Attention-Deficit Hyperactivity Disorder (ADHD)
Whether you are here for a professional adult ADHD diagnosis with medication management or just want to learn more about ADHD, you are in the right place. We'll review what defines ADHD, common signs and symptoms, provide a self-assessment screening tool, and explain how ADHD is diagnosed and treated.
Baltimore Psychiatry Online ADHD Evaluation and Treatment
What Is ADHD?
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that impairs an individuals ability to function socially, academically, and/or occupationally. While this is a complex disorder, symptoms occur primarily due to underdevelopment in an area of the brain known as the prefrontal cortex. This affects executive function, which is comprised of working memory, self-control, decision making, problem solving, planning, time management, and other related abilities.
What Are the Signs and Symptoms of ADHD?
Someone may experience inattentive symptoms, hyperactive symptoms, or a combination of both and not all cases look exactly alike. To receive a diagnosis, symptoms must be significant enough to negatively impair ones ability to function.
Some common inattentive symptoms include:
- Inability to concentrate and focus
- Frequently misplacing or losing things
- Forgetting appointments
- Difficulty organizing tasks or environments
- Lack of follow-through and completion of tasks
- Becoming easily distracted
- Frequently making careless mistakes
- Trouble paying attention even when someone is speaking directly to you
Some common hyperactivity symptoms include:
- Frequently fidgeting or squirming, such as constantly moving hands and feet
- Difficulty sitting still or staying seated
- Difficulty with waiting ones turn
- Interrupting others even when they are busy
- Finishing the sentences of others or answering questions prematurely
- Feelings of being internally driven by a motor
- Inability to relax and unwind during free time
- Significant impulsivity making an individual prone to engaging in risky behavior or getting into conflict with others (untreated ADHD is correlated with higher substance abuse and incarceration rates)
- Difficulty controlling or regulating emotions
I Think I May Have ADHD, How Can I Assess My Symptoms?
There are several well respected clinical scales used by professionals to help support an ADHD diagnosis. The Adult ADHD Self Report Scale is one of the most widely used. This is an abbreviated version that can help you quickly assess your ADHD symptoms. This screening tool is copyrighted by its respective owner and is being shared here with permission.
Remember that this tool only assesses symptoms. ADHD symptoms can have numerous causes unrelated to ADHD. A professional evaluation is necessary to determine the root cause of those symptoms and provide a diagnosis.
Is Adult Onset ADHD Possible?
ADHD in adults is fairly common. According to the U.S. Department of Health and Human Services, it is believed that 4.4% of the adult population ages 18 to 44 in the United States has ADHD. However, this is a developmental disorder that begins in childhood. If you are suddenly noticing symptoms of ADHD as an adult for the first time, it likely means one of two things.
The first possibility is that you had ADHD as a child that went undiagnosed. ADHD may not have been recognized or diagnosed in childhood for myriad reasons. Lack of ADHD awareness and stigma, above average intelligence, strong coping skills, milder symptoms, or other environmental factors may have masked ADHD symptoms in childhood.
The second possibility is there is something other than ADHD that is causing the onset of these symptoms. Numerous medical and psychiatric disorders may imitate or contribute to symptoms similar to those of ADHD. Natural cognitive decline due to aging may also be a factor, particularly for older adults.
Who Can Diagnose ADHD In Adults?
Baltimore Psychiatry can diagnose and provide treatment for ADHD. Click here to schedule an online adult ADHD evaluation with medication management.
There are many different professionals who can diagnose ADHD with varying degrees of proficiency.
Psychiatric Nurse Practitioners and Psychiatrists
They can diagnose ADHD and prescribe medication. They also have the medical knowledge and training to identify and rule out other medical and psychiatric disorders (differential diagnosis). However, many do not provide therapy. If therapy is warranted many will refer out for that portion of treatment. While therapy may be necessary or beneficial for some symptoms of ADHD, it is often unnecessary for many cases.
Primary Care Nurse Practitioners and Primary Care Physicians
They can technically diagnose ADHD and prescribe medication. However, many are uncomfortable making or treating an ADHD diagnosis and will often refer to a psychiatric specialist.
Neurologists
They can diagnose ADHD and prescribe medication. They will excel in differentiating between ADHD and other neurological disorders or cognitive deficits even better than most psychiatrists or psychiatric NP's. However they typically do not have psychiatric experience to differentiate between ADHD and other psychiatric disorders. They also will not provide adjunct treatment for comorbid psychiatric disorders. Therefore, some will still refer out to a psychiatric specialist for ADHD treatment.
Psychologists, social workers, and therapists
They can diagnose ADHD and can be a good source of ongoing therapy treatment. While they may be able to differentiate between ADHD and some some other psychiatric disorders, they do not have the medical background required to differentiate between ADHD and many other potential disorders. They are not also not able to order labs (if necessary during differential diagnosis) or prescribe medication. Therapy may be particularly helpful for those experiencing symptoms of hyperactivity, impulsivity, and emotional lability.
What Are The Treatment Options For ADHD?
Around 50% of children with ADHD will outgrow the disorder as their brain continues to develop and will no longer need treatment. However, once someone reaches adulthood and brain development has stopped, this a chronic and lifelong disorder. The good news is there are extremely effective and affordable treatments available that can help most with ADHD significantly improve their quality of life.
Medication
Medication is by far the most effective treatment for ADHD. Individuals with ADHD experience symptoms in large part because they do not adequately produce and/or utilize a couple key neurotransmitters in the prefrontal cortex. Medication can help improve the production and transmission of these neurotransmitters. While medication is not the only treatment for ADHD, other treatment options will have very limited impact on increasing neurotransmitter level or signaling ability. Instead, these other treatments are typically aimed at reducing symptoms or controlling impulses once they manifest. Medications help prevent symptoms from occurring in the first place.
Therapy
Therapy can be beneficial for some cases of ADHD, but is not always necessary or helpful. It may be particularly useful for those needing assistance coping with emotional lability, hyperactivity, or impulse control. Additionally, some therapists may be able to help educate and coach patients to efficiently organize their environments and plan their daily routine in a manner that mitigates ADHD symptoms. Therapy can be helpful with other mental health disorders that are commonly comorbid with ADHD. However, therapy is generally going to have limited to no benefit helping manage inattentive symptoms with a root origin of ADHD.
Natural Treatments
Adequate sleep, exercise, and healthy eating habits are fundamental and absolutely crucial to all mental and physical health. For someone who naturally has poor habits, correcting those poor habits could potentially have a major impact on symptom severity. At the same time, there is currently no conclusively proven natural remedy, diet, supplement, etc. to treat ADHD.
What Causes ADHD?
We understand that ADHD is caused by a lack of development in certain areas of the brain, but we do not yet understand what causes this lack of development. ADHD appears to be highly genetic and epigenetics may play a major role too. This means that someone may have a genetic predisposition for ADHD, but their environment and behaviors will play a significant role in determining whether they actually develop ADHD. More research is necessary to provide concrete answers.
ADHD Quick Statistics
Percentage of adults who currently have ADHD
Among U.S adults ages 18 to 44
Childhood ADHD persists into adulthood
Around half of all children with ADHD will continue to have the disorder as an adult
Individuals with undiagnosed ADHD seeking mental health treatment for another disorder
References: U.S. Department of Health and Human Services. (n.d.). Attention-Deficit/Hyperactivity Disorder (ADHD). National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/statistics/attention-deficit-hyperactivity-disorder-adhd