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Attention deficit hyperactivity disorder (ADHD) affects an estimated 2.5 percent of adults. It’s a mental health condition that leads to problems such as hyperactivity and impulsive behavior.

Untreated ADHD can disrupt many aspects of your life, such as your employment and your relationships. Getting a proper diagnosis is the first step to getting treatment.

Adults with ADHD often respond well to a combination of psychotherapy and medication.

There’s not one single test to diagnose ADHD. Rather, a comprehensive evaluation helps healthcare practitioners diagnose ADHD.

The key test is a standardized interview, but your healthcare practitioner may also ask to interview close family members and give you tests to rule out similar conditions.

Keep reading to learn more about how ADHD is diagnosed in adults and which tests are generally used.

Diagnosing ADHD can be complex because there’s no single test that diagnoses ADHD. When a healthcare practitioner makes the diagnosis, they use information from multiple sources, such as:

  • an ADHD symptom checklist
  • a detailed history of your past and current level of functioning
  • information obtained from family members or other close loved ones
  • standardized behavior rating scales
  • tests to rule out other conditions or learning disorders
  • a medical examination

Your healthcare practitioner will follow guidelines from the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose ADHD. This is a reference handbook healthcare practitioners use to make diagnoses.

DSM-5 guidelines provide a common set of instructions to increase the likelihood that different healthcare practitioners will come up with the same diagnosis.

These guidelines list three potential patterns of ADHD:

  • inattention
  • hyperactivity
  • a combination of both

There are nine criteria for the inattention pattern and nine for the hyperactivity pattern. Adults need five of the symptoms of either pattern for an ADHD diagnosis, while children need six.

The combined pattern means you have at least five symptoms for both the inattention and hyperactivity pattern.

Below are the DSM-5 criteria for diagnosing ADHD:

Inattention

  1. a frequent inability to maintain close attention to details or frequent mistakes at school or work
  2. frequent trouble maintaining attention on tasks or activities
  3. often not listening when spoken to
  4. often not following instructions or failing to finish duties
  5. often having trouble with organization
  6. a frequent reluctance to do tasks that require sustained mental effort
  7. often losing things
  8. getting distracted easily
  9. often forgetting duties or daily activities

Hyperactivity

  1. often fidgeting or squirming when sitting
  2. frequently getting up from your seat when inappropriate
  3. often feeling restless
  4. often unable to take part in tasks quietly
  5. often “on the go”
  6. talking excessively
  7. frequently blurting out answers before questions are complete
  8. persistently having trouble waiting your turn
  9. frequently interrupting others

Qualified healthcare practitioners follow the DSM-5 guidelines when making an ADHD diagnosis. There may be some variation in which tests healthcare practitioners use, but the following tools are often included.

Diagnostic interview

The most important part of your ADHD examination is the diagnostic interview.

It can be structured or semi-structured. No matter how your healthcare practitioner conducts the interview, they’ll ask you standardized questions about your current and past behavior.

The questions cover a range of topics. Your healthcare practitioner will ask follow-up questions to gather as much information as possible.

For them to make an ADHD diagnosis, your healthcare practitioner needs to find that you’ve shown characteristics of ADHD from childhood to the present.

If possible, your healthcare practitioner may want to do the interview when you’re with a family member or your partner. The interview takes a minimum of 1 to 2 hours to complete.

The interview uses standardized questions to maximize the likelihood that another interviewer would come up with the same diagnosis.

Each question correlates with one of the nine characteristics of either the inattentive or hyperactive pattern of ADHD.

Interview of family or close friends

Your healthcare practitioner may also interview family members or other people who know you well. This part of the diagnosis process helps your healthcare practitioner get extra details and corroborate your answers.

For example, your parents may have the ability to provide details about your childhood that you forgot, or your partner may be able to provide details about your relationship that you may miss.

Standardized behavior rating scale

ADHD evaluation often includes standardized questionnaires used to compare the behavior of people with ADHD with people who don’t have ADHD.

These surveys won’t be used as a diagnosis by themselves, but they can provide support for the diagnostic interview. Your healthcare practitioner may also want your partner to fill out the surveys.

Additional tests

Your healthcare practitioner might give you additional tests to screen for other conditions. These tests may include tests to measure academic achievement, intellectual capability, or to help your healthcare practitioner find coexisting conditions.

As many as 80 percent of people with ADHD have at least one coexisting condition. The most common are:

Medical exam

You may be given a medical examination if you haven’t had one recently. This exam can help your healthcare practitioner rule out other conditions that may cause symptoms that mimic ADHD symptoms, such as thyroid problems or a seizure disorder.

Your family doctor likely won’t diagnose ADHD unless they have specialized training. But they can refer you to a healthcare practitioner who has experience diagnosing ADHD.

Some types of healthcare practitioners who may be able to make the diagnosis include:

  • psychiatrists
  • neurologists
  • developmental pediatricians
  • psychologists
  • clinical social workers
  • nurse practitioners
  • licensed counselors or therapists

Visiting your family doctor is one of the easiest ways to find a qualified professional to diagnose ADHD.

In some cases, your family doctor may have undergone specialized training to make the diagnosis themselves. In most cases, they’ll refer you to a specialist to make the diagnosis.

In many cases, you’ll work with a small team of mental health professionals with different areas of specialization.

Adults with ADHD often show a pattern of inattention, hyperactivity, and impulsivity that causes problems in certain areas of their life, such as their employment or relationships.

For example, a person with ADHD may have difficulty performing well at work because they have trouble focusing and staying organized. They may have relationship trouble because they have angry outbursts and impulsive behavior.

The symptoms of ADHD may be more subtle in adults than children. Many adults with ADHD don’t know they have it. And ADHD often gets overlooked in girls and women.

Some general symptoms of ADHD in adults include:

  • poor focus
  • easily distracted
  • disorganization
  • poor time management
  • hyperactivity
  • forgetfulness
  • impulsivity
  • emotional concerns
  • poor self-image
  • low motivation
  • restlessness
  • fatigue
  • relationship problems
  • substance use

For your healthcare practitioner to diagnose ADHD, they’ll perform a comprehensive evaluation using multiple tests.

The key test is a diagnostic interview where they ask you standardized questions. Your healthcare practitioner will also likely want to interview close family members, have you fill out standardized behavior surveys, and perform tests to rule out similar conditions.

ADHD can produce different symptoms in different people. If you think you may have ADHD, it’s important to visit a trained healthcare practitioner for a proper diagnosis.

ADHD can be disruptive to your life, but treatment can help you successfully manage it.