How Is Adult ADHD Diagnosed?

ADHD usually develops during childhood. However, it’s not always detected then.

If you have ADHD as an adult (and didn’t know beforehand), you’ve likely had the condition for a while, but it went undiagnosed for some reason.

Maybe your parents didn’t think it was necessary to take you to get a diagnosis, or your symptoms were attributed to other causes.

This isn’t uncommon. Parents and teachers might not always be familiar with ADHD and its symptoms or have access to a mental health professional who can help.

You may be wondering why you’d even want to get a diagnosis at this stage in your life. What good would it do?

“Adults may seek a diagnosis later in life if they notice they are experiencing difficulties with social, academic, or occupational pursuits,” explains Jessica Myszak, PhD, a psychologist and the director of The Help and Healing Center. “They may suspect ADHD if they have tried some things to help, but their inattention or hyperactivity/impulsivity does not seem to improve.”

Getting an ADHD diagnosis as an adult can open you up to a network of treatment options and support opportunities that can help manage symptoms.

“Finding out you have ADHD can be a real ‘light bulb’ moment for many adults,” says Billy Roberts, a therapist and ADHD specialist at Focused Mind ADHD Counseling in Ohio. “[It] can offer an explanation for attention struggles you’ve been experiencing. And once you know what those symptoms are, they can be managed.”

“ADHD is one of the most common and treatable mental health conditions,” he adds.

The most accepted criteria for ADHD is established by the Diagnostic and Statistical Manual of Mental Disorders (5th edition). This is a reference handbook that many mental health professionals use to make accurate diagnoses.

To diagnose the condition, a mental health professional will gather information from you, and sometimes those close to you, and compare it to the criteria.

ADHD is characterized by symptoms that show a persistent pattern of inattention, hyperactivity-impulsivity, or both.

According to the DSM-5, to receive a diagnosis of ADHD, your symptoms must be present over a period of time to a degree that they interfere with your work, school, or social life.

But not everyone with ADHD presents the same symptoms or with the same intensity.

That’s why mental health professional keep in mind the main ADHD types:

• Predominantly inattentive presentation. Inattention symptoms have been present and dominant for at least the past 6 months.
• Predominantly hyperactive-impulsive presentation. Hyperactivity-impulsivity symptoms have been present and dominant for at least the past 6 months.
• Combined presentation. Both inattention and hyperactivity-impulsivity symptoms have been present for at least the past 6 months.

There’s a list of qualifying symptoms for each type. A diagnosis of adult ADHD requires that at least five symptoms in the list are present for the past 6 months.

Symptoms of inattention include:

• difficulty paying close attention to details or making careless mistakes
• trouble keeping your attention on tasks
• difficulty concentrating on what someone is saying to you
• trouble organizing your thoughts, notes, or tasks
• avoiding tasks that require more effort for long periods of time
• getting distracted easily
• losing or misplacing things that you need to complete tasks
• difficulty following instructions all the way through on a task
• forgetting about daily tasks

Symptoms of hyperactivity-impulsivity include:

• difficulty sitting still without moving around
• fidgeting or squirming while you’re seated
• feeling restless
• talking excessively and not always getting to the point
• interrupting others or inserting yourself into situations
• shouting out answers too early even without fully understanding the question
• feeling like you’re constantly on the go and unable to stop or slow down
• difficulty waiting in line for your turn to get something you want
• difficulty relaxing or enjoying leisure activities quietly

Lack of impulse control is also a key symptom of some types of ADHD.

These symptoms must be present often and across situations for a mental health professional to consider them symptoms of ADHD.

“An adult with ADHD might experience racing thoughts, restlessness and trouble relaxing, procrastination, and chronic underperformance at work,” Roberts explains.

There are no diagnostic tests or laboratory exams that can be used to formally diagnose ADHD.

Instead, there are multiple tools that a mental health professional can use to detect the condition.

Only a mental health professional can diagnose ADHD. However, you can also work on identifying some of your symptoms by taking Psych Central’s online ADHD test.

Professionals usually diagnose adult ADHD in the following ways:

A one-on-one session

This is the first step toward an ADHD diagnosis.

A mental health professional will talk with you over one or more sessions. These sessions can last at least 1 hour.

In these sessions, you’ll be able to express your concerns and feelings about some of your behaviors.

A professional might also ask you to fill out questionnaires or ask you questions that aim to rate how often you experience specific symptoms of ADHD and how distressing they are to your life.

Family sessions

Sessions with family members and teachers are common when diagnosing a child with ADHD.

They’re also a valuable tool for diagnosing adult ADHD.

While you may have a better understanding of what you’re going through now, it may be hard to recall or recollect examples from your childhood.

Remember that ADHD develops during childhood. To receive a diagnosis, a professional will want to establish if you showed any symptoms before the age of 12.

If possible, they’ll want to talk with those who knew you during your first few years of life.

The questions in these sessions might be similar to what you were asked in your own interview. These additional responses can help paint a clearer picture of your early symptoms.

Standardized behavior rating scales

A standardized behavior scale scores your responses to give you an overall rating.

There are several ADHD rating scales available. They can differ based on the age or needs of the person being tested.

An added benefit from this type of testing is that you can get retested during your treatment to see if you’re making improvements or if your rating stays the same.

Medical evaluation or screening

A medical evaluation or mental health screening will rule out any other explanations for the symptoms you’re experiencing.

Because of the broad nature of ADHD symptoms, it’s possible that something else could be causing your symptoms.

For example, a regular physical exam can help reveal an underlying condition, such as a thyroid problem or seizure disorder, which could also cause you to exhibit symptoms similar to those of ADHD.

You will also undergo a broad mental health screening to see whether you’re living with symptoms of depression, anxiety, or a learning disability.

An adult ADHD diagnosis is typically made by a psychologist, psychiatrist, or a physician.

“It’s important that this person has a specialty of some kind in ADHD,” Roberts says. “Diagnosing ADHD is a nuanced process, as ADHD can look like many other conditions.”

Meeting with a mental health professional to screen for ADHD symptoms might overwhelm you, especially if it’s your first time.

“Individuals can prepare for an evaluation by thinking about how their symptoms have caused difficulties for them and how these may have shown up earlier in life,” Myszak says. “At times, the information requested may seem irrelevant or may be embarrassing to share. However, the psychologist likely has a good reason to ask these things, so be as honest and open as possible.”

Providing accurate information to your healthcare team can help them make an accurate diagnosis.

“It’s common for adults with ADHD to underreport their symptoms when being diagnosed,” Roberts explains. “It’s important not to keep anything a secret when being assessed.”

Only a health professional who is familiar with ADHD can make an accurate diagnosis.

Online tests may help you identify some of your symptoms, which in turn can help your health professional reach a diagnosis.

Scoring particularly high or low on an ADHD online test should not be treated as a final diagnosis.

A specialist might also be able to provide online sessions to start the diagnostic process.

“Currently, it might be necessary to get an evaluation online rather than in person,” Roberts says. “While this is a possible medium for diagnosis, it’s important to make sure the person is licensed and plans on taking the appropriate amount of time to diagnose. Most ADHD testing takes at least a couple of hours.”

Deciding to take the first steps to address your ADHD symptoms and reaching out for help takes a lot of courage.

Adult ADHD is a treatable condition. Seeking the help of a professional can make a difference in your life.

Here are some tips you might want to consider:

• Look for a mental health professional in your area. The American Psychological Association Psychologist Locator can help.
• Check out organizations like CHADD that might offer tips for living with ADHD.
• Look into approved accommodations that can help you succeed at work or in higher education.
• Discuss your ADHD diagnosis with your friends and family, how it affects your life, and what they can do to help.
• Consider an ADHD coach if you think you’ll need extra support. These specialized coaches can help you manage your symptoms and create a unique plan to help address your specific needs.

“ADHD can be a superpower,” Roberts says. “Many famous and highly successful people have ADHD. The cure is in knowing how to channel each symptom to your benefit and knowing how to work around the frustrating parts of ADHD.”