Understanding the Adult ADHD Diagnosis Process

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that usually begins in childhood. Its symptoms fall into three categories: mainly hyperactive, mainly inattentive and combined type.

For a host of reasons, some people are not diagnosed with the disease as children. Getting an accurate diagnosis in adulthood can be life changing. When left untreated, the disease can cause serious health, career and relationship problems.

Here’s what to know about the process of getting an ADHD diagnosis as an adult.

Research reviews show that worldwide, between 2.58 and 5.76 percent of adults have significant symptoms of ADHD.

Some of these adults have undoubtedly missed an early diagnosis, but there is also a prominent question among researchers who study ADHD in adults: can ADHD develop in adulthood, or all adults with of ADHD simply not diagnosed when they were children?

Studies offer conflicting evidence. Some experts say ADHD may first emerge in adulthood. Others say that the symptoms were neglected when the person was younger.

In adulthood, symptoms may be slightly different from those associated with ADHD in children.

ADHD in adults often involves:

  • not being able to prioritize and organize
  • have trouble starting tasks and projects
  • not managing your time well
  • losing the ability to perform tasks that require prolonged mental effort
  • having a chaotic environment or living circumstances
  • losing items and forgetting deadlines or appointments
  • acting impulsively, even in risky situations
  • feeling stressed and overwhelmed by daily demands
  • get frustrated easily
  • feeling restless and uneasy
  • abuse substances

If these symptoms sound familiar to you, you may want to speak with a medical professional about a diagnosis. Although there is no cure for ADHD, the right treatment can balance your personal and professional life.

Yes. ADHD can be diagnosed by any licensed physician, including a family physician, internist, or specialist, such as a neurologist or psychiatrist.

Nurse practitioners and physician assistants can also diagnose ADHD and, like doctors, can prescribe medications to treat the condition.

Licensed mental health professionals such as psychologists and therapists can also diagnose ADHD in adults, but they will refer you to a doctor, nurse practitioner (in some states), or physician assistant for medications.

A diagnosis of ADHD, in childhood or adulthood, is not as simple as having an MRI or a blood test. Instead, your diagnosis will be based on a thorough evaluation of your symptoms and medical history.

To be diagnosed with ADHD, you must have at least five different symptoms. They must affect you in at least two different contexts (school, work, home, etc.).

Your healthcare professional can use a behavioral rating scale to find out how often you experience adult ADHD symptoms in your daily life. Some common scales include:

Once you have been diagnosed, your healthcare professional may use Balance like these from time to time to monitor the effectiveness of your treatments.

Other possibilities

ADHD shares symptoms with several other health conditions. Chronic stress, trouble sleeping, and other mental health issues like bipolar disorder can all look like ADHD in adults.

For this reason, you may need additional tests to rule out other causes for your symptoms. You may also need to take a test that assesses your cognitive abilities to determine if you have a learning disability that needs addressing.

The boys are more likely than girls to be diagnosed with ADHD in childhood.

Some researchers I think it’s because boys are a little more likely to have symptoms of hyperactivity and impulsivity. These symptoms are easier to spot than distraction and inattention, which are slightly more common in girls.

It’s also possible that girls learn compensation skills that mask their ADHD symptoms. For this reason, many girls with ADHD are not diagnosed during childhood.

As adults, women often recognize their symptoms and seek treatment. This is often because ADHD has caused problems in new social situations, higher education, work, or parenthood.

Hormonal changes can also influence how and when ADHD symptoms appear or worsen. Menstruation, pregnancy, and menopause can alter ADHD symptoms, causing them to interfere with productivity and relationships in more noticeable ways.

Getting an accurate diagnosis is vital for women with ADHD because, if left untreated, the condition more often leads to:

  • depression
  • anxiety
  • substance use
  • acts of self-harm

Race influences ADHD diagnoses in children and adults. In one study 2021 involving more than 238,000 children, researchers found that black, Hispanic and Asian children were less often diagnosed with ADHD than non-Hispanic white children.

Among children diagnosed with ADHD, non-Hispanic white children were also more likely to be treated with medication than black, Hispanic or Asian children.

These racial disparities continue into adulthood. When researchers in 2019 analyzed more than 59,000 ADHD cases in a large health insurance cohort, they found that non-Hispanic whites received ADHD diagnoses more often than blacks, Hispanics, and Asians.

All of the people in the 2019 study had private health insurance, so the researchers believed the differences were not due to some study participants not having access to health services. Instead, the researchers said the disparities may exist because:

  • people have different perspectives on mental health care
  • racial bias can cause health professionals to view behaviors as “unhealthy” in some people and “normal” in others
  • people may be more or less willing to use medical services
  • symptoms may be misdiagnosed as another health condition

The researchers noted that ADHD diagnoses are on the rise across all racial and ethnic groups in the United States.

There are several short online tests to check for ADHD symptoms in adults. These tests ask how often you experience many of the hallmark symptoms of ADHD, such as interrupting others, fidgeting, losing track of your belongings, and feeling overwhelmed with complicated tasks.

These tests can be eye-opening and can give you the spark to seek help, for example:

Although you are the expert on your own symptoms, only a professional diagnosis can create a treatment plan that includes medication. ADHD also overlaps significantly with other mental health issues, and a professional can help you get an accurate diagnosis.

ADHD is often thought of as a childhood health problem, but for many people it continues into adulthood. Diagnosis of this neurodevelopmental difference usually involves a thorough medical history and physical examination to rule out other conditions with similar symptoms.

Sex, gender, and racial disparities can make it harder to get an accurate diagnosis. Women and people of color are less often diagnosed with ADHD and therefore may not receive the treatment and support they need until much later in life.

You can use an online tool to find out if your behaviors and feelings indicate you might have ADHD, and then chat with a medical or mental health professional about what you’ve learned.

Medications and other treatments can help relieve ADHD symptoms and give you a better quality of life.