An estimated 15 million Americans have ADHD. Without proper identification and treatment, ADHD can lead to serious consequences such as school failure, family stress, depression, relationship problems, substance abuse, delinquency, accidental injuries, and job failure. Early identification and treatment are crucial. With the right support, individuals with ADHD can lead successful lives.
Attention-Deficit/Hyperactivity Disorder,
What is ADHD?
ADHD is a neurodevelopmental disorder affecting both children and adults. It involves persistent patterns of inattention and/or hyperactivity-impulsivity that interfere with daily life. ADHD affects attention, executive function, and working memory.
How is ADHD diagnosed?
The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association (APA), provides the criteria used by doctors, mental health professionals, and other qualified clinicians to diagnose ADHD. The latest edition, the DSM-5 was released in 2013 and introduced changes to the definition of ADHD, impacting its diagnosis in both children and adults.
What Has Changed in ADHD Diagnosis with the DSM-5?
Teen and Adult ADHD: Previously, ADHD diagnoses focused primarily on children, often leaving teens and adults undiagnosed. The DSM-IV required symptoms to be documented before age 7, but the DSM-5 has raised this to age 12. This change allows for a more accurate diagnosis in teens and adults, as clinicians can now consider symptoms that appeared during middle childhood and adolescence. The DSM-5 also includes detailed examples of how ADHD presents in older age groups.
Symptom Descriptions: The DSM-IV referred to ADHD types as “subtypes,” but the DSM-5 now calls them “presentations.” This terminology reflects that symptoms can change over time, and an individual’s presentation of ADHD may shift throughout their life.
Severity Levels: Clinicians must now specify whether a person has mild, moderate, or severe ADHD, based on the number of symptoms and their impact on daily life.
Pervasive Presentation: Several symptoms must be present in more than one setting, ensuring that ADHD is consistently affecting the person’s life.
DSM-5 Criteria for Diagnosing ADHD
To diagnose ADHD, it’s crucial to first rule out other conditions that might be causing the symptoms. The DSM-5 guidelines are specific:
- Children and Teens: Symptoms must be more frequent or severe than those of their peers. Six or more symptoms are required.
- Adults: Symptoms must persist from adolescence and impact daily life. Five or more symptoms are needed.
Symptoms must create significant difficulty in at least two areas of life (home, social settings, school, or work) and be present for at least six months.
ADHD Presentations
- Predominantly Inattentive Presentation:
- Careless mistakes, difficulty sustaining attention, not listening, failing to follow through on tasks, disorganization, avoiding tasks requiring sustained mental effort, losing things, easily distracted, forgetful in daily activities.
- Predominantly Hyperactive/Impulsive Presentation:
- Fidgeting, difficulty remaining seated, excessive running or climbing, inability to engage in activities quietly, acting as if driven by a motor, talking excessively, blurting out answers, difficulty waiting turns, interrupting others.
- Combined Presentation:
- Meets criteria for both inattentive and hyperactive/impulsive presentations.
Do I Need to Diagnose the Severity of Symptoms?
Yes, the DSM-5 requires professionals to specify the severity of ADHD:
- Mild: Few symptoms beyond the required number, causing minor impairment.
- Moderate: Symptoms or impairment between mild and severe.
- Severe: Many symptoms beyond the required number, causing significant impairment in daily life.
ADHD severity and presentation can change over a person’s lifetime. There is also the possibility of partial remission, where an individual who previously met all the criteria experiences fewer symptoms over a six-month period.
Treating ADHD
Treating ADHD often requires a comprehensive, multimodal approach that includes medical, educational, behavioral, and psychological interventions. Depending on the age of the individual with ADHD, this approach may involve:
- Parent training
- Medication
- Skills training
- Counseling
- Behavioral therapy
- Educational supports
Living with ADHD as an Adult
ADHD can persist into adulthood, and many adults have ADHD without ever being diagnosed. The symptoms can create challenges at work, at home, and in relationships. In adults, hyperactivity might show up as extreme restlessness, and symptoms can become more severe with the increased demands of adulthood.
At Brain Health Psychiatry, we understand the unique challenges that come with managing ADHD throughout your life. Whether you’ve recently been diagnosed or have been struggling with symptoms for years, we’re here to help. Our personalized treatment plans are designed to meet your specific needs and support you in managing your symptoms effectively.
For more information about diagnosis and treatment throughout the lifespan, visit the National Resource Center on ADHD and the National Institutes of Mental Health websites. And remember, Brain Health Psychiatry is here to support you every step of the way.
Call us at; 954-694-7292 Offering telehealth appointment for your convenience.