your symptoms are affecting you right now and in the past. They'll want to know whether you've been diagnosed with ADHD in the past.
Bring your own list of symptoms, especially if they are written down. This will aid in remembering the symptoms and provide your doctor with a a complete picture of the way your symptoms affect you. You may also bring older records like old reports or performance evaluations. These documents can help your doctor determine whether ADHD is a recent problem or has been present for a long period of time. These records can help your doctor rule other problems out, such as anxiety and depression, which have similar symptoms as ADHD.
History
In the past, ADHD has been viewed as a flaw in the character of a person. With advances in diagnosis and treatment, more children are diagnosed and the stigma around the disorder is slowly fading.
In 1902 Sir George Frederick Still presented a series of lectures at the Royal College of Physicians. He outlined his observations of children who were unfocused and incapable of focusing. He also pointed out that these signs were more prevalent in boys than in girls and were not related to the home environment or intelligence. Still's report has been credited as the first formal recognition of ADHD.
The initial version of the psychiatric manual, published in 1952 by the American Psychological Association (APA) did not include ADHD. In 1955, however, the US FDA approved stimulant medications which were prescribed as the primary treatment for ADHD. In 1968, the APA published its second edition which included a list of mental health issues. The second edition of the APA's manual included a variety of mental health conditions, including ADHD symptoms.
In 1994, the fourth edition of the psychiatric book was released. 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 considers these as presentations, not distinct types, and states that they can change throughout the course of a person's lifetime.
NICE (National Institute for Clinical Excellence), published guidelines on ADHD in adults in 2008. It was the first time that the UK as a whole recognized adults with ADHD by providing them with healthcare, funding, assistance and guidance. SIGN (Scottish Intercollegiate Guidelines Network), has also released guidelines on ADHD among children. I Am Psychiatry are the only official NHS recommendations on the condition in Scotland. Private organizations and charities have also issued guidance. In recent years, there has been a growing interest in the biological cause of ADHD. Researchers have started to find the genes responsible. This information can help develop better and more specific treatments in the future.
Physical Examination
A specialist in ADHD conducts an extensive assessment to make a diagnosis. If they are a doctor who is specialized in mental health (such as psychologist or psychiatrist) or a doctor educated in the field of child and youth health (a paediatrician) They will need to collect a range of information about the person's history including the family, educational, work and social history. They might review old school records or talk to coaches, teachers, and other professionals that know the person. They will ask about the symptoms and how they affect life. They will also consider how 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. A specific questionnaire adapted to the specific situation will be administered by the doctor to ask the patient about their symptoms. They will also use various rating scales that look at different aspects of the 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 range of other criteria. They also include questions like "Do you find it difficult to sitting down?" Do you have trouble organizing your time or activities?
They will conduct a physical exam. They will determine if there are any medical conditions that may be creating the symptoms or causing them to get worse, like thyroid problem, hearing or vision issues. They will also ask the person about their diet and lifestyle habits in order to determine if these could be contributing to symptoms.
If a person is evaluated for ADHD at the age of adulthood, they will be asked to fill out the questionnaire with their partner or a trusted friend. This provides a deeper understanding of the person that checklists and questionnaires cannot provide. This can be particularly useful for people with comorbid conditions such as depression or anxiety that often co-occur with ADHD and make the symptoms harder to recognize.
Psychological Evaluation
If a health care professional who is evaluating a child or adult for ADHD begins by interviewing them, they ask them a series of questions on how their symptoms affect their daily lives. They also examine the family history of the patient and mental health.
They can request copies of the student's report cards or school records, especially those from kindergarten through high school. They might also request copies of any previous neuropsychological or psychological testing, including results from IQ tests and learning disabilities assessments.
Typically, a psychologist, psychiatrist or a social worker conducts the interview portion in an assessment of the diagnosis of adhd. They might also interview relatives, friends and teachers as well as employers. It is important to get an extensive assessment since people who suffer from ADHD who aren't treated may face serious issues. These include financial issues (impulsive purchases) or marital issues, or failure to attend colleges or other educational institutions.
During an interview, the doctor may ask the patient to complete standardized behavior rating scales that are designed to detect ADHD symptoms. These questionnaires are based on research that compares the behaviors of people with ADHD with those of those who do not suffer from the disorder. These scores do not constitute an official diagnosis of ADHD but are an important element of the evaluation process.
It is important to also assess the individual to determine if they have other conditions that may have similar symptoms as ADHD. These include mood disorders, sleep disorders, and addiction to drugs, and also medical ailments like thyroid disease or brain injuries. These conditions are more likely than others to respond to specific treatments. It is therefore crucial to determine the correct diagnosis and receive the right treatment.
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 exhibit symptomatic behaviors in at least two different settings like home, school, and work. The symptoms must significantly interfere with the functioning of their lives. Generally, the symptoms must be present since the early years of childhood. A psychiatric provider must determine that the disorder is not caused by a mental illness or comorbidity.