Diagnosing ADHD

There is no single test to determine if a person has ADHD. A specialist makes the diagnosis by comparing a person's pattern of behavior against a set of criteria established by the American Psychiatric Association.

"Sometimes teachers may identify a child as potentially having ADHD," says Galil. "Parents will not always know because they organize and structure and manage so much of the child's life, it masks what's going on."

Although teachers and parents may recognize some symptoms, it's important to get a diagnosis from a health professional, ideally one with training in ADHD and mental disorders, says the NIMH. This may be a psychiatrist, psychologist, behavioral neurologist, or a developmental or behavioral pediatrician. More than one health professional may be consulted to diagnose and treat ADHD, since medical and psychological tests, medication, and counseling may be involved.

"Many health professionals believe that ADHD is over-diagnosed," says Andreason, and doctors need to consider the complete history of patients before diagnosing them.

"It's a hard diagnosis to tease out, and we need to spend some time asking questions about all areas of their life," adds Edmund Higgins, M.D., clinical assistant professor of family medicine and psychiatry at the Medical University of South Carolina and a psychiatrist in private practice.

Some adults may discover they have ADHD only after their children are diagnosed with the disorder. That's how Toni Wood found out she had it.

Wood, of Chesapeake, Va., was a hyperactive child, always getting into trouble at school and always in the principal's office, she says. "If I was quiet, I was sick." Throughout her school years, she had a hard time processing information and asked a lot of questions in class. "It really frustrated me, and everybody was looking at me and rolling their eyes. I knew I wasn't stupid, but I was always behind."

Wood persevered, graduating from high school, serving in the U.S. Coast Guard, and going to college. Civilian life was daunting for her after the structured military environment where "they told you what to wear and what to do," says Wood. She graduated from college, but continued to have difficulty with daily activities — paying bills and completing tasks, especially in the evening when she was most fidgety and inattentive. "I thought I was going crazy," she says.

At age 38, Wood found out that she wasn't crazy. After both her sons were diagnosed with ADHD, Wood's doctor diagnosed her with the condition, too. She felt a weight being lifted off her shoulders, she says. "I'm not using ADHD as an excuse; it's an explanation. Now I understand why."

About: FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.

ADHD: Not a Discipline Problem

ADHD was once looked upon as a discipline and behavioral problem resulting from bad parenting. Some suggested it was caused by high sugar intake, food additives, excessive TV viewing, and family problems. But none of these explanations is supported by scientific evidence.

Most scientists agree that it's a biologically based disorder of the nervous system. Brain imaging research using a technique called magnetic resonance imaging (MRI) has shown that differences exist between the brains of children with and without ADHD, but the exact mechanism of brain function causing the symptoms of ADHD is unknown. Scientists caution that MRIs used in studies are research tools and cannot be used to diagnose ADHD in a specific person.

Recently published research suggests that ADHD tends to run in families. In these studies, children with ADHD have, on average, at least one close relative with ADHD. Over the years, other theories have suggested that exposure to lead in the environment, premature birth, birth trauma, and brain injury may lead to the development of ADHD. Some studies have shown a possible correlation between the use of cigarettes and alcohol during pregnancy and the risk for giving birth to a child with ADHD. For this and many other health reasons, the NIMH recommends that women who are pregnant refrain from both cigarette and alcohol use.

About: FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.

The Consequences of ADHD

Whether in a child or an adult, ADHD can have serious consequences. Some studies show that children with ADHD have more emergency room visits than their non-ADHD peers. Adolescents with ADHD are more likely to engage in risky behavior, leading to substance abuse, sexually transmitted diseases, and teen pregnancy.

Adolescents and young adults are more likely to drop out of school and less likely to enter and graduate from college, according to some studies. And adults with ADHD are more likely to suffer from depression and anxiety, be fired from jobs, and get divorced than non-ADHD adults.

Teens and adults with ADHD have 2 to 3 times more auto accidents and twice the number of severe accidents resulting in vehicle damage and bodily injury as those without ADHD, according to studies done by Barkley and others. "They have coordination deficits, less skill in maneuvering vehicles in traffic, slower reaction time, and inattention," says Barkley.

People with ADHD often have "a huge issue of self-esteem," says Galil. "They may have been underachievers and told 'you're so smart, why can't you do this? You're not trying hard enough.'"

Jergen says he always tried very hard, but he couldn't focus his mind on the task at hand. He likens it to having a song or jingle in your head for days at a time, but "add three or four or five more thoughts to the mix and amplify them. Spin them round and round and round in your head and make them go faster and faster and faster until they become like an all-consuming obsession. Everything centers on those thoughts. You can't focus on anything else. You can't escape them."

About: FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.