Diagnosis of AD/HD in Adults (WWK9S)

This information and resource sheet will help you understand what attention-deficit/hyperactivity disorder (AD/HD) is in adults. It also tells you what happens when an adult sees a mental health professional (for example, psychologist, psychiatrist or social worker) to find out if he or she has AD/HD. It describes:

• the common symptoms of AD/HD in adults
• how health professionals evaluate, or examine, adults to see if they have AD/HD
• what to expect when you see a professional to find out if you have AD/HD

What is AD/HD?

AD/HD is a mental disorder, a disorder of the brain. It runs in some families, so it may be inherited. It is a disorder that can last a lifetime, and anyone can have it.

Some people have mild AD/HD with only a few symptoms or problems. Others have more serious AD/HD with more or worse symptoms. AD/HD can cause problems in school, in jobs and careers, at home, in family and other relationships, and with everyday living.

How is AD/HD diagnosed?

There is no single medical, physical, or other test for AD/HD. To determine if you have the disorder, a doctor or other health professional uses these tools:

1. A checklist of symptoms
2. Tests that tell him or her about the person?s behavior
3. Answers to questions about the person?s past and present problems
4. Information from family members or someone close to you
5. A medical exam to rule out other medical causes for symptoms

The following are symptoms of AD/HD. Most likely no one has them all.

Symptoms of Inattention

1. Often fails to pay attention to details
2. Often makes careless mistakes
3. Often does not listen when directly spoken to 
4. Often does not follow instructions and fails to finish activities, schoolwork, chores or duties in the workplace
5. Often does not follow instructions and fails to finish activities, schoolwork, chores or duties in the workplace
6. Often has hard time organizing tasks and activities
7. Often avoids or dislikes tasks that require ongoing mental effort or concentration
8. Often loses important things
9. Often is easily distracted by unimportant things
10. Often is forgetful in daily activities
    Symptoms of Hyperactivity (being unusually or abnormally active)
11. Often moves hands and feet nervously or squirms
12. Often leaves seat when staying seated is expected
13. Often feels restless
14. Often can't be involved in leisure activities quietly
15. Often "on the go" or acts as if "driven by a motor"
16. Often talks too much or too fast

Symptoms of Impulsivity (acting rashly or suddenly without thinking first)

1. Often blurts out answers before questions are fully asked
2. Often has hard time awaiting turn
3. Often butts in on others' conversations or activities

A doctor or other health professional will determine if you have AD/HD by carefully deciding how many symptoms you have. He or she will want to know how serious these symptoms are and how long you've had them. The professional will ask you if the symptoms cause problems with your life at home, at work, and in other activities.

You must have serious symptoms in two areas of your life-such as at work and at home-to be diagnosed with AD/HD. If you have a number of symptoms, but none are serious, you won't be diagnosed with this illness. For example, do the symptoms make it difficult for you to do your job, keep you from completing schoolwork or cause problems in your relationships?

How do I know if I need an evaluation for AD/HD?

Most adults who need to be evaluated for AD/HD have serious problems with concentration or paying attention, or are overactive in one or more areas of living. Some of the most common problems include:

• Problems with jobs or careers; losing or quitting jobs frequently
• Problems doing as well as you should at work or in school
• Problems with day-to-day tasks such as doing household chores, paying bills, organizing things
• Problems with relationships because you forget important things, can't finish tasks, or get upset over little things
• Ongoing stress and worry because you don't meet goals and responsibilities
• Ongoing, strong feelings of frustration, guilt, or blame

How do I find a professional qualified to diagnose AD/HD?

Ask your primary care doctor to suggest a mental health professional who can evaluate an adult for AD/HD. If there is an AD/HD support group in your area, you can go there and talk with the people in the group. Many of the people there may have worked with one or more professionals in your community and may be able to give you information about them.

Who is qualified to diagnose AD/HD?

A doctor or another licensed mental health professional can diagnose AD/HD. These professionals include clinical psychologists, physicians, or clinical social workers. Only certain medical professionals can prescribe medication. These are physicians (M.D. or D.O.), nurse practitioners, and physician assistants (P.A.) under the supervision of a physician. 

What is a comprehensive-or complete-evaluation?

Not all mental health professionals use the same tools to determine if a patient has AD/HD. The following are important for a complete evaluation: 

• an in-depth interview with you
• information from others, such as your spouse or other family members
• symptom checklists, behavior rating scales for
  AD/HD and sometimes other medical testing

How should I prepare for the evaluation?

Being somewhat nervous about an evaluation is normal. Do not let nervousness stop you from having an evaluation if you have serious problems in your life, like those listed above.

Many professionals will ask you to fill out and return questionnaires before the evaluation. You'll probably be asked to name someone close to you who will also take part in some of the evaluation.  You also may be asked to bring school records or job evaluations.

The Interview

The most important part of your AD/HD evaluation is the interview. You will be asked about your childhood, your life now, your health history, school and work history, family history, and social history.

The interviewer will look for AD/HD symptoms and for other psychiatric illnesses you may have. Other mental disorders sometimes seem like AD/HD, but are not.  Sometimes AD/HD symptoms come from another psychiatric disorder, like depression or anxiety. Many people have mental disorder in addition to AD/HD.  It is very important to know if you should be treated for AD/HD or another condition or both.

You will probably be asked to take tests that will give the interviewer information about how your disorder affects you. Be sure your answers are honest.

You will likely have to have a physical exam to see if you have any other medical problems that can cause symptoms much like those of AD/HD.

Participation of Someone
Close to You

It is important for your health professional to talk to a family member or another person who knows you well. Sometimes people with AD/HD don't remember things that someone close to them remembers. And sometimes people with AD/HD don't realize how their behavior affects other people.

Conclusion

After the evaluation, the health professional will piece together all the information from this interview. He or she will write a report that says whether or not you have AD/HD or another condition, and tell you about the condition. You'll also be told about any other mental disorders you may have. Then you will help plan your treatment, if it's needed.

The information provided in this sheet was supported by Cooperative Agreement Number 1U38DD000335-01 from the Centers for Disease Control and Prevention (CDC).  The contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC. It was adapted from What We Know Sheet #9, "Diagnosis of
AD/HD in Adults," developed by the Attention Deficit Disorder Association, and approved by CHADD's Professional Advisory Board in 2004.

© 2004 Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).

For further information about AD/HD or CHADD, please contact:

National Resource Center on AD/HD
Children and Adults with
Attention-Deficit/Hyperactivity Disorder
8181 Professional Place, Suite 150
Landover, MD 20785
800-233-4050
www.help4adhd.org

Please also visit the CHADD Web site at
www.chadd.org.