Black children and adults with ADHD are less likely to receive an accurate diagnosis and proper treatment due to structural racism, low socioeconomic status, and stigma, all of which can worsen the symptoms of ADHD. Racial disparities in health care are critical to recognize and address because untreated symptoms of ADHD — including learning difficulties, impulsivity, inattention, and hyperactivity — can lead to harsh punishment of students in school, failure to graduate, substance use, and increased risk for incarceration.

In this webinar, you will learn:

• About risk factors for ADHD in Black individuals
• About the facets of racism and the present-day policies that impede proper diagnosis, care, and treatment of ADHD in Black communities
• About the serious consequences associated with untreated ADHD
• What adults and caregivers of children with ADHD need to know to find appropriate providers and ensure proper care and treatment
• How adults and caregivers of children with ADHD can effectively address stigma, build trusting relationships with clinicians, and overcome other barriers to treatment
• About strategies, including Parent Behavioral Training Programs, that can be effective for managing ADHD in families of color

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

Download or Stream the Podcast Audio

Click the play button below to listen to this episode directly in your browser, click the  symbol to download to listen later, or open in your podcasts app: Apple Podcasts; Audacy; Spotify; Amazon Music; iHeartRADIO.

Healthy Equity in ADHD: More Resources

• Get: 2024 Scorecard of ADHD Treatments
  
• Read: The Ongoing Work of Normalizing ADHD in BIPOC Communities
• Read: Why We Must Achieve Equitable ADHD Care for African American and Latinx Children
• Download: How Common Is ADHD in Adults?

Obtain a Certificate of Attendance

If you attended the live webinar on March 7, 2024, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker

Napoleon Higgins, M.D., is a child, adolescent, and adult psychiatrist in Houston, Texas. He is the owner of Bay Pointe Behavioral Health Services and Kaleidoscope Clinical Research.

Dr. Higgins is the Executive Director of the Black Psychiatrists of America, CEO of Global Health Psychiatry, President of the Black Psychiatrists of Greater Houston, Psychiatry Section Chair of the National Medical Association, and Past President of the Caucus of Black Psychiatrists of the American Psychiatric Association.

Dr. Higgins is co-author of Bree’s Journey to Joy: A Story about Childhood Grief and Depression, How Amari Learned to Love School Again: A Story about ADHD, Mind Matters: A Resource Guide to Psychiatry for Black Communities and author of Transition 2 Practice: 21 Things Every Doctor Must Know In Contract Negotiations and the Job Search. (#CommissionsEarned)

Dr. Higgins has worked with and founded programs that help to direct inner-city young men and women to aspire to go to college and finish their educational goals. He has worked with countless community mentoring programs and has special interest in trauma, racism, and inner-city issues and how they affect minority and disadvantaged children and communities.

#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication.

Listener Testimonials

“Fantastic webinar. The examples really brought home the points and he did a good job of showing how complicated this is to navigate.”

“Thank you for providing info about culturally competent ADHD treatment. Dr. Higgins highlighted what us Black parents have always known — that race matters when it comes to medical and educational resources. I wish this information could be proliferated in every school across the nation!”

“Great speaker, and very insightful. I enjoyed this presentation very much.”

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By Russell Barkley, Ph.D.

DSM-5 ADHD criteria are flawed for several reasons. “The DSM-5 does not capture ADHD accurately because its criteria do not conceptualize ADHD as a disorder of executive functioning and self-regulation,” says Russell Barkley, Ph.D. “This limitation greatly narrows the concept of ADHD, trivializes its nature as just an attention deficit, and discourages diagnosing clinicians from focusing on the wider range of impairments inherent in ADHD.”

Despite these flaws, Barkley explains, clinicians can ensure more accurate diagnoses by focusing more on the patient’s symptoms of disinhibition and executive dysfunction and less on the age of onset for ADHD symptoms.

Continue reading “How the DSM-5 Fails People with ADHD — and a Better Way to Diagnose”

DSM-5 ADHD Criteria Challenged: Related Resources

• Read: ADHD Is a Whole-Life Experience. The DSM Needs to Reflect That.
• Read: Why We Need U.S. Guidelines for Adults with ADHD
• Read: What do I need to understand about ADHD that is not fully represented in the DSM?
• Download: How Is ADHD Diagnosed?

2. Deciphering Irritability in Children: Causes and Links to Comorbidities

By William French, M.D., DFAACAP

“Irritability is to mental health providers what fevers are to pediatricians,” says William French, M.D., DFAACAP. “Just as a fever is a core symptom of numerous illnesses and infections, irritability is a core symptom of many mental conditions.” In this guide, French outlines possible causes of irritability and provides a detailed overview of conditions such as DMDD, ODD, ADHD, and bipolar disorder. He analyzes emerging research on treatment approaches and interventions.

Continue reading “Deciphering Irritability in Children: Causes and Links to Comorbidities”

Irritability in Children: Related Resources

• Read: The ADHD-Anger Connection
• Read: Top Emotion Regulation Difficulties for Youth with ADHD
• Self-Test: Could Your Child Have DMDD?
• Read: The Parents’ Guide to Dismantling Oppositional, Defiant Behavior

3. Treatments for Depression and ADHD: New and Forthcoming Approaches

By Nelson M. Handal, M.D., DFAPA

Rising rates of depression — a condition that often accompanies ADHD — have attracted well-deserved concern and attention. Here, Nelson M. Handal, M.D., DFAPA, reviews what we know about major depressive disorder (MDD) and ADHD, combs through the latest treatment options for depression, and touches on alternative approaches for managing depression. “The field of depression treatment is making huge advances,” Handal says, referencing psychedelics, Spravato nasal spray, Zurzuvae (zuranolone), a rapid-acting oral treatment that was approved to treat postpartum depression, and others promising treatments for MDD.

Continue reading “Treatments for Depression and ADHD: New and Forthcoming Approaches”

Treatments for Depression: Related Resources

• Read: The ADHD – Depression Link
• Read: What to Expect When You Start Depression Medication
• Download: The Facts About Major Depressive Disorder in Women
• Read: How Undiagnosed ADHD Triggers Depression and Anxiety

4. Differential Diagnosis of Bipolar and ADHD: Taking a Phenomenological Approach

By David W. Goodman, M.D., LFAPA

A thorough and accurate diagnosis is critical before treating bipolar disorder, ADHD, or the two together. However, high rates of comorbidity and a constellation of overlapping symptoms make the task of distinguishing between bipolar disorder and ADHD especially challenging. David W. Goodman, M.D., LFAPA, explains how clinicians can differentiate between the two conditions.

“To arrive at an accurate differential diagnosis, a clinician must carefully consider family psychiatric history and dial into the patient’s phenomenological experience. The latter focuses on specific symptoms and qualitative nature,” he says. “For example, there is a qualitative difference between a tension headache and a migraine headache, even though both are headaches. The same difference can be seen in sadness vs depression — a qualitative difference in the psychological experience.”

Continue reading “Differential Diagnosis of Bipolar and ADHD: Taking a Phenomenological Approach”

Bipolar Disorder and ADHD: Related Resources

• Download: Solving the Bipolar and ADHD Puzzle
• Read: How to Distinguish ADHD’s Rejection Sensitive Dysphoria (RSD) from Bipolar Disorder
• Read: The Physicians’ Guide for Distinguishing Bipolar Disorder and ADHD
• Self-Test: Bipolar Disorder in Adults

5. Prenatal and Early Life Risk Factors of ADHD: What Research Says — and What Parents Can Do

By Joel Nigg, Ph.D.

Is ADHD caused by birth trauma? Do prenatal complications like maternal obesity or hypertension increase a child’s risk for ADHD? What role do prenatal and postnatal exposures to substances, such as alcohol and smoking, play in the development of ADHD? Joel Nigg, Ph.D., explores the answers to these difficult-to-answer questions and provides an overview of the latest research and steps parents can take to protect their child’s health. “Exposure to risk factors does not guarantee ADHD, and early and effective treatment approaches can often mitigate the effects of previous complications and improve outcomes,” he says.

Continue reading “Prenatal and Early Life Risk Factors of ADHD: What Research Says — and What Parents Can Do”

What Causes ADHD? Related Resources

• Read: Epigenetics and ADHD: The Impacts of Environment, Lifestyle, and Stress
• Download: Free Guide to Hormones & ADHD in Women
• Read: Treating for Two: ADHD Meds in Pregnancy
• Watch: The Unspoken Truths of Postpartum Depression: Help for Women with and Without ADHD

6. The Future of ADHD Research Looks Like This

By Peter Jensen, M.D.

While no one can predict the scientific discoveries that lie ahead, three research areas are especially promising for improving our understanding of ADHD: neuroimaging, genetic research, and non-pharmacologic interventions, like transcranial magnetic stimulation and attention training. Here, Peter Jensen, M.D., describes these key three areas of ADHD research.

“As we discover more specific gene and brain developmental pathways, we should expect to find that different and precise interventions work for different ADHD subtypes, depending on the individual’s particular gene-environment mix and how factors unfold over time,” he says.

Continue reading “The Future of ADHD Research Looks Like This”

ADHD Research Updates: Related Resources

• Download:  Health & Fitness Lifestyle Changes for Adults with ADHD
• Read: The Evolution of ADHD: Examining the Last 25 Years — and the Future
• Watch: ADHD Then and Now: How Our Understanding Has Evolved
• Read: Beyond Genes: Leveraging Sleep, Exercise, and Nutrition to Improve ADHD

7. Sobering Advice: How to Treat ADHD Alongside SUD

By Timothy Wilens, M.D.

ADHD medications — both stimulants and non-stimulants — may be used to treat patients with comorbid substance use disorder and typically improve outcomes for patients with both conditions. “Unfortunately, many patients who have an active SUD (or even a past history of substance use issues) are either not diagnosed with ADHD or, even with a diagnosis, they are denied medication and appropriate treatment for their co-occurring ADHD due to overstated and misplaced fears, bias, and misinformation,” says Timothy Wilens, M.D. “In other words, far too many clinicians discriminate against patients with comorbid ADHD and SUDs.” Here, Wilens examines the role ADHD medications play in SUD treatment and suggests steps to curtail prescription misuse.

Continue reading “Sobering Advice: How to Treat ADHD Alongside SUD”

Substance Use Treatment with ADHD: Related Resources

• Read:  The ADHD & Addiction Link — Addictive Behaviors in Adults Explained
• Read: Does Stimulant Medication Cause Drug Dependence?
• Self-Test: Could You Have a Substance Use Disorder?
• Read: 5 Key Facts About Substance Use Disorders

8. First-Ever Adult ADHD Guidelines Forthcoming

By Carole Fleck

ADHD diagnoses among adults are growing faster than ever in the U.S. despite the absence of formal clinical guidelines for the accurate evaluation and treatment of the condition after childhood. That’s about to change. A task force commissioned by the American Professional Society of ADHD and Related Disorders (APSARD) is developing ADHD diagnosis and treatment guidelines for adults in the U.S., to be published in 2024. In an interview with ADDitude, APSARD President Ann Childress, M.D., discussed the implications of the forthcoming guidelines. “ADHD in adults is not just a minor inconvenience — it is a major public health problem,” Childress says. “Guidelines will help practitioners who previously may have felt uncomfortable evaluating and treating adults with ADHD, and these will improve access to high-quality care.”

Continue reading “First-Ever Adult ADHD Guidelines Forthcoming”

ADHD Treatment & Diagnosis Guidelines: Related Resources

• Read: Adult ADHD Is Real — and Still Heavily Stigmatized
• Read: ADHD in Older Adults: Distinct Diagnostic and Treatment Considerations
• Download: How Common Is ADHD in Adults?
• Read: ADHD in Women and Girls — Why Female Symptoms Slip Through Diagnostic Cracks

9. How Undiagnosed ADHD Triggers Depression and Anxiety

By Nelson M. Handal, M.D., DFAPA

Depression and anxiety disorders occur with ADHD at significant rates. What explains these high comorbidity rates? “Many factors may explain the overlap, and one of them I can’t stress enough: ADHD does not happen in a vacuum, and its effects are far more impairing when the condition goes undiagnosed, untreated, or improperly treated,” Nelson M. Handal, M.D., DFAPA, says. Here, Handal shares why depression appears to take a more significant toll on women with ADHD and how undiagnosed and/or untreated ADHD manifests in patients with depression.

Continue reading “How Undiagnosed ADHD Triggers Depression and Anxiety”

Untreated ADHD in Adults: Related Resources

• Download: Signs of Depression That May Surprise You
• Self-Test: Depression in Adults
• Read: The Depression Treatment Gap for Teens — And How to Close It
• Read: What’s Behind the “Depression Gap” Impacting Women?

10. “A Daily Nightmare:” One Year into the ADHD Stimulant Shortage

By ADDitude Editors

More than one year into the ADHD stimulant shortage, patients still struggle to fill their prescriptions for Adderall XR and other stimulants like Vyvanse, Concerta, and Focalin.

According to an ADDitude survey of 11,013 caregivers and adults with ADHD, roughly 38% of all patients have had trouble finding and filling their prescription medication over the last year, and 21% continue to suffer treatment disruptions today. Here, ADDitude readers share how they have been forced to forgo medications, make do with substitutes that aren’t as effective or cause bothersome side effects, and ration out a dwindling supply, often dividing it between multiple family members with ADHD.

Continue reading “‘A Daily Nightmare:’ One Year into the ADHD Stimulant Shortage”

ADHD Medication Shortage: Related Resources

• Read: How the Adderall Shortage Is Casting a Long Shadow on ADHD Treatment
• Read: The Real Reason ADHD Medication Supply Is Lagging Demand
• Read:  Generic Adderall Shortage Extends to Vyvanse, Ritalin

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Emotion dysregulation, which research has shown to be a fundamental component of ADHD,^{2, 3} is one such symptom. Another is gender differences, particularly in females who tend to mask or internalize their symptoms.⁴ “There’s some research on whether there might be a completely different presentation [of ADHD], at least in females, with a different time of onset and a different level of severity,” said Dave Anderson, Ph.D., in a recent ADDitude webinar on understanding the evolution of ADHD.

If you could add any symptom to the DSM diagnostic criteria for ADHD, what would it be? The answers we received from ADDitude readers included many familiar ADHD behaviors like rumination, daydreaming, time blindness, insomnia, sensory sensitivity, anger, and anxiety. Some readers even suggested changing the name entirely.

“‘Attention deficit’ seems to be the exact opposite of my experience,” said Amanda, an ADDitude reader in Utah. “I cannot pull myself away from the things I am interested in! And hyperactivity represents such a small portion of diagnosed individuals (primarily boys younger than 12). It is only one of dozens of significant symptoms that affect the greater population.”

Below, ADDitude readers share the symptoms that they feel are central dimensions of ADHD. What would you choose to add? Tell us in the Comments section, above.

[Download: 3 Defining Features of ADHD That Everyone Overlooks]

ADHD Symptoms Not in the DSM

“I would love to see separate sets of diagnostic criteria for boys, girls, adult men, and adult women, because (generally speaking) ADHD can look quite different in each of those four groups. Yes, there is some overlap, but I don’t think it serves girls or adult men and women to compare them to a single ADHD picture, that of the stereotypical hyperactive young boy. The rest of us know that isn’t the only face of ADHD.” — Jen, Missouri

“I think the biggest thing I would like to see is more of a focus on emotional dysregulation and the intense emotions that you can feel as a symptom of ADHD. This is one of the main ADHD symptoms that I personally struggle with, and it was never recognized. I was misdiagnosed with bipolar as a teenager because my intense emotions were more associated with BD than with ADHD.” — Kate, Florida

“I’d make sure that comorbidities are noted more directly with the DSM diagnosis of ADHD.” — An ADDitude reader

“I believe today’s criteria don’t adequately address adult patients. The word ‘adult’ obliquely refers to patients age 17 and older, but ADHD may manifest differently in older adults. Our prefrontal cortex continues to develop into our mid-20s, does it not? Typically, career advances are met with increased responsibility and visibility, and ADHD traits can become more of an encumbrance further up the corporate ladder (as I learned in my 40s and 50s). Clinicians would likely benefit from a subset of criteria for adults 25 and older.” — Greg, Ohio

[Read: A Critical Need Ignored: Inadequate Diagnosis and Treatment of ADHD After Age 60]

“Feeling like you have multiple thoughts at once; thinking spherically as opposed to linearly.” — Sunshine, Colorado

“Apparently, sleep issues are a telltale sign [of ADHD] for young children, yet I read every sleep training book I could get my hands on when [my daughter] was a baby, and not one of them mentioned [ADHD]. I didn’t learn this until she was in high school, which I feel is not just criminal negligence by so-called sleep experts but a huge disservice to parents and to kids with ADHD who could be assessed earlier.” — Kelly, California

“The emotional regulation symptoms of ADHD are sorely lacking.” — An ADDitude reader

“The social impacts of ADHD and how it impacts the ability to maintain friendships is a big hallmark for me. In general, I wish the DSM had a great deal more nuance, especially when it comes to identifying ADHD in girls and adults.” — LeAnn, Wisconsin

“I would differentiate between symptoms that boys have versus symptoms that girls have.” — Tracy, New York

“Anything about sensory challenges. To me, this is actually what ADHD is all about: difficulty blocking out sensory input. ADHD encompasses the challenges and ways people deal with sensory overwhelm. The fact that the DSM — and as a result, many practitioners — don’t understand this is so frustrating. Without this understanding, they are missing so many people who are probably unable to get support.” — Katie, Maryland

“Communication lapses: The tendency [for my son] to think that he communicated something verbally because he already thought it in his mind. We’ve had many incidents where family dynamics were impacted by communication lapses. From his point of view, the communication happened even though nothing verbal was spoken, so the other person wasn’t in the know. This also happens with my spouse (who was diagnosed at 52 after our son).” — Julieann, Ohio

“Clumsiness — anecdotally, this is very common among ADHDers, even being accident-prone. I see this a lot in the chat rooms I frequent for ADHDers.” — Diane, New Hampshire

“If it is not already in there, I believe the aspect of emotional dysregulation and/or rejection sensitivity dysphoria is such a huge component of ADHD that gets so very little attention – especially when it comes to treatment for younger children. But even for me as an adult, when I learned about the term RSD and what it meant, it stopped me in my tracks and totally changed the way I looked at my ADHD.” — Geoff, Rhode Island

“I would add criteria under affective disorders relating to anxiety and personality disorders like BPD/OCD to ensure it isn’t ADHD before making one of those other diagnoses.” — Greg, Canada

“Include not recalling content in a conversation literally right after or immediately after the information is shared. I think my kids are ready to kill me; they have told me that they purposefully don’t talk with me that much because I never remember. It’s awful.” — Shannon, Ohio

“I would make sure that something like survivalist, problem-solver, or despiser of mundane tasks were all in there!” — Blythe, Oklahoma

“A ‘constant state of overwhelm’ would be one. Or ‘takes tons of effort just to exist.’” — Natalie, Pennsylvania

ADHD Symptoms Not in the DSM: Next Steps

• Download: Common ADHD Diagnosis Mistakes
• Read: ADHD in Adults Looks Different. Most Diagnostic Criteria Ignores This Fact.
• Watch: The Grave Consequences of Persistent Gender Role Expectations in ADHD
• Read: ADHD Needs a Better Name. We Have One.

Sources

¹ PsychDB. (n.d.) History of the DSM. https://www.psychdb.com/teaching/1-history-of-dsm

² Hirsch, O., Chavanon, M., Riechmann, E., & Christiansen, H.. (2018). Emotional dysregulation is a primary symptom in adult attention-deficit/hyperactivity disorder (ADHD). Journal of Affective Disorders, 232, 41-47. https://doi.org/10.1016/j.jad.2018.02.007

³ Soler-Gutiérrez, A.M., Pérez-González, J.C., & Mayas, J. (2023). Evidence of emotion dysregulation as a core symptom of adult ADHD: a systematic review. PLoS One, 18(1), e0280131. https://doi.org/10.1371/journal.pone.0280131.

⁴ Young, S., Adamo, N., Ásgeirsdóttir, B.B., et al. (2020). Females with ADHD: an expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. BMC Psychiatry, 20, 404. https://doi.org/10.1186/s12888-020-02707-9

Dr. John Ratey and I knew there was more to this condition than what appeared in the textbooks or the Diagnostic and Statistical Manual of Mental Disorders (DSM). We started comparing notes on our patients, whom we listened to and learned from. They were especially helpful in teaching us about the positive tendencies often embedded in ADHD — attributes missing from the textbooks. Increasingly, we saw that the more we identified the talents and passions embedded in our patients’ ADHD, the better they did. This got us excited. We were breaking new ground. We were reframing the perceptions of ADHD, giving hope, and laying new foundations for success.

Writing Driven to Distraction

As the years went by, we developed our strength-based model of ADHD, which posits that there is as much good stuff (creativity, originality, curiosity, an entrepreneurial spirit, spunk, and persistence) as there is bad. In 1994, we gathered our notes and stories and put it all into a book called Driven to Distraction. (#CommissionsEarned)

[Free Download: Secrets of the ADHD Brain]

The public, for the most part, had never heard of the condition, or they dismissed it as a lame excuse used to duck responsibility and hard work. After the book came out, I was on a talk show where the host actually asked me, “What can you do for ADD that a stiff shot of whiskey couldn’t do better?”

Brain Plasticity Research

We’ve come a long way since the mid-1990s. Millions of people have read Driven to Distraction, and almost everyone has heard of ADHD today. They may not understand ADHD in its full, variegated complexity, but they at least know it is a real condition supported by vast research and rooted in hard science.

One of the most compelling new findings in neuroscience is this: The brain can change. In medical jargon, it’s called brain plasticity. Once thought to be fixed after a certain age, the brain is capable of growing, changing, and learning new things throughout our lives.

John and I have been especially captivated by three separate lines of research tied to brain plasticity, each of which has led to a major improvement in the care we give.

[Self-Test: Do I Have ADHD? Symptom Test for Adults]

• Functional magnetic resonance imaging (fMRI). The fMRI has delineated two important networks, or connectomes, in the brain: The task positive network (TPN), which lights up when we’re creatively engaged, and the default mode network (DMN), which activates when the task is over, and we’re staring off into space. John and I used the DMN to explain why people with ADHD are prone to mind-wandering, which can lead to negative thinking and morbid brooding. We help our patients find ways to redirect their attention away from the DMN and activate the TPN by engaging in something positive and stimulating.
• The lifesaving power of human connection. The social sciences have produced a mother lode of evidence on the vital power of connection. We call it the other vitamin C; if you don’t get enough connection, you can wither and die. This is why U.S. Surgeon General Vivek Murthy has called loneliness a public health crisis. People with ADHD are particularly prone to feeling isolated, so we work hard to help our patients learn how to make sustaining connections.
• Brain research. We’ve recently discovered that ADHD action resides in neural pathways between the cerebellum and the front of the brain. The cerebellum controls balance. If you stimulate the cerebellum by doing balance exercises, you may see major improvements in the symptoms of ADHD and dyslexia. Balance has become a therapeutic intervention, as have programs of non-invasive mild electrical stimulation using AC current, such as the Fisher Wallace Stimulator, and other devices.

With these advances in understanding the ADHD brain, I’m no longer being asked if a shot of whiskey could surpass the treatment I can offer.

Driven to Distraction & Brain Plasticity: Next Steps

• Read: The Top 25 ADHD Books of the Last 25+ Years
• Read: People with ADHD Are Wired Differently.
• Download: Top 10 ADHD Parenting Books

Edward Hallowell, M.D., and John Ratey, M.D., co-wrote a series of books on ADHD.

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.
 

Approximately 25 years ago, when ADDitude published its first newsletter, the diagnosis of ADHD was based on criteria published in the Diagnostic and Statistical Manual of Mental Disorders, Version III-C. The DSM-IV diagnostic criteria adopted two years later were the most scientifically validated to date.

Its 18 symptoms were evenly divided into two lists: problems with inattention vs. problems with hyperactivity-impulsivity. To warrant a diagnosis, a patient had to exhibit at least six symptoms on either list, suffer impairment in one or more major life activities (home, school, community, peers), and begin experiencing symptoms by age seven. Furthermore, the symptoms could not be better explained as those of another condition.

Yet, problems remained. The committee handling ADHD criteria for the DSM-5 hoped to improve the DSM’s rigor and diagnostic accuracy. It proposed recommendations that reflected independent research findings. Sadly, many of those recommendations were rejected by higher-ranking committees, perhaps partly out of fear they would significantly increase the prevalence of ADHD diagnoses. Thus, the ADHD criteria in the DSM-5, released in 2013, represented only modest improvements.

The Problems with the DSM-5

The DSM-5 does not capture ADHD accurately because its criteria do not conceptualize ADHD as a disorder of executive functioning (EF) and self-regulation (SR). This limitation greatly narrows the concept of ADHD, trivializes its nature as just an attention deficit, and discourages diagnosing clinicians from focusing on the wider range of impairments inherent in ADHD. These impairments impact executive inhibition, self-awareness, working memory, emotional self-regulation, self-motivation, planning/problem-solving, and other functions not typically associated with ADHD. Ignoring them restricts diagnosis and, ultimately, treatment for many patients.

Why Qualifier Symptoms Should Go Unheeded

In the DSM-5, qualifier symptoms were added after each listing of a symptom to help clinicians understand the expression of that symptom beyond childhood. However, problems with these clarifiers include:

[Read: ADHD in Adults Looks Different. Most Diagnostic Criteria Ignores This Fact.]

• None of these clarifications arose out of prior research that tested them for their affiliation with ADHD, for their relationship to the root symptom they are supposed to clarify, for their accuracy in detecting ADHD, or for their relationship to impairment in major life activities. They were simply invented by committee members in a meeting.
• Adding such new and untested symptoms may have broadened eligibility for the disorder by up to 6 percent in older teens and adults.
• Some clarifications seemed to correlate with anxiety, which could lead to cross-contamination of the ADHD criteria.

These clarifications also were not informed by any theory of ADHD, such as EF-SR theory.

So, until the status of these parenthetical clarifiers is better researched, clinicians would do best to ignore them in making a diagnosis of ADHD in a teen or an adult.

A Better Way to Diagnose ADHD

Clinicians can ensure more accurate diagnoses and more appropriate care by following these five recommendations:

#1. Avoid placing undue emphasis on hyperactive symptoms.

Six of the nine hyperactive-impulsive symptoms on the DSM list reflect excessive activity, even though impulsivity has been viewed as a more prevalent ADHD symptom for the last 40 years. At best, hyperactivity is reflective of early childhood disinhibition of motor movement and, later, the inability to regulate such movement to the demands of the situation (e.g., teacher’s instructions to complete desk work). Those symptoms decline steeply over development and are of little diagnostic value by late adolescence. This is one reason why clinicians before the 1980s thought the disorder was outgrown before adulthood, which we now know is false for most people.

[Research: Only 1 in 10 Children with ADHD Will Outgrow Symptoms]

#2. Look for additional symptoms of impulsivity.

Poor inhibition may manifest not just in speech (currently, the DSM criteria include only three verbal symptoms) but in motor behavior, cognition, motivation, and emotion. Clinicians should screen for any of the following manifestations:

• often fails to consider the consequences of their actions
• has trouble motivating to persist toward goals
• has trouble deferring gratification or waiting for rewards
• lacks willpower, self-discipline, drive, and determination
• seems unusually impatient, easily emotionally aroused and frustrated, and quick to anger

Abundant research shows that these aspects of poor self-regulation are as common in people with ADHD as are the traditional DSM symptoms and, with age, more so than the symptoms of hyperactivity.

#3. Think of inattention as affecting a range of executive function deficits in daily life…

…particularly those involving impaired self-awareness, working memory, self-organization, emotional self-regulation, self-motivation, and time management. This will encourage clinicians to broaden their focus beyond the DSM symptoms when conducting open-ended interviews and selecting rating scales.

After the evaluation is completed, clinicians should explain to clients why their condition is so serious, impairing, and pervasive across major domains of life. This will also help clinicians and parents appreciate why teens (and young adults) may seem to be outgrowing ADHD, based on DSM criteria, when they are far less likely to outgrow their EF-SR deficits (and that these impairments may increase with age).

#4. Use rating scales broken down by sex and not just age.

Research suggests that females in the general population, at least in childhood and adolescence, do not show the same symptom severity as their male peers.¹ This makes it harder for a female to meet the DSM criteria. Another complicating factor: because males were overrepresented in field trials for earlier versions of the DSM, the symptom threshold was male-biased.

#5. Don’t adhere too rigidly to diagnostic thresholds when there are clear signs of impairment.

Empirical research demonstrates that ADHD falls along a continuum in the general population. So, clinicians will see clients who don’t meet all of the DSM criteria, yet who are experiencing enough impairment that they sought a diagnosis. This means clinicians should diagnose ADHD if:

• Clients or their caregivers state that a child or teen has a high number of ADHD (and EF) symptoms (place above the 20^th–16^th percentile in severity) and there is evidence of impairment in major life activities, even if the client fails to meet all DSM-5
• Symptoms became evident sometime during development, usually before age 21–24, and the patient meets all other criteria. DSM-5 raised the age of onset for ADHD from age 7 to age 12, but research repeatedly shows that few people are reliable or accurate in recalling the age of onset of their symptoms. It is a mistake, therefore, to consider age of onset in diagnosing ADHD, where all other criteria are met.

DSM-5 ADHD Criteria Challenged: Next Steps

• Free 7-Part Series: The Clinicians’ Guide to Diagnosing ADHD
• Read: ADHD Is a Whole-Life Experience. The DSM Needs to Reflect That.
• Read: ADHD in Women and Girls — Why Female Symptoms Slip Through Diagnostic Cracks

Russell A. Barkley, Ph.D., is a retired clinical scientist, educator, and practitioner.

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Sources

¹ Young, S., Adamo, N., Ásgeirsdóttir, B. B., Branney, P., Beckett, M., Colley, W., Cubbin, S., Deeley, Q., Farrag, E., Gudjonsson, G., Hill, P., Hollingdale, J., Kilic, O., Lloyd, T., Mason, P., Paliokosta, E., Perecherla, S., Sedgwick, J., Skirrow, C., Tierney, K., … Woodhouse, E. (2020). Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. BMC psychiatry, 20(1), 404. https://doi.org/10.1186/s12888-020-02707-9

For one, the rest of the world already defines the criteria for conditions using the International Classification of Diseases (ICD-10-CM), which became the official health classification of the U.S. government in 2014. But, more significantly, the DSM simply does not describe ADHD as the rest of us experience it.

The DSM was written solely by and for the use of researchers, not for consumers or for practicing clinicians, and it describes only childhood behaviors. Everything else has been intentionally ignored since the very beginning of ADHD, for the sake of publishing research validating ADHD as a real thing with extremely significant impairments in children ages 6 to 12.

Our diagnostic definition is incomplete and grossly inadequate by virtue of ignoring emotional dysregulation, cognition, gender, hormones, ADHD in old age, ADHD at menopause, and the effects of ADHD on a developing personality.

[Free Resource: Rein In Intense ADHD Emotions]

Here are the dimensions missing from the DSM‘s criteria for ADHD:

Emotions: The most impairing feature of ADHD at all ages, emotional dysregulation, was not mentioned in the DSM as a fundamental component because emotions are hard to research. Why?

• They are not always present.
• They are very difficult to measure. (For example, how bad is a temper tantrum? Exactly how would anyone measure and compare one tantrum to another, even in the same child? It can’t be done.)
• People are embarrassed when they cannot control their own emotions and, thus, hide the very impairments that need to be studied.

The problems of controlling emotions are more disruptive and painful than are all the other core features of ADHD (inattention, impulsivity, and hyperactivity/hyperarousal) combined. The subject of emotional regulation in ADHD has begun to appear in research literature only within the last few years and, even now, mostly in European journals.

Age: The ADHD criteria have never been validated in a study of participants over the age of 16. All the research on adults has been done using twisted versions of the childhood criteria. For an adult to meet the child-based criteria, they would have to be functioning on the level of an elementary school-age child with untreated ADHD. Though it was officially acknowledged in 1980 that ADHD usually persists into adult life, work has only just begun on writing official adult ADHD criteria 43 years later.

[Read: Why We Need U.S. Guidelines for Adults with ADHD]

Development: ADHD remains the same throughout life. We are the ones who change as the challenges of life grow, shift, and demand more of us. We are very different at age 28 from what we were at eight or 18. This makes ADHD look as if it is changing when it’s not. The sources of the impairments from ADHD are the same, the medications and doses of medications used for ADHD are the same, and the problems with controlling emotional expression remain the same.

Gender: Simply put, it was once thought that females did not get ADHD because they are not as hyperaroused and disruptive as are males. This is still a significant problem. No existing research studies involve only females in adulthood.

It’s Time for a Shift in Thinking

ADHD was once a vague, controversial idea. Today, no rational person doubts that ADHD exists and that, if left untreated, it can have devastating consequences through adulthood. The time has come to see the full picture of ADHD. It is more than a disorder of behavior; it impairs emotions and affects the lives of millions of people.

While we are at it, we should give the same attention, thinking, and research to additional components of ADHD that impair people every day: the sleep disturbances caused by the hyperarousal of ADHD, rejection sensitivity, and the effects of an ADHD nervous system on the development of personality.

William Dodson, M.D., is a psychiatrist and consultant on adult ADHD medicine.

Emotional Dysregulation & Adult ADHD: Next Steps

• Watch: The Emotional Symptoms of ADHD That Everyone Overlooks
• Read: Why ADHD in Women is Routinely Dismissed, Misdiagnosed, and Treated Inadequately
• Read: The Controversy That Was Adult ADHD

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SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Removed]]> https://www.additudemag.com/emotional-dysregulation-dsm-5-adhd-women/feed/ 0 https://www.additudemag.com/webinar/health-equity-racial-disparities-adhd-diagnosis-treatment/ https://www.additudemag.com/webinar/health-equity-racial-disparities-adhd-diagnosis-treatment/#respond Tue, 15 Aug 2023 17:40:34 +0000 https://www.additudemag.com/?post_type=webinar&p=337580 Episode Description



African Americans and other individuals of color are less likely to get an accurate ADHD diagnosis and proper treatment. Why? Stigma, myths, and misconceptions about ADHD, historical mistrust of the medical community, and a shortage of clinicians of color who are knowledgeable about ADHD all contribute to proper care and treatment challenges.

Education and outreach are important ways community members, clinicians, educators, and other allies can help improve outcomes for individuals with ADHD in BIPOC communities.


In this webinar, you will learn:

• About the factors that hamper proper ADHD diagnosis and treatment in communities of color
• About the historical context for the persistent ADHD myths and misconceptions that contribute to stigma and stereotypes in these communities
• How educators and clinicians can overcome ethnic and cultural barriers to ADHD care
• About practical strategies for improving outcomes for individuals with ADHD in communities of color

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.


Download or Stream the Podcast Audio

Click the play button below to listen to this episode directly in your browser, click the symbol to download to listen later, or open in your podcasts app: Apple Podcasts; Google Podcasts; Audacy; Spotify; Amazon Music; iHeartRADIO.


More on Health Equity & ADHD

• Download: How to Prepare for Your ADHD Evaluation
• Read: Why ADHD Is Different for People of Color
• Read: We Need to Talk About ADHD Stigma in BIPOC Communities

Obtain a Certificate of Attendance

If you attended the live webinar on October 3, 2023, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

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Meet the Expert Speaker

Evelyn Polk Green, M.S.Ed., is a past president of both ADDA (the Attention Deficit Disorder Association) and CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder). She is an adult with ADHD and the mother of two adult sons, Perry and Robert, both of whom also have ADHD. Active in ADHD and mental health advocacy for almost 30 years, Evelyn has served as a leader representing the family and educator voice in the ADHD and mental health communities in many capacities, including as a member of the Network on Children’s Mental Health Services funded by the MacArthur Foundation. Learn more about Evelyn here.

Listener Testimonials

“Dr. Polk Green is fantastic. I attended her last webinar. She is an amazing resource. Thank you for having her present to us.”

“Very informative and empowering.”

“Just absolutely grateful… I am a non-binary adult person of color with ADHD who was late diagnosed and resonate deeply with the content as the issues are spot on. Thank you!”

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Follow ADDitude’s full ADHD Experts Podcast in your podcasts app:
Apple Podcasts | Google Podcasts | Spotify | Google Play | Amazon Music | RadioPublic | Pocket Casts | iHeartRADIO | Audacy

]]> https://www.additudemag.com/webinar/health-equity-racial-disparities-adhd-diagnosis-treatment/feed/ 0 https://www.additudemag.com/webinar/what-causes-adhd-advances-research-diagnosis-treatment/ https://www.additudemag.com/webinar/what-causes-adhd-advances-research-diagnosis-treatment/#respond Thu, 29 Jun 2023 15:12:42 +0000 https://www.additudemag.com/?post_type=webinar&p=334884 Episode Description



The exact causes of ADHD are not yet known. ADHD is believed to be highly heritable —researchers have made strides in recent years identifying genes involved in the disorder — but it is also understood that ADHD may be influenced by non-inherited risk factors, such as trauma and stress. With scientific advances in the next decade or more, and perhaps with the aid of AI, we could see the diagnosis of many more subtypes of ADHD and new kinds of treatments involving novel therapies.


In this webinar, you will learn:

• About the current research involving genetic influences and environmental factors associated with ADHD
• How scientific discoveries could lead to the recognition of more than a dozen subtypes, and the implication of such findings
• How scientific advances may one day lead to the prevention of ADHD in utero or in the first two years of life
• About the future of promising therapies to retrain the brain to compensate for executive function weaknesses stemming from ADHD

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.


Download or Stream the Podcast Audio

Click the play button below to listen to this episode directly in your browser, click the symbol to download to listen later, or open in your podcasts app: Apple Podcasts; Google Podcasts; Audacy; Spotify; Amazon Music; iHeartRADIO.


More on ADHD Research, Diagnosis, and Treatment

• Download: How Common Is ADHD in Adults?
• Read: The Buzz Around Neuroimaging
• Read: The History of ADHD and Its Treatment

Obtain a Certificate of Attendance

If you attended the live webinar on August 23, 2023, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

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Meet the Expert Speaker

Peter S. Jensen, M.D., founded the REACH Institute in 2006 to improve access to mental health care for children by training healthcare professionals in the diagnosis and treatment of common disorders. Previously, Dr. Jensen was an Associate Director of Child and Adolescent Research at the National Institute of Mental Health (NIMH). He left NIMH and served as the founding director of the Center for the Advancement of Children’s Mental Health at Columbia University. While there, he developed the core methods REACH uses today to close the gap between science and practice. The strategy was to bring together leading scientists, mental health experts and agencies, primary care providers, parents, and schools to identify the best scientific findings available to help children. Then Dr. Jensen led REACH to implement, disseminate, and evaluate these methods.

The result was The REACH Institute’s first and most popular course, Patient-Centered Mental Health in Pediatric Primary Care. This course has trained more than 6,000 primary care providers to help children and teens with mental health issues.

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Listener Testimonials

“This webinar was high-level and yet understandable! Such great information!”

“Almost every piece of information provided today will improve my practice and allow me to explain information more completely to my patients. Dr. Jensen is a gifted teacher. Thank you so much for this webinar.”

“I’ve been craving this information for so long I forgot how much I wanted it! ADDitude strikes again! Thanks!”

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Webinar Sponsor

The sponsor of this ADDitude webinar is…


 

 

Play Attention: Research conducted at Tufts University School of Medicine demonstrates that Play Attention improves attention, behavior, executive function, and overall school performance. Harnessing cutting-edge NASA-inspired technology, Play Attention offers a sophisticated platform for improving executive function and self-regulation. Through our digital trainer, you can control personalized cognitive exercises using just your mind! Additionally, your program comes complete with a dedicated Personal Executive Function Coach who will tailor your plan as you progress. Both home and professional programs are available. Contact us at 828-676-2240 or click here to schedule your Live Demo and witness Play Attention in action!

ADDitude thanks our sponsors for supporting our webinars. Sponsorship has no influence on speaker selection or webinar content.

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Follow ADDitude’s full ADHD Experts Podcast in your podcasts app:
Apple Podcasts | Google Podcasts | Spotify | Google Play | Amazon Music | RadioPublic | Pocket Casts | iHeartRADIO | Audacy

]]> https://www.additudemag.com/webinar/what-causes-adhd-advances-research-diagnosis-treatment/feed/ 0 https://www.additudemag.com/adhd-diagnosis-guide-children-parents-1b/ https://www.additudemag.com/adhd-diagnosis-guide-children-parents-1b/#respond Thu, 25 May 2023 20:46:33 +0000 https://www.additudemag.com/?p=330880

RSD: Is rejection sensitive dysphoria a symptom of ADHD?

A: Rejection sensitive dysphoria (RSD) is not a medical diagnosis, but a way of describing certain symptoms associated with ADHD… | Keep reading on WebMD »

EMOTIONS: Is emotional dysregulation a symptom of ADHD?

A: Emotional dysregulation is a term used to describe an emotional response that is poorly regulated and does not fall within… | Keep reading on WebMD »

SUBTLE SYMPTOMS: What symptoms of ADHD are often missed by educators, professionals, and even parents?

A: It’s not easy to know if your child has ADHD. As a parent, it may be less about the symptoms shouting ADHD, and more about feeling something’s not right. Your kid is struggling, but you don’t know why… | Keep reading on ADDitude »

EARLY YEARS: How does ADHD manifest in toddlers?

A: Emotional dysregulation often looks like excess emotion. Neurotypical toddlers typically experience up to three tantrums a week. Toddlers with ADHD, on the other hand… | Keep reading on ADDitude »

SOCIAL SKILLS: What social executive function deficits may suggest ADHD in my child?

A: Children and teens with ADHD tend to have a hard time with skills that underlie social interactions, such as perspective-taking, situational awareness… | Keep reading on ADDitude »

MISDIAGNOSIS: What symptoms of ADHD are my child’s doctor most likely to miss or misread?

A: Some children resort to defiant behavior to cover up anxiety, and other children who appear “defiant” are actually just impulsive. This is another case where it’s important for doctors to tease out the root cause… | Keep reading on ADDitude »

FIRST-PERSON: “When the First Signs of My Child’s ADHD Were Revealed”

“I asked our son why he didn’t like to wash his hair. ‘It takes too long and it’s boring,’ he told me. ‘Yeah, it is kind of boring,’ I replied. That’s when we decided to have him evaluated for ADHD. (I have ADHD myself, and told him he might have inherited mommy’s ‘silly brain.’)” | Keep reading on ADDitude »

RELATED RESOURCES

SYMPTOM TEST: Working Memory Deficits

A working memory deficit could explain a child’s difficulty with reading retention or mental math. | Take the self-test on ADDitude »

SYMPTOM TEST: Executive Function Deficit

Does your child have trouble getting started or struggle with problem-solving? | Take the self-test on ADDitude »

8-Part Guide to ADHD Diagnosis in Children, from WebMD x ADDitude:

DECISION 1: How can I better understand ADHD, its causes, and its manifestations?
> DECISION 2: How can I understand the aspects of ADHD that might be new to the doctor?
DECISION 3: How can I improve the odds of an accurate ADHD evaluation for my child?
DECISION 4: How can I find a professional to diagnose and treat my child’s ADHD?
DECISION 5: What should a thorough evaluation for pediatric ADHD include and exclude?
DECISION 6: How can I be sure my child’s evaluation screens for psychiatric comorbidities?
DECISION 7: How can I be sure my child’s evaluation considers look-alike comorbidities?
DECISION 8: Should my child be screened for the sleep, eating, and other disorders?

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DEFINITION: What is today’s medical understanding of ADHD?

A: ADHD (attention deficit hyperactivity disorder) is a brain disorder that affects how you pay attention and control your behavior. It happens in children and teens and can continue into adulthood… | Keep reading on WebMD »

SYMPTOMS: How can I tell if my child is showing signs and symptoms of ADHD?

A: The symptoms of attention deficit hyperactivity disorder — or ADHD — vary from person to person, but consist of some combination of inattention, hyperactivity, and impulsivity… | Keep reading on WebMD »

SUBTYPES: What are the key differences between inattentive, hyperactive, and combined-type ADHD in children?

A: Signs of hyperactivity include squirming, fidgeting, tapping, talking, and constant movement, especially in situations where it’s not appropriate. Signs of… | Keep reading on WebMD »

INATTENTIVE: Why do doctors and patients often misunderstand inattentive ADHD?

A: Formerly called ADD, inattentive ADHD is characterized by disorganization, a lack of focus, poor time management… | Keep reading on ADDitude »

ADHD IN TODDLERS: How young is too young for ADHD?

A: Though no clinical guidelines exist for diagnosing ADHD in children under the age of 4, a growing number of studies suggest that ADHD symptoms first show up during these early years… | Keep reading on ADDitude »

FIRST-PERSON: “Our Long and Winding Trek to the Summit”

“I am thankful that we got a fairly early and accurate diagnosis for our kid. It turned around his poor self-esteem and helped him understand that he’s not damaged; he’s just neurodevelopmentally unique.” | Keep reading on ADDitude »

“Dear Parent of a Newly Diagnosed Kid”

“It’s OK to feel mad. It’s OK to feel it’s not fair that the universe handed this diagnosis to your kid. Your kid is hard. You can love your kid to the moon and back and still look at him and think, you are hard.” | Keep reading on ADDitude »

RELATED RESOURCES

SYMPTOM TEST: ADHD in Children

Could your child’s distractibility, blurting, and difficulty remaining seated be due to ADHD? | Take the self-test on ADDitude »

SYMPTOM TEST: Inattentive ADHD in Children

Symptoms can show up as missing instructions, forgetfulness, and difficulty sustaining attention. | Take the self-test on ADDitude »

8-Part Guide to ADHD Diagnosis in Children, from WebMD x ADDitude:

> DECISION 1: How can I better understand ADHD, its causes, and its manifestations?
DECISION 2: How can I understand the aspects of ADHD that might be new to the doctor?
DECISION 3: How can I improve the odds of an accurate ADHD evaluation for my child?
DECISION 4: How can I find a professional to diagnose and treat my child’s ADHD?
DECISION 5: What should a thorough evaluation for pediatric ADHD include and exclude?
DECISION 6: How can I be sure my child’s evaluation screens for psychiatric comorbidities?
DECISION 7: How can I be sure my child’s evaluation considers look-alike comorbidities?
DECISION 8: Should my child be screened for the sleep, eating, and other disorders?

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The Adult’s Guide to ADHD Diagnosis is a joint effort from WebMD and ADDitude designed to guide individuals through the difficult, important decisions they face when pursuing an evaluation for ADHD and its comorbid conditions. This guided email course will cover the following topics:

DECISION 1: How can I better understand ADHD, its causes, and its manifestations?
DECISION 2: How can I understand the aspects of ADHD that might be new to my doctor?
DECISION 3: How can I improve my odds of an accurate ADHD evaluation?
DECISION 4: How can I find a professional to diagnose and treat my ADHD?
DECISION 5: What should a thorough evaluation for adult ADHD include and exclude?
DECISION 6: How can I be sure my ADHD evaluation screens for psychiatric comorbidities?
DECISION 7: How can I be sure my ADHD evaluation considers look-alike comorbidities?
DECISION 8: Should I also be screened for the sleep, eating, or other disorders?

NOTE: This resource is for personal use only.

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DEPRESSION: What distinguishes ADHD from depression?

A: Depression is more than just an occasional case of the blues. It’s deep sadness and despair you feel every day for at least 2 weeks at a time… | Keep reading on WebMD »

ANXIETY: What distinguishes ADHD from anxiety?

A: When you have anxiety along with ADHD, it may make some of your ADHD symptoms worse, such as feeling restless or… | Keep reading on WebMD »

BIPOLAR: What distinguishes ADHD from bipolar disorder?

A: Approximately 20 percent of people with ADHD also suffer from bipolar disorder, characterized by depressive and manic episodes… | Keep reading on ADDitude »

MOOD DISORDERS: What distinguishes ADHD from a mood disorder?

A: Making the distinction between moodiness in ADHD, ODD, DMDD, and other disorders requires studying the mood’s intensity and… | Keep reading on ADDitude »

OCD: What distinguishes ADHD from obsessive-compulsive disorder?

A: Symptoms of OCD include recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions)… | Keep reading on ADDitude »

ODD: What distinguishes ADHD from oppositional defiant disorder?

A: Adults with ODD are more than just aggressive and irritating from time to time. They feel mad at the world every day, and lose their temper… | Keep reading on ADDitude »

FIRST-PERSON: “ADHD: ‘I Really Fouled That Up.’ Anxiety: ‘Hold My Beer.’”

“ADHD means I can’t be productive. Anxiety means I can’t relax. ADHD won’t let me resolve problems. Anxiety makes me think I have problems I don’t actually have. ADHD makes planning difficult. Anxiety convinces me I need to plan everything down to the tiniest of detail.” | Keep reading on ADDitude »

RELATED RESOURCES

SYMPTOM TEST: Generalized Anxiety Disorder in Adults

No two people experience anxiety in the same way, however common symptoms do exist. | Take the self-test on ADDitude »

SYMPTOM TEST: Depression in Adults

Do simple tasks take forever to accomplish? Do you feel irritable all the time, or stuck in life? | Take the self-test on ADDitude »

8-Part Guide to ADHD Diagnosis in Adults, from WebMD x ADDitude:

DECISION 1: How can I better understand ADHD, its causes, and its manifestations?
DECISION 2: How can I understand the aspects of ADHD that might be new to my doctor?
DECISION 3: How can I improve my odds of an accurate ADHD evaluation?
DECISION 4: How can I find a professional to diagnose and treat my ADHD?
DECISION 5: What should a thorough evaluation for adult ADHD include and exclude?
> DECISION 6: How can I be sure my ADHD evaluation screens for psychiatric comorbidities?
DECISION 7: How can I be sure my ADHD evaluation considers look-alike comorbidities?
DECISION 8: Should I also be screened for the sleep, eating, or other disorders?

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EVALUATIONS: What is the step-by-step process for getting an ADHD evaluation?

A: An evaluation for ADHD often starts with a routine visit to your primary-care physician, but chances are it won’t end it there… | Keep reading on ADDitude »

ENSURING ACCURACY: What should a comprehensive ADHD evaluation include?

A: An accurate and well-rounded ADHD diagnosis is a complex, multi-step process including a clinical interview, a medical history review,… | Keep reading on ADDitude »

ONLINE CARE: Can I get diagnosed with ADHD via a telehealth appointment?

A: While much of the process can be done online, medication fulfillment, physical exams, and cognitive or educational testing may… | Keep reading on ADDitude »

ADULT GUIDELINES: How are current diagnostic criteria unhelpful for evaluating adults?

A: U.S. practice guidelines — and multiple ones at that — currently only exist for childhood ADHD. This is a gap we must close… | Keep reading on ADDitude »

DIFFERENTIAL DIAGNOSIS: How can I be sure my symptoms don’t point to another condition?

A: Several conditions may be confused with, or appear along with, ADHD, including anxiety, a sudden life change, sleep problems… | Keep reading on WebMD »

FIRST-PERSON: “But I Went to Law School! I Couldn’t Have… Oh.”

“The three-part evaluation included a computer test, which indicated that 94% of the people who took it were better able to remain on task than I was — in other words, only 6% of people were more easily distracted.” | Keep reading on ADDitude »

RELATED RESOURCES

FREE DOWNLOAD: How Is ADHD Diagnosed?

Three essential components of an ADHD diagnosis — and a few diagnostic “fads” that simply aren’t worth your time or money. | Download now on ADDitude »

FREE DOWNLOAD: How to Prepare for Your ADHD Evaluation

This handout identifies the six most important steps any adult should take before consulting their physician for an ADHD evaluation. | Download now on ADDitude »

8-Part Guide to ADHD Diagnosis in Adults, from WebMD x ADDitude:

DECISION 1: How can I better understand ADHD, its causes, and its manifestations?
DECISION 2: How can I understand the aspects of ADHD that might be new to my doctor?
DECISION 3: How can I improve my odds of an accurate ADHD evaluation?
DECISION 4: How can I find a professional to diagnose and treat my ADHD?
> DECISION 5: What should a thorough evaluation for adult ADHD include and exclude?
DECISION 6: How can I be sure my ADHD evaluation screens for psychiatric comorbidities?
DECISION 7: How can I be sure my ADHD evaluation considers look-alike comorbidities?
DECISION 8: Should I also be screened for the sleep, eating, or other disorders?8-Part Guide to ADHD Diagnosis in Adults, from WebMD x ADDitude:

 

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GENDER: Why is ADHD so often missed or misdiagnosed in women?

A: Girls tend to show less “hyperactive” behavior, and most studies focus on those hyperactive ADHD patterns that are more common in males… | Keep reading on WebMD »

YOUNG ADULTS: How can I recognize signs of ADHD in a young adult?

A: Young adults with ADHD usually don’t show as much hyperactivity as they did when they were kids. But they can be restless, with trouble… | Keep reading on WebMD »

OLDER ADULTS: What distinct diagnostic criteria benefit older adults with ADHD?

A: Clinicians must look beyond DSM-5 criteria when evaluating older patients for ADHD because it does not adequately consider… | Keep reading on ADDitude »

AGE VS. ADHD: How do clinicians distinguish signs of ADHD vs. aging in older adults?

A: Doctors don’t learn to look for ADHD in people over 60. It’s likely they’ll look for other causes of inattention and fuzzy thinking… | Keep reading on WebMD »

MENOPAUSE: How do hormonal fluctuations and aging impact ADHD in women?

A: Higher levels of estrogen are linked to enhanced executive function and attention. Low or fluctuating estrogen levels are associated with… | Keep reading on ADDitude »

ANDROPAUSE: How do hormonal fluctuations and aging impact ADHD in men?

A: Both women and men with ADHD report the greatest symptom severity from ages 50 to 59 — during menopause and andropause… | Keep reading on ADDitude »

FIRST-PERSON: “How I Lost 10 Years of My Life”

“I lost a decade of my life, not just to one arrogant man, but to all of the doctors who hand-waved my symptoms away, each convinced that they knew my body and brain better than I did.” | Keep reading on ADDitude »

RELATED RESOURCES

SYMPTOM TEST: ADHD Symptoms in Women and Girls

In females, ADHD may manifest as shame about organizational skills, difficulty coping, etc. | Take the self-test on ADDitude »

WEBINAR REPLAY: ADHD in Older Adults

Expert Webinar with Kathleen Nadeau, Ph.D.  | Listen now on ADDitude »

8-Part Guide to ADHD Diagnosis in Adults, from WebMD x ADDitude:

DECISION 1: How can I better understand ADHD, its causes, and its manifestations?
DECISION 2: How can I understand the aspects of ADHD that might be new to my doctor?
> DECISION 3: How can I improve my odds of an accurate ADHD evaluation?
DECISION 4: How can I find a professional to diagnose and treat my ADHD?
DECISION 5: What should a thorough evaluation for adult ADHD include and exclude?
DECISION 6: How can I be sure my ADHD evaluation screens for psychiatric comorbidities?
DECISION 7: How can I be sure my ADHD evaluation considers look-alike comorbidities?
DECISION 8: Should I also be screened for the sleep, eating, or other disorders?

Removed]]> https://www.additudemag.com/adhd-diagnosis-decisions-adults1c/feed/ 0 https://www.additudemag.com/download/clinicians-guide-to-differential-diagnosis-adhd/ https://www.additudemag.com/download/clinicians-guide-to-differential-diagnosis-adhd/#respond Wed, 03 May 2023 17:37:01 +0000 https://www.additudemag.com/?post_type=download&p=329806

The Clinicians’ Guide to Differential Diagnosis of ADHD is a clinical compendium from Medscape, MDEdge, and ADDitude designed to guide health care providers through the difficult, important decisions they face when evaluating pediatric and adult patients for ADHD and its comorbid conditions. This guided email course will cover the following topics:

• DECISION 1: How can I better understand ADHD, its causes, and its manifestations?
• DECISION 2: What do I need to understand about ADHD that is not represented in the DSM?
• DECISION 3: How can I avoid the barriers and biases that impair ADHD diagnosis for underserved populations?
• DECISION 4: How can I best consider psychiatric comorbidities when evaluating for ADHD?
• DECISION 5: How can I differentiate ADHD from the comorbidities most likely to present at school and/or work?
• DECISION 6: How can I best consider trauma and personality disorders through the lens of ADHD?
• DECISION 7: What diagnostic criteria and tests should I perform as part of a differential diagnosis for ADHD?

NOTE: This resource is for personal use only.

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