Do I Have ADHD? Adult Assessment & Diagnosis From A Therapist

Attention-deficit hyperactivity disorder (ADHD) has gotten much more media attention in recent years due to an increase in understanding of symptoms and diagnostic methods. However, although this increased attention can have positive impacts on some people, encouraging them to get help, it can also lead to misinformation. Below, explore the symptoms of ADHD according to the most widely used diagnostic manuals and discover why seeking therapy is the best and most effective way to get help. 

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Understanding attention-deficit hyperactivity disorder (ADHD) 

Attention-deficit hyperactivity disorder is a neurodevelopmental condition present from birth that tends to start showing symptoms in the first few years of life, similarly to autism spectrum disorder (ASD), a commonly co-occurring condition. This condition is characterized by several common symptoms, including hyperactivity, inattention, and impulsivity. Because ADHD can be difficult to diagnose, some people don’t receive a diagnosis until adolescence or adulthood. However, symptoms must be present and recalled in one’s childhood for ADHD to be diagnosed. 

Understanding the ADHD subtypes and symptoms 

Previously categorized as either ADHD or attention-deficit disorder (ADD), ADHD is now separated into three subcategories in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Revised (DSM-5-TR) and International Classification of Diseases (ICD) by the World Health Organization (WHO). Below are the symptoms separated into each category. 

ADHD-PI

The primarily inattentive subtype of ADHD used to be referred to as ADD but is no longer categorized this way. The inattentive symptoms of this subtype and combined type ADHD include the following: 

• Difficulty paying attention when following instructions 
• Making frequent careless mistakes at school, work, or during instructed or structured activities
• Losing items frequently 
• Difficulty sustaining attention for long periods 
• Difficulty waiting 
• Difficulty listening when spoken to (might seem absent) 
• Difficulty finishing or following through on projects
• Difficulty organizing their home or workspace
• Avoidance of tasks that require significant mental effort
• Becoming frequently distracted by external stimuli 
• Forgetfulness 

ADHD-HI

Hyperactive-impulsive ADHD is a subtype involving six or more of the following that have persisted for at least six months and started in early childhood: 

• Fidgeting frequently 
• Leaving the seat when required to stay seated, especially at school or work
• Running or climbing in inappropriate situations
• Seeming to be “driven by a motor” or “always on the go” 
• Talking excessively or loudly and interrupting others
• Blurting out answers to questions before the question is finished being asked
• Difficulty waiting in line 
• Impulsive behaviors, such as substance use, risky sex, risky relationships, frequent spending, and dopamine-seeking 
• Intruding on the conversations or activities of others 
• Difficulty regulating emotions 
• Intense hyperfocus on passionate interests 

Combined ADHD symptoms  

Combined ADHD involves major symptoms of both the inattentive and hyperactive-impulsive subtypes of ADHD. Combined ADHD is the most common type and can result in difficulty with focus and self-control, leading to potentially more intense or severe symptoms. However, all types of ADHD can be severe and difficult to manage, requiring treatment. 

Common co-occurring mental illnesses and neurodevelopmental conditions 

ADHD commonly co-occurs with other mental health conditions and developmental disorders, including but not limited to the following: 

• Anxiety disorders (25% of people with ADHD have anxiety) 
• Autism spectrum disorder (up to 70% of Autistic people have ADHD) 
• Mood disorders like bipolar disorder (one in six people with bipolar disorder has ADHD) 
• Obsessive-compulsive disorder (25% of people with OCD have ADHD) 
• Depressive disorders (up to 53% of people with ADHD have depression) 
• Sleep disorders 
• Personality disorders 

The rise in ADHD self-diagnosis trends

ADHD has been discussed more commonly in recent years online, especially on social media platforms like TikTok, Instagram, and Facebook. Through short-form video content, creators can share information about mental health conditions and find community with other people who are diagnosed with them. However, as ADHD becomes a trending topic, more people are wondering whether they may have the condition. As people sharing information online are often not professionals, they may inadvertently share misinformation without realizing it. When people get misinformation, they may self-diagnose based on incorrect assumptions of the condition, which can lead to more people thinking they have ADHD when they do not. 

The potential harm of self-diagnosing attention-deficit hyperactivity disorder (ADHD)  

Self-diagnosis may be helpful for people who cannot afford an ADHD assessment. However, therapists can also diagnose ADHD, and many therapists offer sliding-scale support options. When people self-diagnose based on misconceptions, they may wrongly believe they have a condition they do not, which can lead more people to seek medication, treatment, and support for ADHD when they may be struggling with something else. 

The BetterHelp platform is not intended to provide information on which medication or medical treatment may be suitable for you. The content provides generalized information that is not specific to one individual. Do not take any action without consulting a qualified medical professional.

ADHD mental health myths and misconceptions spread online 

Below are some common myths about ADHD spread online and reasons why they’re false: 

• “ADHD only affects children” (False): ADHD first appears in childhood but can be diagnosed at any age. 
• “ADHD is the same as autism” (False): ADHD and autism are separate conditions and do not always co-occur. 
• “Social media is a good place to get information about ADHD” (False): Although some content on social media is correct, experts have found that 52% of videos on platforms like TikTok are offering misinformation about the condition. 
• “ADHD is a fancy term for laziness” (False): People with ADHD have significant struggles with daily tasks and are living with a real neurological difference impacting daily life.
• “If you relate to a video about ADHD, you have ADHD” (False): Many videos about ADHD, even if they are accurate, are not the full picture. For example, a person might say, “Since my ADHD makes me hyper-focused, if you also become hyper-focused on projects, you have ADHD.” People without ADHD can have some symptoms of ADHD, but not fit the diagnostic criteria. 
• “Self-diagnosis is never harmful” (False): Although some people might genuinely struggle to find someone to diagnose them, self-diagnosis can be harmful because it is not based on the professional qualifications or diagnostic manuals and training that professionals possess.   
• “ADHD is just difficulty focusing” (False): Even if someone has a primarily inattentive type of ADHD, they must meet six or more of the symptoms outlined in the DSM-5 to qualify for diagnosis. There are many causes of a lack of focus, not only ADHD. 

How is ADHD diagnosed by a therapist? 

A therapist, psychiatrist, social worker, psychologist, or counselor can diagnose ADHD by conducting a comprehensive assessment that involves interviews, symptom checklists, and other relevant tools. Common diagnostic tools used include: 

• The Vanderbilt ADHD Diagnostic Rating Scale
• The Conners scales 
• DSM-5 and ICD-11 manuals 
• The Swanson, Nolan, and Pelham (SNAP) Scale
• The Child Behavior Checklist (CBCL) 
• The Behavior Assessment System for Children (BASC) 
• The Adult ADHD Self-Report Scale (ASRS) 
• The Wender Utah Rating Scale (WURS) 
• The Brown Attention-Deficit Disorder Symptom Assessment Scale (BADDS) for Adults
• The Conners’ Adult ADHD Rating Scales (CAARS)

Providers may also use traditional mental health and ADHD testing methods, such as the Rorschach test, IQ testing, autism tests, and interviews, to identify other conditions and potential causes of ADHD-like symptoms. If the provider finds reason to believe a client has ADHD, a diagnosis is then made after several meetings. In some cases, a diagnosis is made by a therapist after several therapy appointments, during which the therapist gets to know the client’s life, symptoms, and their impacts. 

The importance of finding a licensed therapist or psychiatrist for diagnosis 

The reason it’s essential to seek a professional for a diagnosis of ADHD is that the diagnostic process involves more than checking off a checklist. Below are some of the other requirements and steps that go into diagnosis, which make it important to talk to a therapist or another mental health provider: 

• ADHD symptoms must persist for over six months 
• Symptoms must be present before the age of 12
• Symptoms (especially hyperactivity) must not be due to a difficulty with obedience or conduct disorder (CD) 
• Symptoms must not be explained by autism spectrum disorder or another neurodevelopmental condition 
• The therapist must talk to the client and get to know them 
• Symptoms must cause substantial difficulty in one or more areas of function, such as socializing, work, school, or self-care
• Symptoms must not be due to a medical condition 
• Symptoms must persist throughout life, though they may change with age, hormones, and other factors 

Diagnosis often involves several steps, including interviews, therapy sessions, and questionnaires, and isn’t limited to just examining symptoms. Someone can have many symptoms of ADHD but be living with another condition altogether or no mental illness at all. Therapists are trained to look for these subtle signs in a way that a stranger on the internet cannot. Online videos are not a substitute for personalized support or advice, nor are articles, books, or self-help checklists. These tools can be helpful, but they are not a replacement for professional diagnosis. 

How a therapist may treat ADHD 

ADHD is commonly treated using mental health therapy, medication, or a combination approach. In some cases, children with ADHD may benefit from alternative support options, such as occupational therapy, play therapy, or group sessions. In-school support and accommodations can also help a child or adult manage symptoms more easily. 

Note that some medications for ADHD are addictive, so they may be listed as controlled substances when you pick them up from the pharmacy. Talk to your doctor before starting, changing, or stopping any medication for ADHD, and ask them about the side effects and potential interactions with other medications. 

Alternative mental health support options 

Accessing in-person therapy as someone with ADHD can be difficult, adding another appointment to a potentially busy schedule. In these cases, online therapy platforms like BetterHelp for adults or TeenCounseling for teens may be more accessible. Through an online platform, you can attend appointments from home via phone, video, or live chat so you don’t have to get up and get dressed for an in-person visit. Additionally, you can access all resources from one place, including weekly online support groups, webinars, journaling prompts, and worksheets.

Online therapy has been found effective for people living with ADHD. For example, in one study, online therapy was found to be more effective for people who have had past difficulties with in-person therapy for ADHD and reduced symptom severity for the participants.