Understanding the Adult ADHD Diagnostic Process
Medically reviewed by Geralyn Dexter, PhD, LMHC
If you’re an adult wondering if you have attention deficit hyperactivity disorder (ADHD), you’re not alone. While ADHD is considered as a neurodevelopmental disorder that typically presents in childhood, people may experience symptoms of ADHD and not receive a diagnosis until later in life.
Seeking information about adult ADHD can be life-changing because leaving ADHD untreated can cause serious challenges to a person's health, career, and relationships. This article provides more insight into adult ADHD so you can determine how to get assessed for adult ADHD diagnosis.
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Related: Common Risks of Untreated ADHD in Adults
How Many Adults Are Diagnosed With ADHD?
Recent estimates suggest 8.7 million adults in the United States have a diagnosis of ADHD. However, this number is noticeably rising.
The number of adults diagnosed with ADHD is growing for several reasons that include:
Increased awareness from healthcare providers and general public
ADHD diagnostic changes (i.e., how ADHD is defined has changed over time)
Increased access to healthcare
Decreased stigma
Related: ADHD Criteria for Diagnosis
What Does ADHD Look Like in Adults?
There is no single look to ADHD. This means you can’t tell someone has ADHD by looking at them or observing their behaviors. People living with undiagnosed ADHD may also find it challenging to determine whether their symptoms are associated with ADHD.
ADHD is defined by symptoms that fall under three main categories or types, including:
Predominantly inattentive presentation
Predominantly hyperactive-impulsive presentation
Combined presentation
Takeaway
Adult ADHD is diagnosed when someone experiences at least five symptoms associated with a type of ADHD or combined type.
Experts say these 12 symptoms are common in adults with ADHD:
Lack of attention to detail
Abandoning tasks or starting new tasks before finishing old ones
Challenges with staying organized
Inability to focus or pay attention unless experiencing hyperfocus
Repeatedly losing or misplacing things
Forgetfulness (i.e., missing appointments, forgetting important dates)
Restlessness and edginess
Interrupting others, blurting out responses, or speaking out of turn
Mood shifts including sudden irritability and quick to anger
Low threshold for stress
Extreme impatience to the point of being physically uncomfortable
Engaging in high-risk activities such as reckless driving and substance misuse
Symptoms Look Different in Adulthood
Symptoms can look different in adulthood. For example, the Centers for Disease Control and Prevention (CDC) say hyperactivity in adults may appear as extreme restlessness or wearing others out with their activity.
People experiencing undiagnosed ADHD in adulthood may also struggle with self-harming tendencies, suicidal ideation and behavior, and other complex conditions, including substance use disorders. Many of these disordered behaviors are attempts at coping with the challenges of living with undiagnosed ADHD.
Crisis Support
If you are having suicidal thoughts, contact the 988 Suicide & Crisis Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database.
Related: 988 Is the New National Mental Health Hotline
Who Can Diagnose Adult ADHD?
A mental health care professional or healthcare provider can help determine whether or not your symptoms fit the diagnostic criteria for ADHD diagnosis. If you’re not sure where to start, consider speaking with your healthcare provider about what you’re noticing and why you think you may have adult ADHD.
Takeaway
Being as specific as possible when talking about your health history and symptoms is helpful to give a full picture of your lived experience. Your healthcare provider can then help determine the best next steps including a referral for official diagnosis based on symptom severity and current functionality in everyday life.
Examples of professionals who may be able to diagnose ADHD include:
Physicians (psychiatrist, neurologist, family doctor or other type of physician)
Related: Patient Advocacy
ADHD Testing for Adults
There is no genetic, physical, or behavioral test that can confirm or deny the presence of adult ADHD. Rather, qualified practitioners will rely on several resources to assess the likelihood of adult ADHD. This type of testing may involve any of the following resources:
ADHD symptom checklists based on the Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)
Standardized behavioral ratings scales
A detailed history of past and current functioning
If available and appropriate, information obtained from family members or significant others
Additional evaluations to rule out learning disabilities and/or mental health conditions with overlapping symptoms
Related: ADD vs ADHD: What Are the Differences?
Sex and Gender Disparities in Adult ADHD Diagnosis
There are sex and gender disparities in adult ADHD diagnosis. This is attributed to the gender gap. For example, ADHD is diagnosed and treated more in cisgender (a person whose gender identity matches the gender they were assigned at birth) men than cisgender women, but this could be attributed to under-diagnosis and missed diagnoses in young cisgender girls and women due to gender-based stereotypes.
Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) says girls with ADHD often go undiagnosed until later in life, or may be diagnosed instead with only anxiety and depression, and boys with ADHD have been historically more likely to receive prescribed stimulant medications much earlier than girls.
Cis women are also said to have more inattentive traits than cis men, which can contribute to the signs of ADHD being missed in childhood. Inattentive traits include challenges with paying attention, disorganization, and forgetfulness.
Related: ADHD Symptoms in Women and Common Treatments
Racial Disparities in Adult ADHD Diagnosis
Racial disparities in ADHD diagnosis can be linked to several factors including systemic racism and inequalities in access to mental health care, mistrust of the medical community based on historical injustices, and the digital divide or access to Internet-based health information.
For example, research on racial disparity in ADHD diagnosis has found that:
White youth are most likely to receive an ADHD diagnosis.
Black youth are 22% less likely to receive an ADHD diagnosis.
Latinx youth are 32% less likely to receive an ADHD diagnosis.
Asian youth are 73% less likely to receive an ADHD diagnosis.
Insufficient research on adult ADHD is available to fully determine how this disparity is represented across a person's life span. The American Psychiatric Association says research suggests Black individuals in particular face many of the same risk factors for ADHD diagnosis, but the intersection of race, low socioeconomic status, racial marginalization, and discrimination may also worsen the symptoms of ADHD.
Related: Data Finds Racial and Ethnic Disparities in Mental Health Diagnoses
Adult ADHD Self-Assessment Options
Online ADHD tests can serve as tools to provide insight into whether or not it makes sense to seek an official or formal diagnosis. They are not considered official diagnostic tools.
Self-assessment options include:
ADHD test by the Attention Deficit Disorder Association
ADHD symptom test adapted from the Adult Self-Report Scale (ASRS) Screener
ADHD test by Mental Health America
Read Next: The ADHD Brain vs. the Non-ADHD Brain
Summary
Adult ADHD is defined by challenges in everyday life and functioning. ADHD in adulthood can cause challenges with work, health, and relationships. The path to adult ADHD diagnosis may look different in everyone when based on several factors, including previous diagnosis history, sex and gender, and racial disparities in diagnostic processes and access to adequate care.
Using self-assessment tools can provide a starting ground for determining what to talk about with your healthcare provider and whether or not to seek referral for formal diagnosis.
Read Next: 4 Types of Adult ADHD Therapy
Read the original article on Verywell Health.
