Dronile Hiraldo
Clinically reviewed by Dr. Gayle Jensen-Savoie
Many licensed health professionals, advocates, and fitness influencers are taking to TikTok to illuminate what ADHD is and isn’t. Yet despite efforts to spread awareness about the mental condition, many of the videos on the platform aren’t addressing the subtleties and presentation of symptoms over time.
Older folks with ADHD — who grew up in a time when ADHD was less known, for example— may have internalized negative messages about their character due to problems that may have initially started because of their ADHD. Today’s young people, on the other hand, have a lot more information at their fingertips. But that can lead to misdiagnosing one’s self.
If left untreated, ADHD can result in poor work performance, drug abuse, addiction and relationship problems. With a diagnosis, the problems of ADHD can become strengths. People can channel their restlessness and creativity in a career that requires high energy and innovation. That’s why a professional diagnosis is the first step to identifying whether you or a loved one has ADHD.
Why Self-Diagnosis Isn’t The Best Approach
Gregory J. Harms, Psy.D., a psychologist based in Chicago, Ill., sat down with ADHD Online’s Lindsay Guetzel to dive into the importance of an ADHD diagnosis on a recent episode of our podcast. What he highlights are the intricacies that come with ADHD that can’t be pinpointed in a TikTok video.
Harms says that understanding your possible ADHD is important, even if you definitely aren’t interested in taking any medicine.
“Even if you don’t want to do medication for yourself or put your child on medication, there still are a lot of other strategies … for addressing [ADHD] and managing it that you can still start learning about,” he says.
Many of the TikTok videos also address what Harms calls “associated problems” such as spaciness, sensitivity to rejection, sensory sensitivities and sleep deprivation — all of which can be linked to ADHD yet aren’t direct symptoms of the condition. Hyperactivity
is the most common and well-known symptom of ADHD. But it’s actually one of three ways ADHD can show up, according to the most recent edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, the DSM-5. The three types of ADHD are:
- Predominantly Inattentive: For those with predominantly inattentive ADHD, symptoms can look like incomplete tasks and projects, being easily distractable, forgetfulness and disorganization.
- Hyperactive-Impulsive: Hyperactive impulsivity is what most people think of when they think of ADHD. It might be the young girl who squirms in her seat and can’t sit still, the student who calls out of turn, the high-achieving Ivy Leaguer who feels a constant need to move and be on the go.
- Combined: In some cases, ADHD can look like a combination of both inattentiveness and hyperactive-impulsivity. This could mean the individual displays more control over their physical impulses yet may struggle with tasks that require deep intense focus. Or they may be someone who is highly organized yet requires a lot of stimulation.
Much like genetics, how ADHD presents itself will vary from person to person. Because of how well high-achieving ADHDers can mask and manage their symptoms, for example, a change in their coping strategies might be what helps them uncover their ADHD.
Having a lot of structure and support around them can help these individuals succeed. Yet they may find that they hit a wall without assistance. What makes a diagnosis even more complicated is that symptoms can often mirror overlapping conditions.
Harms mentions, for instance, that there’s a 33% overlap between ADHD and bipolar disorder. A thorough assessment provides an accurate picture of whether your or your child’s systems are ADHD or not. In cases where an assessment shows no ADHD, your doctor might instead offer recommendations for depression, bipolar disorder, anxiety, obsessive-compulsive disorder or other possible conditions.
What To Look For When Choosing An ADHD Professional
When seeking a diagnosis, the first thing to ask is if the professional or specialist is experienced with ADHD. Harms recommends asking about the professional’s experience with people who thought they had ADHD but didn’t. You might also ask them about treatment options they usually suggest. “Does it feel like what they’re recommending would be a good fit for your own personal style?” he asks.
Harms also says that if you prefer to talk things through and understand the “why” behind your condition, then an expert who focuses heavily on modifying and changing your actions or behaviors may not be an ideal fit.
Instead of committing six months to a professional who might not be a good fit, Harms advises a four-session trial. Then you should honestly evaluate if it feels like you’re being heard or like the relationship is working.
The right professional will look for at least six symptoms in a child and at least five in an adult to determine if what they’re experiencing is ADHD or not.
Difficulty paying attention or challenges with time management could be linked to ADHD. But it’s all about the timeline, Harms says. Someone who started experiencing difficulties later in life, such as in high school, may actually be dealing with a condition other than ADHD. At least some symptoms of ADHD show up by the time a person is 12, and very often long before then.
“The big thing is when the difficulties first started because that really is the key to an accurate diagnosis and a conceptualization of what’s going on,” Harms says. “ADHD is very much like a lifespan condition. It starts very early on, in childhood. Early grade school.”
Early indications of ADHD can become more manageable over the years, making the ADHD seem as if it’s disappeared. Yet, for many, the condition will continue into adulthood.
How To Prepare For A Diagnosis
Is preparation needed ahead of the assessment? That can depend on the circumstances.
Harms notes people will often get the timeline of their symptoms wrong. That’s why it’s important for both the person being assessed and the specialist to talk to parents, siblings, or spouses.
“If your parents saved your report cards, you know you could look at those if the teachers made comments,” he says. Comments that could be especially illuminating for adults who are a little bit older include: “needs to sit still,” “needs to learn to listen,” and “needs to learn not to talk back.” Those would signal challenges at an early age.
For an in-office assessment, which Harms provides in his practice, a person should bring in any previous ADHD diagnosis, if available. Harms also will usually send questionnaires to people who know the patient well. That group might include a spouse, a parent, a close friend, a pastor or a boss.
The idea is to confirm that the person’s symptoms are linked to ADHD and not a harsh self-judgment, a bout of depression or manifestation of low self-esteem. In-office assessments can also include thorough testing of attention and executive functioning, including ADHD rating scales and brain scans. These are used to identify any of those parallel conditions that might better explain the challenges the individual is experiencing.
Available Treatment Options for ADHD
The struggles resulting from ADHD will continue without an accurate diagnosis. Struggling through life, the feeling of not getting things done, losing things, forgetting to pay bills, getting hit with late fees, getting locked out of accounts, and the like will all continue to happen if ADHD isn’t properly treated.
Medication is an avenue of treatment many might consider. Yet Harms again says you should find someone who is an expert in ADHD to ensure the person getting assessed receives the proper treatment. “Psychology Today is a great resource for that. You could check with your own insurance. Call them and see who might be in-network that’s close to you who might have ADHD as a specialty. There’s a lot of ways to find that,” he says.
If you feel medication might not be the best route, working with an executive functioning or ADHD coach is also an option. Coaches and therapists can provide practical strategies to help individuals diagnosed with ADHD. Those strategies might include putting things into a calendar, creating to-do lists, creating prompts and reminders, scheduling time between tasks, using meditation to refocus, and talking to individuals in your life about ADHD.
A therapist can also help patients address the emotional baggage that comes with a mental condition.
If you’re a parent of a child with ADHD, then these therapist-recommended strategies could be a jumping-off point for talking with your child’s teacher about classroom accommodations.
An ADHD diagnosis for an adult can clear up a lot of self-misconceptions from childhood and be a validating experience, Harms says. “It can be a relief just to kind of get the answer that, ‘Yes, it is ADHD that’s causing this,'” he says. “It’s not that ‘I’m a terrible person or lazy or have no motivation’ — which can be the message people kind of get throughout their life.”
Harms encourages everyone not to be discouraged by the stigma that comes with a mental health condition. Instead, he says, “take it as more information” and see a diagnosis as a way to maximize life.
Whether the diagnosis is for yourself, a child or a loved one, it’s best first to find a medical practitioner who has previous experience and extensive knowledge in treating ADHD.
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