How Is ADHD Diagnosed in Children and Adults?

Diagnosising ADHD in Adults

Years ago, being an adult with ADHD was an unheard-of phenomenon. People just assumed that kids with ADHD would gradually grow out of the condition by the time they became adults, so you never had to worry about the consequences of ADHD as an adult.

Of course, that way of thinking is seriously flawed. Adults can have ADHD, and they do have ADHD at high rates.

Still, there is a tremendous amount of confusion and misinformation when it comes to finding the appropriate diagnosis for an adult with ADHD. Remember, having the correct label helps the professionals guide treatment to the individual’s needs and wants.

ADHD in Adulthood

Rather than experiencing ADHD symptoms that simply fade away in time, many adults see their symptoms continue, change, and intensify during their 20s and beyond. As many as 2.5 percent of adults in the U.S. have ADHD with about 1.5 men to every woman with the condition.

Fortunately, there is not much to separate ADHD during childhood from ADHD during adulthood. The same symptoms apply no matter how old the person is.

Instead of being a child struggling in school, having conflict with their teacher or parents, and playing video games for countless hours, an adult with ADHD may be struggling at work, having conflict with their boss or spouse, and still playing video games for countless hours. An adult with ADHD could frustrate others in their life due to the lack of attention to detail and follow through with issues that are not problematic for most other people.


Surely, some people find ways to manage or embrace their ADHD symptoms during adulthood by focusing on activities and areas of interest that emphasize their abilities and strengths. Others will fall into the same traps that plagued them throughout childhood.

The Most Important Factor

Adults have ADHD, but there is one crucial piece of information most people do not know or understand about ADHD in adults. Symptoms of ADHD must present in a person before they turn 12 ever to receive the ADHD diagnosis.

Imagine there is a person who lived a typical life throughout childhood and began to struggle with attention and hyperactivity in college. Could they receive an ADHD diagnosis?

No! The ADHD diagnosis does not account for symptoms that develop later in life. Unless those symptoms were present during childhood, a mental health professional will not/ should not diagnose the individual with ADHD.

This distinction may seem arbitrary, but it is part of the diagnostic criteria for ADHD outlined by the American Psychiatric Association.

Disorders Disguised as ADHD

What happens to the person who lived their normal life until ADHD symptoms presented during college? If an ADHD diagnosis is impossible based on the lack of symptoms before age 12, what can be done?

In these cases, the ADHD symptoms might not be related to ADHD at all. There are many mental health and substance abuse conditions that create symptoms of poor attention, forgetfulness, and hyperactivity, so the symptoms may be better explained by another disorder.

Possible problems disguised as ADHD in adults include:

  • Anxiety disorders. Mostly known for their ability to produce worry and physical tension, anxiety disorders can make it very difficult to concentrate or focus on what is happening around. A person with anxiety could also feel very jittery, which could be confused for the hyperactivity of ADHD.
  • Depressive disorders. Depressive disorders like major depressive disorder have the distinct ability to reduce the attention and concentration of the person with the condition. A person with depression could also have reduced judgment and decision-making skills like those linked to ADHD.
  • Bipolar disorder. Bipolar disorder is possibly the condition most often confused with ADHD. Bipolar can create poor attention, concentration, and judgment during depressive episodes as well as hyperactivity and recklessness during manic episodes. Many people with bipolar disorder are misdiagnosed with adult ADHD.
  • Personality disorders. Personality disorders like borderline personality disorder, narcissistic personality disorder, and others are difficult to separate from ADHD, especially in young adults. ADHD and personality disorder share symptoms like disorganization, social skill problems, emotional problems, and poor attention.
  • Substance use disorders. Alcohol and other drugs can create symptoms that closely mirror those of ADHD. Someone intoxicated from a stimulant like cocaine or methamphetamine will show a lot of hyperactivity while the substances are in their body. This change is similar to someone intoxicated from an opioid or marijuana who will seem very distractible or inattentive. In addition to the changes during intoxication, one should note the changes after the substance wears off and when a person is experiencing withdrawal from the drug or alcohol. These experiences can create symptoms similar to ADHD without actually being ADHD.

Adult ADHD or Something Else?

To find the real cause of the symptoms, an adult with symptoms related to ADHD should get a professional evaluation from a mental health professional. The counselor, therapist, psychologist, or psychiatrist will ask a lot of questions about the symptoms, when they started, and what other symptoms co-occur with the inattention and hyperactivity.

Only by forming a clear understanding of the symptoms can the professional prescribe the correct treatment. Without an accurate diagnosis, the treatment could harm the individual.

Consider the example of an adult with ADHD symptoms, but the true cause is anxiety. A common intervention for people with ADHD is to use a stimulant medication to relieve symptoms, but if a person with anxiety takes a stimulant, chances are excellent that their worry, tension, and fears will increase to very uncomfortable levels.

You could have adult ADHD, but you must consider the possibility that it could be another condition producing your symptoms. Know the facts about ADHD and always work with a trusted mental health professional for the best results.

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