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Ask the Mental Health Expert Archives 2001-2004

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Signs of ADHD

Q. I'm a 19-year-old female college student. For several years I have showed signs and symptoms of Attention Deficit Hyperactivity Disorder (ADHD), however my parents don't like to think I have any problems and therefore have not allowed any tests. They instead accuse me of being lazy and unmotivated as reasons for my low grades.

I currently have a 2.2 GPA at my college, however I know from my SAT scores that I'm not stupid (1320). I have taken several online self-tests which all say I have a high probability of having ADHD, and that I should be tested. I'm fed up with my parents and decided that since I'm 19 and I can get myself tested--so I am. But I'm worried I won't be diagnosed with ADHD.

Is there anything in particular that physicians look for, more than other things, when diagnosing a patient with ADHD? Also, I am adopted. I know that family history plays a part in diagnosing as well. Could this also prevent me from being properly diagnosed? I just want to be able to concentrate on my work and get good grades. Can you help?

A. First of all, it's important to realize that there is no foolproof test for ADHD. The diagnosis is made by a skilled clinician with experience in this disorder, based upon a careful clinical assessment of the patient. This includes a careful evaluation of school records, and--in some cases--a discussion with the patient's parents (biological or adoptive).

Sometimes, special scales designed to pick up ADHD (such as the Wender/Utah scale) are used, but are not essential. Similarly, if you are able to afford neuropsychological testing, this can help to clarify the diagnosis. For example, pointing to specific learning disorders versus ADHD--but it is not necessary to make a diagnosis or to begin treatment.

For a diagnosis of ADHD, it is important to establish that the symptoms of inattention or hyperactivity are present in more than one setting, such as school, home, and work. The problem is, symptoms consistent with ADHD are also seen in other psychiatric disorders. For example, many children and adolescents with bipolar disorder may show symptoms of distractibility, poor attention, and hyperactivity when they are in a mood upswing (mania or hypomania). This does not mean they have ADHD, and some medications used to treat ADHD may sometimes worsen bipolar disorder.

Anxiety disorders, depression, and specific learning disabilities may also be causes of poor attention and/or low grades. Therefore, it's very important that you obtain a careful diagnostic evaluation. I would recommend seeing a psychiatrist with expertise in ADHD. Your college health service might either have somebody on staff, or be able to direct you within your community. Good luck!

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January 2004

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