How is an ADHD diagnosis made?

July 12, 2007 5:18 AM

I believe I might have adult ADHD. How is this diagnosed? How do I approach my doctor about this?

How is a diagnosis made? Is it a questionnaire or something more formal such as a PET scan? How do I bring this up with my doctor? Saying, "I believe I have ADHD" seems rather silly and self-diagnostic. Will I be referred to a specialist or is more simple than that?

I've read quite a bit about it, including questions here, but I never saw anything about how it is actually diagnosed - at least in adults. Please note: I realize that this is a somewhat controversial topic and I would appreciate that commentary on ADHD or solutions other than going to a doctor be refrained from.

posted by anonymous to health & fitness (19 comments total)

mostly, it's diagnosed through an analysis of your behavior. usually, this is done by someone other then you, often in a school setting. for adults, i'm not so sure.

bringing it up to your doctor will result in being referred to a specialist--that is, a psychiatrist. he'll most likely talk to you for a bit, and then try a prescription to see how it works. one of the best ways to tell if someone has adhd is to see if the medicine actually works-- for people who aren't adhd, taking speed will make them act like they have it. for those who have adhd, the effect is the opposite.
posted by lester's sock puppet at 5:34 AM on July 12, 2007

With any assumed condition it is best not to play doctor and try to figure out what it is. Try to record all of your symptoms and go to the doctor with those. Visiting the doctor and telling him that you have ADHD might throw the doctor on the wrong trail.
posted by JJ86 at 5:49 AM on July 12, 2007

You should probably also record your diet as accurately as possible. Many problems can be associated with a specific diet.
posted by JJ86 at 5:50 AM on July 12, 2007

I went to the doctor, discussed it with him. He said that since the medication was pretty mild, we could try it out and see what happened. Thus, I walked out with a prescription.

True, the medication is mild, but it does make quite a difference!
posted by tomble at 5:56 AM on July 12, 2007

I would ask to be referred to a psychiatrist for a diagnosis. There's a lot of things that can look like adult ADD, including depression. Your doctor can only give you pills, a specialist can actually treat you.
posted by SpecialK at 6:03 AM on July 12, 2007

I've been through a screening with a psychologist. I spent a half day doing, well, psychological tests -- things like memory games, etc. There were no brain scans or anything like that.
posted by sugarfish at 6:04 AM on July 12, 2007

There is no getting around the self diagnostic element. If you suspect you have ADD, unless you have an excellent relationship with your family doctor, there is no real reason to discuss it with a general practitioner. Get a recommendation from your local CHADD, and go straight to a psychiatrist, or perhaps a neurologist. Any specialist who routinely sees ADDers will perform an evaluation. You go in and tell him your symptoms. Some will want to see old report cards and hear testimony from family members, others won't. There are a number of conditions that have similar symptoms to ADD. Two of the most common are thyroid and sleep apnea. You and your doctor work to narrow down the list of conditions that could be causing your symptoms. The amount of time this takes depends on your doctor's skill and integrity. Once you are both satisfied with a diagnosis of ADD you start talking about treatments. Since there is no conclusive test, approaches vary.
posted by BigSky at 6:10 AM on July 12, 2007

I *just* was diagnosed last week. I've had some depression problems in the past that probably obscured the ADD. Overlap in symptoms, see.

What happened with me is that during a routine visit to the psychiatrist last week for medicine management, I presented him with a detailed record of the last three months of problems I was having. (Which came from my blog.) I hadn't ever done that before.

Something I said must have piqued his interest, because he began asking me a ton of seemingly unrelated questions. After my answers to his questions, he decided I had ADD. We discussed treatments (I have some complications taking many of the typical meds because of a co-existing seizure disorder), and came up with a plan.

I left relieved that maybe I wasn't a terrible, lazy, easily distracted person by nature, after all.

That's MY story of being diagnosed.
posted by Stewriffic at 6:17 AM on July 12, 2007

I happen to read an article in a magazine. One psychiatrist visit later I was diagnosed and given medication. No brain scan.
posted by Baud at 8:34 AM on July 12, 2007

Nthing the suggestion to go to a mental health specialist.

I was diagnosed by my shrink after I took the Wender Utah Rating Scale. The questions are standard (things like: were you hyperactive? bossy? irritable? as a child? how about now?) and ask you to rate your behavior as a child, and then as an adult.

The shrink told me that results on this test are not necessarily definitive, but they were helpful.

I got meds, which help, though now I've come to realize that part of the reason why I procrastinate at work is because I hate my job. No pill for that, sadly
posted by veronica sawyer at 8:43 AM on July 12, 2007

I was diagnosed in conjunction with a study. Don't know if I got the placebo or the real drugs, but they definitely agreed that I had it!

One complicating factor is that a lot of the symptoms are very similar to anxiety in some people (and aggravated by it, I'm sure). Wellbutrin is sometimes used to treat both.

You will definitely have to go to a psychiatrist or another trained professional. Think about how long you've had the symptoms, specific ways they affect you, times when it's the worst, times when you've figured out how to cope, etc.

They may give you a battery of task-based tests, whether computerized or on paper. They may also ask you to do a symptom inventory ("Do you feel like you are driven by a motor?"). In my case, they did ask to talk to other family members to hear about my history.

Some treatments are much stronger than others. Ritalin made me feel like I was riding a trike through Jello; Wellbutrin gave me wacky dreams; Strattera (which I believe was the medication in the study) takes a while to start working. If you and your psychiatrist decide that medication is the way you want to go, be patient and honest about your expectations and what you're willing to put up with. It may take a while to find one that's right for you. (I haven't been on anything since that icky day on Ritalin in 2003.)

I found myself doing a lot of second-guessing at work because I was in a tough situation and didn't want to use my then-new diagnosis as some sort of crutch or excuse. You're still YOU; you just have a new name for how a part of you works (which hasn't changed!). If you feel like you can discuss it with your boss, do it when you feel comfortable. I personally felt more comfortable just saying, "I'm much better at focusing when I'm busy, so let's make sure that my workload is structured accordingly." That's no different from saying, "I suck at math, so I'm not an accountant," right?

Look at it as aspects of your singular personality, not "I have this one condition; thus I/you can assume X or Y about my behavior or prospects." Don't fall into that trap, and don't let others.

Good luck!
posted by Madamina at 8:52 AM on July 12, 2007 [1 favorite]

Check out this study on adult ADHD, it describes exactly how it is diagnosed.

send me an email if you can't access the full version, email's in the profile.
posted by jourman2 at 9:23 AM on July 12, 2007

Have you looked at the diagnostic criteria?

You should let a mental health professional assess whether you meet those criteria rather than trying to determine it yourself, but this can give you an idea of what, precisely, she or he will be assessing.
posted by dersins at 9:24 AM on July 12, 2007

Diagnosis for ADD is not so clearcut, especially if there are 'co-morbid' (love that word) conditions, such as depression, anxiety. Not knowing anything about your background- have you considered PTSD? Sometimes what looks like ADD is actually complex PTSD.

I read recently about how a lot of kids who are being medicated for what is thought of as ADD have actually experienced violence and abuse at home and are displaying symptoms of traumatization. Pretty sad.

nthing JJ86's comments on diet as well. Get tested for hypoglycemia.

Either way, good luck.
posted by solongxenon at 9:49 AM on July 12, 2007

Saying, "I believe I have ADHD" seems rather silly and self-diagnostic.

It does but that's all they've got to go on beyond observing your behaviour and the self reporting of symptoms. When I filled out a questionnaire I doubted the validity of the test, seemed so subjective. I was seen by a psychiatrist who specializes in adults with the disorder and, he made the diagnosis. To be honest, I still wasn't entirely convinced until I was prescribed Ritalin.

there is no real reason to discuss it with a general practitioner.

Depending on where they live they may have to discuss it with their GP in order to get a referral.
posted by squeak at 10:18 AM on July 12, 2007

for people who aren't adhd, taking speed will make them act like they have it. for those who have adhd, the effect is the opposite.

This is correct. [Non-ADHD here, living with my ADHD fiance]
posted by desjardins at 11:03 AM on July 12, 2007

My diagnosis consisted of a 15 - 20 conversation with a psychiatrist. I think he was in the "try the meds and see what happens" school. I don't know if that is a valid way to go about it but I do know that my medication, Dexedrine, has a far different effect on me that it does on others. The most obvious difference is that when I take it I'm quieter and more laid back and when my g'friend took it (just once) she was bouncing off the walls and jabbering like a monkey.
posted by Carbolic at 12:37 PM on July 12, 2007

From the book Driven to Distraction:

"One man who turned out to have adult ADD presented with this unusual triad of symptoms: cocaine abuse, frequent reading of pornography, and an addiction to crossword puzzles. Can you understand him, even if you do not have those symptoms?"

I was diagnosed mid-college; I went to a recommended psychiatrist who looked at my grades and written course evaluations from my college and private elementary/middle school. When I met with him, he showed me patterns that had been documented by my teachers/profs that lead him to believe I had ADD.

The meds work great, but just like wearing glasses doesn't teach you to read, taking ADD meds won't give you good work habits. However the meds offer a much better starting point to improve habits.
posted by colgate at 1:56 PM on July 12, 2007

The greatest thing that ever happened to me was being diagnosed, as an adult, with ADHD, and getting treatment. I had previously been misdiagnosed with everything from clinical depression to food allergies.

The positive difference that treatment for ADHD has made in my life is impossible to put into words. If you think there is the slightest chance you could be struggling with this, don't hesitate to pursue it further.

I agree with those who say to see a psychiatrist. G.P.s don't always know enough about the disorder or the treatment options.

I also agree that self-diagnosis is nothing to discount -- you truly are the leading expert on the workings of your own brain. You've obviously taken the time to educate yourself about ADHD, and believe you may have it -- that's a strong recommendation to take this to the next step.

I take the meds (Adderall XR) and I also had an ADD coach help me put various coping strategies into place. The behavioral changes are just as important as the meds. However, personally, I don't think I could have tackled the behavioral changes successfully *without* the meds, but your mileage may vary.

Finally, good luck! You will hear people spout all sorts of ill-informed (and unsolicited) opinions about ADHD. Just let it go. This validity of this disorder is not "controversial" to those who have it, and have been helped by the treatment.
posted by purplegenie at 4:27 PM on July 12, 2007