How is Adult ADHD Diagnosed?

You don’t have to sit in a classroom anymore but daily struggles with paying attention, organizing your things, or holding back impulsive urges are negatively impacting your life. You might find yourself wondering if you have adult attention-deficit hyperactivity disorder (ADHD).

Medically reviewed

Last update: August 17, 2022
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    ADHD is a fairly common mental health disorder that is most typically diagnosed in childhood. However, many people actually get diagnosed for the first time as adults. According to statistics from the National Institute of Mental Health, around 4.4% of adults have a diagnosis of ADHD, but it is estimated that fewer than half are actually diagnosed. 

    Getting diagnosed with ADHD for the first time as an adult is less common since the majority of people get their diagnosis due to experiencing issues in a classroom setting. However, it’s pretty common for kids to get missed due to different presentations, lack of access to care, or well-developed coping mechanisms. Women are more likely than men to live with undiagnosed ADHD, but it can happen to anyone. 

    As our understanding of the disorder and how it presents across the lifespan expands, more and more adults are seeking assessments to determine if ADHD is indeed the root cause of many of their challenges. 

    Untreated adult ADHD can lead to many disruptions in a person’s daily life, relationships, and goals. Fortunately, it’s possible to identify your weaknesses and harness your strengths as a person living with ADHD at any age. 

    Keep reading to learn more about what adult ADHD looks like and how you can go about getting a diagnosis. 

    Recognize the symptoms of ADHD

    As an adult, the way ADHD impacts your daily life looks quite a bit different than the classic image of a disruptive child in a classroom. Symptoms present differently over development due to your maturing brain, advanced coping mechanisms, and a change of environment.

    Does and ADHD brain look different than a typical brain?

    Yes, it does! A massive MRI study used brain scans to compare 1,713 participants diagnosed with ADHD to 1,529 healthy controls (people without ADHD) and found significant differences in five key areas. 

    What brain areas are different?

    • Two areas of the Basal Ganglia (Caudate and putamen)- a brain region that controls emotion, cognition, and voluntary movement

    • Nucleus accumbens- a brain region involved in motivation and action. It plays a key role in eating, sexual, reward, stress-related, drug self-administration behaviors

    • Amygdala- Region of the brain that processes fear and stress

    • Hippocampus- Important functions such as memory and goal-directed behavior 

    A lot of adults with ADHD also tend to pick careers and lifestyles that make their symptoms more bearable, which can sometimes mask the symptoms or make them less obvious than those experienced by children in a structured classroom situation. 

    If you’re an adult with ADHD, you may experience symptoms such as:

    • Difficulties managing daily tasks

    • Consistently losing or misplacing things

    • Struggling with organization and neatness

    • Problems staying on top of bills, appointments, and other responsibilities

    • Feeling overwhelmed or frustrated with everyday tasks

    • Frequent job changes

    • Struggling with time management

    • Relationships problems due to forgetfulness, hyperfocus, or disorganization

    • Strong emotional reactions to seemingly minor problems

    • Extreme restlessness and impatience when asked to wait or remain still

    • Engaging in highly stimulating activities such as extreme sports or fast driving

    ADHD presents differently depending on the category of your diagnosis. Clinicians have divided ADHD into three distinct categories: 

    1. ADHD Predominantly inattentive type: Primary difficulties with organization, carelessness, losing things, and tasks requiring sustained attention. You may also have a pattern of starting multiple projects without ever finishing them.

    2. ADHD Hyperactive-impulsive type: Primary difficulties with sitting still or staying put. Characterized by talking excessively, interrupting others, and having difficulty with quiet activities. You may feel physical stress when required to engage in activities you find boring.

    3. ADHD Combined type: A combination of symptoms from both inattentive and hyperactive-impulsivity types of ADHD. 

    In addition to different types of ADHD, there are also differences in severity level. A person may be classified as mild, moderate, or severe depending on how much their symptoms impact their daily lives. It’s possible, and quite normal, for two individuals with ADHD to have extremely different presentations. 

    In order to be diagnosed with ADHD, you must have several of these symptoms present before the age of 12. Many children, especially girls, go undiagnosed for a variety of reasons, making it entirely possible to get your first diagnosis as an adult. 

    If you find that the symptoms above are relatable and they negatively interfere with your life, you might be interested in seeking out a diagnostic assessment for ADHD. Getting diagnosed is a vital first step for learning how to work with your strengths and beginning your journey to meeting your best self. 

    Seek a professional ADHD diagnosis

    You cannot diagnose ADHD yourself using online surveys, questionnaires, or by reading a symptoms checklist. ADHD can only be diagnosed by a healthcare professional such as a psychologist, psychiatrist, neurologist, or in some cases, nurse practitioners, physicians, or psychotherapists. When you seek out a diagnosis, be sure to clarify whether the healthcare provider is qualified and experienced in diagnosing ADHD. 

    Getting an appointment for an ADHD assessment can be a pretty big challenge for adults. The lack of qualified providers, long waitlists, and exorbitant costs associated with private clinics can all make you feel discouraged. As the need for more accessible care gains awareness, alternative options such as virtual assessments are gaining popularity. 

    Complete the evaluation process for ADHD

    Your assessment experience for ADHD can vary depending on your provider and the goals of the assessment. Typically, assessments take between one and three hours but can be much longer. 

    An assessment is made up of several parts that help your clinician paint a whole picture in order to accurately assess your symptoms and recommend appropriate treatment plans.

    Typically, assessments consist of:

    1. Personal and medical history intake: This interview gathers information about your development, health, family, and lifestyle history. You may be asked to provide health records from previous providers or pharmacy records and any previous cognitive tests. Your clinician may also want to interview your partner, parent, or another family member. Sometimes this part can be kept brief if your case isn’t complicated. 

    2. Current concerns: In order to understand your symptoms and how they impact your life, your clinician will want to investigate your current concerns, their impact on your functioning, and how you currently cope. They may also ask questions about your current relationships, work, family, and social life in order to better understand what challenges you’re facing in your daily life.

    3. Questionnaires and Rating scales for ADHD: There are a variety of tools used to assess ADHD that help to document and diagnose the condition. Some of these may be administered by a healthcare professional or are self-report forms. They can be helpful to use on an ongoing basis to monitor the severity of symptoms as you begin your treatment plan. 

    4. Cognitive screenings for ADHD: In some cases, you may be asked to do a cognitive screening. These are comprehensive assessments that highlight your strengths and weaknesses on a variety of tasks. You’ll receive scores for measures such as verbal memory, processing skills, and more. These tests will demonstrate your ability to maintain attention, impulsivity levels, and will also identify any learning disabilities. Learning disabilities and ADHD commonly occur together, with about 30% of people with ADHD also having a diagnosed learning disability. 

    5. Other Measures of Attention and Distractibility: Your healthcare provider may also suggest the administration of some additional assessments to further understand your strengths and limitations. Computerized tests such as the Test of Variables of Attention are effective for measuring complicated qualities such as cognitive control and sustained attention, which can contribute to many of the difficulties associated with ADHD. 

    6. Other Mental Health Tools: ADHD commonly occurs along with conditions such as anxiety and depression. Therefore, your diagnostic assessment may also include some questions, forms, or tools assessing these issues. 

    Getting a diagnosis of ADHD and any anxiety or depressive disorders is an essential first step to learning what changes you can begin making to improve your quality of life. ADHD can leave you feeling frustrated and helpless as an adult– the diagnostic process is the first step in gaining a better understanding of your wiring and getting the treatment you deserve. 

    Build an ADHD treatment plan

    Your ADHD treatment plan will depend on factors such as severity, diagnosis, and individual unique needs. Most people benefit from a treatment plan that is multi-faceted, focusing on skill-building, therapy, lifestyle changes, and in some cases, medication.  Your treatment plan could include any of the following:

    1. Medication for ADHD

      Not every person with ADHD will need medication to help them reach their treatment goals. However, for some people, medication can be a life-changing experience. Medication options for ADHD include stimulant and non-stimulant interventions.  ADHD medications help to boost focus and regulate other symptoms such as impulsivity. For many people, it makes daily tasks more manageable and takes away a great deal of emotional burden.  Stimulants are either amphetamine-based or methylphenidate-based capsules such Ritalin or Adderall, that come in immediate, sustained, and extended-release forms. Whereas non-stimulant options include medications such as Strattera or Intuniv. Medications can be taken as needed or on a daily basis. Your healthcare provider will discuss the best treatment plan for you and help you find a single medication or combination that works best for your symptoms. 

    2. Therapy for ADHD

      Since the classic definition of ADHD makes you think about behavioral issues, many people are surprised to learn that therapy is an excellent form of treatment.  Therapy will help you more effectively manage stressors, develop skills to navigate your symptoms and lean into your strengths. Whether it’s discovering ways to manage tasks, regulate impulses, or learning how to accept and love yourself– therapy can make a huge difference to your quality of life. Therapies such as Cognitive Behavioral Therapy, Mindfulness-Based Therapy and Brief Motivational Interviewing have all been shown to help improve the quality of life in adults with ADHD. 

    3. Lifestyle changes for ADHD

      Certain lifestyle changes can be extremely helpful for improving symptoms of ADHD and your overall wellbeing. One of the most important changes you can make with ADHD is to focus on good sleep hygiene. It is common for people with ADHD to have erratic sleep schedules. Maintaining a consistent wake-time, reducing electronic use before bed, and staying away from stimulants close to bed are all important changes that can boost your sleep and subsequently quiet your symptoms down. Additionally, keeping a fairly structured daily routine and adding in habits such as meditation and daily intentions can be extremely valuable changes to adopt. There are many avenues of self-care that are beneficial to ADHD, it’s about finding what works for you. 

    4. Diet and Exercise for ADHD

      Diet and exercise impact pretty much every facet of our wellbeing so it’s no surprise that they are important for ADHD. Regular exercise is especially beneficial for helping people with ADHD manage extra energy, stress, and anxiety which can make day-to-day life feel much more manageable.  As for diet, minimizing processed and sugary foods and focusing on a protein-rich diet can be extremely helpful. There is also evidence that supplementing with omega-3 fatty acids can help reduce symptoms of ADHD. 

    5. ADHD Coach

      An ADHD coach is a person specially trained to help you develop practical skills to help manage symptoms of ADHD. A coach may help you with setting goals, creating schedules, time management tools, and tips for staying organized. Coaches are also great for creating accountability and keeping you motivated as you begin implementing lifestyle changes. 

    Bottom line

    If you have a lifelong pattern of difficulties such as being disorganized, impulsive, frequently losing things, and struggling to pay attention to certain types of tasks, you may be wondering if you have ADHD. 

    Although ADHD is common, it is usually diagnosed in children and often missed in adulthood. Women with ADHD are especially more likely to travel through life without a diagnosis. Living without understanding the root cause of your struggles can lead you to feel like you are flawed, misunderstood, and exhausted from trying to self-regulate. 

    If you feel like you may have symptoms of ADHD, you can seek out a diagnostic assessment and begin a treatment plan. Trying a service like Frida is an excellent way to get a rapid assessment, gain a deeper understanding of your challenges, and learn the most effective ways to begin managing your symptoms and living your best life. 

    Getting a diagnosis at any age is an important first step to improving your wellness and reaching your goals.  Reach out today and rediscover your inner strengths.

    Lisa Batten, PhD, CPT, PN1

    Lisa Batten is a clinical scientist, therapist, and writer specializing in neuroscience and clinical pharmacology. She has a master’s degree in clinical psychology and a Ph.D. in developmental psychology.