Understanding ADHD Diagnosis: Everything You Need to Know

Is it ADHD? How to Seek a Diagnosis

Many children and adults struggle with unexplained challenges that make daily life itself a constant challenge. But what if that’s ADHD? If you suspect this complex neurodevelopmental disorder, it’s time to seek a diagnosis. But how does it work? How do you get started?

In this article, we’ll outline your roadmap to diagnosis, including:

• The multifaceted process of diagnosing ADHD
  
• Overcoming barriers to diagnosis of ADHD and seeking support
  
• Insights into ADHD criteria and diagnostic tools
  
• Personal stories that reflect the lived experiences of ADHD

Ready to explore the many nuances of an ADHD diagnosis? Let's get into it.

Why Diagnosis is Important

If hearing the stories and experiences of people with ADHD keeps making you say ‘That’s me!’ 🙋‍♀️, then it may be time to explore a formal diagnosis, even for adult ADHD. 

See, just because you haven’t already been diagnosed, doesn’t mean you don’t have ADHD. Plenty of people lack access to the high-quality mental health care necessary to detect this early. Plus, ADHD symptoms can be easily masked by other conditions, particularly anxiety disorders, learning disabilities, sleep disorders, depression, and other mental health conditions, that you may already be diagnosed with.  

But what difference can a diagnosis make if you’ve already lived years or decades with it undiagnosed? 🤷

Attention Deficit Hyperactivity Disorder (ADHD) can bring a lot of challenges and difficulties. It’s a neurodevelopmental disorder that can impact how we handle our life on a day-to-day basis, often making us feel overwhelmed, frustrated, and even lost. We may struggle to stay productive, achieve goals, or perform at a level appropriate for our developmental stage. 🏆

One experience many people with ADHD share is the feeling that we’re not reaching our full potential. That we could do more if only our brains would cooperate. 🧠 

That’s a good enough reason to seek a diagnosis, in my opinion. 😏

But, more importantly, ADHD can seriously impact your mental health, cause sleep and mood disorders, build low self-esteem, and lead to impulsive behaviors that may put you at risk. 

You need to find ways to treat and manage your symptoms for a happy, healthy life. That can look different for everyone, whether it’s ADHD medication, behavioral therapy, or lifestyle changes, which a professional can guide you through.

So, where should you begin?

The Roadmap to Diagnosis

Before you visit your doctor or GP, you’ll need to get organized and prepare (and yes, the irony is not lost on me here.) 😂

The first thing you need to do is set expectations for yourself. Accessibility to diagnosis is different in each country. If you pay for healthcare or choose to go private, you’ll need to research how much an assessment will cost you. Unfortunately, this will not be affordable for everyone, but there may be organizations that can help.

For countries with free healthcare, there may be long waiting lists. 📅 You may even have to wait over a year or two. This is usually due to a shortage of trained mental health professionals. 

If you have private health insurance, make sure you check your policy to see if ADHD assessments are included, so you don’t face any unexpected costs. Let’s avoid the ADHD tax. 💪

Once you’ve figured out the logistics, it’s time to get booked in with your doctor or GP. 

There’s No Definitive ADHD Test

Attention Deficit Hyperactivity Disorder has come a long way since its discovery in 1902, with ADHD in adults only becoming officially recognized in 2013. It’s only really come into the spotlight in recent years. 💡

That’s why we still don’t know everything about ADHD and there are limited resources on how to diagnose Attention Deficit Hyperactivity Disorder. 

As of writing, there is no single ADHD test or medical exam that can give an accurate diagnosis to an individual. 

Instead, mental health care professionals use standardized behavior rating scales or ADHD symptom checklists that ask about your symptoms, how and where they manifest, and plenty of other things (like family history) outlined in the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) by the American Psychiatric Association, the main criteria for diagnosing Attention Deficit Hyperactivity Disorder.

As you can imagine, it’s not an easy task. People learn to mask their ADHD symptoms or don’t realize that what they’re experiencing is different from anyone else. That’s why it’s essential that you, as the only person who knows how your mind works, do your research to understand what ADHD is.

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Which Mental Healthcare Professional Should I Go To?

It can be confusing to know what your first step is, and who you should contact to start the process. You need an ADHD specialist, like a psychiatrist or psychologist, right? 

Whilst this is true, depending on your country, you’ll likely need to approach your general practitioner (GP) first for an initial assessment. 🩺

If the GP agrees it’s worth investigating, they will refer you to an ADHD specialist for further evaluation and management. In the U.S., many insurance companies will require a referral for you to see an ADHD specialist.

In some countries, you can directly approach an ADHD specialist and seek a diagnosis, so it’s worth checking if this is an option. 

ADHD specialists may specialize in other areas, but they need to have the expertise needed to carry out an ADHD diagnosis. They are often part of a multidisciplinary team that will help address ADHD in different aspects. Depending on your needs and your country's approach to dealing with mental health conditions, you can receive a diagnosis from a psychologist, psychiatrist, psychometrician, or general practitioner. 👩‍⚕️

The Initial ADHD Interview

Before you’re referred to a specialized psychiatrist, you’ll usually have to visit your GP or family doctor first. 

This can be a daunting first step for many, especially those of us with anxiety disorders. 

Even if we’re nearly certain we have ADHD, the prospect of explaining that to someone can create self-doubt. But it’s important to persevere and self-advocate. You can always seek a second opinion if you don’t agree with the doctor's decision, or if their response is unprofessional (which, unfortunately, is still a problem). 

Here are a few tips for this stage:

• Bring a friend or family member. You don’t have to do this alone. By bringing someone you trust, you have someone to vouch for you and moral support. 🫶🏻‍
• Bring pre-prepared examples of your ADHD symptoms. Don’t rely on your memory. You’ll likely forget things, and be too focused on remembering them that you don’t clearly communicate everything you want to.‍
• Ask your friends, family, and coworkers (if you’re close) if they can think of any examples of your ADHD-like behavior that may be worth mentioning. You’ll likely be asked to do this later in the process, but it’s helpful to know going into your first appointment, even if you don’t use it.‍
• Ask your family about their medical history. People can often keep this private (or don’t bring it up in casual conversation), so you may not know whether ADHD runs in the family unless you ask about other family members.‍
• Reach out to the community, or a local ADHD support group. Plenty of people who have been through this process will be happy to share advice.

Personal Story: Misconceptions & Barriers
Someone close to me once asked for advice on her ADHD diagnosis. She’d been experiencing persistent symptoms of ADHD and wanted to speak to a doctor about getting a diagnosis. 

Her parents were hesitant because they believed ADHD was only found in younger children with hyperactive behavior (a common misconception). After she explained how many adults can also experience ADHD and how it was affecting her work and day-to-day life, they supported her decision. 

Her visit to the family doctor, however, didn’t go as planned. The doctor, who’d known her since childhood, claimed she was ‘too smart to have ADHD’ and denied her request for diagnosis. 🙄   

While the reasoning for this decision shows this doctor doesn’t know enough about ADHD - you can have ADHD and be a genius - sometimes a rejected ADHD diagnosis is actually the right decision.  

While understandably this can be disheartening and it may feel as though your feelings have been invalidated, what if it isn’t ADHD?

It might be an anxiety or mood disorder (because their symptoms can overlap, too), or maybe you need a second opinion to find the right approach required for your ADHD diagnosis. 

‍Diagnosing ADHD can sometimes be a struggle for professionals because it can rely heavily on their judgment, but it shouldn't be a reason to give up.

ADHD Criteria: What You Need to Know

Once referred to a specialist, the next step is the ADHD assessment. This is where your symptoms are looked at in greater detail and rated against the Diagnostic and Statistical Manual for Mental Disorders (DSM-5). ✅

Created by the American Psychiatric Association (and used in much of the world), the DSM is the diagnostic criteria used by doctors or primary care providers to assess a person for a certain mental disorder. The DSM-5 is the current version, published in 2013.  

The DSM-5 includes criteria for the three types of ADHD: predominantly hyperactive-impulsive type, predominantly inattentive type, and combined type. 

To provide an accurate ADHD diagnosis, your health care professional will ask a series of questions related to several symptoms of inattention (being easily distracted, making careless mistakes) or hyperactivity (fidgeting, extreme restlessness, interrupting, blurting out answers). ❓

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You should always answer these questions as accurately and honestly as possible. These will help your healthcare provider understand the symptoms of ADHD present, and how they affect your daily life. If inaccurate, it can affect how effective your ongoing treatment will be.  

However, it’s not as simple as whether or not you experience these symptoms.

The criteria also look at:

• The number of core symptoms of hyperactivity-impulsivity or inattention you experience
  
• How long these symptoms have been present for
  
• If the symptoms of ADHD were present before the age of 12
  
• If the symptoms are present in two or more settings, (such as at home, school, or work)
  
• If these symptoms are better explained by another mental health condition or disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or personality disorder)
  
• How appropriate these symptoms are for your developmental level

Let’s look at a couple of these in more detail. 👇

Number of ADHD Symptoms

You don’t need to have every symptom to be diagnosed. 

For children up to 16 years old, doctors need to identify six or more symptoms to make a diagnosis. This can be six hyperactive-impulsive behaviors or six inattentive ADHD traits. 6️⃣

If a child shows enough inattentive and hyperactive-impulsive symptoms, they can be diagnosed with the combined type of ADHD. 

The same is true for adult ADHD and adolescents over the age of 17, except it only needs five symptoms of either, or both. 5️⃣

Duration of Symptoms

Even if you have checked off enough symptoms for the diagnosis of ADHD, your assessor will need to check that these symptoms are apparent for more than six months and existed before the age of 12. 

This is because ADHD doesn’t come and go. Symptoms typically start in childhood and continue. A child’s ADHD symptoms may seem to improve, or ‘disappear’ in adulthood, but this is often due to many adults masking and learning to hide the symptoms responsible for their childhood behavior.

If you’re experiencing ADHD symptoms, but it’s sudden and recent, it may be something else, or even a phase. Perhaps you’ve experienced a lot of change or disruption in your life. 

This is particularly something to look out for with children. We sometimes tend to underestimate how changes to a child’s life can affect their development.

This criteria ensures you’re not misdiagnosed with ADHD, as ADHD symptoms that come and go may be more indicative of other disorders, instead.

Intensity of Symptoms

To be diagnosed with ADHD, your symptoms have to have a significant impairment or disruption to two or more settings of your life, like home 🏡, school 🏫, work, or socializing.

You’ll need to explain how these symptoms affect particular areas, especially how the symptoms interfere with your daily activities.

For example, being unable to focus on anything that requires sustained mental effort or meeting deadlines can seriously impact your work or school performance, while being unorganized and paying bills late can make managing your home and finances a struggle. 

Possibility of Other Mental Disorders

As we’ve briefly mentioned, ADHD has many comorbid conditions that can coexist and share overlapping symptoms. 

Some of these can be brought about by the symptoms of ADHD. For example, with the additional struggles ADHD brings, and the lack of emotional control, mood disorders like anxiety and depression can be more common. When combined with impulsivity, this can also extend to substance abuse disorders. Mental hyperactivity can lead to sleep disorders.

There are also comorbidities like ASD and bipolar disorder that are distinct conditions but, according to research, are more common in those diagnosed with ADHD. 

However, despite all this, what you’re experiencing may be one of those conditions, rather than ADHD, so these possibilities need to be ruled out first.

These diagnostic criteria can determine if your symptoms, and the negative consequences that come with them, qualify for an ADHD diagnosis. 

Advocating for Yourself & Finding the Right Tools for the Journey

There are many reasons a healthcare professional may overlook ADHD.

That’s why we must do our part to advocate for ourselves and fully understand our ADHD symptoms so we can speak up and help those professionals make the right diagnosis of ADHD. 💬

One way to do this is through ADHD self-diagnosis. You can use self-reports to identify your symptoms yourself. These are questionnaires you can do at your own pace. As with any part of diagnosis, you must answer as accurately and truthfully as possible. 

Our ADHD Self-Assessment Workbook walks you through all the common symptoms, each with a dedicated self-assessment page for you to score the impact that the symptom has. 

You can then take these self-reports with you to your doctor. They can help supplement your doctor with the correct information that you may forget during your appointment. You may also find that having these self-assessments with you gives you the confidence to speak up, knowing you have the evidence to back you up. 📢

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ADHD tools like these can make the process of diagnosing and treating ADHD so much easier, taking the pressure off you and your memory, focus, or social skills. With ADHD, our thoughts can tend to fly out of our brains the second we step into formal settings, so we need the right tools for a little external help. 🛠️ 

Key Takeaways

• Diagnosis is the first step you can take to improve ADHD symptoms and reduce their impact for a better quality of life.
  
• ADHD diagnosis involves a comprehensive evaluation including medical history, behavioral assessments, and symptom monitoring.
  
• The diagnosis typically starts with your GP or family doctor, followed by a referral to an ADHD specialist for a full assessment, if necessary.
  
• ADHD is diagnosed using the DSM-5 criteria which focuses on symptoms like inattention, hyperactivity, and impulsivity across different settings.
  
• ADHD can be difficult to diagnose due to overlapping symptoms with comorbid conditions like anxiety disorders, learning disabilities, mood disorders, sleep disorders, substance abuse disorder, ASD, bipolar and depression.

Understanding ADHD and navigating the path to a proper diagnosis is a journey that requires patience, self-advocacy, and persistence. But don’t forget: a diagnosis of ADHD can be a pivotal step towards unlocking a better understanding of yourself and finding treatment, lifestyle changes, and complementary health approaches that enhance your quality of life. 

Your journey towards self-discovery and improvement begins with understanding and advocating for your needs. 🦋