Attention-deficit/hyperactivity disorder (ADHD) can be, due to its complex nature, difficult to diagnose. The challenge in reaching an accurate diagnosis is that the individual symptoms on their own may not appear to be disruptive or outside the realm of typical behavior. At any given time, an individual can feel distracted, unfocused, or have scattered thought patterns. Because each of these isolated symptoms is not necessarily debilitating on their own, an accurate diagnosis may be delayed, or even remain undiagnosed over the course of a patient’s lifespan.
Additionally, many ADHD symptoms can be misdiagnosed and can be similar to the presenting symptoms of other diagnoses, such as learning disabilities and emotional issues — both of which require very different treatments. This can lead to ineffective treatments, however, with the proper initial assessment and an accurate diagnosis, ADHD is manageable and treatable.
How to Accurately Test and Diagnose ADHD
ADHD cannot be diagnosed by drawing blood, an MRI, or other common physical tests. Therefore, healthcare professionals must rely on other resources to ensure a proper diagnosis, most notably the guidelines found in the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual (an abbreviated version is available at the CDC’s website). Per the APA guidelines, ADHD can be accurately diagnosed when a patient shows a persistent pattern of 6 or more of the known symptoms of inattention and hyperactivity.
However, in adults only 5 symptoms are needed to make an ADHD diagnosis. It is not always possible to accurately diagnose ADHD through a simple, short observation of behavioral patterns and may require a longer assessment that utilizes insightful questions about past and present behaviors, and an exam to rule out other potential causes for inattention and hyperactivity. In addition to the initial assessment, other criteria must also be met before an accurate diagnosis can be made; the symptoms must be present in more than one setting and not isolated to the time and location of the assessment. If the symptoms of inattention and hyperactivity only present in one very specific situation, then it is likely that a different treatment may be prescribed.
A Closer Look at the Symptoms
A patient may be diagnosed with ADHD if they show 6 or more of the following symptoms in more than one setting:
- Fails to notice details or makes careless mistakes in work or school on a regular basis
- Has difficulty holding attention on assigned tasks or chosen play activities
- Seems reluctant to take on tasks that require extended mental effort
- Can’t keep track of details that are necessary for important tasks
- Is easily distracted
- Seems to be very forgetful
- Doesn’t appear to listen when someone is speaking directly to them
- Constantly fidgets, squirms, or taps hands and feet
- Talks excessively
- Raises voice and is loud when involved with recreational activities
- Acts as if they are constantly “driven” to do the next thing
- Has difficulty remaining seated for extended periods
- Interrupts others on a regular basis
While this list provides numerous symptoms of hyperactivity, impulsivity, and inattention, it is not exhaustive and additional symptoms may present in the diagnosis of ADHD.
Understanding the Potential Treatments
ADHD diagnoses are on the rise, and there are several options for treatment, including medication and psychotherapy. The former options include,
Stimulants – The right medication can be effective in controlling hyperactivity. Stimulants contribute to improved concentration; however, it is crucial to work closely with a healthcare professional to find the medication that is best for you. The most commonly prescribed stimulants include amphetamines (such as Adderall) and methylphenidate (such as Ritalin and Concerta).
Non-stimulants – Atomoxetine and clonidine are frequently used to treat ADHD. In many cases, these medications have proven to be an effective, non-stimulant alternative for those struggling with ADHD.
However, medication is not always the most effective or necessary choice for the treatment of ADHD. Psychotherapy can also assist in the management of hyperactive and inattentive behavior. In milder cases, a therapist can help a patient recognize the hyperactive and inattentive behavioral attributes that may be bordering on, or resembling, symptoms of ADHD. Once the patient takes note of the behaviors in question, the therapist can guide and teach coping skills that will assist in the management of the areas of concern, primarily concentration, focus, and hyperactivity.
While both medication or therapy alone are beneficial to the patient, therapy combined with medication will generally lead to the most effective, lasting results. A combined treatment approach allows the patient to develop the focus and concentration they desire, as well as the lifelong skills necessary to cope with ongoing symptoms.
ADHD symptoms can greatly impact an individual’s life, therefore a proper diagnosis is the first critical step in a patient’s recovery. A combined treatment course that includes elements of behavioral medicine, general psychotherapy, and medication management, will then allow the patient the space for lasting, effective personal growth.