You’re here because you’re probably wondering if you have ADHD. You might have come across a Youtube or Tiktok video about ADHD and recognized the symptoms. And now you’re wondering how to get diagnosed. Let me tell you straight up: Getting evaluated as an adult who possibly has ADHD poses challenges.
For instance, did you know that only a fraction of professionals who can diagnose the condition can prescribe medication as treatment? Or that the diagnostic criteria were primarily written for adolescents and children?
In this blog, I’ll share with you how to identify the symptoms of ADHD, how to select the best professional to meet with, and what to expect in that appointment.
Let me start by saying I am not a medical professional or an ADHD expert. I’m simply someone whose life was on a nosedive going through 15 years of failure. I got diagnosed unexpectedly by luck in my 30’s. Since then, I have rebuilt my entire life. I'm happily remarried and making 6 figures at a Fortune 500 company. I’ve also created a YouTube channel to share the things I’ve learned along the way.
Step #1: Recognize the signs of ADHD in adulthood.
There is a great list on chadd.org which I’ll quickly go down:
1.) Inconsistent performance in jobs or careers.
2.) History of academic and or career underachievement.
3.) Poor ability to manage day-to-day responsibilities such as completing household chores, etc.
4.) Relationship problems due to not completing tasks.
5.) Forgetting important things or getting upset easily over minor things.
6.) Chronic stress and worry due to failure to accomplish goals and meet responsibilities.
7.) Chronic and intense feelings of frustration, guilt, or blame.
Upon hearing those you might be thinking to yourself doesn’t that apply to every single person? Yes, but for some people, especially those with ADHD, the problems are so persistent and pervasive that they interfere with every aspect of their life from work to home to school.
Now if you’d like to do a self-assessment, the World Health Organization has developed the Adult ADHD Self-Report Scale or the ASRS. It’s available for free online at this link.
It’s 18 questions and a way for you to start to match your experiences against some of the diagnostic criteria.
Step #2: Select a professional that you'd like to meet with.
Your first decision is going to be whether or not you want a professional that can prescribe medication. Several professionals can diagnose ADHD and provide treatment for it. These include psychiatrists (physicians), psychologists, social workers, nurse practitioners, and other licensed counselors or therapists. However, as described on chadd.org only certain medical professionals can prescribe medication and perform a thorough physical evaluation to rule out other possible causes of your symptoms. As chadd.org says, these professionals are physicians, nurse practitioners, and physicians’ assistants under the supervision of a physician.
Even if you don’t know whether or not you want to take medication, you are going to want the option of at least investigating or having the dialogue about it.
If I were choosing to go get a diagnosis today, I would choose to see a physician or someone capable of prescribing medication. You might think you'll just get diagnosed through this other professional and then they can transfer the diagnosis to a physician to prescribe medication. That's not how this works. Anyone that’s going to prescribe medication is going to want to do their own evaluation.
Other considerations in choosing a professional to work with is you’ll want to find someone that takes your insurance and specializes in ADHD, ideally adult ADHD. Having someone that understands the symptoms in adulthood and how they manifest in the workplace and relationships versus school and homework can help.
There are two options that you could use to go about finding an appropriate professional. First, search through your insurance provider's website. If that’s not an option you can try psychologytoday.com. Pop open Psychology Today's website to look at therapists or you can look at psychiatrists. Narrow your search even more by using your insurance provider.
Here are a few notes from my experience getting diagnosed. I had to call a lot more psychiatrists than I expected. It turns out that there are a lot of psychiatrists that don’t even want to get near ADHD because of ADHD medication. It’s a controlled substance. They're afraid of the liability for people coming to them that don’t have the condition but are just trying to get the meds. Another reason is that most people I called couldn’t see me for a month or longer.
The only reason I went to get a diagnosis in the first place was my life started falling apart. I had just moved to a new city following my divorce and had a pretty good job. While I was in my probationary period and after two months of positive feedback, I was told that my work was not cutting it. My boss said I needed to work overtime for as many weeks as it took until she felt my work was high enough quality. I was already pushing myself to my absolute max. Here we go again I thought. I really wanted this time to be different, but alas, no.
I was afraid if I didn’t get an appointment for a month I’d be fired. So that's why I had to make a lot more phone calls than I expected to. I finally got in to see someone.
Step #3: What to expect in your appointment.
There is definitely going to be a clinical or diagnostic interview where the clinician will attempt to evaluate your symptoms against the DSM-5 criteria for ADHD. They will also evaluate how much of the impairment to your life is due to those symptoms, and also rule out other disorders such as anxiety or mood disorders like depression. They might have you fill out some more detailed self-report assessments or scales. They could even request to obtain a patient history from another individual such as your parent to shed some light on your symptoms.
The main thing that the professional is evaluating you for is the diagnostic guidelines for ADHD. I encourage you to familiarize yourself with them. Take a look at the CDC website for the criteria. They are a bit complex, but in general, for children, you need six or more symptoms. So, with adults, you’re going to be looking at five or more. If you’re 17 years or older, these symptoms will need to have been present for at least six months and they’re inappropriate for developmental level.
There's an additional question asking if several of the symptoms were present before 12 years. You can look through the symptoms. There are nine total and you’re looking to have at least five. They are things like failing to give attention to details and not following through on instructions. You can see the hyperactivity and impulsivity guidelines also on this website separately.
Based on your symptoms there can be three kinds of presentations that you can be diagnosed with. A combined presentation which is the criteria for both inattention hyperactivity and pulsivity. A predominantly inattentive presentation, which is what I have, or a predominantly hyperactive-impulsive one.
Now keep in mind, this is on the CDC website, and they say their criteria is in a shortened form, and ultimately only a trained healthcare provider can diagnose or treat ADHD. But I wanted to give you that background so you have a reference point for what to expect in the appointment.
Here's one issue to consider as an adult going for a diagnosis because you think you suffer from ADHD: you will likely have to explain all of your current workarounds you use in your life to have managed not getting diagnosed until today. If you've gone this long in your life without a diagnosis you’ve no doubt put in place all sorts of adaptations and ways to manage your symptoms. So, in my experience, it’s helpful to explain to the clinician all of the systems you have in place because of the symptoms you have.
In my case I did very well in school growing up, but that masked a much bigger problem which took 15 years of failure to finally be diagnosed, like I never finished reading an entire book throughout my schooling and chronic almost laughable levels of procrastination. I was gifted with some natural intelligence. I had support from a supportive family as well as older sisters who had already gone through the same grade and could help me. I also had a very smart supportive friend group. Just because I was able to pull off a result in the real world through very elaborate gymnastics, didn’t change the fact that I had symptoms and the struggles I dealt with day in and day out for my entire life.
I was talking with someone recently who suffers from a lot of ADHD symptoms and when they went to get a diagnosis, the physician said that they couldn’t possibly have ADHD because they had finished a graduate degree. The fact is that's simply not true. Some of the foremost experts on ADHD have ADHD themselves and yet they’re medical doctors and PHDs and very accomplished professionals. If you run into that sort of hurdle, come prepared to explain some of those things you do to make the clinician's job a little easier. You can also seek a second opinion.
That's what I've learned along the way about how to get diagnosed with ADHD, the things that I wish I knew, and things that I uncovered in researching for this. Do you have any tips? Leave them in the comments below.