How to Diagnose ADHD in Adults?

Lorena Salthu

– Last updated: June 18, 2024

The diagnosis is established based on the clinical history, questionnaires specifically developed for adults, and, in cases where the physician deems it necessary, neuropsychological tests that assess executive functions.

Although there is currently no medical evaluation (such as scans or neuroimaging) that allows for an ADHD diagnosis, pharmacogenetic analysis can identify markers indicating the risk of ADHD and help identify the most suitable medication for each patient.

Receiving a diagnosis of ADHD can be a great relief for those who have suffered from ADHD symptoms since childhood, believing it was a problem related to their personality. It can help them understand the numerous difficulties they have faced throughout their lives and allow them to see the possibilities for improvement through appropriate treatment and by addressing their challenges from a new perspective.

For most people, an ADHD diagnosis can be a turning point in their lives; for others, it can be emotionally devastating. Some may feel overwhelmed by anger, pain, guilt, or sadness because their symptoms went unrecognized until adulthood.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the diagnostic criteria for ADHD are as follows:

1. A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, characterized by (1) and/or (2):

Inattention:

Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and negatively impacts social and academic/occupational activities. For older adolescents and adults (age 17 and older), a minimum of five symptoms is required:

Often has difficulty paying attention to details or makes careless mistakes in schoolwork, work, or other activities (e.g., overlooks or misses details, work is inaccurate).
Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused in lectures, conversations, or lengthy reading).
Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of obvious distractions).
Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked).
Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks, keeping materials and belongings in order; messy, disorganized work; poor time management; fails to meet deadlines).
Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; preparing reports, completing forms, reviewing lengthy papers).
Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile phones).
Is often easily distracted by extraneous stimuli or unrelated thoughts.
Is often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents and adults, returning calls, paying bills, keeping appointments).

Hyperactivity and Impulsivity:

Six (or more) of the following symptoms have persisted for at least six months to a degree that is inconsistent with developmental level and negatively impacts social and academic/occupational activities. For older adolescents and adults (age 17 and older), a minimum of five symptoms is required:

Often fidgets with or taps hands or feet, or squirms in seat.
Often leaves seat in situations when remaining seated is expected (e.g., leaves their place in the classroom, in the office, or other work settings).
Often runs about or climbs in situations where it is inappropriate (in adolescents or adults, this may be limited to feelings of restlessness).
Often unable to play or engage in leisure activities quietly.
Is often “on the go,” acting as if “driven by a motor” (e.g., is unable to or uncomfortable being still for extended time, as in restaurants, meetings; others may see them as restless or difficult to keep up with).
Often talks excessively.
Often blurts out an answer before a question has been completed (e.g., completes people’s sentences; does not wait for their turn in conversation).
Often has difficulty waiting their turn (e.g., while waiting in line).
Often interrupts or intrudes on others’ conversations, games, or activities (e.g., may butt into conversations, games, or activities; may start using other people’s things without asking or receiving permission; in adolescents and adults, may intrude or take over what others are doing).”

B. Some symptoms of inattention or hyperactivity-impulsivity were present before the age of 12.

C. Several symptoms of inattention or hyperactivity-impulsivity are present in two or more settings (e.g., at work, with friends or family, at home, etc.).

D. It must be clearly established that the symptoms interfere with social, academic, or occupational functioning, or reduce its quality.

The diagnosis should be made by a clinical psychologist or a physician specialized in psychiatry or neurology. It is important that these professionals have experience in this field.

A thorough diagnosis will allow for the establishment of the most appropriate treatment plan for each individual (medication, cognitive-behavioral therapy, couples therapy, family therapy, coaching, lifestyle modification, work adjustments, etc.).

With over 25 years of international experience in clinical and corporate settings, Lorena Salthu is a psychological counselor (Argentina) with specializations in Psychoneuroimmunology (Spain and the U.S.), psychoanalysis at EFPP (France), and Cognitive Behavioral Therapy (CBT).

She practices clinically in London, Monaco, and Paris, offering services in Spanish, French, and English. She is also a member of the National Counselling and Psychotherapy Society in the United Kingdom.

As the founder of PSY S.O.S, Lorena has created a global platform dedicated to providing free psychological crisis support, promoting mental health as an inherent human right.

Lorena Salthu – Founder of PSY S.O.S