Diagnosing ADHD in Adults is a Mess!

Written By Cynthia Hammer, MSW

Written by Cynthia Hammer, MSW

 

First, let me clarify.  “Mess” is “a situation or state of affairs that is confused or full of difficulties.”

Here are the reasons for the diagnostic mess.

It is a struggle for those with Inattentive ADHD to get properly diagnosed. Some clinicians are unfamiliar with Inattentive ADHD.  They are comfortable diagnosing depression or anxiety, and patient often wastes years taking meds for depression or anxiety which only partially help because the underlying problem is inattentive ADHD. Until that is diagnosed….life for the patient doesn’t truly improve.

Some clinicians are reluctant to diagnose ADHD because something about the patient or the patient’s history makes them worry you may be a drug addict.  Or some believe the patient hasn’t’ demonstrated significant impairments in her life, even though she is stressed and anxious, struggling to keep her impairments hidden from view.  The patient is working so hard, but that doesn’t count to the evaluating clinician.

In addition to not getting diagnosed or getting diagnosed with the wrong condition, the diagnostic process runs the gamut.  How can we have confidence when it is all over the board?-- from a few minute interview with a physician before he declares, “You have all the signs of ADHD” to lengthy interviews of the patient and close family member, rating scales, continuous performance tests on a computer, neuro-psych evaluations, blood tests, EKGs, and probably other stipulations I am not even aware of.  Even then, whether the patient gets correctly diagnosed or not, depends on the practitioner’s perceptions, skills, and values. 

But now there is a way out of the mess—the DIVA 5, a structured diagnostic interview for ADHD in adults that is proven valid in diagnosing ADHD.  A noted ADHD researcher in the United States recently said, “The DIVA is a valid method of diagnosis.  Diagnosing and treating ADHD over the phone is possible assuming the clinician is appropriately trained.”  He further said, “ The DIVA is a good choice for clinicians who are not experts in ADHD diagnosis. But someone with lots of experience would not need it."   Great progress! 

 Unless we know that the clinician we see for a diagnosis is an expert, we should ask if they use DIVA 5 to make the diagnosis of our adult ADHD.

Cynthia Hammer, MSW

Cynthia Hammer, MSW, was diagnosed with inattentive ADHD in 1992 when she was 49 years old. The following year she created the non-profit organization, ADD Resources, with a mission to educate adults and helping professionals about ADHD in adults. She ran the organization for 15 years before retiring.

During the Covid isolation she wrote a book about her life with inattentive ADHD which should be published by the end of this year. In writing the book, she was dismayed to learn that children with inattentive ADHD continue to be under-diagnosed and adults with inattentive ADHD often are incorrectly diagnosed with depression or anxiety.

She created a new non-profit in 2021, the Inattentive ADHD Coalition (www.iadhd.org), to create more awareness about inattentive ADHD and the need for early diagnosis and treatment.

https://www.iadhd.org
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