What are the ADHD
Symptoms in Adults Used in Diagnosis?
Diagnosing ADHD symptoms in adults is a difficult task. While
the criteria for an adult ADHD diagnosis is
fairly straight-forward, getting a timely and
precise diagnosis is often the real problem.
The difficulty in diagnosing adult ADHD is often
the result of doctors not being completely
knowledgeable about ADHD symptoms in adults.
This is not a knock against doctors, but more a
statement of the unique difficulties of
diagnosing adult ADHD.
A 2004 study of adult ADHD diagnosed patients
reviewed 537 psychiatrists medical records and
317 primary care doctor medical records. Of the
patients with no prior diagnosis, 56 percent
stated that they complained about ADHD symptoms
to other health professionals without being
diagnosed.
A New York University Medical Center and School
of Medicine survey found that almost 50 percent
of primary-care doctors surveyed reported a lack
of confidence in diagnosing
ADHD for adults. Only 34
percent of the 400 doctors surveyed reported
being "very" or "extremely" knowledgeable about
ADHD symptoms in adults. A full 85 percent said
they would take a more active role in diagnosing
adult ADHD if they had better screening tools.
Difficulties in Diagnosing Adult ADD.
The greatest difficulty in diagnosing adult ADHD
is that other conditions commonly found
alongside adult ADD can mimic ADHD symptoms in
adults.
Comorbidity, the coexistence of another disease
or condition, is more the rule than the
exception with adult ADHD. Depression, bipolar
disorder, anxiety, substance abuse and
personality disorders commonly cluster with
adult ADHD. Separating symptoms to determine
which is the true condition to treat makes
diagnosing the adult ADHD incredibly difficult.
Depression and adult ADHD share the symptoms of
poor concentration, attention and memory, and
difficult completing tasks. Bipolar and adult
ADHD share the symptoms of hyperactivity, mood
swings and difficulty maintaining attention and
focus. Anxiety and adult ADHD share the symptoms
of fidgeting and difficulty concentrating.
Substance abuse and adult ADHD share the
symptoms of mood swings and poor concentration,
attention and memory. Personality disorders and adult
ADHD share the symptoms of impulsivity.
The "chicken or egg" aspect of which condition
came first is always a question in diagnosing
adult ADHD. Did a lifetime of dealing with
undiagnosed ADHD symptoms produce depression or
is the depression independent of Attention
Deficit Disorder? Is the adult ADHD self
medicating through substance abuse or did the
substance abuse precipitate ADHD symptoms? If comorbid conditions exist, the patient needs to
understand that treatment can resolve the ADHD
symptoms in adults but the other psychiatric condition
might need additional treatment.
To make the adult
ADHD diagnosis even more difficult is the fact
that Attention Deficit presents about six
different types - some of which have a
depressive tone, others that have tones of
anxiety and personality disorder. The depressed
adult with ADHD, for instance, might have a
depressive variation of Attention Deficit
Disorder, might have two separate conditions or
depression because of the ADHD symptoms. Knowing
which condition to treat is likely unclear.
Medical conditions can also mimic
symptoms of adult ADHD.
Hyperthyroidism, seizure disorders, hearing
difficulties, lead toxicity, previous head
injuries, sleep apnea and drug interactions can
all cause problems with inattention,
concentration, memory and hyperactivity. For
ADHD women,
menopause and hormonal issues can
contribute to the problem.
For a
thorough diagnosis, the evaluating doctor should rule out
these medical conditions.
Physicians often use an assessment checklist of
symptoms or an
ADHD scale
to determine the presence of Attention
Deficit Disorder. The doctor performing an
assessment of adult ADHD can use the standard
ADHD criteria but this assessment better
reflects childhood ADHD symptoms. Adults often
retain some, but not all, of their childhood
symptoms. Furthermore, the ADHD symptoms in
adults often take on different forms.
Hyperactivity, for example, is a common feature
in children but tends to be less overt in
adults.
Criteria for Adult ADHD Diagnosis.
- The
symptoms ADHD were present in childhood.
- The adult symptoms are present in more than one settings
- work, social settings or at home.
- There is clear evidence that the adult ADHD symptoms
cause a significant impairment functioning in these
settings.
- The symptoms cannot be better accounted for by
another mental disorders or medical condition.
Additionally, many of these ADHD symptoms
in adults should be present to reach a diagnosis;
- Poor concentration.
- Employment problems.
- Relationship problems.
- Inability to monitor behavior.
- Rapid and extreme mood changes within a very short
period of time and without appropriate external reasons.
- Hot temper or difficulty controlling anger.
- Inability to complete tasks / procrastination.
- Disorganization / poor organization skills.
- Low stress or frustration tolerance.
- Impulsivity.
- Difficulty relaxing.
- Restlessness or chronic boredom.
- A feeling of being chronically "on edge."
- Chronic lateness and forgetfulness.
- Anxiety.
- Low self-esteem.
- Substance abuse or addiction.
- Depression.
Attention Deficit Disorder does not have
clear physical signs that can be seen in an x-ray or a lab test.
Therefore, the diagnosis is subjective and
rests on observing symptoms and ruling out other factors.
Adult
ADHD treatment options are
developed based on these tests.
For an accurate diagnosis, the doctor will take a
history of the patient's childhood behavior and interview the
patient's partner, parent, close friend, or other close
associate. To rule out other medical or mental factors, the
doctor should perform a physical examination and psychological
tests. The best way to
test adult ADD is by using a
multidisciplinary team that might include various doctors,
psychiatrists or other behavioral specialists.
To receive prescription ADHD treatment, the person must receive
an adult ADHD diagnosis. However, there are many
non prescription adult ADD medication. These
alternatives should
be explored. Some alternative treatments can be highly effective
at reducing ADHD symptoms in adults.
