How Does a Psychiatrist Diagnose ADHD in Adults?

Although children are most commonly diagnosed with ADHD, many people don’t receive a diagnosis until adulthood. Since those with undiagnosed ADHD frequently struggle with feelings of inadequacy due to symptoms like forgetfulness and disorganization, receiving a diagnosis as an adult can be a relief.

To diagnose ADHD in adults, a psychiatrist uses a combination of psychological tests, behavior rating scales, and symptom checklists.  

In this article, we’ll discuss this process, including the most common diagnostic methods and assessments used to identify this neurotype, and the difference between inattentive or hyperactive ADHD.  

Are you frequently experiencing symptoms associated with ADHD and want a professional diagnosis? At Klarity, we can connect you with a mental healthcare provider within just 48 hours of booking your appointment—no insurance needed. 

Find a provider on Klarity today and get seen within 48 hours. Evaluation notes are accessible through the secured portal upon request. If diagnosed, your provider will discuss the treatment options and send the prescription to your local pharmacy, if applicable.

Who Can Diagnose ADHD in Adults?

If you suspect that you have ADHD as an adult, you should be evaluated by a licensed mental health professional. 

A professional in the mental health field that can diagnose ADHD can be a clinical psychologist, psychiatrist, neurologist, family doctor, clinical social worker, and more. When choosing a professional to conduct an ADHD diagnostic test, you want to make sure that you are choosing someone who is experienced in this field of mental health treatment. 

Choosing the right professional is very important because ADHD, especially inattentive ADHD, can be difficult to recognize in adults. The correct diagnosis and treatment plan are essential for improving a patient’s mental health, so you want to avoid any possibility of misdiagnosis. 

Tests for ADHD Diagnosis

DSM-5 Criteria for ADHD Diagnosis

The DSM, or Diagnostic and Statistical Manual of Mental Disorders, is used by a majority of mental health professionals in the United States as a reference handbook. It helps physicians and psychiatric professionals properly diagnose mental health conditions in adults and children. 

The latest version of the DSM is the DSM-5, which was released in March of 2022. It provides criteria that can be used by professionals to evaluate a patient and come to a diagnosis if one is applicable. 

For ADHD, the criteria that have to be met for a diagnosis vary by age. Children up to 16 years old must show six or more of the criteria, and adults above 17 years old need to show five or more criteria for at least six months. This is the same for all three kinds of ADHD.

ADHD Self Tests

There are a lot of self-assessments available online that will tell you how likely it is that you have ADHD. However, these tests are not a diagnosis. In order to be diagnosed and receive any prescriptions, you will need to be evaluated by a mental health professional. 

A study conducted by the NCBI in 2020 assessed the accuracy of two self-tests, the Adult ADHD Self-Report Scale (ASRS) and the Wender Utah Rating Scale (WURS). The study concluded that both tests have high diagnostic accuracy. However, this is only a tool and not an official diagnosis. 

Three Types of ADHD

There are three types of ADHD: attentive, hyperactive/impulsive, and a combination of these two. 

Inattentive Type Diagnosis Criteria

Formerly known as ADD, inattentive type ADHD is identified in individuals who have difficulty with the following

• Following detailed instructions
• Organization
• Memory
• Listening
• Following through with tasks
• Paying attention 
• Keeping track of things 

Inattentive ADHD is most commonly diagnosed in women and girls and manifests as forgetfulness, being easily distracted, and disengaging often. It can be confused with certain mood disorders and anxiety, especially in adults. Individuals with this kind of ADHD are also often seen as lazy or apathetic.

Hyperactive/Impulsive Type Diagnosis Criteria

Hyperactive and impulsive type ADHD is different from the inattentive type, and it is also the one that people think of more when someone mentions ADHD. Hyperactive/impulsive type ADHD is commonly characterized by an inability to sit still and focus. People who have ADHD at any age may show the following symptoms

• A need to constantly be moving
• Fidgeting often
• Excessive talking
• Interrupting others
• Blurting out thoughts or answers
• Struggle with impulse control

This kind of ADHD is often diagnosed in children and is much more noticeable even to a person who is not a doctor or professional. 

Combined Type Diagnosis Criteria

It is possible to have a combined form of these two conditions, and this is called combined type ADHD. Individuals have combined ADHD when they meet six or more criteria for each of the two types of ADHD.

Comorbid Illnesses and ADHD

There are a lot of mental health conditions that can occur at the same time, or they share symptoms that make it look like you have one or the other. When diseases occur simultaneously, it is referred to as comorbidity. Recognizing the comorbidity of some mental health conditions is very important for determining treatment options.  

ADHD has a high rate of comorbidity with other disorders, and a majority of individuals with ADHD also have an additional condition or learning disability. If you are diagnosed with more than just ADHD, it is important to treat the condition with the larger problem first, not always at the same time. 

Depression or ADHD?

About a quarter of adults who have ADHD also have symptoms of depression, but in some cases, the two can exist at the same time. In people who have ADHD, the comorbidity of depression is about three times more likely. However, many of the symptoms overlap, so just because you may have some of the symptoms of depression, it doesn’t necessarily mean you have both.

In some cases, ADHD and depression can present very similar symptoms, and distinguishing between the two can be difficult. For example, restlessness and boredom can be symptoms of both, and some side effects of ADHD medication can cause symptoms of depression like loss of appetite, mood swings, fatigue, and more. 

Anxiety or ADHD?

Individuals with ADHD may also share symptoms with or have anxiety. Anxiety is a natural response to situations that are difficult, scary, or uncomfortable, but it becomes an issue when the anxiety is excessive and persistent. One of the common symptoms that anxiety shares with ADHD is the avoidance of responsibilities and tasks. 

The major difference is what is causing the lack of focus. Anxiety may cause you to avoid something because you are afraid of doing it or what may come after. Whereas when a person has ADHD, they avoid tasks or have trouble completing them because they cannot maintain focus. 

Bipolar Disorder or ADHD?

Bipolar disorder (BD) is often comorbid with ADHD, and in fact, recent research shows that around 1 in every 13 patients has ADHD and BD comorbidly. Bipolar disorder is a mental illness that causes extreme mood changes and shifts in energy levels, known as depressive and manic episodes. 

Individuals with BD will experience periods of extreme depression, followed by mania and overly elevated energy levels. This cycle will repeat itself continuously, and many individuals with undiagnosed BD mistake manic episodes as a sign that their depression is improving. 

ADHD shares symptoms of both the manic and depressive sides of BD, such as increased energy, being easily distracted, talking a lot, impulsivity, inattention, and more. BD is a very serious condition, so distinguishing between the two during diagnosis is very important. 

Thyroid Disorder or ADHD?

The thyroid is a gland that has many very important functions in the body by creating two additional hormones called triiodothyronine and thyroxine. A person’s thyroid regulates heart rate, breathing rate, calorie burning, and heat production. Thyroid hormones are also incredibly vital for brain development and function later in life. 

Disruptions in brain function can cause symptoms similar to those of ADHD due to cognitive and behavioral impairment. ADHD shares symptoms with both hypothyroidism, such as insomnia, but it shares more symptoms with hyperthyroidism. Difficulty focusing, hyperactivity, irritability, insomnia, and anxiety can all be symptoms of both hyperthyroidism and ADHD. 

Treatment for ADHD Diagnosis

If you are diagnosed with ADHD by a professional, there are a few treatment options. There are several medications available as treatment, and they are usually an important part of improving patients’ symptoms. A medical provider will work with you to choose the medication that is going to be right for you, and sometimes they only need to be taken at certain times, such as before work or school. 

Often central nervous system (CNS) stimulants are prescribed for ADHD, and they work by increasing the amount of dopamine and norepinephrine in the brain. The stimulants provide a calming effect and, as a result, improve attention span and concentration. Common CNS stimulants include Adderall, Dexedrine, Desoxyn, and Focalin. 

For some patients, a provider may prescribe non-stimulant medication for ADHD treatment. This is usually considered an option when stimulant medication is not working, or the side effects are too severe. These medications increase levels of norepinephrine and help with memory and focus. Antidepressants like Pamelor, as well as other medications like Strattera, can also be used to treat ADHD.

Get an ADHD Diagnosis and Treatment Plan With Help From Klarity

Living with undiagnosed ADHD as an adult can disrupt everyday life, making certain tasks and responsibilities more challenging. Daily activities like cleaning the house or doing laundry can become overwhelming, and focusing at work or school can be extremely difficult. 

Receiving a professional diagnosis can help alleviate these challenges by providing access to treatment options to manage your symptoms, improve your focus, and make daily tasks easier. 

If you resonate with the discussed symptoms, Klarity can connect you with a certified and licensed mental health medical professional in just 48 hours. They’ll accurately evaluate your symptoms, provide an appropriate diagnosis, and help you create a suitable treatment plan.

Take the first step toward managing your symptoms—start with a free self-assessment to get connected with a qualified healthcare provider on Klarity.