Many people might seem to exhibit classic traits of the disorder, but distraction, procrastination, and chronic lateness don’t necessarily mean an adult has ADHD. The symptoms must inhibit the patient in at least two areas of life, such as at work and in a personal relationship, Bilkey says. “And it’s a matter of degree. A lot of people procrastinate about paying their taxes. A patient with ADHD might not file taxes at all.”
The upcoming revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is used by doctors to diagnose psychiatric disorders, will relax the criteria for adult ADHD in an effort to make the diagnosis easier, according to Mary V. Solanto, director of the ADHD Center at Mount Sinai Hospital in New York. The revised DSM, due in May, also provides language to help doctors understand how classic childhood ADHD symptoms might look in an adult.
Driscoll, the mother of three, said her doctor was skeptical at first, and dismissive of an online ADHD test she had taken. But after an in-depth psychological test, the doctor prescribed medication.
The Ritalin calmed her down, helped her listen better, improved her memory, and aided her sleep, she said.
Critics of loosening the criteria forADHD worry about escalating use and misuse of stimulants, particularly on college campuses.
Solanto acknowledges that some medical professionals may make an ADHD diagnosis without a thorough inquiry — which she says should involve at least two hours of questioning to establish a history and persistence of symptoms. But, she said, that doesn’t change the data, which repeatedly show that adult ADHD is “abundant and real.”
J. Russell Ramsay is cofounder and codirector of the University of Pennsylvania’s Adult ADHD Treatment and Research program, which helped pioneer cognitive behavioral therapy strategies for ADHD patients. He says that while medication can “unlock barriers,” it doesn’t teach someone how to navigate life.
Young adults with ADHD often have trouble with school, jobs, and relationships, he says, and those who go undiagnosed can “start having negative thoughts about themselves.” Cognitive behavioral therapy helps patients reframe negative thinking to address self-esteem issues and develop strategies for planning and time management.