Diagnosis and medication — demystifying two of the most misunderstood processes in ADHD care
“This was originally published on HealthShare.”
There are many myths circulating about attention-deficit hyperactivity disorder (ADHD). If you’ve been told that ADHD can be diagnosed using surveys alone, or that medication is the only effective treatment, then you’ve come across some of the most common misunderstandings about ADHD. Here, we explain why these myths are incorrect. If you or someone you know has ADHD or suspects they have it, we hope these explanations will help to demystify the processes involved in getting diagnosed and treated.
Myth 1: ADHD can be diagnosed with just a survey.
Reality: ADHD is diagnosed via an in-depth series of assessments, including a clinical interview and medical assessments.
Explanation: Getting a positive result or a high score on a self-assessment does not necessarily mean that someone has ADHD. If you have symptoms that are interfering with your life, your experiences and struggles are absolutely valid. But until you have a proper assessment, it’s impossible to rule out other explanations for your symptoms.
Some people take free tests for ADHD, usually based on self-report scales. Some of them are designed to be used for “ADHD screening” and some of them claim to diagnose ADHD. One test that is commonly searched for is the “ADHD Spectrum Test.” These kinds of tests can highlight when symptoms are interfering with your life. But you shouldn’t assume that you know what the cause of your symptoms is. Instead, a high score on a screening test should prompt you to visit your doctor for advice.
Similarly, even if you find it very useful to use supports and tools designed for people with ADHD (such as ADHD planners, “ADHD music,” “brown noise,” “white noise,” ADHD apps, fidget spinners, and so on), this information – on its own – is not enough to make a diagnosis of ADHD.
Before someone can be diagnosed with ADHD, they need to be assessed by a registered clinical professional who is trained in diagnostic assessment using one of the main diagnostic systems. The two main diagnostic systems are (a) the Diagnostic and Statistical Manual of Mental Disorders, currently in its fifth Edition, known as DSM-5, and (b) the International Classification of Diseases, now in its 11th Edition, known as ICD-11.
There are many different conditions that can cause problems with attention and productivity, including both physical and mental health problems. If you are struggling with symptoms of what you believe to be ADHD, it will be important to find the correct cause(s) of the symptoms because that is the only way to determine the best treatment options.
The clinical interview is just one step in receiving a diagnosis. Medical tests are also required, to check for other explanations for someone’s symptoms (other than ADHD) and to exclude physical and mental health conditions. A baseline health assessment is also required before anyone can start certain medications.
In addition to the steps above, the diagnostic process also involves gathering information from the person and from some of the key people in their life. This may include finding reports from the person’s school experiences as a child and/or sending questionnaires to the person’s family. This is all done after a discussion with the person about the process and about the people being contacted.
Once these various pieces of information have been evaluated by a registered clinical professional, they can then advise the person whether they are likely to have ADHD, as well as whether there are additional health conditions that could be contributing to their symptoms.
Myth 2: Medication is the only effective treatment.
Reality: If ADHD symptoms are interfering with your life, medications can be an important tool to support you to thrive. But even if you find that medications help you, they are definitely not the only part of your treatment.
Explanation: If ADHD symptoms are interfering with your life, your psychiatrist will talk to you about your medication options, including their pros and cons. The best choice of medication for you will depend on many things, including the other diagnoses you may have.
Medications come with risks as well as benefits. It will be important for you to learn about the pros and cons of the different options, and to decide how these fit in with what matters to you. You may need to try more than one medication before you find one that works well for you. You and your psychiatrist can work together to figure out a plan of action, including a plan for whether to try medication, and which medication to try first.
You and your treating team will look out for how the medication improves your symptoms, and any side effects you experience while you’re on it. If the benefits are outweighed by the downsides, you can try other medications to see if they work better for you.
Even after you find a medication that works for you, the other parts of treatment will remain very important. This should include cognitive behavioural therapy (CBT) with a qualified therapist as well as continual education about ADHD and any other conditions you have.
You’d also be surprised how important it is to establish and maintain healthy sleeping habits, exercise habits, and eating habits. If you have ADHD, this can make it more challenging to have a healthy lifestyle, but it also makes it much more important to gradually work towards it. In our experience, supporting people to make healthy lifestyle choices is a core part of our treatment for everyone with ADHD.
This post was written by Call to Mind.