Diagnosing ADD and ADHD

Diagnosing ADD (attention deficit disorder) or ADHD (attention deficit hyperactivity disorder) should be carried out by a qualified mental health practitioner.

Sometimes, the signs and symptoms of ADD / ADHD - including hyperactivity, impulsivity and inattention - can be confused with other mental or physical conditions.

Your practitioner should run a full assessment and evaluation which reviews a complicated set of symptoms, so seeing a professional who specializes in the disorder can be helpful. The conditional assessment used at present does not rely on laboratory or imaging testing, but rather on observation of behavioral patterns and their duration.

In diagnosing ADD / ADHD, the American Academy of Pediatrics recommends that a clinical evaluation for childhood ADD / ADHD include:

• A thorough medical and family history.
• A general physical and neurological exam.
• A comprehensive interview with the parents, the child, and the child’s teacher(s) to determine behavioral patterns in various settings.
• Standardized screening tools for ADD / ADHD.
• Observation of the child.
• A variety of psychological tests to measure IQ and social and emotional adjustment.

As ADD / ADHD has come to light as a significant disorder only in recent years, many adults have now only just discovered that they have the condition. Often, diagnosing ADD / ADHD occurs as a result of self-education on the topic, or because the symptoms take over their daily life to such a degree that normal functioning becomes severely impaired and the adult seeks out help.

ADD / ADHD can also occur in conjunction with other mental afflictions like depression, anxiety and obsessive-compulsive disorder (OCD); this makes diagnosing ADD / ADHD less straightforward than it otherwise would be. In order to fit in with the establish way of diagnosing ADD / ADHD, both children and adults must fit certain criteria, in addition to displaying hyperactivity, inattention or impulsivity, as follows:

• Symptoms must negatively impact social life, education, career and other aspects.
• Symptoms must have been present from at least the age of seven.
• Symptoms must have duration of at least six months.
• Symptoms must occur in more than one setting, such as home, school, work or other social settings.

Certain life altering circumstances can cause reactions that masquerade as ADD / ADHD, such as divorce, death in the family or other traumatic events; this makes diagnosing ADD / ADHD a little trickier. In addition, the following conditions can often co-occur with the disorder, but can also be mistaken for it so that proper treatment fails to be implemented; again, these must be taken into account in diagnosing ADD / ADHD. These conditions include:

• Anxiety - Defined as excessive worry that occurs frequently and seems out of control. Symptoms include restlessness or edginess, chronic fatigue or a feeling of listless-ness, concentration difficulties, irritability, muscular tension, and sleep disturbances like insomnia.
  
  
• Conduct Disorder - Children who suffer from conduct disorder display a pattern of behavior persistently violating other’s basic rights or generally known and universally-accepted rules in society. Sometimes, this is called oppositional-defiant disorder, when it relates to people perceived to be in authority. Behaviors may include aggression toward others, willful and continual destruction of property, deceitfulness, theft or other serious rule infractions and possibly illegal activities.
  
  
• Depression - A common condition in which patients have trouble concentrating, sleeping, and have overwhelming feelings of sadness, dejection and guilt. Depression takes on many forms, but the most common seen in coordination with ADD / ADHD includes dysthymia, which consists of a depressed mood for several consecutive days, and disrupted eating habits (overeating or neglecting to eat), oversleeping or insomnia, generalized low energy, lowered self-esteem, disrupted concentration, and feelings of hopelessness and despair. This condition can sometimes be mistaken for mood swings, which are a separate manifestation.
  
  
• Learning Disabilities - Problems with processing information which leads to trouble with reading, writing, or mathematics. When given standardized tests, the student's ability or intelligence appear markedly higher than his or her achievement in the classroom. While children with ADD / ADHD do generally have problems with school performance, these difficulties stem from issues with attention and memory, rather than a learning disability; in diagnosing ADD / ADHD, the distinction must be made.
  
  
• Oppositional Defiant Disorder - Children display a pattern of negative, hostile, and defiant behavior, especially with superiors. Symptoms include temper tantrums, arguing with those in authority, refusal to obey rules or guidelines, intentionally annoying others, or blaming others for difficulties. The person appears consistently irate, offended, spiteful, and overly prone to emotional reactions.

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