Diagnosing ADHD in adult patients is challenging
Attention deficit hyperactivity disorder (ADHD) affects both children and adults, though it is often associated only with children and often goes unnoticed in adults. The functional impact of ADHD in adults is different from that in children and this makes it difficult to arrive at a proper diagnosis.
It is usually assumed that the hyperactivity/impulsivity in children tail off as they grow into adults. However, in reality, there is only a shift in the symptom cluster, evolving from behavioral to cognitive. As adults, they begin to feel restless and this symptom usually replaces their childhood behavior of running around and being disruptive in school. Though the disruptive behavior can be easily identified in children as signs of ADHD; restless adults (due to ADHD) are hardly termed as ADHD patients.
Nevertheless, certain behavioral traits can help ascertain attention deficit in adults. Such people usually find it difficult to complete tasks, are poor in time management, get easily distracted, forget things, have poor concentration and are unable to sustain their attention in everyday activities.
Here, we look at six challenges faced by experts in diagnosing ADHD in adult patients:
- Unavailability of validated diagnostic criteria: ADHD is a developmental disorder and hence, earlier (childhood) symptoms are paramount to diagnose the current condition. But patients often have difficulty recalling symptoms present during childhood. This is one of the biggest hurdles in zeroing in on symptoms denoting ADHD in adult patients.
- Overlapping of psychiatric comorbidity and symptoms: Sometimes ADHD symptoms overlap with other psychiatric conditions. For instance, the manic and hypomanic symptoms of bipolar disorder are somewhat similar to the hyperactive and impulsive characteristics associated with ADHD. These similarities in symptoms make it difficult to conclude whether it is ADHD or another psychiatric condition.
- Coping mechanisms: Few patients who have ADHD, also have a higher than average IQ and this usually helps them develop coping mechanisms and become highly functional. They may have a to-do list and would accomplish their tasks like any other normal adult. They may even persuade colleagues and family and friends in helping them remember important tasks. All these may camouflage ADHD symptoms in these adults and make it difficult for clinicians to diagnose.
- Failure to demonstrate significant clinical impact: To establish ADHD in adults it is important to see clear evidence which is possible in children but not adults. For instance, to clearly establish clinical evidence there should be incidences of disciplinary action at work, discordant relationships, frequent accidents, etc. If a person often shows behavioral problems resulting in such incidents it could indicate ADHD.
- Over-diagnosis vs under-diagnosis: There is often the problem of over-diagnosis and under-diagnosis in ADHD. Not only do mental health symptoms overlap but people even feigning ADHD is common. At times, the diagnosis of ADHD in adult patients can also become difficult due to drug addiction.
- Drug-seeking behavior and prescription drug abuse: Most adult patients with ADHD symptoms are between 18 and 24, an age group when drug-seeking behavior is on the rise. This again dilutes the accuracy of a proper clinical diagnosis of ADHD in adults since substance abuse elicits signs quite similar to ADHD.
Treatment is the way forward
Whether induced by ADHD or some other psychiatric condition, mental health problems need immediate attention. Sovereign Health, San Clemente, offers behavioral health treatment services for most mental illnesses and addiction. Hence, if a loved one is suffering from any mental disorder, and you are scouting for mental health treatment programs, call our 24/7 helpline number or chat online for further information. Our mental health treatment centers are among the best in the country.